Sex & Intimacy in Couples Therapy: Why Desire Shuts Down and How Couples Become Lovers Again

Key takeaways

• Desire shuts down because of unresolved pain, protection and resentment.

• Couples who lack sex usually want to feel desired. It's rarely about the sexual act itself, but the energy of wanting and being wanted.

• We can't consciously override how our body feels. Saying "I understand" or "I'm sorry" is not healing.

• Sex is a mirror. It gives us insight into ourselves and the state of our relationships.

• Connected sex is when our hearts meet. Mechanical sex is when our bodies meet.

If you're looking for support with sex and intimacy in your relationship, you may be struggling with:

• A sexless marriage that leaves you feeling more like roommates than lovers

• Low or mismatched desire, where one partner wants more and the other less

• Shame, anxiety, or difficulty communicating about sex

• Feeling disconnected, bored, or stuck in a rut after years together

• Difficulty talking openly about what you actually want

Sex and intimacy can be some of the hardest things for couples to talk about, which is exactly why so many couples stop talking about them, and why so much hurt ends up quietly collecting there.

A note on who this is for: I speak to heterosexual couples here, because that's who I mostly work with. Masculine and feminine energy aren't exclusive to any gender, though, and gay and lesbian couples need polarity too.

Talking About Sex in Couples Therapy

Sex comes up naturally in couples therapy. Together we create a safe, non-judgmental space and build enough trust that you feel you can talk about anything. Most of what couples feel embarrassed about is far more common than they realize, so a big part of the work is normalizing what you're going through and working through the shame that makes these conversations so hard. You don't need to arrive knowing exactly what to say.

I tend to look at sexual challenges as something happening between the two of you, rather than a problem that belongs to one person. Sometimes there is an individual piece, and that's worth exploring too, but the relationship is usually where we focus. Through a developmental lens, every partner has a growth edge, so we get curious about where yours might be in relation to your partner at this particular stage of your partnership or marriage.

The European Society for Sexual Medicine takes a similar view. Its first recommendations for couples distressed by differences in desire are to normalize those differences, stop treating them as a disorder in one person, and see them as something that happens between two people (Dewitte et al., 2020).

From Roommates Back to Lovers

Maybe you're still good friends, but the sensuality, the aliveness between you, has gradually slipped away, and somewhere along the way you became more like roommates than lovers. It happens so easily, because parenting and stressful jobs make everything transactional, and you start relating to each other for utility. There's nothing inherently wrong with that, but this whole world of intimacy and closeness slowly falls to last on the priority list. You can get stuck identifying as the Friend or the Parent and forget the Playmate and the Lover.

What I hear from couples who lack sex in their marriage is that, more than anything, they want to feel desired. It's rarely about the sexual act itself. It's the energy of desire, of wanting and being wanted, that takes us out of the roommate dynamic and back into being lovers and playmates.

That's why sex is such an important dimension of most partnerships. It doesn't always have to mean having sex or physical intimacy, but building your emotional connection and your ability to connect physically in a variety of ways is a fun way to play and connect as adults, and it's great for the growth and long-term quality of your relationship.

Research seems to agree. In a two-year study of long-term couples in Ontario, people's sexual satisfaction predicted how satisfied they were with the relationship later on (Fallis et al., 2016). Another study, following couples over 13 months, found that intimacy and sexual satisfaction feed each other: when partners open up and feel responded to, sex gets better, and better sex brings more of that closeness (Beaulieu et al., 2023).

It can feel vulnerable to admit there's a gap, or that you're not fully satisfied with where things are, and it takes a certain kind of courage to own what you really want. The good news is that the spark doesn't fade randomly. It fades for specific reasons, which means we can understand them.

Why Desire Shuts Down

Desire shuts down because of unresolved pain, protection and resentment. When we've been hurt by each other, our bodies shut down and protect themselves, even from the person we love.

Every time you get hurt, your body contracts and your nervous system reacts. If that pain isn't fully seen, received and empathized with by your partner, the pain and the protection remain, and it becomes one layer between you.

