Should we really talk about sexual fantasies in therapy? For what reason? We encounter ideas of sexuality everywhere, sex only becomes interesting or even problematic when it is charged with meaning. Be it difficulties related to sexual functioning, porn use, sexual preference, affairs, differences in sexual desire—individual and couple conflicts are characterized by ratings of fantasy life as "too little," "too much," or "wrong." Sexual fantasies offer a very direct access to the eroticism of the creative person and thus the person to himself. With them, descriptions of conflicts can be therapeutically contextualized and framed as markers for a developmental transition of the person or the couple. In therapy, depending on the initial situation, it can be possible to redevelop fantasies, to explore the sexual or basic needs they contain, to integrate them as part of the self and possibly to redesign them so that they are experienced in a way that suits the new system and is nurturing. When discussed in therapy, sexual fantasies offer the chance to use them as creative problem-solving figures for eroticism and far beyond.