By Anna Moochoon, LCPC
Many people come to therapy believing something is fundamentally wrong with them:
“I’ve lost my sex drive.”
“My body isn’t working.”
“I should want sex more.”
“I don’t understand why this keeps happening.”
One of the ideas that has most influenced how I understand these concerns is the Dual Control Model, proposed by researchers John Bancroft and Erick Janssen.
The model offers a different perspective on sexual difficulties. Rather than assuming they are simply caused by too little desire, it suggests that sexual response is shaped by the interaction of two partially independent systems: one that encourages arousal and another that inhibits it.
For many clients, this shift in perspective can be remarkably freeing.
Two systems working together
Our nervous system continually evaluates what is happening around and within us. Some experiences encourage sexual arousal, while others signal that this may not be the right time.
Researchers describe these as the sexual excitation system (SES) and the sexual inhibition system (SIS).
The excitation system responds to things that make sexual activity feel appealing, such as:
- Physical attraction
- Affectionate touch
- Emotional closeness
- Erotic thoughts
- Novelty
- Pleasant memories
- Sensory experiences involving sight, sound, smell, or touch
The inhibition system serves an equally important purpose. It responds to circumstances suggesting that sexual activity could be unsafe, emotionally costly, uncomfortable, or incompatible with the present moment.
These circumstances might include:
- Stress or exhaustion
- Relationship conflict
- Fear of rejection
- Pain or discomfort
- Body-image concerns
- Worries about sexual performance
- Concerns about pregnancy or sexually transmitted infections
- A lack of privacy
These responses do not mean your body is broken. They are signals your nervous system is taking into account.
Excitation and inhibition are not opposites
An important part of the model is that excitation and inhibition are not opposite ends of one spectrum. Both systems can be highly responsive at the same time.
This is something I often see in therapy.
A person may genuinely desire intimacy while also feeling anxious about sexual performance. They want to move closer, yet another part of their nervous system is urging caution.
Those experiences are not contradictory. They are two systems operating simultaneously.
Recognizing this can help people understand why desire may be present even when arousal feels difficult—or why the wish for intimacy does not always translate into a physical response.
How the model changes therapy
One reason I appreciate the Dual Control Model is that it changes the questions we ask.
Instead of asking:
Why don’t you have enough desire?
We can begin asking:
What might be increasing inhibition?
What helps your nervous system feel safe enough for intimacy?
What naturally supports excitement, pleasure, and connection?
These questions often open conversations that would otherwise remain hidden.
Someone experiencing erectile difficulties, for example, may become anxious about maintaining an erection. Their attention gradually moves away from pleasure and toward monitoring their performance.
As that anxiety increases, the inhibition system becomes more active, making arousal even more difficult. A frustrating cycle develops—not necessarily because the person lacks desire or attraction, but because anxiety is interfering with the body’s sexual response.
For someone else, chronic stress, exhaustion, or relationship distress may keep the inhibition system activated long after the workday ends. Their partner might interpret this as rejection or a loss of attraction when the person’s nervous system is simply not in a state that supports sexual engagement.
Understanding this distinction can shift the conversation from blame to curiosity.
There is no perfect balance
People naturally differ in how responsive these systems are.
Some become sexually excited more easily than others. Some have inhibition systems that respond especially strongly to stress, uncertainty, or changes in their environment.
Neither pattern is inherently good or bad.
Difficulties arise when the interaction between excitation and inhibition repeatedly interferes with the kind of sexual experiences or relationships a person wants.
The purpose of therapy is not to eliminate inhibition or maximize excitement. Both systems serve valuable functions.
Instead, therapy can help people understand their individual patterns and create conditions in which their nervous system can respond more safely and flexibly.
Replacing self-criticism with understanding
Perhaps the greatest gift of the Dual Control Model is that it offers a more compassionate understanding of sexual difficulties.
Rather than treating them as evidence of personal failure, we can recognize them as the result of a dynamic interaction between systems designed both to encourage intimacy and to protect us.
This perspective does not resolve every sexual concern. But it can change where the conversation begins.
And in therapy, changing the starting point can change the entire conversation.
Ready to begin?
If you’re considering therapy, schedule a consultation to see whether we may be a good fit.
References
Bancroft, J., & Janssen, E. (2000). The dual control model of male sexual response: A theoretical approach to centrally mediated erectile dysfunction. Neuroscience & Biobehavioral Reviews, 24(5), 571–579. https://doi.org/10.1016/S0149-7634(00)00024-5
Janssen, E., Vorst, H., Finn, P., & Bancroft, J. (2002). The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: I. Measuring sexual inhibition and excitation proneness in men. The Journal of Sex Research, 39(2), 114–126. https://doi.org/10.1080/00224490209552130
Janssen, E. (Ed.). (2007). The psychophysiology of sex. Indiana University Press. ISBN 9780253348982. Publisher page
