Sexuality & Intimacy – Page 14 – The Amateur's Guide To Death & Dying

March 17, 2014

Holly Returns With Good News

“She stood and faced me, and her hands reached out until they came to rest on my scars. It was like her touch was both fire and ice, but I didn’t pull away. There was no turning back. I was finally doing what I should have done two years ago.”

Do you remember me introducing you to my friend, Holly? She is a 43 year old graphic artist who shares a home with her wife of ten years, Jean, and their teenage daughter Annie. She is also living through breast cancer. She had a double mastectomy three years ago and has been cancer-free since.

Holly has been dealing with some big-time body issues post surgery. The mastectomy scarred her psychologically as well as physically. This has had a tremendous impact on her intimate life with Jean.

In the earlier column I mentioned above, I recounted an meeting she and I had where we tried to come up with a strategy to overcome these emotional and physical obstacles so that she could resume some semblance of intimacy with Jean.

During that meeting I asked Holly if she had ever taken the time to grieve the loss of your breasts. I suggested that she go to Jean and ask her to hold her while she mourned for what is no longer hers?

I recommend that the Holly and Jean begin to explore what is possible in their sex life together now. I suggested they avoid comparing what they are able to do now with how things were in the past. “Keep the exploration simple and open-ended. And I suggested that they avoid creating a goal to be achieved in their exploration. That’s where most people in their situation go wrong.

I gave Holly two exercises: 1) spoon breathing — to rebuilding a sense of confidence about being physically together with Jean again. And 2) guided-hand touch — to help reestablish a threshold for what is possible between she and Jean as they move forward now.

I suggested that she and Jean keep these exercises playful and that she honor her limits. I asked her to get back to me in a few weeks and let me know how things are going.

Two weeks later an ebullient Holly returned to see me.

“I’ve had a great two weeks. No kidding. Jean and I are on cloud nine. It all started when I got home from our last session. No sooner did I get in the door than Jean was at me with her usual twenty questions. ‘How did it go? What did you talk about with Richard? Did you talk about me?’ And so on and so on. She was following me around the house like a puppy.

I was afraid that was gonna happen. On my way home from your office I was trying to work things out in my head — what should I tell Jean? I couldn’t just blurt it all out, all the stuff you and I talked about. Besides, I was afraid that Jean would pitch a fit about me airing our dirty laundry in public. I thought maybe if I told her I have a headache she’d leave me alone and I won’t have to mix it up with her right then and there.

As a matter of fact, I did have a headache, a big one, but it was mostly from all the anticipation. I had so much bottled up inside of me for so long, all that fear and shame, I didn’t know how it was gonna come out or even if it would come out at all. I was so afraid that I would say the wrong thing and make matters worse. I’ve done that more than once in our relationship.

When I got in the house, I headed straight for the bedroom but she cut me off at the kitchen. ‘What’s wrong, babe? Don’t you want to talk about it?’ I was shaking all over. My legs felt like rubber. I began to cry. I kind of fell in a swoon right into Jean’s arms, just like in the movies, except I’m lots bigger than she is so she couldn’t really catch me. I wound up slumped on the floor where my crying became a wail.

‘Jesus, Holly, what is it? Talk to me. Are you sick? Say something, damnit. You’re freakin’ me out.’

It was only then that I realized I hadn’t yet said a word to Jean since I got home. I tried to speak, but nothing came out. I was like a madwoman curled up on the floor rocking back and forth sobbing like a motherless child.

Jean was indeed getting pretty freaked out by this time. She had never seen me like this. She helped me to my feet and we stumbled to the bedroom where we both collapsed on the bed. Mind you, I was still carrying on this whole time.

I started to undress. This generally is a signal for Jean to leave the room, because I haven’t let her see me naked since the surgery. She was afraid to leave me alone in my hysterical condition, but she also didn’t want to embarrass me any further. She got up to go. I could feel her anguish. By now, tears were streaming down her face too. I reached for her hand and pulled her back down to the bed next to me. Still no words.

