“I love my partner—but I just don’t want sex anymore. What’s wrong with me?”

“It’s always me who wants it more. It feels like rejection every time.”

Discrepancies in sexual desire are among the most common—and most misunderstood—issues couples bring to therapy. For some, the gap between wanting and being wanted becomes a quiet ache; for others, it becomes a cycle of pursuit and withdrawal that slowly erodes intimacy.

This third webinar in our four-part series, Hidden Realities of Sexuality, explores the paradox of desire discrepancy: why partners fall out of sync, what the latest research reveals about the neurobiology of wanting, and how therapists can help couples reconnect without pathologising natural variation in desire.

While the series unfolds as a progressive conversation, each webinar is self-contained and can be attended independently.

Rethinking Desire: Beyond Drive Theory

For decades, therapists and the public alike have been taught to view libido as a biological drive—akin to hunger or thirst—that must be “satisfied.” Yet contemporary neuroscience paints a far more complex picture. Desire is not a fixed quantity nor a simple physiological urge; it is a motivational state shaped by attention, learning, and context.

Dr Nicole R. Prause draws on emerging research in conditioning and sexual incentive motivation to show how desire functions more like curiosity than compulsion. It waxes and wanes depending on expectancy, novelty, and environmental cues. Recognising this allows therapists to approach desire discrepancies not as dysfunctions, but as relational patterns shaped by learning and meaning.

Based in the United States and rarely teaching in the UK, Nicole’s presence in this series represents an exceptional opportunity for British clinicians to engage with cutting-edge neuroscience that has direct clinical implications.

Moving Beyond Gendered Narratives

Traditional frameworks have long gendered desire: “low desire” framed as feminine inhibition, “high desire” as masculine excess. The history of pathologising desire discrepancy is littered with harmful labels—”frigid” women, “hypersexual” men—that obscure the reality that desire variation exists across all genders and relationship configurations.

Nicole explores how cultural scripts, relational dynamics, and conditioning histories shape partners’ differing erotic rhythms. She introduces the concept of sexual incentive salience—how partners come to differ not in what they want, but in the cues that activate their wanting. Understanding this helps clinicians move beyond stereotypes and into the real complexity of erotic motivation.

Evidence from cross-orientation and same-sex couples shows that desire discrepancy is not a gender issue—it’s a relational one, shaped by the dynamics between a “higher desire” and “lower desire” partner regardless of gender.

Conditioning, Novelty, and Expectancy in Desire

What we attend to, repeat, and anticipate profoundly shapes desire.

• Conditioning – The brain learns to associate sexual arousal with specific contexts, sensory cues, or emotional states. This explains why attraction may be intense early in relationships but fade as novelty diminishes.
• Novelty – Reward systems habituate quickly; repetition dulls incentive salience. Introducing novelty—through play, imagination, or environmental change—re-engages attention and desire.
• Expectancy – Anticipation matters as much as touch. How partners think about sex, and what they expect it to mean, influences arousal pathways before any physical contact occurs.

Nicole integrates laboratory findings with clinical application, demonstrating how these mechanisms can guide therapy—not toward performance enhancement, but toward curiosity, responsiveness, and agency.

When Desire Discrepancy Becomes Distress

Desire differences become clinically significant when they are misinterpreted: the higher-desire partner feels rejected; the lower-desire partner feels pressured or defective. Left unexamined, these patterns can erode emotional safety and reinforce shame.

Therapists often rush to equalise desire through behavioural scheduling or compromise—but such strategies miss the deeper dynamics of attention, avoidance, and emotional function. Nicole demonstrates how to explore what each partner’s desire—or lack thereof—expresses within the relationship: Is low desire a form of self-protection? Is high desire an attachment strategy to secure connection? When does wanting itself become a language of power, resentment, or longing?

Connecting to the Previous Webinar

Building on the exploration of pornography in the previous webinar, Nicole addresses a common clinical scenario: one partner uses pornography while the other doesn’t, creating tension around perceived desire discrepancy. Rather than pathologising pornography use as “addiction” or excessive desire, this framework invites us to explore whether use reflects an attempt to manage desire mismatch—one partner’s incentive system seeking stimulation the relationship currently doesn’t provide.

