Sexual Health: What is Arousal Nonconcordance?

This article was updated on September 19, 2026.

Most people do not understand arousal nonconcordance because they never learned about it in sex education. This mismatch between mind and body often causes deep confusion and relationship conflict.

Arousal nonconcordance occurs when the mind and body are out of sync—a common experience that specialized couples therapy can help resolve.

What is Arousal Non-Concordance?

Arousal non-concordance is a mismatch between physical genital responses and mental or emotional feelings of sexual excitement. Your body might react physically without mental desire, or your mind might feel turned on while your body does not react.

Arousal Concordance vs. Non-Concordance

• Arousal Concordance: Emotional, mental, and physical sexual arousal happen at the exact same time and match each other.
• Arousal Nonconcordance:
  One or more of these aspects are out of sync.

Common Examples of Nonconcordance

• Mental Desire without Physical Response: A person feels emotionally turned on or wants sex, but does not experience vaginal lubrication or an erection.
• Physical Response without Mental Desire: A person’s body has a physiological reaction (like lubrication or an erection) from physical stimuli, but they feel no emotional desire or interest in sex.

Physical Arousal is Not Consent

Physical arousal is an automatic nervous system reaction, not a sign of choice.

Verbal Consent Matters: Clear verbal consent is the only true indicator of a person's desire to engage in sexual activity.

Never Assume: Do not assume a physical reaction means your partner wants to have sex. Always ask and rely on your partner's clear words.

Frequently Asked Questions:

Is arousal nonconcordance normal?

Yes. Research shows that arousal non-concordance is a completely normal human experience experienced by both men and women.

Why does my body get wet or hard when I am not turned on?

Genital blood flow and lubrication are reflexive responses to touch, context, or neutral physical stimuli. They do not automatically mean your brain is experiencing emotional desire.

How can couples cope with arousal non-concordance?

• Talk openly about how your body changes with age, stress, or fatigue.
• Use supplemental lubricants without assigning emotional meaning to physical changes.
• Rely on clear verbal communication rather than guessing based on physical signs.

A Case Study in Arousal Non-Concordance: Mary and Bob

The following clinical vignette is a composite of common cases with all identifying information removed to protect confidentiality.

The Relationship Presentation

Mary and Bob sought sex therapy after 23 years of marriage because they were experiencing severe intimacy issues. Bob felt highly discouraged and rejected during sex. Even though Mary would verbally tell him she was in the mood, Bob noticed she was not experiencing natural vaginal lubrication.

The Misunderstanding

Because Bob did not understand how arousal works, he assumed Mary was lying to appease him. He believed that if she were truly turned on, her body would automatically lubricate. As a result:

• Bob stopped initiating sex out of fear of rejection.
• When Mary initiated sex, Bob turned her down because he felt anxious about her lack of physical response.
• Mary felt deeply frustrated because she genuinely loved Bob, found him attractive, and wanted to be intimate. However, because she was postmenopausal, her body naturally produced less lubrication—a common biological shift.
• Mary suggested using store-bought lubricant, but Bob refused, viewing the lubricant as proof that he could no longer turn his wife on.

The Sex Therapy Breakthrough

During our therapy sessions, I introduced the concept of arousal nonconcordance to the couple. Once Bob understood that a lack of physical lubrication did not equal a lack of emotional desire or attraction, his perspective completely shifted.

Realizing this was a normal, common experience relieved his anxiety. Bob accepted the use of supplemental lubrication, the fear of rejection dissolved, and their sexual relationship dramatically improved.

Therapist Takeaway for Couples

Physical signs of arousal (like lubrication or erections) fluctuate due to age, hormones, stress, and medications. Never use physical responses as a test of your partner's love or desire. Instead, rely on their clear verbal communication and keep tools like high-quality lubricants readily available.

Ready to Bridge the Gap Between Your Mind and Body? 

Arousal nonconcordance and intimacy blocks are incredibly common, but you don't have to navigate them alone. Let’s talk about how individual or couples therapy can help you reclaim a fulfilling sex life. 

Take the Next Step Toward Healing and Connection

If you or your partner are struggling with arousal nonconcordance, low desire, or relationship conflict, you do not have to struggle in silence. 

As a certified sex therapist and licensed psychotherapist in New York City, I provide a compassionate, sex-positive environment to help individuals and couples thrive (visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist).

• Couples Therapy: Rebuild intimacy, resolve communication breakdowns, and untangle misunderstandings about physical arousal.
• Individual Therapy: Understand your personal sexual accelerators and brakes, heal from sexual anxiety, and feel confident in your body.

