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A big part of our role as therapists is giving our clients the language they need to express themselves. Many people grow up feeling uncomfortable talking about sex. A topic considered taboo in many households can later translate into secrecy and an inability to communicate openly. One of the most common opening statements in couples therapy is the generalization, “We’ve become distant.” More often than not, the root of this frustration is a discrepancy in desire.
Understanding Desire Disorders
The DSM-5 categorizes desire disorders differently for men and women. Male Hypoactive Sexual Desire Disorder and Female Sexual Interest/Arousal Disorder both indicate a lack of sexual interest, though the latter intertwines arousal and desire in women. Addressing these concerns effectively requires a clear understanding of these terms.
Arousal: The Physiological Response
Physiological arousal is a measurable physical response—how our bodies react sexually, much like how we assess blood flow, muscle tension, and heart rate. Because arousal is a physical function, treatment typically requires the expertise of a sex therapist.
Desire: A Psychological Component
Unlike arousal, desire is not something that can be objectively measured. It has historically been considered a psychological factor, often attributed more to women than men. However, while desire discrepancy remains a common issue in relationships, an increasing number of men—both in heterosexual and homosexual relationships—are now seeking therapy due to decreased desire.
The Nature of Desire and Its Influence on Relationships
Sex therapist Laurie Mintz describes desire as “the ‘We can’t keep our hands off each other’ stage of a relationship—also known as the limerence phase.” This heightened level of wanting is intense but ultimately unsustainable. Desire is rooted in the act of wanting, and just as arousal can be treated, there are interventions to help reignite desire.
When individuals take the time to reflect on why they may not be in the mood, they often identify underlying factors such as stress, parenting responsibilities, or a need for more physical intimacy. Clarifying these needs can help partners support one another, fostering a return to authentic wanting—rather than merely focusing on performance.
The Path to Open Communication and Connection
By giving clients the tools to articulate their needs and emotions, therapists help couples navigate the complexities of arousal and desire. Understanding these distinctions allows individuals to communicate more effectively with their partners, fostering deeper intimacy and connection. When desire is approached with openness and empathy, relationships can evolve in ways that honor both partners’ emotional and physical well-being.
Dr. Lisa Barrows is a psychologist at Lukin Center for Psychotherapy, specializing in treating couples, families, individuals, and parents through relational dynamics and life transitions. As a therapist, Dr. Barrows takes an integrative approach with compassion and collaboration. Her methodologies include cognitive behavioral therapy (CBT), emotionally focused therapy (EFT), internal family systems (IFS) and interactive approaches. She helps her clients overcome setbacks through practical, attachment based reorientation.
Dr. Barrows has experience among various demographics. She has worked in high-performing school districts as well as inpatient hospital based crisis settings for children and adults. She is trained in psychoeducational testing and has provided evaluations and advocacy for school based specialized learning and gifted services. She has supported families in Bergen County for over ten years and has conducted research in the area of sleep studies. Dr. Barrows is a graduate of Johns Hopkins University and earned her doctorate from Fairleigh Dickinson University.
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