Abstract
Following Dr. Polonsky's erudite discussion of the challenges of dealing with patients with low sexual desire, I briefly present a variety of related topics: classification of expertise; a list of circumstances that clinicians can expect to encounter among patients with this problem; a reminder of the importance of trying to separate personal sexual developmental failures in classic Freudian terms from those acquired in marriage difficulties; the notion that a young couple's sexual equilibrium is a valuable, underappreciated, frequently mismanaged resource; an iteration of the human basis of psychotherapy; and an illustration of the constant private internal dialogue that every therapist has with every patient, individual, or couple.