I began to undo the buttons of my top. My hands were shaking and I was moaning deep inside. I turned away from Jean and undid my bra and let it slip from my shoulders. I had gone this far, now all I had to do is turn and face her. But I couldn’t raise my head. I was frozen in place.

I was never so scared in all my life. Jean stroked my back with her fingers. Her caress was so gentle that it could hardly even be called a touch at all. But for some reason her touch calmed me. I took a couple of deep breaths and stood. Then I slowly turned toward Jean. I brought my hands to my face in shame and began to sob more intensity.

She stood and faced me, and her hands reached out until they came to rest on my scars. It was like her hands were both fire and ice, but I didn’t pull away. There was no turning back. I was finally doing what I should have done two years ago.

When I was finally able to speak, the first words out of my mouth were, ‘they’re gone.’ I took Jean in my arms and pulled her close and we kissed like lovers do for the first time in three years.

I was stunned by Holly’s story. Tears welled in my eyes as she recalled her joyous reconnection with her lover. I thought to myself, what a courageous woman!

After my breakthrough with Jean, I noticed that I have a renewed interest in living. I don’t mean just going through the motions. I’ve done too much of that already. I want to live. I want to be present for whatever life holds for me and for as long as it is available to me. It also means being aware of my limits. When I’m tired or in pain I need to acknowledge that and rest. I’m not real good at taking care of myself in this way, but that’s going to improve, so help me.

What a role model Holly is for anyone facing a similar situation, indeed anyone of us. Too bad there isn’t a place out there where people, like Holly, could tell their intimate stories, successes as well as disappointments, and inspire others.

February 21, 2014

Bringing To a Close a Long Life Together

“Each of us is entitled to intimacy and pleasure in our life, regardless of how our body looks or at what stage of life we are at. The fact that we might be sick, elder, or dying need not cut us off from these precious life-enhancing things. However, we will most likely have to take the lead in defining what it is that we need and want, and then communicate that to those who are in a position to answer our need. We ought to have confidence that this will be as enriching for partner as it will be for us.”

Clare, 73, and her husband, Charley, have been married for fifty-three years. They have four children, nine grandchildren, and five great-grandchildren. Clare’s leukemia, which was in remission for over ten years, has recurred. This time it is considered untreatable. She has decided to forego any of the heroic, life-sustaining measures for which modern medicine is so famous. She and her doctors agree that hospice is her best option. “I’ve done my homework. I’ve shopped around. I interviewed all the hospices in town and have chosen the one I feel will honor my wishes for the kind of end-of-life care I want.”

Clare has lived a rich and full life. “I was a career woman long before there was such a thing as a career woman. I’ve always been a take-charge kind of gal. This leukemia may very well kill me, but it will never get the best of me.” Her illness has made her very frail. Her skin is almost translucent. She has an otherworldly look about her, but there is no mistaking her remarkably robust spirit.

Her youngest son Stan, her one and only ally in the family, brought her to our meeting. Stan says, “Oh yeah, she’s feisty all right. There’s no flies on her, and the ones that are there are paying rent.”

Clare’s biggest concern is her family. They are pressuring her to fight against death even though she doesn’t want to. She wishes that they would join her in preparing for her death rather than denying the inevitable.

“I worry about how they will manage when I’m gone. And even though I’m ready to die, I feel as though I need their permission before I can take my leave.

I try to tell myself that my Charley will be just fine after I’m gone. After all he does have our four grown kids and their families to look after him. But deep down, I know how lost he’ll be without me. Even after all these years, he still needs me to help him find a missing sock!

Whenever I try talking to him about how he’ll manage when I’m gone, he gets this awful flush across his face and starts shaking like a scared little boy. It makes me feel so terrible. I feel so bad for upsetting him like that.

I’m so confused! I want to talk to Charley about all of this. He’s my husband and has been my best friend for well over fifty years, but I honestly don’t know how to reach him on this one.”

Clare straightens herself up in her chair and continues.

“Stan, here, is the only one I can talk to. Everyone else, including my husband, won’t hear a word when I start talking about planning my funeral or who will get my antique Tiffany lamp. They just say, ‘Oh, mother, stop talking like that, you’ll outlive us all.’

