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Chronic Illness and Sexuality: What Do You Mean I Can’t Have Sex?!

Updated: Oct 6, 2018

Imagine going to a doctor and he or she informing you that you will never have an intimate relationship due to your chronic pain condition or illness. You leave the office feeling like a ton of bricks hit you leaving you feeling hopeless…..


I have been treating the psychological factors associated with chronic pain and illness for 6 years. I became interested in this work when I was previously employed as a geriatric psychotherapist at a local community mental health clinic in the Hampton Roads region of Virginia. However, not all of my clients with chronic pain and illness were elderly. I remember some of my clients coming into my office and informing me their medical provider told them they would most likely lack the desire and/ or the arousal for sex due to the severity of their illness. I was stunned and my clients were in despair. Since working with clients who experience chronic pain and illness, research in this area has been halted by a societal taboo that supports the idea that patients with a chronic illness are not “sexual beings”. Well, I beg to differ!


It is critical to note that the relationship between the client’s illness and sexuality is not inescapable, meaning not every person with a specific illness will experience the same problems. However, the illness may impact the client’s physical condition, resulting in problems associated with intimacy and sex. When treating chronic pain and illness, there is this idea that acceptance is needed. Once the individual or the couple is able to accept the chronic condition, meaning not only the acceptance of the diagnosis, but also the course of treatment, complications and limitations, there is this process in moving forward where we can address intimacy and sex. This process can take, weeks, months or even years! This is difficult because when a diagnosis of a chronic illness is confirmed, there is this unexpected responsibility where the individual is no longer in a relationship with a healthy partner he or she chose, but to a partner with an illness. The partner with the chronic illness feels hopeless, guilty, and unwanted.


As clinicians working with individuals and couples who are impacted with chronic illness, Bender and Gianotten, two researchers out of the Netherlands inform us that we want to validate and revalidate sexuality. It is common for individuals with chronic pain and illness to experience a lack of desire for sex. Therefore, in using validation, the goal is to help the client gain a positive view of their possibilities as it relates to relationships and sexuality. I ultimately work with the client on the development of a positive sexual identity, meaning the client can achieve a level of functioning given the limitations of their illness.


Example:


I had a client who was diagnosed with diabetes mellitus Type 1 at the age of 6. He spent most of his life growing up feeling uncertain about relationships and sexuality. As a child, his parents were extremely protective and kept him home often isolating him from the world and with his peers. After processing his sadness and anxiety at the age of 28, he became more confident of a partner relationship seeing sexuality as a part of his life. When working with our clients, we want to revalidate sexuality. This is used when sexual development occurred prior to the onset of the illness. The goal here is to help the client or the couple overcome the sexual limitations they experienced prior to the diagnosis. I find the objective is to help the individual or couple cope with the changes and regain a positive sex life.



Example:


I worked with a couple where the wife was diagnosed with multiple sclerosis (MS) at the age of 30. Prior to being diagnosed; she and her husband had a healthy and vibrant sex life. They reported having sex 3-4 times a week. After having issues related to the illness, which included a significant amount of sexual dysfunction, the couple completely stopped having sex. I then worked with the couple to revalidate their sexuality focusing on what was still possible instead of what is no longer achievable.


Using validating and revalidating sexuality can be used as a skillset in addressing the attitudes toward sex and can provide the individual or couple with tools on how they can overcome the barriers that prevent them from receiving pleasure.




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Dr. Lee

PHILLIPS

2001 Richmond Highway Suite 1201 Arlington, VA 22202

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