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Chronic Illness....It is just not about the pain. What about sexuality?

There is so much more associated with chronic illness than just the pain. Pain causes significant emotional distress. This includes depression, relationship problems, sexual dysfunction, anger, and anxiety. Most individuals with chronic illness are plagued with constant worry because of all the uncertainty of what may come in the future. This happens particularly with dynamic illnesses, which are those illnesses that generate cycles of relapse and remission. An example of this would be fibromyalgia and multiple sclerosis. Psychotherapy is now the cutting edge treatment for chronic pain. It can be a place to process your feelings and emotions centered on the pain and illness. This process also allows you to be heard.


So what about sexuality? Sexual satisfaction is important for a partnership. And when I say this, I mean you do not have to reach an orgasm to make it fun and exciting. There are many things partners can do for pleasuring. When battling a chronic illness, the goal is to look at what is possible as opposed to what was once achievable. It is diving deeper into the "new normal" of the partnership. Care for physical health and health behaviors are both an important dimension for sex. The body is the foundation for sexual functioning and psychological well-being. Because illness is a significant enemy of sexual function, wellness is critical. With recent medical advances, sexual function may be facilitated with medications and devices. These can be integrated into the couple's sexual style and cannot be "stand alone" interventions. I always suggest to my clients that relaxation is the foundation of pleasure and function.


Pain causes the body to tense up; therefore, relaxation skill building is a major way of helping the couple relax when we see emotional distress in the partnership. Although it may seem counterintuitive, physiological, psychological, and interpersonal relaxation form the basis for sexual function. Individuals and couples may worry that relaxation can cause arousal problems, but in fact, physical relaxation and the focus on pleasure facilitate easier and more reliable arousal awareness of the value of sensual relaxation as a couple also accentuates the importance of psychosexual skills. Mindful attention to relaxation is an anti-performance strategy via calm cognitive focus on bodily sensations. This serves to redirect focus from "spectatoring" to physical relaxation and sensual pleasure. I do want to add that if you are in a relapse phase of an illness, you may not have sexual desire. This is when communication between you and your partner becomes paramount. When facing an illness and if you are in a remission phase, relaxation ameliorates performance pleasure and anxiety, and this can lead to a powerful source for comfort, pleasure and intimacy.




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Dr. Lee

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