Burnout Kills Your Sex Drive. Dr. Kate Balestrieri Explains How to Get It Back.

WHEN IT COMES to long-term relationships, we often hear that sexual desire can have its ebbs and flows. There are moments of fiery passion and connection, followed by stretches where the idea of having sex feels distant, even laughable.

While this is totally normal, what happens if you find yourself yearning for more sex—but your mind and body seem at odds? How do you reconnect with your erotic self and start to feel desire again? And how do you rebuild trust with a partner after facing betrayal? These pressing questions are tackled by Dr. Kate Balestrieri, Psy.D., CST, founder of Modern Intimacy, in her new book, What Happened to My Sex Life? A Sex Therapist’s Guide to Reclaiming Lost Desire, Connection, and Pleasure.

With over 15 years of clinical experience, Dr. Kate has dedicated her career to helping individuals and couples navigate the intricacies of their sex lives. In this interview with Men’s Health sex columnist Zachary Zane, she shares her expertise and perspective on overcoming some of the most challenging obstacles to sex, eroticism, and intimacy.

ZACHARY ZANE: In the book, you talk about how we often pathologize people who have “low desire,” especially women. So, what is a better way to reconceptualize having low sexual desire?

KATE BALESTRIERI: Desire is subjective, right? One person’s low might be another person’s high. So, I think it’s important to understand that desire ebbs and flows over time throughout our lifespan. Also, “low” suggests it is being measured to someone or some norm. It’s really important to remember there will be moments when desire is more or less important to you—so, thinking about “low desire,” I think about where you want to be and what feels like a meaningful amount of desire you want to have. And how big is the chasm between those two things? And if you want to be more sexual, then maybe there’s a process to bring yourself back into a sexual connection.

ZZ: This is something I’m currently struggling with personally. My sexual desire is lower than it’s ever been, but also, being a highly sexual person has become a part of my identity. Like, I have a memoir called Boyslut. Which leads me to my next question: Can you talk about erotic identity, first by defining it?

KB: Your erotic identity is how you see yourself as an erotic person. So, a lot of folks define their erotic identity through the desires that they have, the kind of sex that they want to have, the people they’re attracted to, or what it means to be embodied and feel pleasure.

ZZ: You talk about how there’s often this cognitive dissonance between desire and erotic identity. What’s going on with that?

KB: For many folks, the things that they find erotically interesting or arousing are things that they have been conditioned to believe someone “like them” should not want. And I’m saying “like them” in quotation marks because we already do a lot of othering in our world. Someone is met with this dissonance when they believe people “like me” should or should not want these things, but I want these things. Can I be myself? Can I integrate that part—those fantasies—into myself without fundamentally changing who I am, or how I’m received in the world? And we see a lot of this coming up when people have to negotiate their erotic fantasies, play, and desires when the in-groups that they belong to or want to belong to basically say “those things aren’t acceptable here.”

ZZ: Yeah, absolutely.

KB: So it creates a lot of conflict for folks in their relationships but also within themselves, right? “I shouldn’t be someone who likes this.” We “should” ourselves so much sexually, and then we end up keeping these fragmented parts of us cut off and away from our experience, consciously or unconsciously, which means that our desire might not be in full force because we’re depriving ourselves of the parts of sex and eroticism that turn us on, so that we can fit into an idea of who we think we should be to be included in a group that we want to be a part of.

ZZ: And hiding this aspect of yourself through compartmentalization takes an emotional toll over time.

KB: It does. It creates a lot of shame, too, and shame can shut people down sexually.

ZZ: The book also explores how it can be challenging to trust a partner, especially for survivors of sexual assault or for people who’ve had previous partners lie and betray them, say, with infidelity. How can you help find that balance between knowing, “Okay, I know this is my own shit I need to work on and unpack,” but also, “I do need additional support from my partner to help me to work on this.” In essence, I’m asking how do you find that balance of, this is a me issue but it can only be resolved through us?

KB: I love that you phrased the question that way, because when we have relational wounds, we can only do so much of the healing as an individual. Part of the healing that we need to do has to happen in relationships. So it’s important that we take responsibility and accountability for the woundedness, which was not our fault, but that is our responsibility to address and heal. So, it’s important to think about what are the things that I can do for myself to lean into the growth edge that feels accessible to me, where can I ask for support, and how can I start to build trust with someone when my survival system says I shouldn’t trust anyone, or maybe not this person who previously hurt me?

ZZ: Absolutely.