📞 Contact Josephine Ferraro, LCSW

• Office Location: Greenwich Village, NYC (10011) and Telehealth available
• Phone: (917) 742-2624 during standard business hours
• Email: josephineferraro@iCloud.com
• Next Step: I offer a complimentary 15 minute phone call before setting up an appointment.

 

To Improve Intimacy in Your Relationship, Get Off the Sexual Staircase

This article was revised on September 14, 2026.

In their book, Desire - An Inclusive Guide to Navigating Libido Differences in Relationships, Lauren Fogel Mersey, PsyD and Jennifer A. Vencill, PhD., discuss the "Sexual Staircase" to describe the kind of routine, goal-oriented sex that people engage in when they're having sex with their partner (see my article: Understanding Your Sex Script).

What is the Sexual Staircase?

According to Mersey and Vencill, the Sexual Staircase, which is a metaphor, is how most people think sex is "supposed to be."

Improve Intimacy in Your Relationship

The Sexual Staircase is a list of hierarchical steps that usually start at the bottom of the staircase with foreplay and ends with sexual intercourse and orgasm.

Depending upon the couple, the sexual acts between foreplay and intercourse can include kissing, caressing, genital touch, oral sex, and so on.

For many people in long term relationships these steps don't deviate. They engage in the same steps in the same way most or all of the time.  

After a while, people in long term relationships often skip some of the steps as they prioritize a goal-oriented approach that always ends with penetrative sex and strives for orgasm.  

Having sex the same way all the time becomes boring after a while (see my article: What is Sexual Boredom in Long Term Relationships?).

What's the Problem With the Sexual Staircase?

If you and your partner enjoy doing the same thing, the same way all of the time and neither of you have a problem with it, then there's nothing wrong with the Sexual Staircase for you.

But many people find this approach to be too routine and unfulfilling.  The problem is that they think this is the way they're supposed to do it, so they just keep doing it the same way.

People who find the Sexual Staircase boring, sexually unfulfilling or not applicable to them often have the following problems with it:

• It's a heteronormative sex script that focuses on cisgender heterosexual men. For heterosexual men, sexual intercourse is one of the most reliable ways to have an orgasm, but this isn't the case for most women (see below).

• It assumes that most people want penis-in-vagina sex even though there are many people who don't want it or it doesn't work for them because of problems with dyspareunia (persistent or recurrent genital pain that occurs during penetrative sex) or erectile unpredictability (a persistent or recurrent problem with getting and maintaining an erect penis) or because they're not heterosexual (see below).

• Sexual intercourse is the least reliable way for most women to have orgasms because they need direct clitoral stimulation, which they often don't get from sexual intercourse or clitoral stimulation is skipped altogether (see my articles: Closing the Orgasm Gap - Part 1 and Part 2).

• The Sexual Staircase emphasizes goal-oriented, performative sex instead of focusing on sexual pleasure (see my article: What is Performative Sex and Why Is It a Problem?).

• In many long term relationships, the Sexual Staircase gets shorter and shorter over time so that there is little or no foreplay, which has a negative impact of women's sexual pleasure. The focus becomes getting sex over and done with it as quickly as possible because it's unsatisfying.

• In addition to problems with painful sex and erectile unpredictability, penetrative sex isn't always possible for a variety of reasons, including childbirth, certain disabilities, age-related physical limitations, surgery or other types of problems.

• When penetrative sex isn't possible (for whatever reason), many couples skip having sex altogether because penetrative sex is the only way they know how to have sex.  Over time, one or both of them become frustrated and dissatisfied.

• The heteronormativity of this model isn't useful for LGBTQ people, as previously mentioned. Many LGBTQ people assume that since they're not having penis-in-vagina sex, they're not having "real sex," which, of course, is false.  This often leads to feelings of shame, guilt and self consciousness about their sexual orientation.

The Wheel Model

The authors of Desire cite the Wheel Model, which was inspired by Robert T. Francoeur in his book, Becoming a Sexual Person (1991).

Picture a wheel that's divided into different sections with sexual activities represented in a non-hierarchical way.  

Rather than the linear, hierarchical model represented in the Sexual Staircase, in the Wheel Model none of the sexual activities has a higher priority over any of the others.  Other than sexual pleasure, there are no goals, which usually means less pressure for both people and more enjoyment.

In addition, with the Wheel Model, people can engage flexibly pick and choose what they like, in whatever order they like without being constrained to the rigid model of the Sexual Staircase.

The authors provide an example of what sexual activities might be included in the Wheel Model:

• Kissing
• Caressing
• Touching
• Massaging
• Using a sex toy
• Showering together
• Cuddling
• Oral sex
• Orgasm
• Penetrative sex
• Manual stimulation

And more.

The sexual activities included with the Wheel Model are only limited by your imagination.

