It usually comes out at the end.
We'll be forty minutes into a first session about communication, or the in-laws, or the division of household labour, and then someone will say "and I guess, also, we haven't really… in about a year," and look at the floor.
Desire discrepancy is one of the most common reasons couples seek therapy and one of the last things they actually mention. Partly shame. Partly because it's a subject with an unusually cruel structure: the more you want it, the more pressure you create, and the more pressure there is, the less appealing it becomes. Both of you end up feeling rejected by the same problem.
Good news, and I mean this: this is one of the more workable things couples bring in.
The Most Useful Thing I Can Tell You
Desire doesn't work the way most of us were taught.
The standard model says desire comes first — you feel like it, so you initiate. That's spontaneous desire, and it's real, and roughly speaking it's more common in men and in the early phase of relationships.
But there's another perfectly normal pattern called responsive desire, where the wanting arrives after arousal begins, not before. Someone with responsive desire may genuinely never spontaneously feel like it — and still very much enjoy sex once they're in it.
Consider what happens when a responsive-desire person believes the spontaneous model is the only correct one. They wait to feel like it. They never do. They conclude something is broken in them, or that they've fallen out of love with their partner, or that they're simply not a sexual person. Meanwhile their partner concludes they're not wanted. Both of them are wrong, and the entire misery rests on a misunderstanding of a normal variation.
This single reframe resolves a meaningful chunk of what walks into sex therapy. It's not always the whole answer. It's often a big part of it.
The Part Where the Pressure Makes It Worse
There's a loop that develops. It goes roughly like this.
The higher-desire partner initiates. The lower-desire partner declines. The higher-desire partner feels rejected, and after enough repetitions, unwanted and undesirable. So they initiate less, or they initiate with more anxiety, or they start monitoring — reading every touch for whether it's leading somewhere.
The lower-desire partner, meanwhile, starts experiencing all physical affection as a potential opening bid. So they withdraw from that too, because declining is exhausting and guilt-inducing. Now there's no casual touch left in the relationship at all.
Which removes the exact conditions under which responsive desire could actually emerge.
Both people are now lonely, both feel rejected, and neither is doing anything wrong. That's the tragedy of it and it's also why willpower doesn't fix it. You can't want your way out of a structural problem.
What We Actually Look At
- Context, first. Desire is enormously context-dependent. Exhaustion, resentment, an unequal division of labour, a body you're not currently at peace with, a partner you're quietly furious at about the recycling — these are not separate from your sex life, they are your sex life. It is genuinely difficult to want someone you're keeping score against.
- The brakes, not just the accelerator. Most people ask how to increase desire. The more useful question is often what's suppressing it. Stress, poor sleep, medication side effects, hormonal shifts, pain, body image, a fear of not performing well, an unresolved argument from three weeks ago. Reduce the brakes and desire frequently reappears without needing to be manufactured.
- Medical and physiological factors. Antidepressants and hormonal contraceptives affect libido. So do perimenopause, chronic pain, thyroid function, and testosterone levels. I'm not a physician and I'll say so, but I will absolutely encourage a proper medical conversation rather than letting you spend six months assuming it's psychological.
- Neurodivergence. Interoception — the ability to read your own internal signals — is often different for autistic and ADHD folks. Sensory factors matter enormously. And a lot of neurodivergent people need explicitness rather than intuition, which conflicts badly with the cultural script that sex should be spontaneous and unspoken. Naming this out loud helps more couples than you'd think.
- Rebuilding touch that isn't transactional. Separating affection from initiation, so that a hand on a back can go back to meaning a hand on a back. This is often where the actual work starts.
- How you talk about it. Most couples have either stopped discussing it entirely, or only discuss it during or immediately after a failed attempt — the two worst possible times. We work on a way to have the conversation that doesn't require anyone to be brave in a vulnerable moment.
About Asexuality, Briefly
Sometimes the answer isn't that desire is suppressed. Sometimes someone is asexual, or on that spectrum, and that's not a dysfunction to be fixed.
That situation still needs work — a mixed-desire relationship where one partner is allosexual requires real negotiation about intimacy, exclusivity, and what each person needs. But the goal isn't converting anyone. Any therapist whose framework assumes everyone should end up wanting the same amount of sex is going to do damage here.
What Sex Therapy Is Not
There's nothing physical in the room. No demonstrations, no touching, no undressing. It's talk therapy with a specialism, plus, usually, structured exercises to do privately at home. I mention this because a surprising number of people avoid booking for years based on an assumption they were too embarrassed to check.
You also don't need to arrive articulate. Most people don't have the vocabulary for this, because nobody teaches it. Fumbling through is completely normal and part of what we're building.
Working With Cinnamon Counselling
We offer sex therapy, couples counselling, and therapy intensives from our Vancouver office at 525 W 8th Ave, plus virtual sessions across BC — Vancouver, Burnaby, Richmond, North Van and beyond.
We're queer-affirming, kink-aware, poly-friendly and neurodivergent-affirming, which means you can describe your actual situation rather than a simplified version of it.
Oliver the therapy dog does attend sex therapy sessions. He has opinions about treats, not about your sex life.
If this has been the unspoken item on the list for a while, book a free consult.