I know they mean well. They’re just scared and upset. But boy oh boy, it’s really getting under my skin. I know I only have a short time left to live, so I want it to be real. I’m sick of always having to smile and pretend when I’m with them. It’s about time for them to start considering my feelings for a change.”

Clare’s immediate concern and the reason for our get together is her husband Charley. She is afraid that they are drifting apart right when they need each other the most. I ask her for a little background on their intimate life together.

“I was well into my thirty’s when the woman’s movement began. It was a time of great awakenings for me. Charley was threatened, of course, but I was able to win him over in time. It was only then that our sex life started in earnest. I finally realized that sex could be about pleasure and not simply about duty. What a liberating experience that was!

Even now Charley and I are intimate, or were until the last couple of months or so. After we both turned 60 our sex wasn’t like when we were youngsters, all heated and hormonally driven, but it’s just as special. Oh, I’m so glad I am able to talk about this with you.

My main concern is the medications I’m taking for the pain. I’m woozy when I take them, but irritable without them. I want to be more available to Charley for the closeness that’s so important to each of us, but I’m often too out of it. This is a problem for Charley too, because he doesn’t know how touch me anymore. And so, I’m afraid, he keeps his distance. This only makes matters worse for the both of us.

How do I change this? Or maybe there’s no changing it. Maybe it’s just over. What a terribly sad thought that is.”

I reach out for Clair’s hand. “I am touched by the loving depiction of the intimate life you’ve had with your husband over the years. It can’t be easy for either of you to see this wind down. However, the closeness and tenderness you’ve had throughout your marriage need not stop now.

May I ask; do you still sleep together in the same bed? Would you be comfortable initiating a little cuddling with Charley? Good! Then I’m going to suggest a regiment of spoon breathing and guided-hand touch that I’m sure will work for you both. You will, of course, need to take the lead role in this since, as you say, Charley no longer knows how to touch you, but once he gets the hang of it and he has your permission to do so, he can continue even when you’re not able to reciprocate or even respond.

Allow me to quickly explain spoon breathing. Here’s what you do; lay on your side with Charley on his side close behind you like two spoons. Then see if you can match one another’s breathing pattern. You will be amazed at how calming and comforting this will be for you both. It will also be a very effective way to reestablish a threshold for what is possible between the two of you now, in this final stage of your life.

Now the guided-hand touch; take his open hand in yours and guide it to where you like to be touched. Show him how you like to be touched where he is touching you. Long strokes, slow strokes, short strokes, soft strokes, or just having his hand rest on you, whatever. Show him the kind of pressure you are comfortable with where he is touching you. Once you’ve established a simple routine of breathing and touching, give Charley permission to carry on even if you happen to fall asleep. Because this breathing and touching technique is so gentle and loving, it should be able to serve you even as you are actively dying. But you’ll have to let Charley know that this is what you want and need. You could tell him that you want to die in his arms. What an ideal way to bring your life together to a close. Do you think Charley will accept your invitation?”

“I can’t say for sure, but I think if I suggested it to him in a way that lets him know that he would be doing it for me, it might work. But I’m not sure about what I should say.”

“When words fail to communicate what is in your heart, you can always rely on touch. Maybe you will find that nothing needs to be said at all, Clare. Draw him close and keep him near you with touch. Something tells me Charley will find this irresistible. It could be the fondest of farewells. Something he’ll never forget.

This is my philosophy. Each of us is entitled to intimacy and pleasure in our life, regardless of how our body looks or at what stage of life we are at. The fact that we might be sick, elder, or dying need not cut us off from these precious life-enhancing things. However, we will most likely have to take the lead in defining what it is that we need and want, and then communicate that to those who are in a position to answer our need. We ought to have confidence that this will be as enriching for partner as it will be for us.”

February 14, 2014

Everlasting Love

HAPPY VALENTINE’S DAY!

Love transcends! One couple went to great lengths to exhibit to those who survived them that their love would endure for all ages. I don’t suppose it’s important to know who these individuals were, or where they lived, or how they died. Their cemetery art, like all such art, speaks to the heart. The language is universal. Their’s is a timeless Valentine’s Day gift to all the hopeless romantics among us.