Now multiply that over years. Most couples have thousands of unrepaired, unresolved arguments that have built up like layers of clothes, layers of armour between them, until they can't feel each other anymore. It's like a knight in shining armour trying to touch another person. No matter how much he wants to, the armour gets in the way.

Underneath all those layers, what your body is really saying is: I don't feel emotionally safe with you. I can't trust you to support me emotionally. By support I mean receiving my heart and holding it, and valuing my experience of what happened.

So of course we can't have sex with someone who keeps dropping us emotionally, someone who's unable to stay with us and keep us company in our experience, to receive our side of the story, or to care about the impact they had on us without making it about themselves.

Every partner is asking: Do you understand what it's like to be me in relationship with you? Can I trust you to hold my heart? Do you actually understand how you hurt me?

Whether we like it or not, we can't consciously override how our body feels. You can't talk yourself into feeling safe with someone your body doesn't trust yet. So instead we have to learn to work with our nervous systems, which means learning how to repair, and learning to empathize with and receive each other so well that the pain, protection and resentment dissolve and melt away.

That's what repair is for. Only when you're able to truly take your partner in emotionally without reacting, and empathize with their pain without making yourself bad or wrong, can the pain begin to dissolve. Saying "I understand" or "I'm sorry" is not healing. Demonstrating understanding is.

I've seen this in my own life and in my work with couples: even pain that has built up over years can be released and forgiven when partners are finally able to see each other and demonstrate that understanding.

Three Dimensions of Sexual Connection

Unrepaired hurt is a big part of the picture, but it isn't the whole picture. The way I personally view sexual connection is through three lenses: polarity, interpersonal connection (the flow of energy between you), and self-connection (your relationship to yourself, your body, pleasure, boundaries and desire). When desire has disappeared, it's usually because something has broken down in one or more of these.

Polarity

For the feeling of attraction to be there, there has to be polarity, and polarity is opposites. I often explain it with a real dance, where there's a leader and a follower. The leader plans, directs and initiates, while the follower surrenders and flows. When there are no opposing roles or energies, the dance becomes less dynamic. If the leader isn't decisive and clear in his direction, it's harder for the follower to let go and flow.

When a couple's polarity has become diluted, the feeling of attraction that's created by those opposite poles simply isn't there.

This can happen without either of you noticing. Some couples are unconsciously codependent and have blended into sameness. They've lost their polarity, shut down their own desire in life in general, and spend their energy over-managing their partner's experience, and then they expect themselves to just be able to have sex. Understandably, they don't realize what the real problem is.

Sexual medicine experts point in a similar direction. Helping each partner become more self-differentiated is one of the European Society for Sexual Medicine's suggestions for couples struggling with mismatched desire (Dewitte et al., 2020).

Interpersonal Connection

This is the flow of energy between you, and it's where unrepaired hurt does its damage. Emotional wounds are a lot like physical wounds that haven't been tended to. They either stay raw, or they close off and cut us off from our ability to feel each other. As layers of protection, hurt and resentment build up over time, the flow of energy that was there at the beginning of the relationship, before you'd hurt each other thousands of times, gets blocked. To feel each other again, all of that buildup has to be dissolved.

Researchers describe intimacy in much the same way: one partner opens up, and the other responds so that they feel understood and cared for. Over time, more of that kind of intimacy predicted more sexual satisfaction (Beaulieu et al., 2023).

Self-Connection: Sex Is a Mirror

Then there's your connection to yourself: your own felt sense, your body, your pleasure. How connected are you to your own desire and to what you want in life, and how much do you go for it? How boundaried are you? Do you over-attune to other people?

So many of us lose connection to what we personally want, because we make pleasure about pleasing the other person and become so concerned about them that we lose ourselves. On top of that, we learn all kinds of conditioning about sex, about pleasure, and about men and women, and most of us never learned how to ask for what we want in a way that's grounded in consent. So we shut down what we really want, because it might be unacceptable, or because we were hurt before when we did ask, or simply because it's vulnerable to really ask for what you want. It's vulnerable to receive, too, to let someone in.

