Out of context, the photograph that was spread across yesterday's newspapers -- of the first family lovingly holding hands while the family dog, Buddy, romped at their side -- had the syrupy quality of the happy family snapshot that comes with a drugstore picture frame. But context, of course, is everything, and by the time the Clintons arrived in Martha's Vineyard, speculation about the state of the first family had reached a fever pitch. Were Hillary and Bill speaking? Was Chelsea standing between them so they wouldn't have to touch each other? Were Hillary's shoulders sagging just a bit? And how could Chelsea be so poised -- kissing, hugging and schmoozing with the Vineyard crowd -- when her parents' marriage may be crumbling around her? Now that the president has come clean about his "inappropriate" relationship with Monica Lewinsky, the public is left wondering: Can the first family be saved?

"God, I hope Chelsea has a good therapist" is a refrain heard countless times since the Lewinsky crisis began. Domestic crisis -- whether it's alcoholism, infidelity or divorce -- often spurs families to get professional help. In interviews conducted during the past few days with therapists across the nation, many of whom specialize in sexual disorders, a familiar theme emerged: The first family will only be able to survive if the thick layers of anger and shame are chipped away.

"Sometimes a trauma like this can actually bond people, but the family must work together and be willing to forgive the person who has brought the trauma into the family," says Sandra Davis, a psychotherapist and sex therapist in Pittsburgh. "First they must get through the anger that goes with the exposure of it." Davis believes that the first lady is displaying a lot of anger and hurt. "I see it in her body language, even though she's sticking by him," she says.

According to some White House sources, the Clintons seem shell-shocked and out of touch with the public. They had scheduled a rally in Philadelphia for Friday, believing it would give them the chance to appear defiant before a big, enthusiastic crowd, and top-echelon White House staffers reportedly had to make a series of strident phone calls to convince them to call it off. Sources report that out of the public eye, both Clintons are visibly depressed, rather than the resilient, determined figures they present to the world. Aides have told the first couple to keep up appearances or their private depression could start to infuse their public personas. While such a split-personality strategy may be good politically, however, it could make it especially difficult for the Clintons to face up to their problems honestly.

One can only speculate how the first family would have faced this trauma had it not been played out on an international stage, where their every gesture and statement is dissected by a hungry public. Some wonder whether the first lady would have stood by her husband this long if she wasn't part of a public partnership and speculate that perhaps she will leave the president once they leave office.

"Sometimes, of course, there is divorce after something like this happens because a basic trust has been violated and there is the added dimension of embarrassment," says Sam Alibrando, a Pasadena, Calif., therapist who specializes in sexual issues. "For couples who rely on each other, something like this really shakes their foundation. But can a family put the pieces back together after something like this? Yes."

This relies largely on the ability of the "shamed" person to trust his or her partner enough to allow for another chance. "Usually, if it's a shock, the first thing the spouse wants is to understand what happened and then they want a guarantee that it won't happen again," says Sharon Nathan, a clinical psychologist and sex therapist in New York City. "Sometimes a compromise can be worked out if the partner will promise to work on their problem and promise that it will never happen again."

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But if recent press accounts are accurate, the president might be continuing his clandestine relationship with Monica Lewinsky through subtle -- almost subversive -- forms of communication. Wednesday's New York Times reported that the president wore a gold and blue Zegna tie, given to him by Lewinsky, on the day she began her grand jury testimony, perhaps as a sly "I'm thinking of you" message -- or a plea for her not to give damaging testimony. If it was purely coincidental, as the president contended when questioned about it during his testimony, could his gesture be a sort of Freudian slip?

"I don't think it's Freudian," insists Nathan. "Believe me, I think [wearing it] was an overt statement, another subtle manipulation, an implicit message about how much she means to him, a way for him to say, 'Don't tell the truth about us.'"

Shirley Glass, a sex therapist in Baltimore, agrees: "It seems to be a deliberate attempt to send a message of some kind, the basic meaning being that there was some type of emotional attachment: 'I haven't forgotten you.' It's a signal of not repudiating [the relationship]. When somebody has an extramarital relationship and it includes an emotional attachment, gifts are often a symbol of that. Even when the relationship ends, people hold on to the gift as a memorial of that romance."