January 17, 2014February 7, 2014

Wheelchair Blues

“I’m not used to such a frank discussion about sex. I’m more comfortable with the locker room bravado that passes as sex talk for us guys. At least in that situation I don’t have to be honest. This is very intimidating.”

Michael is 52. He was diagnosed with multiple sclerosis four years ago. Two years ago his disease process escalated to the point where he was confined to a motorized wheelchair. This past year he has had several MS-related setbacks that have kept him bedridden for several weeks at a time.

Things have become so difficult that several months ago he was forced to sell his once-thriving law practice. The few hours of work he can manage a week at his old firm are more frustrating than fulfilling for him.

Mike is often depressed. He continually repeats his self-defeating mantra: “I’m not half the man I used to be.” The superhuman support of his second wife Maryanne and his son Kyle along with his beloved Seattle Seahawks are the only things that keep him from killing himself.

The first time I met this couple, an exasperated Maryanne tearfully reported how Mike’s smoldering rage and bouts of sullenness terrorize the family. “I love him, but he’s gotta get off his pity-pot or I’m gonna walk, and take Kyle with me.” Mike sheepishly acknowledged his disruptive behavior. His ruggedly handsome face distorts with shame. “It’s not me. It’s this damn MS. I just can’t seem to get it together. I feel like such a failure.”

When Mike and I have some one-on-one time together, I broach the topic of sex. Mike blanches. I start by asking him some very pointed questions about his intimate life with his wife.

Mike responds:

“I’m not used to such a frank discussion about sex. I’m more comfortable with the locker room bravado that passes as sex talk for us guys. At least in that situation I don’t have to be honest. This is very intimidating.

I’ll be straight with you. I don’t want to talk about this because I’m afraid you’ll want to know how a gimp like me does ‘it.’ I’m afraid that if you ask, I would have to tell you that a gimp like me no longer does ‘it’ because he can’t get it up anymore.

I’d probably then have to tell you how frustrating it is for me not to be able to make love to my wife, and how this is a source of constant friction between Maryanne and me, how she accuses me of throwing out the baby with the bathwater, how she doesn’t care if I have a hard-on, all she wants is for us to be close.

So you see, if I told you all these things I’d really be embarrassed. So I’m not going to say anything at all.”

“I see,” I responded. “Do you really see yourself as a gimp? Or is that just a term of endearment you use for yourself?”

“What do you think? Just look at me. I’m one fine specimen of virile manhood, wouldn’t you say?”

Mike turns bright red. I can’t tell if it’s rage or embarrassment. Maybe it’s both.

“Ok, Mike, have it your way. Maybe you are a gimp. Although I wouldn’t have guessed by just looking.”

I decide to tell Mike about another client I had years ago. He had an even more advanced case of MS than Mike. His wife claimed that despite being a very large man and being bedridden he was a remarkably good lover. She said he had a vivid imagination and an exceptionally talented mouth. He was affectionate and gentle and there was absolutely no hint of a chip on his shoulder. My former client used to say that his pleasure came from giving pleasure to others.

Mike apologized. “I’m not myself today. Or maybe this is what I’ve become. I know my wife and son think so.”

“So is all of this rage just about being unable to have an erection? Us men folk are so amazing!”

I go on to tell Mike that many women don’t care at all if their partner has an erection or not. In fact, most women report that when their partner’s penis is hard it generally means only one thing and it’s rarely about them. It’s the old “get it up, get it in, get it on, get it off and roll over” routine, which is not particularly fulfilling for a woman.

While losing the ability to have an erection may be a humbling experience for a guy, his female partner may have an altogether different experience. For her it may signal the possibility of some really good sex.

I ask, “How do you feel about your oral sex technique, Mike? If Maryanne wanted you to pleasure her orally would you be comfortable doing that? Maybe she would prefer hand stimulation.

Ya know, that other MS client that I just mentioned? He couldn’t use his hands very well so his wife used them for him. She would take his hand and stimulates herself with it. He loves it. Would you feel comfortable if Maryanne used your hand like that?