All of these stories and experiences form the water we're swimming in, and it rarely stops at the bedroom. Many of us learned not to express ourselves in life in general, and that our authenticity and our truth aren't okay.

This is why I see sex as a mirror. It gives us insight into ourselves and the state of our relationships, not just with our partner, but with our own pleasure, fears, desires and boundaries. It's also why individual or couples therapy can help, by giving you a place to work through the conditioning and old hurts that block energy, full self-expression, desire, presence and creativity, all the makings of great sex.

Bringing It Together

As long as there are no physical complications, we can work on both your relational dynamic and your connection to yourself. That means helping you begin to express the fullness of who you are and what you want, balancing your partner's needs and desires with your own boundaries, and building the trust that's required for you to surrender and let go of control. Over time, you learn to care for each other's hearts and actually take each other in energetically.

Sex isn't purely a physical act. Great sex comes from cultivating emotional connection through the art of repair, so that you've learned to be receptive to each other. After all, that's what intimacy is: learning how to take another person in, and allowing the fullness of yourself to be taken in too.

The Pressure and Protection Cycle

One pattern I see a lot is a cycle that neither partner chose. One partner reaches for sex and gets turned down. They feel rejected, so they reach harder, bringing it up more and watching every hug for a sign it might lead somewhere. Meanwhile the other partner stops experiencing an invitation and starts experiencing pressure, so they pull away. That withdrawal feels like even more rejection, so the pursuit intensifies, and round and round it goes.

One partner is protecting themselves from rejection, while the other is protecting themselves from pressure, and both of them are hurting.

Couples therapists who work with these patterns describe a sexual cycle running alongside the emotional one, and interestingly, sometimes the partner who withdraws during conflict is the one who pursues for sex (Borden & Allan, 2024).

Erectile Dysfunction, Not Initiating and Low Desire

Sexual difficulties often get treated as one partner's problem, but very often there's a relational side to them.

Erectile dysfunction is a good example. A man's erection is a barometer for connection: the flow of energy between you and the polarity in your relationship. That's why ED can sometimes be a relational challenge, not purely an individual one. Because ED can also be a sign of heart or circulation problems, it's important to see your doctor first to rule out physical causes.

Research backs up the psychological side. Stress, depression and performance worry can all contribute to erectile problems, and partners of men with ED often feel unattractive, rejected or unloved (Allen et al., 2023), which is why it affects both of you.

The same goes for partners who don't initiate. Oftentimes they're scared, for different reasons. Some don't know how to manage their boundaries around sex, while others don't feel connected to their own desire, for a multitude of reasons.

Mismatched Desire

Differences in desire are common. One partner may want sex more often than the other, and desire naturally fluctuates with stress, parenting, health, medication, relationship conflict, life transitions, or simply the differences between two people.

Rather than deciding who has the "right" level of desire, we can get curious about the dynamic itself. The aim isn't to make two people identical, but to help you navigate your differences with more honesty, consent and connection.

Research suggests how you handle the gap matters a lot. In a study of 964 couples, the difference between how much sex people wanted and how much they were having, how they communicated about sex, and how initiation worked between them all mattered for sexual satisfaction (Velten & Margraf, 2017). Couples who turned toward each other when their desire was out of sync, by talking or connecting in other ways, were more satisfied than those who dealt with it alone (Vowels & Mark, 2020).

It's completely legitimate to care deeply about sex, and repeated rejection hurts. That hurt doesn't give you ownership over your partner's body, though, and at the same time, your partner's right to say no doesn't mean they have no responsibility for the sexual relationship. In an interdependent partnership, both people's experiences matter.

Connected Sex vs. Mechanical Sex

Many of us learned to perform sex. Our sex education came from pornography, movies or romance novels, and without realizing it, we act out that programming of pleasing, proving, perfecting and performing in the bedroom. Sex becomes one-dimensional: bodies against each other, hearts closed, trying to please the other or trying to get what you want, often full of shame and guilt.