Many of those interviewed were skeptical of reports that Hillary Clinton had believed her husband's lie all along. "People always say, 'How come the wife is always the last to know?' Well, often she does know, but the idea of the betrayal is so painful, she pushes it away," says Barbara Okun, the training director of the doctoral program in psychology at Northeastern University and a clinical professor at Harvard University. "Someone who says the right words and is charming the way [Clinton is] often has someone in their family who allows them to get away with it."

Complicating this is the fact that the president was unfaithful in the home that he shares with his wife. The first lady must reside at the scene of the crime, so to speak -- a fact that could clearly hinder the healing process. "Often the spouse wants to know about all the details about the affair -- every person, place and gesture," says Nathan. "But I try to discourage that. I find that those images become burned into the spouse's mind and are then hard to get around."

Many therapists said they believed that Clinton's indiscretions constitute an even greater psychological nightmare for his daughter, despite her unruffled demeanor. Chelsea "might be so tied to her parents, so loyal to them, that her loyalty might be taking precedence over anger," says Okun. "She might have a nice set of defenses up right now, but she will have to deal with this at some point." Dealing with the private knowledge would be difficult enough. But Chelsea has been blitzed with an endless stream of photos and videos of her father embracing the woman with whom he had an adulterous relationship -- a woman not much older than she is.

Coming at an age when his daughter is developing her sexual identity and exploring her relationship to men, the psychological damage incurred by a sexually reckless father can be manifold, therapists say. "This can overload a young woman, bringing sex and shame and guilt together at a crucial time in her sexual development," says Nathan. "I am only speculating, but this could make her cynical of relationships and untrusting of future partners. The flip side could be promiscuity."

Still, how children weather something like this hinges on their overall psychological health. "If Chelsea called me up and said, 'What should I do?' I would say, 'You could drop out of college but I recommend going back, getting back in the saddle so to speak,'" says Alibrando. "I would suggest that she set up strict boundaries at school whereby she refuses to discuss this matter with anyone but her closest friends. Should she go into therapy? Perhaps. If this incident is a symptom of family dysfunction, it would be as good a time as any for her to go."

Many of the therapists interviewed surmise that the psychological impetus for President Clinton's reckless sexual behavior stems from a condition known in therapeutic circles as "sexual compulsion." According to Cooper, the fastest growing category of sexually compulsive individuals is very successful men, who often have high-profile jobs. (Think Dick Morris, Magic Johnson.) "Men tend to sexualize their needs -- they use sex as a way to 'self-soothe,'" says Cooper.

Several therapists observed that Clinton's childhood traumas (a father who died before his birth; an abusive, alcoholic stepfather) and sexual history would suggest that he suffers from at least some symptoms of this condition. Some sexual compulsives are obsessed with pornography or masturbation or have sex with prostitutes; others have "serial affairs" with many partners, as the president may have. All therapists interviewed agree that all sexual compulsives share one trait: When it comes to intimacy, they are emotionally impotent.

"I've had people tell me they'd rather be alcoholic than sexually compulsive because it's less embarrassing," says Helen Friedman, a sex therapist and radio talk show host in St. Louis. "Sexual compulsivity is about disconnecting from one's inner pain. The bottom line is that it's an intimacy disorder -- not a sexual one."

Al Cooper, the clinical director of the San Jose (Calif.) Marital and Sexuality Center, says that the president appears to possess a number of traits that are among the criteria used to diagnose sexual compulsion, including a tendency toward denial and engagement in high-risk sexual behavior to the point of interfering with his professional duties. But people who are sexually compulsive "are not the ones who knock on my door -- they do not get help of their own volition," he adds. "They only come when they are told they have to." Cooper says that families of those who are sexually compulsive must often stage interventions, in which they confront the loved one and offer them "tough love."

Therapists insist a sexually compulsive person may have countless partners and engage in reckless sex while still adoring and cherishing their spouses. "There are two parts to sexuality," explains Okun, "intentional sport-fucking and making love. Sexual compulsives who get caught often don't understand why their spouse is upset, because to them, it doesn't mean anything, it is purely sport."

Would Okun recommend family therapy for the Clintons? "I'm not sure that I would," she says. "This family feels like they've been victimized, they have a conspiracy theory, they think they've been set up. I don't think they really want to hear what other people say or think. Often high-profile couples will come to see me only because a child has dragged them there, because the child is suffering, but the Clintons truly don't think they have a problem. In therapy, high-profile people often just go through the motions."