How well are you able to communicate your needs for sex and intimacy to Maryanne? Are there any specific issues that get in the way of asking for what you need?”

“We stopped talking about sex about the same time I got sick. Actually, we never really discuss it at all. What generally happens is Maryanne brings up the topic, I get angry, and she gets hurt. That’s how ‘discussions’ about sex go in our house.

I wish I could tell her how I really feel, how ashamed I am, not just for being such a bully, but also for being such a coward. I wouldn’t even know how to begin such a conversation. I can’t seem to get past saying ‘I’m sorry.’ I’m sorry, all right, real freakin’ sorry. I’m afraid of what would happen if I opened this can of worms. Would I ever be able to look her in the eye again? Sometimes I wish I were dead.”

“So you’re not talking to your wife. Are you talking to your doctor about your erection concerns?”

“Nope, I just figured there wasn’t anything to talk about. Besides, it’s too goddamn embarrassing to admit.”

“Listen, Mike, you may want to reconsider that. Here’s my advice. First, begin a dialogue with Maryanne. Let her know that you are serious about working through your problems as a couple. I’m here to help if you need someone to guide the conversation.

Second, contact your doctor as soon as possible and initiate a frank discussion about your erection concerns. A great deal of progress has been made recently in understanding and treating male erectile dysfunction.

Most men occasionally experience the inability to have an erection, but repeated problems, whether they are organic or situational, constitute what was once referred to as impotence. Men with chronic erection problems are often too embarrassed to ask for help, and they may not have the impetus to do so if they’re not partnered. So statistics on how widespread this concern is among us guys is hard to come by, no pun intended.

Getting an erection for a man is like lubricating for a woman. Both processes combine complex emotional and biological functions. So it’s clear that either a physiological or psychological problem can interfere in the arousal stage of the sexual response cycle for either women or men.

For example, a relationship problem, depression, anxiety, prescription medications, excessive alcohol consumption, a hormone imbalance, cardiovascular disease, a neurological problem, being overweight, even some over the counter cold and allergy medications and something as simple as a poor diet can contribute to arousal dysfunction.

As you undoubtedly know, major breakthroughs in treating erection problems was made by a chance discovery in the mid 1990’s. A researcher who was studying the effects of a new heart medication noticed a remarkable side effect in some of his male subjects…erections. When Viagra hit the market it revolutionized erectile dysfunction therapy.

It’s important to note that this medication as well as all the other erectile dysfunction meds out there are ‘erection enhancers’ not ‘erection inducers.’ I say that because without proper stimulation, these medications will not cause an erection on their own.

There are some reported side effects to these medications and one can only get them by prescription, so you better talk to your doctor as soon as possible.

You see, Mike, there are options. Stop thinking about what used to be and start working at finding out what is currently possible.

If you can’t take any of these ED meds, there are still other options, like a penis ring and pump. And if these things don’t work there’s still no need to go without partnered sex and pleasuring. There are erogenous zones all over and in your body.

Your erection-centric sex life maybe over, but there is so much more available to you if only you give yourself and Maryanne a chance to make the discoveries. Why not give it a try. I mean, how much time do you have left? Don’t let this issue continue to contaminate your marriage and short-circuit the intimacy that is still available to you. Maryanne deserves better and so do you. I’ll continue to be available to you as a coach and guide if you wish. Because there’s no need to go through this alone if you don’t want to.

Now get out of here and make something pleasurable happen. You won’t regret it.”

December 16, 2013

Holly’s Dilemma

“Can’t you see I’m starving? I have needs too, you know. For as much love as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I woulda joined a convent. Your sex aversion is making me sick.”

I want to introduce you to my friend, Holly, (not her real name). She is 43. She had a double mastectomy three years ago and has been cancer-free since. She’s a graphic artist, shares a home with her partner (now wife) of ten years, Jean, and their teenage daughter Annie.

A beautiful smile radiates from Holly’s full mocha-colored face. Oodles of thick jet-black braids spring from her head as from a fountain gone mad. She is forever brushing one or another of them from her face as she speaks. Her frequent laughter is like music, making her whole body dance and shake, but her levity masks a somberness and apprehension that is very troubling to her.

