Esther Perel is a Belgian-born sex therapist who has become widely known for her speaking and teaching about sex, intimacy, and relationships. Her first book, Mating in Captivity, examined and overturned a lot of preconceptions about how to sustain emotional and sexual intimacy in a committed relationship. Her TED talk on desire (“The secret to desire in a long-term relationship”) has gotten over 11 million views online. And her new book, The State of Affairs, inspired another juicy TED talk distilling the essence of the book, “Re-thinking infidelity.”

Perel has achieved media stardom partly because she’s a strikingly attractive blonde woman with a charming European accent — I mention her photogenic personality to make the point that it combines with a sharp intellect and a gracious sense of humor to get across some very provocative and challenging ideas in a remarkably accessible way. She was recently interviewed about the material in her book on NPR’s “Fresh Air” by the ever-appealing Terry Gross. Few therapists in the public arena have impressed me so much with their sensible approach to the subject of sex and relationships.

In particular, I was struck by how Perel talked about a subject that I encounter frequently in my own practice, which is the situation where there is a big difference in libido: one partner wants sex and the other doesn’t.

Terry Gross: How do you deal with relationships where one partner desires something that the other partner isn’t willing to give? Doesn’t enjoy sex, doesn’t want it frequently, therefore they’ve become sexually incompatible. What’s your position for the partner who desires something that partner can no longer get within the marriage?

Esther Perel: If you ask about what to do with the discrepancy around desire for sex within the relationship, thinking that what people miss is the act of sex, you fail to understand what people are really asking for. Sexuality is often a pathway for connection, for intimacy, for tenderness, for sensuality. For playfulness, for power, for curiosity, for relaxation. When people are deprived of sex, it’s this whole set of feelings and experiences they are deprived of. They can have sex in various places. What they want is everything that the connection gives them. When they are deprived of that, what they experience is a depletion of energy, of vibrancy, of aliveness, of vitality. That’s what they’re yearning for. So the conversation begins not with sex but with loss. Loss on both sides. The person who is no longer interested is not so happy about that, either.

To me, this was the most interesting part of the interview:

Terry Gross: When someone no longer feels sexually aroused by your partner, is that something you feel they can get back?

Esther Perel: Arousal is one thing, desire is something else, and willingness is a third. We do not start sexually only because we are aroused and turned on. We sometimes start to be involved sexually because there is willingness. You’re not always hungry. But then there is food in front of you, and it looks beautiful, and it smells really good, and you have a little taste, and you think, “Hmm, after all, I wouldn’t mind a little bit more.” And even after you ate, you may say, “That was delicious, I wasn’t really hungry,” and you still enjoyed it. So we have multiple doors for entering into an intimate engagement with our partner. Excitement is just one of them. Sometimes you are desirous but you don’t have an arousal, you’re not turned on physiologically yet. But you have the idea, you have the wish for it, you’re in the mood. And sometimes you are excited and turned on but you’re not necessarily in the state of desire. I think we need to separate these concepts and these entry points, first of all.

Second of all, I think the more important question sometimes is: “I turn myself off…how? I shut down my desires…how?” That’s not the same as “You turn me off when…” and “What turns me off is…” That puts the responsibility only on the other person: if only the other person did amazing things it would move me. The fact is, if I’m shut down, if I’ve closed the door, you can do a lot of things but there will be nobody at the reception desk. There needs to be receptivity, an openness, a willingness, and that is the fundamental sovereignty of desire. That is something that I own. I decide if I want to open that or not. What they’re talking about is the ways they have closed themselves off from possibility of touch, of connection, of sensuality, of pleasure, of surrender, for a host of reasons that range from sexual trauma to self-criticism to lack of self-worth to negative body image to issues of self-esteem. It is those things that make us close ourselves down.

Terry Gross: Is that something you can help fix?

Esther Perel: Yes, many times. That’s the work. The work is about helping people often to reconnect with parts of themselves they’ve neglected or they’re in conflict with or that they despise. Or that they feel loathsome about or don’t feel deserving of because they gained too much weight or they haven’t performed well enough at work, because their mother left them for another man so they decided they would be all mother and they killed the woman inside of them the day they had a child. Or because their father was violent and aggressive and they don’t know how to bring together love and lust. Those are the deeper conflicts around desire and intimacy and sexuality that I work with in my practice.

I encourage you to listen to the entire half-hour interview yourself online here.  Check it out and let me know what you think.