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Sexuality and Chronic Illness: Understanding and Overcoming Shame

Updated: Aug 30

Sexual health is a critical component of overall health and well-being. Sexual behaviors stabilize our sexual identity. Sex allows us to feel confident as an individual. It ignites passion and pleasure in us and it allows us to be present with our partner. It helps us refine and stabilize our identity as a sexual human being. It clarifies the nature of our intentions as consisting of peaceable mutuality or varieties with kink and other forms of alternative sexuality. In established relationships, sexual behavior reinforces the sense that one is loved and capable of loving. But, what happens when an illness strikes? It can change everything.

In my practice, I work with people daily on reclaiming sexuality after chronic illness. When I see two partners in a relationship, I find that it is critical to help with the emotional disconnection before we work on reclaiming sexuality. The emotional disconnection is often due to guilt, shame, anger, and anxiety centered on the illness. It is critical that we learn about these emotions and how they manifest in the relationship. The ill partner feels shame about the changes in their sexuality. Suffering from a chronic illness may mean not only restricting sex but also the shame that comes with the reduced capacity in arousal. This may be the most difficult part of a chronic medical illness. Both partners may feel less attractive, less confident, and concerned about how their body works and adapts to the illness. Both partners may become plagued with anxiety due to reduced sexual activity and fear of the future.

When experiencing a chronic illness, such as fibromyalgia, multiple sclerosis, diabetes, heart disease, and cancer, some changes may be physical, such as the changes in one’s body; side effects from medication, sexual dysfunction, fatigue, and pain. Both partners may experience psychological changes like depression and anxiety. Most of all, there is constant shame around sexual ability and sexual performance. The ill partner may struggle because sexuality played a critical role in their identity prior to getting sick, and now they are covered in shame. In the past, they may have been the one who initiated sex and now the healthy partner may have to take on this sexual role in the partnership.

Let’s talk about shame and how it relates to chronic illness and sexuality. The root word for “shame” comes from the ancient words meaning “to cover”. This tells us that when we feel ashamed, we want to hide ourselves from the world. I hear this often from people with chronic illness. The illness takes over and they want to hide from everything, and this hiding triggers a lack of desire for sex. I believe that shame is a primeval emotional response that has no good place in life. Feeling ashamed makes us feel rejected and when it is severe enough, shame makes us feel that we are ultimately excluded from humankind. Shame shreds the cloth of our social relationships and it leaves us in emotional pieces. The deepest shame of all is being unloved and this can be the result of a chronic illness.

So how do we overcome shame when we are battling a chronic illness? The way we overcome this beast of an emotion is talking about it. When my clients have allowed me into their emotional world, they often share with me the feeling of being suffocated by shame. When I offer the feedback of how much courage and vulnerability it takes to talk about shame, this is where change starts to happen. The rewards of facing and overcoming shame are immeasurable. Mastery over and transcending shame reactions can open the door to a life in which we choose the kind of relationships we want and the desire in becoming a more creative and self-determined sexual being. Ultimately, overcoming shame allows us to restructure ourselves into the freeing person we have always wanted to be, and it allows us to give and accept love since love is the antidote for shame. #shame #healing #sexuality #chronicillness




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Dr. Lee

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