KB: It’s a question of identifying your needs in that relationship, and what kind of tangible support would allow those needs to feel met? And then, can you bring that out into a conversation and let your partner show up for you? Now, if they don’t, that’s information. You can fine-tune it; you can renegotiate, but relying too heavily on a partner to do that inner work creates a dependence on someone else for our sense of safety and trust when really we can’t control other people’s behavior. All we can control is how we show up for ourselves and how we show up for other people.

ZZ: Since we’re discussing dependency, you talk about enmeshment and how that can cause problems. So what is enmeshment, how is it developed, and why is it an issue?

KB: Enmeshment is a phenomenon that occurs where there is too little differentiation between one partner and another. We often think about enmeshment through the lens of parent-child relationships, where a parent doesn’t necessarily know where they stop and their child starts. So, it’s a very boundary-less relationship. It can feel intrusive. There can be the demand for a lot of groupthink in those dynamics, so with a partner, it can look like the two of you not having solid boundaries and not having enough independent psychological space to be yourself. Enmeshment requires very little space between you and me, so the “we” becomes almost like this blurry amoeba-like mishmash of two identities. That is a pattern that can sometimes feel familiar and safe for people in some ways, but it really does eclipse a lot of eroticism because there’s not enough individuality, individuation, or differentiation for you to bring unique things and texture to the relationship.

ZZ: You’re also mirroring a relationship you had with a parent, which was not erotic, or at least it shouldn’t have been.

KB: Yeah, and that can engender a lot of avoidance and pushback. If somebody’s parent was very intrusive and enmeshed, it can create a fear of being connected to someone, which means there might be some push-pull dynamics going on, or there might be a lot of needs for independence declared, but steps not taken to create that independence.

ZZ: Ah, so it can manifest in either an anxious or an avoidant attachment. I’m anxious, and now we have to do everything together the way I’m used to, or I don’t want to have the type of relationship I had with my mom, so I’m taking a big step back.

KB: It’s also a flaw deriving from the patriarchy because when you have men who have been conditioned not to be emotional, then they’re emotionally distant and avoidant, but their partners need that emotional connection, and so they lean on their kids for that, and the cycle continues.

ZZ: Changing topics slightly, I want to talk about how burnout impedes sexual desire.

KB: Yeah, it taps your energy right out, and it puts the body in a state of depleted survival strategy. So you’re depleted because you’re constantly in a state of trying just to get by and survive when you’re overburdened and under-resourced. The body does not give energy to things unnecessary for survival. Desire and sex are not necessary for survival. We need things like sleep. We need restoration. We need collaboration and partnership or community to ease our burden, which creates more room for people to be in their bodies in ways that feel good.

ZZ: Then there’s something related to burn-out: compassion fatigue.

KB: Yeah, so compassion fatigue comes up a lot in the context of people in the helping professions [e.g., therapists, doctors, teachers, nonprofit workers, etc.]. And this can also include caregivers for a loved one, or I think about parents all the time in this space, too, because the caregiving is nonstop.

ZZ: It never ends when you’re a mom.

KB: But what happens is we go into a state of distress, and if we don’t address the distress, then we move into a space of burnout where we have anhedonia and fatigue. When we do give ourselves permission to recalibrate, we can usually bounce back and find our zhush again. But if we don’t, and that burnout goes on and on and on, what ends up happening is it morphs into something that is systemically imbalanced and really difficult to heal with a vacation. Because compassion fatigue is the body’s state of being so over-extended, we lose the ability to have compassion for ourselves and others. We can go numb and feel very disconnected. We lose some capacity for empathy, which means you are fried beyond the point of fried. And so if you’re a caregiver or somebody in a healing profession, that’s pretty dangerous for you to give when you’re just so beyond that point of no return. It usually requires bigger lifestyle changes and a longer period of time in those lifestyle changes to really get your sense of energy and power and connection in your body back.

ZZ: So if you see it coming on, you should take action sooner than later—don’t just push through another year—because once you’re knee-deep, it’s much harder to get out of it.

KB: The recovery can be really long if you don’t take care of it sooner rather than later.

ZZ: Last question: If you could leave readers with one takeaway from your book, what would be that fundamental kernel?

KB: What I would say is that having a sex life that you feel really alive in is a practice. It is not something that you just arrive at. It is something that requires inner cultivation and relational cultivation. So, give yourself permission to grow and evolve in your relationship with sex—in the same way you might give yourself permission to grow and evolve professionally or in other aspects of your life. Your relationship with sex is going to change as you change. So, opening up your mind to what sex can be and not “should” be is a really important step in creating volition, excitement, and permission to be sexual in a way that is meaningful to you at this moment in your life.