How To Navigate Sexual Mismatch and Rebuild Intimacy | Dr. Jordan Rullo | #154
Sexual intimacy is often treated like a mysterious switch: flip it on with novelty, and everything clicks. The conversation with Dr. Jordan Rullo shows why that belief keeps couples stuck. Desire is a system with brakes and gas, and most partners try to fix sex by stomping harder on the gas while their foot stays glued to the brake. Fatigue, SSRIs, pain, anxiety, body image, conflict, shame, and culture all pile weight on those brakes. When the engine only revs louder, you don’t move forward—you just burn out. The smarter move is diagnostic: list biological, psychological, relational, and sociocultural blockers, circle the heavy hitters, and remove what you can. Only then do “date night,” lingerie, or toys start to help.
The most liberating reframe is understanding two valid types of desire. Spontaneous desire is the media-friendly spark that feels like hunger; responsive desire is the slow warmth that appears when conditions are right. Many people panic because they don’t feel spontaneous desire and miss that they reliably feel responsive desire once touch, privacy, safety, and connection show up. If you have either type consistently, you likely don’t meet criteria for a clinical sexual disorder. If you have neither type for six months, it’s time to seek professional help. This language defuses shame and changes the problem from “I’m broken” to “let’s set better conditions.”
Desire differences are common and, in many couples, perpetual. Not every discrepancy is a crisis; sometimes it’s a temperament difference, like neat vs messy or early vs late. Acceptance matters. Treat the gap as a solvable management issue rather than a moral failing. Don’t schedule sex, which often breeds pressure, resentment, and a pattern of consensual unwanted sex. Instead, schedule connection. Protect a weekly block where you decide in the moment whether you cuddle, talk, play, or get intimate. Pressure drops, autonomy rises, and trust grows. Avoid the avoidant spiral where rejection leads to zero initiation, then less touch, then roommate energy. When you hear no, don’t punish or withdraw. Ask, “Is there another way we can connect tonight?” That response preserves safety and increases future yeses.
Medical realities also matter. Sexual function is health-dependent. Rule out medical causes early: medication effects, hormonal changes, pelvic pain, erectile dysfunction, or neurological issues. For men, erectile issues can signal cardiovascular risk; for women, perimenopause and menopause shift arousal and comfort. A sex therapist and a physician make a strong team. Ignoring biology keeps you chasing psychological fixes for a physical brake. Integrative care shortens the path to relief and reduces shame because the problem stops being “in your head.”
To keep intimacy alive, lead with friendship, respect, and trust. Gottman’s research shows erotic risk sits on a foundation of emotional safety. Small rituals are the scaffolding: six-second kisses at departures and reunions, daily stress-reducing conversations that leave the relationship out and focus on life, and a non-negotiable weekly date. Add a weekly State of the Union: share five gratitudes, repair any small hurts, ask how to feel more loved this week, and include one question about your sexual connection. Over time, these habits become the Magic Six Hours—tiny investments that compound into security, warmth, and desire.
Finally, strengthen the skill most of us never learned: sexual communication. It’s often harder to talk about sex than to have sex. Use structured tools to practice. Read Come As You Are and work through the companion workbook together. Create shared language for brakes, gas, and desire styles. When life gets hectic, return to prioritization, not perfection. A flooded basement gets urgent attention; your bond deserves the same. If a provider minimizes your concerns, ask for a referral. Sexual struggles are treatable, and help exists. Start with safety, build with rituals, talk with honesty, and tune the brakes before you press the gas.