Understanding the bigger picture of Persistent Genital Arousal Disorder (PGAD) is necessary in order to treat it effectively, efficiently, and sustainably. An underdiagnosed and misdiagnosed medical anomaly, PGAD is often misunderstood as a physical experience related to hypersexuality or sex addiction. If a person is lucky enough to find a pelvic pain specialist who understands PGAD, they commonly still receive a tunnel-view approach to treatment, which often includes medical procedures and/or a referral to cognitive behavioral therapy (CBT). Unfortunately, these treatments alone rarely reduce the symptoms effectively or sustainably. Moreover, the majority of therapists and counselors have zero to minimal training in providing care for this condition and related pelvic and sexual pain disorders, which can lead some to assume the symptoms are “all in their head.” This chapter will review the anatomy, physiology, and literature supporting psychological interventions for PGAD, as well as highlight multimodal treatments that address all layers of PGAD’s root cause. Treatment strategies will be described through a detailed case presentation of a cisgender female with PGAD.