But this is not to say that you and your partner should engage in the activities they write about or that you should stop having sexual intercourse if it's enjoyable to both of you.  You can do whatever you both enjoy.

The Wheel Model helps to dispel the myth that there's one right way to have sex or that everyone should have the same predetermined sex script.  

Making Changes to Your Sex Script

Once again, I want to reiterate that if you and your partner are happy with your sex script, you can continue using it without a problem.

But if you're stuck in a routine and you're getting tired of doing the same thing over and over again, consider how you can work towards making changes in your sex script (see my article: Changing Your Sex Script).

As Emily Nagoski, PhD., sex educator and author of the book, Come As You Are, says, "Pleasure is the measure."

This means "good sex" is what's pleasurable for both of you.

Getting Help in Sex Therapy

A skilled sex therapist can help you to overcome sexual problems.

Sex therapy is a form of talk therapy where the focus is on sex and relational problems getting in the way of sexual enjoyment (see my article: What is Sex Therapy?).

Individuals and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

There is no nudity, physical exam or sex during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?)

Rather than struggling on your own, seek help in sex therapy so you can lead a more fulfilling life.

Contact & Consultation Information

I see clients online throughout New York State and in person at my private office in Greenwich Village, New York, NY 10011.

I offer a free 15-minute introductory phone call before scheduling your initial appointment.

• Website: Visit Josephine Ferraro, LCSW - NYC Psychotherapist to learn more about my practice.

• Email: Reach out confidentially via email at josephineferraro@iCloud.com.

• Phone: Call me directly at (917) 742-2624 during standard business hours.

 

How to Stop Getting Into Power Struggles About Your Spouse's Porn Viewing

This article was updated on September 15, 2026.

In my New York City sex therapy practice, I frequently find that couples get trapped in cyclical arguments over screen time and intimacy. Shifting away from a rigid power struggle allows partners across New York State to rebuild foundational safety and define mutually agreed-upon boundaries.

Power Struggles in Relationships About Porn

Some women also think mainstream porn is "disgusting" because it's degrading and exploitive of women and against their own moral values.

Now that the Internet provides access to pornography 24/7, more couples are getting into arguments about porn viewing. These arguments often devolve the point where some wives call their husbands "sex addicts" or "porn addicts" with ultimatums to go to therapy "or else."  

Most of the time arguments about porn viewing go nowhere because couples get locked in power struggles with nowhere to go. These power struggles leave wives feeling dejected and hurt and they leave husbands feeling defensive, guilty and ashamed. 

So, there's no real discussion about what would be most productive--the underlying issues involved, which could bring a couple together so they can understand each other.

(Note: I've written this article from a heteronormative perspective, however, these concepts can apply to any two people in a relationship regardless of gender or sexual orientation.)

Occasional Porn Viewing vs. Compulsive Porn Viewing

It can be upsetting to discover that your husband has been secretly watching porn or, even worse, that he made promises he'd stop watching porn but then you discover he's still doing it. 

But porn doesn't have to be a threat to your relationship--especially if it's not interfering with your sex life or your husband's daily activities of living. So, I'm not referring to men who watch porn compulsively where it's interfering with his daily activities. That's a different matter. 

I'm referring to the average man who watches porn occasionally on his own in the privacy of your home.

Here are some things you might not know:

• Just because your partner watches porn doesn't make him (or her) a "porn addict" or "sex addict." Unfortunately, these terms are thrown around too easily and they're hurtful and destructive. Not only are these terms of out of date and misleading, but they're not relevant if your spouse isn't watching porn compulsively to the point where it's interfering with your sex life or daily activities. So, rather than using these derogatory terms, try to get curious about why your spouse watches porn so you can listen to him with an open mind. (If you're curious about sexual compulsivity so you can understand the difference, see my article: Sexual Health: Treating Sexual Compulsivity in Sex Therapy: Sexual Addiction or Out of Control Sexual Behavior [OCSB?]).

• Although you might feel insecure about your body when you realize your husband is watching porn, you might not know that it's unlikely your husband is comparing your body to the women's bodies he's seeing in porn. Also, ask yourself if you were already feeling insecure about your body because this is a common experience for many women even without porn (see my articles: Is a Negative Body Image Ruining Your Sex Life? and How Mindfulness and Self Compassion Can Help With Body Acceptance).

• Porn is fantasy. It's not real. Your husband knows that. He knows he's watching actors acting out a script. He might be drawn to the female character in the video, but he's not falling for the actual person because he doesn't know her. He only sees the character she's portraying in the fantasy--not the woman who has her own problems in her relationship and her own personal stressors.  Furthermore, your husband probably knows that mainstream porn doesn't depict real life situations where one or both spouses might be tired or unwell. He probably doesn't expect sex between the two of you to resemble what he's seeing in porn because he knows it's make believe.