She tells me; “I often become consumed with worries about getting sick again. My fears can turn into a paralyzing dread that takes days and sometimes weeks to shake. I know that until I can accept the possibility of my own death, I’ll never be able to embrace all the great things that are right in front of me.”

Later in our conversation she says;

“Ok, so if ya wanna know the truth, I’m dealing with some big-time body issues. The mastectomy really scarred me psychologically as well as physically. I didn’t realize the dimensions of all of this until I had finished the chemo and radiation I was doing. For a good six months after the surgery, I was so sick from all that poison that the thought of sex of any kind made me nauseous. I didn’t even want to have Jean in the same bed with me. It was awful.

Over time the nausea diminished and I was able to resume some semblance of intimacy with Jean. We were able to be close and do some touching, like sitting on the couch holding hands while watching TV, just as long as it wasn’t sexual.

Then a couple of months ago, Jean and I had this big blowout. We were screaming and yelling about God only knows what when she finally blurts out; ‘Can’t you see I’m starving? I have needs too, you know. For as much intimacy as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I woulda joined a convent. Your sex aversion is making me sick.’

The intensity and ferocity of Jean’s outburst blew me away. I had completely forgotten about her needs. I know I still love her, of course, but after the surgery I didn’t feel whole. I didn’t feel like a woman, know what I mean?

When things simmered down a bit, I think Jean could tell she wounded me deeply, she said; ‘I’m doing this as much for you as I am for myself. You gotta deal with this, babe.’

Jean was right! I was starving too, but I was too afraid and ashamed to admit it. We’ve made some lame attempts to move past the status quo since then, but it’s still not like the old days.

My God, in the old days Jean and I were like wild women, letting it all hang out. Some of that was lesbian pride, but it was also a kind of in-your-face protest. We were both like; ‘These are my breasts, damnit! Get over it!’ I don’t see how I can ever regain that.

I mean, how can I make a gift of myself to someone if I’m not feeling much like I’m a treasure? I still have shame about losing my breasts. I’m not a whole person anymore.”

“Hold on there, Holly. Where did you lose your breasts, at the laundromat? You didn’t lose your breasts. You had cancer. They were surgically removed to save your life. There’s no shame in that! To think otherwise is self-defeating.

breast cancer

Besides, it doesn’t sound like Jean thinks of you as damaged goods at all. You’re still attracted to her, right?

That’s what I thought. Well then, you’re just gonna have to let your love for one another heal you of your shame and self-doubt. You are no less a woman without your breasts. I wonder, have you ever taken the time to grieve the loss of your breasts? Could you go to Jean and ask her to hold you while you weep for what is no longer yours?

Your shame is indeed getting in the way of you reconnecting with Jean. But Jean is your life partner and this is part of life. Share it with her. Don’t try to carry this alone.”

Holly countered; “But I have this completely non-existent sex drive. The first couple of months after the chemo and radiation, I would have this weird feeling when Jean would try to be close to me. It was like being on a bad acid trip or something. I felt as though my body was there with her but I wasn’t. I felt nothing. My headspace was totally different from how it was before I got sick. I would lie there thinking, ‘Oh my God, what’s happening? Will I ever feel normal again? How many more opportunities will I have to be with Jean like this before I die? Why don’t I feel what I used to feel?”

I said, “Well, for one thing, you were fighting for your life back then, right? That’s bound to alter a person’s perceptions a bit, wouldn’t you say?

healing touch

Listen; can I suggest that you have a heart-to-heart talk with Jean about your concerns? Tell her what you are telling me. Just be sure that you have this conversation at some neutral time, not during an intimate moment. This way you could speak freely about what you are thinking and feeling without fear of Jean misinterpreting your comments as sexual rejection. How does that sound to you?”

“But what if I screw this up?” What if this somehow scars Jean for the rest of her life? I don’t what that to happen. I wouldn’t be able to forgive myself. I’m afraid something bad might happen and that’s why I’m frozen in place.”

