One of the most common difficulties that bring couples into my practice is the extinguishment or disappearance of passion, lust, desire, or yes, even love itself. Often these couples have gone years (yes years) sinking ever further into a deeper rut of feeling like they are living with a platonic friend or roommate, but not a lover. They may have gone months or years without having sex. Indeed, research shows that about 1 in 7, or about 15% of long-term couples are sexless (meaning no sex in the last six months). When I ask these couples to describe their daily habits, they often describe lots of intimate behaviors such as holding hands, kissing, engaging in various activities together, and even sleeping together in the nude. But no sex. They describe loving each other, but not “being in love,” meaning no longer experiencing that lustful attraction that comes with passionate love.

In my experience, the success of turning things around and rekindling desire depends on a number of factors. First, how long has this relationship been passionless? The longer the couple has been alienated, the harder the task becomes. In addition, there are a number of contextual factors to consider. For example, how much resentment has piled up? Resentment, as I’ve written about before, is one of the most toxic and corrosive emotions within a relationship. It’s a combination of anger and entitlement, which leads to contempt. Indeed, contempt, along with criticism, defensiveness and stonewalling, is one of the four key factors that research has identified as predictive of negative outcomes in relationships. As a result, resentment needs to be weeded out right away before it has a chance to build roots. Those relationships with deep-seated resentment face greater challenges in rekindling desire.

Another consideration is how separate each partner’s life has become. Some individuals have checked out, and have created a parallel life to their relationship in which their partner does not participate. According to the developmental model of couples’ theory, in which I was trained, this individual is in the midst of the practicing stage, meaning he or she is practicing their individuality outside of the scope of the relationship. Now, this is often a needed and healthy stage of a relationship’s development (and of course every individual needs their own space and to preserve their own individuality) but sometimes folks get lost in this stage, and instead of embracing their differences as a means of enhancing the relationship, they just drift further and further away until there is nothing left keeping the partners together.

With all that said, I counsel my couples to always be mindful of keeping the lover role intact. When they first met, they met as lovers. But then, over time, life kicks in, and other obligations and responsibilities become prioritized, such as work, kids, family, etc., and so in effect, each relationship takes on more and more additional roles, crowding out the lover role until, for some folks, it is completely gone. And that’s the key element to determine: Is there anything left of the lover role? If there is at least a little dot left, we’ve got a chance. But once gone, it’s gone forever.

So let’s take a look at a few examples of how I work with relationships where some of the lover role is still present, even if smoldering somewhere in the embers. The first thing I want to do is to take the focus away from sex, as that is usually the elephant in the room that creates pressure and anxiety. Instead, I want to help this relationship get in touch with elements of being lovers that they may have long ago abandoned, such as creativity and spontaneity. Usually these folks are so burdened by responsibility and acclimated to the grind, that their life has become as predictable and “workman like” as a grandfather clock. There is no passion or desire in that sort of precise mundanity. I’ll often ask, “When was the last time you went on a date?” and I know that the lover role has been completely buried when I get blank looks back.

I’ve written before on how I use menus to help partners explore their sexualities together, and indeed an entire section of Chapter 10 in my book, Modern Sexuality, is on that very topic. But I also use menus to create spontaneity outside of the bedroom. I’ll have both partners make a list of things they are very interested in doing, somewhat interested, and not interested in all, and then I have them compare lists and negotiate activities. Sometimes this jump starts some sort of romance, sometimes not. But this one of the first things I look at, because even if this intervention is unsuccessful, it is still diagnostic in that it provides me more information about the couple. If they can’t even plan a date, we’re a long way away from sex.

In these cases, a number of other factors have to be resolved before the couple can even get to the sex part. They may come in thinking that the only thing missing is sex, but discover that they are not even communicating on an appropriate level, and have even lost track of knowing who their partner has become. Sometimes I need to spend weeks or months helping a couple overcome their communication and relational (such as resentment) barriers before we can even begin to address anything sexual. This is why, as I’ve written about before, all sex therapists need to be good couples therapists. But yet, even if communication and relationship issues get resolved, the sex doesn’t always return. These would be the cases in which that lover role has completely disappeared. This could be through the neglect I’ve described in this article, or sometimes people have grown so different, they just fall out of love.

Love is not an entitlement, it has to be carefully nurtured and cultivated. And even still, it may only have a specific time limit, flowering when people find each other at the right moment, but dying as these same folks drift apart through the passage of time. I go through a very thorough checklist of specific interventions tailored for the needs of each relationship, and I exhaust every possibility, and I have helped a number of couples revive desire and love, but sometimes it is just gone and it is impossible to resurrect the dead. In these cases, I allow my clients to come to their own conclusions, and when they are ready we then need to face the existential aspects of deciding to stay in a passionless relationship or ending it with grace and intentionality. Fortunately, folks often don’t need to choose between binary options, as there’s a number of relationship structures, styles, and agreements that they can entertain. For more on this, check out my article on Working With Relationships in Transition or for a concise list of many of my articles about couples’ and sex therapy, take a look at my article Common Issues in Partners’ Sex Therapy.