It's no news flash that sexual passion declines over time in intimate relationships. "Not tonight, honey, I have a headache..." Words that live in infamy-or at least too often in the bedrooms of married couples. Billions of dollars are spent to address the problem, from ED drugs and sex toys to advice columns in women's magazines and psychotherapy. And yet the problem persists.

Most explanations of sexual boredom are wrong. It's not about our biology (yes, we're wired to desire erotic pleasure and its accompanying sense of connection, but, no, that doesn't explain anything at all about the how, what, with whom, or how often of sexual desire). It's got nothing to do with some evolutionary imperative (apparently males achieve reproductive success through inseminating multiple females-ho-hum...so how does that account for why my patient Ben prefers porn over his wife?). The fact is that it's all psychological and entirely understandable if you accept the premise that sex begins in the mind and travels downward, not vice versa.

Here's the Rosetta Stone for understanding sexual desire-or the lack thereof. You can't get aroused if you feel, consciously or unconsciously, too worried, responsible, or guilty about your partner. And you can't get turned on if you're feeling rejected or inferior either. These states of mind are incompatible with sexual excitement.

The opposite of feeling worried and responsible is feeling selfish and, indeed, there is an element of selfishness that is absolutely necessary for maximum sexual desire. The emphasis today on getting more attuned to one's sexual partner is fine, but if it leaves out selfishness it's a disaster. You have to be able to be both connected and separate, separate enough to surrender to your own pleasure without worrying too much about the other's.

Enter intimacy. Unfortunately, the thing that's great about intimacy-security, giving and receiving caretaking, feeling deeply understood and accepted-works against separateness. It opens the door to greater guilt and worry-greater because you know your partner better and care about what you know. You can't ignore his or her vulnerabilities, nor can you conceal your own. The very conditions of intimacy are a potential cold shower for the libido

Yeah, yeah, I know that this varies greatly, that some couples have much better sex for a time precisely because they learn more about each other's needs and preferences. And I know that each person also brings his or her own idiosyncratic problems into the bedroom. I wouldn't be in business if this wasn't true and if I weren't able to help such folks. But let's get real-regardless of these variations, the thematic truth of the matter is that desire wanes over time.

The important thing is really what we do with the fact of sexual boredom. Here's what I see people doing that's both unreasonable and either self-destructive or destructive to their partners: First, people feel way too depressed about the decline in sexual frequency and intensity, as if it means you're a failure, a loser, or a sad sack. It doesn't. Second, in response to boredom, too many people think that the solution is to change partners. It isn't. The solution is unfortunately more complicated. I won't go into detail about the healthier strategies that people can employ to deal with sexual boredom, because it would take too long and distract from the point I'm trying to make. But suffice it to say that in addition to understanding the underlying dynamics of the situation, sometimes you just have to lean against the wind, figure out how to insist on sexual contact even if you or your partner don't spontaneously want to rip each other's clothes off. Why? Because when couples have sex, even if intermittently, they usually feel closer and their relationship and self-esteem gets better. And because for most folks, once you get started in the bedroom, you're usually reminded of how much you enjoy it.

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