Connected sex is different in every way. It requires authenticity, which is freedom of self-expression, and it's free of shame and guilt. It also requires us to have resolved and repaired the hurt from the past, so there are no walls or layers around our hearts.

Connected sex is when our hearts meet. Mechanical sex is when our bodies meet.

Great sex begins with a connection to yourself, but you also need to be able to manage the needs and desires of your partner with your boundaries. Boundaries are what regulate space and closeness, and they're what keep us safe enough to engage in sexual experiences with consent. Consent, in turn, is what makes it feel so good, when both of your bodies are fully online to receive the experience.

You can feel the difference between "I'm not turned on yet, but I'm open and curious about connecting with you" and "I don't want this, but I'll do it so you don't get upset." The research shows it too. In a 21-day study of couples, on days when people went along with sex without really wanting it, both partners were less sexually satisfied, and the person who went along felt more distressed. When people felt a genuine yes and said it clearly, both partners were more satisfied (Shi et al., 2025). It also helps to know that desire doesn't always come first. It's often responsive, sparked once you're already connecting (Dewitte et al., 2020).

Every partnership is unique, so we get curious about finding ways for you to play with each other, to experiment, explore and discover, and to take the pressure off pleasing, proving, perfecting and performing. Your partnership can become a laboratory for exploration, for vulnerability, for connecting with your humanity, for exploring each other's bodies and pleasure, for cherishing and lust and passion and softness, creativity, submission, surrender, dominance. Any adjectives are welcome in the container of the relationship you want to create. When you move beyond taboo and conditioning, so much becomes available, as you grow in awareness of yourselves and invite all the parts of yourselves out to play with each other, to connect and to be seen.

What's Possible

I want to paint a picture of what's possible, because most people don't have good role models for it.

I used to be a people-pleasing nice guy who was afraid of going after what he wanted, and afraid of women. Through my own personal growth journey I liberated myself, and my partner did the same. We've both done tons of work on ourselves, personally and in relation to the opposite gender. So when we met, we were two fully expressed, liberated people who come together to play and relish and delight in each other's bodies, souls and essence. We use sex as a way to enjoy each other, and we know the depth and richness of the connected sex we get to have is rare.

When you're truly free of shame, sex becomes such a satiating, fulfilling experience, about so much more than two bodies. That's where the spiritual element of sex comes in. It's union, a sharing of the feeling of closeness that can only come when two people are fully expressed.

The Wheel of Consent: Who Is This Touch For?

One framework I draw from in my work around intimacy is the Wheel of Consent, developed by Dr. Betty Martin. It offers a useful distinction: there are two different ways of receiving and two different ways of giving.

Two ways to receive

• Take: touching for your own pleasure.

• Accept: receiving someone else's touch for your pleasure.

Two ways to give

• Serve: touching another person for their pleasure.

• Allow: giving another person access to touch you for their pleasure.

Imagine one partner massaging the other's shoulders. If I'm massaging your shoulders for your pleasure, you're accepting and I'm serving. Now imagine the physical movement looks almost identical, but I'm touching your shoulders because I enjoy the experience of touching you. Now I'm taking and you're allowing. The action may look similar from the outside, but the intention and the experience can be completely different.

That leads to the question: "Who is this touch for?"

It's a question that matters even more once touch starts to feel loaded. When every kiss, cuddle or back rub becomes an attempt to escalate, the body learns that touch means expectation, and a partner can stop wanting touch altogether. Sometimes a hug needs to be allowed to stay a hug.

The Wheel of Consent is an experiential practice, so it needs to be experienced and embodied rather than just read about. If it resonates, I'd invite you to check out Betty Martin's book, The Art of Receiving and Giving: The Wheel of Consent.

Frequently Asked Questions

What is considered a sexless marriage?

