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Boundaries, Shame, and Chronic Illness

Updated: Mar 15, 2019

When two people build a relationship, they must find a comfortable degree of intimacy, agreeing on how deeply to share feelings, how much time to spend together, and how to openly express affection. We observe a continuum of degrees of intimacy in relationships. Intimacy is not a static concept, so that you and your partner can travel through different stages of closeness over time. When you both have the optimal balance between intimacy and autonomy, your boundaries touch yet remain distinct. Both are aware of each other’s needs and emotions. But what happens when an illness strikes? As a couple, your previous success in resolving intimacy issues will determine how well you cope with the an illness. During the crisis period of an illness, you may have the tendency to oscillate between more extreme points of the intimacy range. On the attempt to support each other, you may begin to violate each other’s autonomy. But there is hope. There is a “new normal” that has to emerge for the partnership to work and this starts after the acceptance of an illness. Illness can make you vulnerable to fear, loss, and loneliness. Taking time to communicate and to reduce the impact of the illness on intimacy is the key to maintaining happiness despite health problems. One part of that intimacy is sexuality. Your unspoken agreements can help or hurt as the both of you undergo the stress of illness.


What About Shame?


Shame, sex and chronic illness? It is not talked about in our culture. But, it is talked about in my office on a daily basis. When I work with a couple who experience chronic illness, the ill partner feels shame about the changes in their sexuality. Suffering from a chronic illness may mean not only restricting sex but also experiencing a reduced desire for sex. We know there are a lot of negative messages around sex, pleasure, and eroticism. I remember as a child being told by my teachers that sex was dirty. Well that only made me more curious about it. Growing up with negative messages, being disabled or becoming chronically ill can add another layer of shame. So how can we access pleasure without shame? Well, it goes back to the idea of acceptance. We know there is no cure for a chronic illness, but when you are able to accept an illness and take the steps to learn how to live well with it, you can address, process, and if possible free yourself from the messages and conditioning that you have internalized for many years. Learning to integrate the illness into your lives can make the sexual energy between the both of you stronger and more powerful! Intimacy requires vulnerability and when you are able to work through and not around the roadblocks of a chronic illness, you both are able to discuss the sexual issues and you can explore a new sexual theme together.



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Dr. Lee

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