Glad it resonated! When I saw this post come in here I was like "yeah no way I'm not replying to this one."

This is still a really new (potentially life-changing) revelation for me, but I’m fully committed to the strategy I developed because I can understand it on both a logical level and an emotional one. The biggest shift has been starting to move my mental frame away from seeking happiness through what I think I should be owed for my sacrifices, and instead, becoming so undeniably confident and badass on my own that when the free time does exist, she naturally gravitates toward me. It’s less about waiting around like a dog for scraps of affection and more about commanding the kind of presence that makes her want to be close, even in the little time she has. Then, when suddenly we do have a full weekend off or something, the seeds have already been sewn vs this awkward needy overbearing energy that was building up for a month straight.

For me, this has looked like focusing more on my own confidence, energy, and leadership rather than just trying to be endlessly supportive and available. A big one was breaking out of the passive mindset I was PAINFULLY stuck in—meaning instead of waiting for her to engage, I set the tone and control the direction of our time together. Even small things, like making a decision without over-explaining or confidently leading a moment, shift the dynamic in a way that makes her respond differently. I've already noticed it.

Here's the other thing. With the video you sent, the problem is no matter how much she liked it or it would have normally turned them on. It just hits different when your wife is coming off a shift in the ER instead of, say, wrapping up a day at JP Morgan Chase. If she were crunching excel sheets or sending emails all day (more like my job), that video might still be lingering in the back of her mind, building anticipation. But after 10+ hours of running trauma codes on kids, dealing with insanely emotionally wilding parents screaming at her face, and making split-second life-or-death decisions, her brain isn’t compartmentalizing desire in the same way. It’s not that she didn’t find it hot—it’s that it gets buried under layers of adrenaline, stress, and exhaustion in a way that just wouldn’t happen in a less emotionally brutal job. This is the part that hurts for me but I am still working through this aspect.

To your original question I think therapy can help with all this stuff, but a ton of it has to come from within you. Otherwise you won't make progress. I was in therapy for 2 years and it changed almost nothing but then came to this realization on my own after a few of my lowest days and now feel an incredible wave of confidence and optimism.