This reframing helps avoid the “addict/victim” dynamic and opens space for genuine dialogue about what activates desire for each partner.

New Frontiers: Pharmacology, Brain Stimulation, and Psychotherapy

Recent developments in the biology of sexual motivation offer ethically complex but illuminating insights. Pharmacological agents, neuromodulation, and non-invasive brain stimulation techniques have shown potential to modulate sexual desire—both increasing and decreasing it. Nicole discusses these studies not as treatment recommendations, but as ways of understanding the neurobiology of wanting: how attention, novelty, and meaning interact at the level of the brain.

She explores how therapists can integrate this understanding without reducing desire to chemistry—using neuroscience to deepen, not replace, psychological and relational inquiry. She will also preview two emerging interventions showing promise for couples navigating desire discrepancy, approaches that work with partners’ neurobiological responsiveness patterns rather than against them.

Clinical Implications: Desire as Dialogue

In therapy, desire discrepancy often mirrors the couple’s broader communication style. The goal is not to make desire symmetrical, but to restore dialogue. Nicole offers practical approaches to help therapists:

• Explore the meanings partners attach to initiation, refusal, and pursuit
• Normalise fluctuation in desire as a natural feature of long-term intimacy
• Use curiosity and mindfulness to expand erotic attention and flexibility
• Introduce evidence-based exercises focused on discovery rather than obligation
• Work effectively with diverse gender combinations and relationship structures beyond heteronormative frameworks

When desire becomes something partners can talk about—without shame, hierarchy, or blame—it often becomes something they can feel again.

Key Learnings

Understand desire as a motivational process shaped by attention, expectancy, and learning rather than a fixed biological drive

• Identify cultural myths and gendered assumptions that perpetuate shame and conflict around desire
• Recognise the roles of conditioning, habituation, and novelty in sustaining or diminishing arousal
• Differentiate relational, psychological, and physiological contributors to desire discrepancies
• Relate the previous presentation on pornography to desire discrepancy work, avoiding pathologisation
• Describe brain stimulation and pharmacological approaches that can alter sexual responsiveness
• Identify two forthcoming interventions that may improve outcomes for couples with discrepant desires
• Apply evidence-based, non-pathologising approaches that transform distress into dialogue

About Dr Nicole R. Prause

Dr Nicole R. Prause is a neuroscientist and licensed psychologist internationally recognised for her research on sexual physiology, reward processing, and psychophysiology. She earned her PhD at The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University, concentrating in neuroscience and statistics; completed clinical internship at the VA Boston Healthcare System; and held a research fellowship in couples treatment for alcoholism at Harvard University.

As research scientist at UCLA’s Semel Institute, Nicole has authored numerous peer-reviewed studies on sexual response, motivation, and the conditions under which sexuality becomes distressing. Her laboratory has conducted groundbreaking work including the largest study of male orgasm physiology to date and pioneering research applying transcranial brain stimulation to alter sexual responsiveness—the first such study in the United States.

Her research bridges laboratory science and clinical practice, challenging reductionist myths about desire while offering grounded, evidence-based insight into its variability. Nicole’s teaching is known for combining scientific rigour with clinical empathy—helping therapists translate neuroscience into therapeutic understanding that supports curiosity, flexibility, and connection.

The Series: Hidden Realities of Sexuality

“You Want It More Than I Do” forms Part 3 of Hidden Realities of Sexuality—a four-part exploration of how pleasure, pain, power, and perception intersect in the consulting room. Each webinar can be attended individually or as part of the full series spanning trauma, shame, neurophysiology, and desire—together inviting us to rethink what sexual health and healing truly mean in contemporary psychotherapy.

Join Dr Nicole Prause for an evening that challenges assumptions about desire, offers neuroscience-based alternatives to pathologising frameworks, and opens new possibilities for helping couples navigate difference.

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