Is sexual desire a need or a want? Many couples seek couples therapy. While most couples do not seek out sex therapists for common sexual difficulties, such as a presentation of “differences in desire,” it is essential that couples therapist have necessary skills to address this very common sexual scenario. How do you help a couple when one person’s desire is so much higher than their partners? How do you manage each of their needs without pressuring the lower desire spouse? How do you work with the couple without shaming the higher desire spouse? How can a couple get their “needs” and preferences met while committing to an exclusive and committed relationship?