There's no clinical definition. You'll often see "fewer than ten times a year" online, but the number matters much less than what it means to the two of you. Couples who lack sex usually want to feel desired, and it's rarely about the act itself so much as the energy of wanting and being wanted.

Can a sexless marriage be fixed?

It depends on why you're not having sex. When there are no physical complications, desire usually shuts down because polarity has become diluted, because unrepaired hurt has built layers of protection between you, or because you've lost connection to your own body, boundaries and desire. These are all things we can work on together.

Is it too late for sex and intimacy in our 50s or 60s?

I work with many couples in their 50s and 60s, and many of them still want sex to be an important dimension of their relationship. When you've been together that long, there's naturally been more buildup of hurt over the years that never got repaired, so partners are often left feeling unseen and not understood, and not really trusting each other to support them emotionally. Of course the body doesn't feel ready to open up. Through healing and repair work, the flow of energy between you can be reestablished. It helps to see sex as an energetic dance of polarity rather than a physical act based on pleasing and performing. Age itself doesn't seem to be the barrier: in one large study, neither age nor relationship length predicted sexual satisfaction (Velten & Margraf, 2017).

Is erectile dysfunction a relationship problem?

Sometimes. A man's erection is a barometer for connection and polarity, so ED can be a relational challenge. Because it can also signal heart or circulation problems, see your doctor first.

Do we need a sex therapist or couples therapy?

In couples therapy, we talk about sex openly and work on the relational side. If there are concerns with sexual functioning, pain or medical factors, a sex therapist or physician may be the right fit, sometimes alongside couples work. I'm a couples therapist, not a sex therapist, and if I think a referral would help you, I'll tell you.

Do you work online?

Yes, all of my sessions are online.

Getting Support With Sex & Intimacy

Struggling with intimacy doesn't necessarily mean something is fundamentally wrong with your relationship. Sometimes couples just need a different kind of conversation, one that makes room for desire, disappointment, boundaries, pleasure, vulnerability, and the things that are hard to say to each other.

Want support with this in your relationship? Reach out to work with me.

References

Allen, M. S., Wood, A. M., & Sheffield, D. (2023). The psychology of erectile dysfunction. Current Directions in Psychological Science, 32(6), 487–493. https://doi.org/10.1177/09637214231192269

Beaulieu, N., Bergeron, S., Brassard, A., Byers, E. S., & Péloquin, K. (2023). Toward an integrative model of intimacy, sexual satisfaction, and relationship satisfaction: A prospective study in long-term couples. The Journal of Sex Research, 60(8), 1100–1112. https://doi.org/10.1080/00224499.2022.2129557

Borden, L., & Allan, R. (2024). Integrating sex therapy with emotionally focused therapy to treat sexual desire discrepancy. The Family Journal, 32(4), 522–530. https://doi.org/10.1177/10664807241264813

Dewitte, M., Carvalho, J., Corona, G., Limoncin, E., Pascoal, P., Reisman, Y., & Štulhofer, A. (2020). Sexual desire discrepancy: A position statement of the European Society for Sexual Medicine. Sexual Medicine. https://doi.org/10.1016/j.esxm.2020.02.008

Fallis, E. E., Rehman, U. S., Woody, E. Z., & Purdon, C. (2016). The longitudinal association of relationship satisfaction and sexual satisfaction in long-term relationships. Journal of Family Psychology, 30(7), 822–831. https://doi.org/10.1037/fam0000205

Shi, X., Impett, E. A., & Zheng, Y. (2025). The impact of sexual consent on sexual and relationship well-being in Chinese romantic relationships. The Journal of Sex Research, 62(8), 1514–1531. https://doi.org/10.1080/00224499.2024.2445059

Velten, J., & Margraf, J. (2017). Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE, 12(2), e0172855. https://doi.org/10.1371/journal.pone.0172855

Vowels, L. M., & Mark, K. P. (2020). Strategies for mitigating sexual desire discrepancy in relationships. Archives of Sexual Behavior, 49, 1017–1028. https://doi.org/10.1007/s10508-020-01640-y