Sex Therapy Advanced

Desire: Brakes & Accelerators

A sex therapy worksheet based on the dual control model that helps clients map their sexual accelerators and brakes, identify common inhibitors and plan small changes to share with a partner.

1-page fillable PDF · US Letter (prints on A4) · Dual control model

Key facts

Approach / concern
Sex Therapy
Technique
Dual control model
Format
Fillable PDF, 1 page (US Letter / A4)
Access
Advanced plan
For
Licensed clinicians to use with clients
Updated
October 2026

What is the Desire: Brakes & Accelerators?

The dual control model, developed by Bancroft and Janssen at the Kinsey Institute, proposes that sexual response depends on the balance between a sexual excitation system (accelerator) and a sexual inhibition system (brakes). Emily Nagoski popularized this framework, helping many people understand that desire is context-dependent.

Why it works

Understanding individual differences in sexual excitation and inhibition helps explain varied sexual responses and reduces self-blame (Bancroft & Janssen, 2000). Focusing on easing brakes, such as stress and relationship conflict, can be more effective than trying to force desire.

When to use it

  • Low or mismatched desire in couples
  • Desire changes after childbirth, illness or menopause
  • Sexual anxiety
  • Psychoeducation in sex therapy

How to use it in session

  1. Explain the accelerator and brake metaphor.
  2. Have each partner complete the sheet individually.
  3. Explore common brakes without blame.
  4. Identify small, realistic changes.
  5. Share and discuss in a couples session.

Clinician tips

  • Normalize responsive desire, which emerges in response to intimacy rather than spontaneously.
  • Screen for pain, medical and medication factors.
  • Keep the conversation curious and non-judgemental.

Worked example

Accelerators: feeling rested, laughter together, slow affection. Brakes: mental load, unresolved arguments. Plan: share the evening routine so I’m less depleted; schedule a no-pressure date night.

Sharing with clients

Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.

Frequently asked questions

What is responsive desire?

Desire that emerges in response to pleasurable context or touch, rather than appearing spontaneously beforehand. It’s common and normal.

Is low desire a problem that needs fixing?

Only if it causes distress for the person or relationship. Many differences in desire are normal variation.

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.

Nagoski, E. (2015). Come as you are: The surprising new science that will transform your sex life. Simon & Schuster.

This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.