Desire & Intimacy
The Sexual Desire Poisons Inventory
Dr. Barry McCarthy, one of the most-cited sex therapy researchers of the last 40 years, identified seven 'poisons' that quietly drain sexual desire: anger, guilt, inhibitions, fear, obsessions and compulsions, shame, and anxiety (both anticipatory and performance). Becoming aware of the poison - and your role in keeping it alive - is the first step to flushing it out. This is the same exercise Vanessa Cushing, MS, uses with couples in her Miami practice.
Your worksheet
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Step 1 of 8
Read the seven poisons
Anger destroys intimacy and fuels sexual avoidance. Guilt lowers self-esteem and repeats the very behavior it punishes. Inhibitions (poor body image, fear of initiating, embarrassment) make sex mechanical. Fear of rejection or failure shuts the body down. Obsessions and compulsions kill spontaneity. Shame from past experiences becomes a secret that controls your sexual self-esteem. Anxiety - anticipatory ('what if it goes wrong?') and performance ('am I doing this right?') - is the most common desire killer of all.
Step 2 of 8
List your individual poisons
On your own, write the poisons most alive in you right now. Be specific: not just 'anxiety' but 'anxiety that I won't get hard,' not just 'shame' but 'shame about my body since the C-section.'
Step 3 of 8
List the couple poisons
Now name the poisons that live between you as a couple - the dynamics, not the individuals. 'We fight about housework and bring it into bed.' 'We avoid initiating because rejection hurts too much.'
Step 4 of 8
Be honest about the payoff
Every poison has an advantage, or you'd have dropped it. Anger can feel like control. Avoidance protects from rejection. Guilt can feel like accountability. Name the payoff for each poison - without judgment. You cannot let go of something whose function you do not understand.
Step 5 of 8
Imagine life without it
For each poison, write one sentence: 'If this were gone, our relationship would feel ___.' This is your motivation. Keep it visible.
Step 6 of 8
Own your role
McCarthy's core principle: you are responsible for your own attitudes and behaviors, not your partner's. For each couple poison, name what YOU specifically do that maintains it. Not your partner. You.
Step 7 of 8
Make one specific plan
Pick ONE poison. Write a clear, behavioral plan: 'The poison is anger. I will write the resentment letter I've been avoiding by Sunday. I will not use sex as the place I punish my partner. When I notice the urge to refuse touch out of anger, I will name it out loud instead.'
Step 8 of 8
Exchange and honor
Share lists with your partner. Their honesty is a gift - receive it that way. No defending, no rebutting. Thank them for the vulnerability, then ask: 'What's one thing I can do this week that would help?'
Things to remember
- Naming the poison is not the same as being the poison. You're identifying a pattern, not a personality.
- Couples who do this work together - not as opponents - recover desire faster. McCarthy's research is unambiguous on this.
- If shame, trauma, or chronic anger keeps coming up, that's a signal to bring in a therapist. This exercise opens the door; therapy walks you through it.
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