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Time to Talk About Sex and Chronic Illness

Couple lying in bed touching noses

Awkward topic, isn’t it? It’s not an area we usually delve into with great confidence or pride.  For those of us with chronic illness, the topic of sex can bring up a whole host of emotions: fear, hurt, guilt, sadness, feelings of inadequacy and disappointment. Sure, there are moments of great passion and pleasure but those seem few and far between when our illnesses flare or we’re too exhausted from the events of the day. Adding to the complexities of sex for the chronically ill are the myriad of side effects from the many medications out there intended to ease our pain and discomfort.  Many stunt our desire for sex or leave us way too tired to even think about a night of romance.

So just how crucial is satisfying sex to a healthy marriage? It turns out that good sex is important but not central to happy relationships. According to sex educators and researchers Barry and Emily McCarthy of American University in Washington, D.C.happy spouses attribute only 15 to 20 percent of their happiness to a gratifying sex life, while unhappy partners claim 50 to 70 percent of their marriage woes are due to sexual problems.  Satisfied partners see sex as one of many sources of pleasure and intimacy, while unhappy partners focus on sex and often view it as the primary cause of trouble.

Why is sex such a big issue for dissatisfied spouses? Because sex is usually the first thing affected when a relationship breaks down.  It’s not the real problem though.  According to psychologist Dr. Sue Johnson, what’s really happening is that a couple is losing connection; they don’t feel emotionally safe with each other.  That in turn leads to decreased desire and less satisfying sex, which leads to less sex and more hurt feelings, which leads to even weaker emotional bonds and around it goes.  To put it simply: no safe bond, no sex; no sex, no bond.

What’s a chronic couple to do? First, understand that a strong emotional connection and satisfying sex go hand in hand; they feed off of each other so to speak.  Emotional connection creates fulfilling sex (whatever that means to you) and fulfilling sex creates deeper emotional connection. When spouses are emotionally available and engaged, sex becomes a deeply enjoyable adventure.  They feel free and confident to explore and fulfill their sexual needs as well as share their longings and vulnerabilities.

Second, many chronic couples place too much emphasis on performance as if it were the only measure of intimacy.  In actuality, touch is the “royal route into love relationships.”  Our almost eighteen square feet of skin is the largest sense organ we have.  Touch brings together two fundamental drives: sex; and our need to be held and recognized as special by our significant other.

If your sex life is fraught with conflict and performance issues, why not abstain from sex for a while?  For some of you, this could mean weeks or months. With sex forbidden, anxiety and disappointment wane and you can both concentrate instead on exploring all the sensations of touching.  According to Dr. Johnson, getting used to asking for tender touch deepens a couple’s bond, and knowing one another’s bodies more intimately, what moves and pleases each other, becomes a precious part of a couple’s “only for you, only with you” connection.

Connecting and reconnecting, falling in love again and again, and the resulting passion is essentially play and the ability to “let go” and surrender to sensation.  For both of these, we need emotional safety.  In fact, a recent survey on sex in America by Edward Laumann of the University of Chicago shows that married partners who have spent years together and built up emotional security have more frequent and more satisfying sex than non-married folks.

Most of us married long enough know that passion is not a constant.  Desire naturally waxes and wanes with events in our lives and most especially with our health.  These fluctuations, however, hit a nerve in most of us, and unless we can talk about them openly, can easily spark or heighten relationship problems.

Many partners can tolerate infrequent sex, but they cannot tolerate feeling like their spouses do not desire them.

We used to think that thrilling and passionate sex and a safe, secure relationship were mutually exclusive.  Now we know that secure relationships are the foundation of a healthy and satisfying sex life.  Keeping your physical relationship responsive and engaged helps keep your emotional connection and desire strong. Do you feel that you do enough touching and holding in your relationship?  A single stroke can express connection, comfort and desire.  When would you like to be touched and held more?

Please leave a comment and share your thoughts!

Content for this post has been adapted from the book Hold Me Tight by Dr. Sue Johnson, founder of Emotionally Focused Therapy.

© Copyright 2011 by Helena Madsen, MA All Rights Reserved.

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  • Susanne August 4th, 2011 at 2:32 PM #1

    Funny how when something is good it can lead to so many other good things in life. But when something like the sex in a marriage is bad that seems to be the only thing that the couple can harp on and then it is sure to break everything down even worse. I am not sying that sex has to be the core of a marriage, but good sex never hurts in the way that bad sex does.

  • Lynne Silva-Breen, LMFT August 4th, 2011 at 5:34 PM #2

    Awesome post Helena! I wish every couple in marriage therapy could appreciate the truth of everything you said.

  • j anderson August 4th, 2011 at 6:54 PM #3

    if an illness is not letting you enjoy your sex life to the fullest,dies it mean the relationship should suffer?!no.it means you need to find other ways to keep each other bonded and connected.and the author gives a very good technique in the post.thank you for the post.

  • ross August 6th, 2011 at 9:12 AM #4

    dont know anybody with chronic illness but then for those with it-even the folks without any chronic illness have lows in their sex life,it’s my like it’s perfect for us either,everybody has highs and lows in their sex life.so enjoy your in whatever way you can! :)

  • darlene phelps August 7th, 2011 at 7:16 PM #5

    Massage is a wonderful way of keeping that feeling of connection going when either of you is experiencing a lack of libido or just too tired. I agree that touch can be more important than sex. We all want to feel desired and to share intimate moments. I can enjoy a good massage more than sex sometimes because it relaxes me.

  • Case August 8th, 2011 at 4:42 AM #6

    I am sorry, I know that sex can be wonderfully healing, but I have had friends who have gone through chemo pr whatever and I can tell you that none of them ever looked up to having that kind of intimacy while going through this. This is something that is ravaging your body on the inside and out, and probably the last thing that you feel like doing is getting all warm and cuddly with someone. I know that sex is important in a relationship but there are other ways to bond when going through a terrible illness.

  • D.M. August 9th, 2011 at 10:22 PM #7

    Whenever my husband is within arm’s length of me he always reaches out and touches my arm or my back or something, usually unconsciously while he’s talking. I can be standing at the stove making dinner and he’ll come by and give me a quick cuddle as he’s passing. That means the world to me.

  • Adrienne Rice August 9th, 2011 at 11:19 PM #8

    There’s so much more to a great marriage than sex alone. And I hate the word sex. It’s cold and doesn’t reflect what it should be about: making love is a more fitting description. When sex isn’t an expression of love but sex for sex’s sake, it’s never that good.

    Although we make love less frequently now because my husband’s illness leaves him physically and mentally exhausted, I don’t mind a bit because he shows me in other ways he still loves me with little touches like holding my hand or always kissing me first thing in the morning and last thing at night every day.

  • Tammy Dent August 11th, 2011 at 5:12 PM #9

    Couples get out the habit of small demonstrations of affection, especially as they get older, and it’s sad. My girl friends often comment on how their husbands don’t even take their hands anymore when they are out and how loving mine is towards me. Just because we’re middle aged doesn’t mean we need to stop.

  • Bruce December 4th, 2013 at 8:10 AM #10

    But you have many different sex partners Tammy! You just want me as a friend? How is that right?

  • LISA December 21st, 2013 at 9:47 AM #11

    I happened to google sex and chronic illness and found this post. I am the one with chronic illnesses and feel all the emotions you stated. I am struggling but your post has made me think differently. Thanks!

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