These days, more than ever before, adult women are undertaking therapy with the speci c purpose of coming to terms with a traumatic childhood in which sexual abuse played a major part. Before therapy, most manage to reach some kind of balance in their lives-in their families of origin, at work, in their families of procreation. Upon revelation of the secret and on opening up the subject of their childhood sexual abuse, that fragile balance is upset. During the therapeutic process the abuse survivor confronts her pain and fear, and this task draws energy previously invested in day-to-day functioning, at work and at home or, in more severe cases, in merely getting through the day. This inevitably affects the couple's relationship. This paper describes the impact of therapy for childhood sexual abuse: (1) on the functioning of the adult woman survivor as an individual and as a marital partner; (2) on the spouse's sense of well-being within the relationship; and (3) on the marital system. Three brief, illustrative case examples are presented, and suggestions are made regarding the timing and type of intervention with marital issues.