Sexuality and Intimacy - Lisa Donley
Lisa Donley has run the Psycho Social Services for Breastlink for the past 10 years. She has provided huge support and helped devise useful and practical solutions for our patients and their partners and families.
"For it was not into my ear you whispered, but into my heart. It was not my lips you kissed, but my soul." Judy Garland
There are many obvious challenges resulting from a breast cancer diagnosis. One of the most compelling surrounds intimacy and sexuality. Because there are so many factors which impact intimate and, more specifically, sexual satisfaction, we encourage each patient to actively pursue intimacy in a manner that feels appropriate to her at each stage of diagnosis and treatment. The first step in this process is to identify how each patient feels about herself, not only in her altered body image but also how she thinks and feels about the integrity and meaning of her journey with breast cancer, her self-esteem and sense of self-worth. Intimacy requires self-disclosure – the experience of being able to “stand naked” –physically, emotionally, mentally and spiritually, first with self, and then with a partner.
Each patient must answer the question: “How has breast cancer impacted on my sense of myself as a whole as well as my sense of my sexuality?”
Each partner must ask: “How has the experience of loving my wife/partner with breast cancer, altered me as a person and challenged my ability to be intimate, not only sexually, but emotionally, mentally and spiritually?”
The answers to these questions form the relationship foundation for the ongoing “post-breast cancer” partner-to-partner dialogue which is essential to reclaiming intimacy and which is the prelude to sexual contact. Having identified the manner in which the cancer diagnosis has impacted on her relationship to self, each patient will then decide how and in what manner she approaches her partner with her concerns and desires. Each partner will also identify the changes in themself and their partner and have the opportunity to choose how and when they initiate dialogue around their concerns and desires. Because intimacy is as unique as each person, there are an infinite number of ways for patients and their partners to reclaim and renew their intimacy after breast cancer.
Critical junctures and questions in the process of intimacy renewal include:
- The patient pre-diagnosis feelings about her body and sexual satisfaction.
- The patient’s post-diagnosis and treatment feelings about her body and the impact on her ability to pursue the level of intimate and sexual relationship that she desires;
- The patient’s ability to communicate her thoughts, feelings and needs, both generally and specifically as they impact sexual functioning.
- An honest and open identification and communication of fears associated with sexual contact for both the patient and her partner.
A plan of approach which may be mutual or individual, depending on each patient and partner. For example, some patients prefer to view and touch their altered body alone first, to have time to explore and understand the way in which treatment has impacted on them. Others prefer to have their partner join with them, to touch or to see them first, and to engage in a mutual exploration. Some treatments result in premature menopause which may lead to hot flashes, diminished libido and decreased vaginal lubrication. There are both medical and psychosexual interventions which may help to alleviate some of this distress and encourage the ongoing re-discovery. Your treatment team should be concerned and available to assist in resolving your specific concerns related to this process. This is a time and opportunity for partners to approach each other – without expectation and with a renewed sense of exploration and creativity.
For further information on support services offered to Breastlink patients, click here
Resources
Kahane, Deborah Hobler, No Less A Woman: Femininity, Sexuality & Breast Cancer, Hunter House, 2nd Revised edition (October 1995).
Beth, et al, Fighting For Our Future: How Young Women Find Strength, Hope and Courage While Taking Control of Breast Cancer, McGraw/Hill/Contemporary Books (September 9, 2002).
Schover, Leslie R., Sexuality & Fertility After Breast Cancer, John Wiley & Sons, (September, 1997).
Weiss, Marisa and Weiss, Ellen, Living Beyond Breast Cancer, Three Rivers Press (September 14, 1998).
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