• Under most circumstances, average porn viewing doesn't take away from your sex life. Under the right circumstances, ethical porn, also known as feminist porn or fair trade porn, can enhance your sex life, if you're open to it (see my article: Understanding Your Sex Script).

• Many men (and many women too) often use porn for quick stress relief. It can be a quick way of getting sexually aroused and masturbating to overcome stress or to help with sleep. 

• Most men experience masturbation with porn as being a very different experience from making love to their partner. Masturbating to porn is usually a quick release whereas making love to a spouse or partner involves an emotional and sexual connection.  These are two very different experiences.

• There's a difference between privacy and secrecy. Everyone is entitled to privacy regardless of their relationship status (see my article: Privacy vs Secrecy in a Relationship).

How to Stop Arguing About Your Spouse's Porn Viewing

As long as you're arguing with your spouse based on a right-or-wrong perspective and giving him ultimatums, you're unlikely to resolve this issue.  In fact, arguing in this way usually makes the conflict worse.

Typically, when men are threatened with ultimatums about porn, they might try to stop watching just to appease their partner, but they often feel misunderstood and resentful.

Also, as mentioned above, some men try to appease their partners by telling them they'll stop, but they're not being honest. They're just trying to do a better job of hiding it. 

Obviously, lying only makes the issue worse because it fuels the other partner's doubt and mistrust and this leads to bigger problems. So, when I'm working with a couple who is  struggling with this problem, I strongly urge the husband not to lie about it.

Instead of arguing with your husband on moral grounds, speak to him about how you feel about yourself when you know he's watching porn.  This will involve owning your feelings and opening up to your spouse to allow yourself to be emotionally vulnerable. 

Understandably, this might not be easy when you feel hurt and angry.  But speaking from an "I" perspective about your feelings about yourself is more likely to evoke your husband's empathy and understanding so he can listen and respond without being defensive. He can also express his own emotional vulnerability so you can empathize and understand his point of view.

In addition, when you speak about your feelings about yourself as it relates to his porn viewing, it provides an opening for the two of you to discuss the underlying issues involved instead of getting into a power struggle about porn.  This can provide a better chance of making progress than getting into a power struggle.

Compare the following statements

Compare Statements 1 and 2 to Responses 1 and 2:

Statement 1:
"Porn is disgusting! I can't believe you would rather look at those women in the video than look at me."

Response to Statement 1:

"Well, that's your opinion! Stop telling me what to do!"

Versus:

Statement 2:

"I feel insecure about my body when I know you're seeing those beautiful women in the video. When I feel insecure, I feel like you would rather look at them than me."

Response to Statement 2:

"I didn't know you felt that way. I love you and I love your body. I don't want you to feel insecure. Let's try to work this out."

Statement 1, which is hostile and judgmental, is usually a non-starter if you want to have a calm and productive discussion with your spouse. Rather than responding with empathy, your spouse is more likely to respond by matching your hostility and getting defensive.

Statement 2, which is emotionally vulnerable because it reveals an insecurity, provides an opening for your husband to empathize with your feelings so he'll be more likely to address the issue in an open way.

Statement 2 also allows for the possibility that the two of you could talk more openly about your sex life to try to improve your sex script if it has become repetitive and boring (see my article: How to Talk to Your Partner About Sex).

If you object to mainstream porn because you think it's immoral or degrading to women, you might want to consider ethical porn which is usually made by feminist women with women's pleasure in mind. If you enjoy it, you and your partner could watch it together, which you both might enjoy.

If you object to all pornography--both mainstream and ethical porn--then you and your spouse can talk about reaching a compromise about it--just as you would about any other issue that you both disagree about--without power struggles and volatility.

If you can't stop the arguments and power struggles, consider seeking help in sex therapy.  

A skilled sex therapist, who works with individual adults and couples, can help you to develop the necessary skills to talk about this and get to the underlying issues involved so these issues can get worked through.

Note: Most couples therapists aren't sex therapists so they don't have the training and skills to work with this issue.

Get Help in Sex Therapy

If you and your spouse get stuck in power struggles about porn, you can seek help from a licensed mental health professional who is a sex therapist.

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?).

There is no nudity, physical exams or sex during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Individual adults and couples seek help in sex therapy for a variety reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help from a skilled sex therapist so you and your partner can have a more fulfilling life together.

Book: You might also find it helpful to read His Porn, Her Pain: Confronting America's PornPanic with Honest Talk About Sex by Marty Klein, Ph.D., Sex Therapist.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, IFS, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

I offer a free 15 minute phone call before setting up an appointment.

I see clients in person in my office in Greenwich Village in New York City and online.

You can reach me at (917) 742-2624 during business hours or email me.