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.

 

Experiential Therapy, Like EMDR, Helps Achieve Emotional Breakthroughs

This article was updated on September 18, 2026. 

In trauma recovery, chronic self-blame frequently functions as a unconscious psychological defense mechanism designed to maintain an illusion of interpersonal control over a catastrophic, uncontrollable event. When individuals become mired in guilt following a traumatic loss, their psyche falsely convinces them that if they had altered a single action, the outcome would be entirely different. 

While traditional top-down modalities like Cognitive Behavioral Therapy (CBT) can successfully challenge these distortions on an intellectual level, true emotional resolution often requires a bottom-up, somatic approach. Experiential therapies like EMDR (Eye Movement Desensitization and Reprocessing) bridge this gap, helping clients translate logical understanding into deep, embodied emotional breakthroughs (see my articles: Self Blame and the Internal Critic and What is EMDR Therapy?).

Deep somatic resolution: Experiential therapies like EMDR lower nervous system distress by helping the brain safely process unintegrated trauma loops and release deep-seated self-blame from the inside out.

To protect clinical confidentiality, the following scenario represents a composite case study detailing how somatic memory processing safely dismantles persistent post-trauma guilt.

The Case of Rena: When Intellectual Insight Falls Short

Rena sought psychotherapy years after her husband tragically died on September 11th at the World Trade Center. Every day, her mind trapped her in a painful, repetitive loop. She replayed their final morning together in their bedroom: her husband was coughing and hesitant about going to work, and Rena remained silent instead of insisting he stay home. That silence became her psychological prison.

Shortly after the tragedy, Rena completed a course of structured CBT. Through that work, she achieved a clear cognitive realization that she was not responsible for the attacks. However, this insight remained stranded on an intellectual level. Deep down in her core, she still carried a crushing weight of survival guilt. The unintegrated trauma restricted her life entirely; she isolated herself from her community, withdrew from friends, and spent her non-working hours sleeping. Seeking a deeper mind-body intervention, she decided to initiate EMDR therapy.

The Somatic Difference: Tracking the Trauma in the Body   

After completing foundational history-taking and establishing robust internal coping resources, we began active trauma processing. When asked to identify the visual anchor representing the most disturbing fragment of the memory, Rena visualized her husband standing indecisively in their bedroom while she stood nearby, concerned but silent.

The psychotherapeutic differences between talk therapy and experiential processing emerged immediately during this stabilization phase:

• Somatic Localization: Rather than simply talking about the memory, Rena was guided to track where the emotional distress lived in her physiology. She localized the intense grief and guilt as a physical tightness choking her throat and chest.
• Baseline SUD Assessment: On the Subjective Units of Disturbance (SUD) scale—where 0 represents neutral calm and 10 represents the maximum possible psychological pain—Rena rated her current distress at a definitive 10.
• Targeting the Negative Cognition: Her core, maladaptive internal belief was identified as: "I should have forced him to stay home so he would be alive today." Her target positive integration goal was to genuinely feel: "I did the absolute best that I could."

Facilitating the Emotional Breakthrough via BLS

Over several weeks of utilizing rhythmic Bilateral Stimulation (BLS), Rena navigated intense waves of somatic sorrow. Because EMDR prioritizes client autonomy, she was continually reminded that she held full control over the pacing of the session. Throughout the processing, she reported a distinct, sub-verbal "internal shifting"—a common neurological indicator that the brain's Adaptive Information Processing (AIP) model is actively reorganizing maladaptively stored data.

Then, during a pivotal session, Rena experienced a profound emotional breakthrough. As she tuned into her somatic felt sense, she realized the self-blame had dissolved. She was deeply sad, but she no longer felt responsible.

This somatic shift transformed her entire relationship to the tragedy:

• Gutteral Realization: The logical truth finally dropped from her head into her heart and gut. She knew intuitively that based on her husband's lifelong behavioral patterns, he would have gone to work that morning regardless of what she said.
• Dismantling the Illusion of Control: She recognized that her persistent guilt was actually a hidden psychological strategy to maintain an emotional attachment to her husband—clinging to that final bedroom scene kept him alive in her mind.
• Releasing Pent-Up Grief: Relinquishing the impossible burden of control allowed her to fully process her un-empathized grief, while safely addressing secondary layers of trauma, such as natural feelings of abandonment.

Ultimately, EMDR allowed Rena to cultivate a healthy, internalized sense of closeness with her late husband, freeing her to step out of the traumatic memory loop and return to active living. 

In trauma recovery, chronic self-blame frequently functions as a subconscious psychological defense mechanism designed to maintain an illusion of interpersonal control over a catastrophic, uncontrollable event. 

When individuals become mired in guilt following a traumatic loss, their psyche falsely convinces them that if they had altered a single action, the outcome would be entirely different. 

While traditional top-down modalities like Cognitive Behavioral Therapy (CBT) can successfully challenge these distortions on an intellectual level, true emotional resolution often requires a bottom-up, somatic approach. Experiential therapies like EMDR (Eye Movement Desensitization and Reprocessing) bridge this gap, helping clients translate logical understanding into deep, embodied emotional breakthroughs (see my articles: Self Blame and the Internal Critic and What is EMDR?).

 Ready to Release the Burden of Self-Blame?

If you are exhausted from replaying a painful memory over and over in your mind, logically knowing it isn't your fault but still feeling the heavy weight of guilt in your chest, traditional talk therapy may have reached its limits. 

True healing happens when your emotional heart and physical body align with what your brain already knows to be true. 

About Josephine Ferraro, LCSW

As an advanced trauma clinician based in Greenwich Village, NY 10011, I provide specialized EMDR, Somatic Experiencing, and IFS Parts Work in person and online to help you move past cognitive coping into profound emotional breakthroughs (see my website: Josephine Ferraro, LCSW - NYC Psychotherapist).

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

You can call me at (917) 742-2624 or email me to begin your healing journey.

Medical Disclaimer: The information provided in this article is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified mental health professional or physician regarding a medical or psychological condition.