“There are ways to overcome this stalemate, Holly. First, you need to reassure Jean that you are committed to working through this impasse with her. I think she needs some assurance that you haven’t given up. And in return you could ask her for her patience, because the process may be a slow one. One thing for sure, you’re gonna have to give her some sort of timeline; otherwise you may find yourself putting this off indefinitely. And that won’t do.

I recommend that the two of you begin to explore what is possible now in your sex life together. Avoid comparing what you are able to do now with how things were in the past. Keep the exploration simple and open-ended. And I suggest that you don’t create a goal to be achieved. That’s where most people in your situation go wrong. Keep you exploration moving forward, of course, but also try to keep it open-ended.

You guys might start with some cuddling and spoon breathing. Do you know what that is? It’s a great exercise! I highly recommend it.

Here’s what you do lay on your side next to one another like two spoons—Jean’s front to your back. Then try to match one another’s breathing pattern. First Jean will try to match your breathing pattern then you guys could switch position—your front to her back, and you could try to match her breathing pattern. This exercise can be done with or without clothing. You will be amazed at how comforting this will be for you both. It’s the ideal place to start rebuilding a sense of confidence about being physically together.

sleep_09

As time goes on, your spoon breathing embraces could become more adventuresome. When you are feeling up to it, take one of Jean’s hands in one of your own hands and guide it over your body in a way that feels pleasurable and comfortable for you. You could show her the kind of stroke and pressure that is desirable for you. This will be a very effective way of reestablishing a threshold for what is possible between the two of you now as well as moving forward.

Guided-hand sensual touch like this can be expanded to include genitals if and when you ready. You could help educate Jean on how to pleasure you in a way that would allow you to be more of a passive recipient rather than an active participant in your lovemaking if that’s what you want.

I suspect that these two exercises will be a good place for you and Jean to start the non-verbal communication that is just as essential as having that chat that I mentioned earlier. The only other suggestions I have to offer are these: keep these exercises playful and honor your limits.

Maybe you could get back to me in a few weeks and let me know how it goes.”

November 18, 2013

Awakening Your Sensual-Self Post Prostate Cancer

“Folks frustrated by what life throws at them are often filled with rage and self-pity.”

Recently I got an email from a 58-year-old man who lives in San Diego. His name is Doug and this is what he had to say.

“HI, I need some help. I had my prostate removed due to prostate cancer. I feel I have lost my manhood. I don’t experience erections anymore. My penis is dead. Can you recommend something to help me?”

I don’t think Doug is dying, not actively dying anyhow, but he sure is experiencing a profound sense of loss — the death of his sexuality. Or at least the death of the sexual expression he was accustomed to before his radical cancer treatment.

Another truly uncanny thing is that in the same week I heard from Doug, I’ve received distressing email from three other people who were at their wits end because life had dealt them a crushing blow. While each person who wrote to me had a very different presenting problem, all were experiencing a similar “death” to what Doug was experiencing. I heard from a woman in Toronto who is recovering from a radical mastectomy. I heard from a guy in Dallas who had just started a recovery program for his serious meth addiction. A young wife and mother in North Carolina whose husband, and father of her two kids, had returned from Afghanistan an emotional and physical basket case. And now Doug.

It’s astonishing that, despite the dramatic differences in each person’s life story, all of my correspondents reported pretty much same thing. Each felt less than whole, disconnected from their sexuality and devoid of any real intimacy or meaningful sexual outlet. It is so amazing how, despite our unique individual difficulties, there is often a universal response to life’s troubling complexities, particularly as it applies to who we are as sexual beings.

When I wrote back to Doug I wanted to empathize, but also encourage. Regaining a sense of sexual-self after prostate surgery, or any of the other problems I mentioned above, is an arduous, but rewarding task.

Hey Doug, I’m so glad you wrote to me. I’m sorry to hear of the problems you’ve bee having since your surgery, but I think I have a few tips to offer you.

Considering your ebbing self-confidence and zero libido, I suggest that you begin your rehabilitation by connecting with others similarly challenged as you. In your case, that will probably be other men living with and through prostate cancer. More likely than not, they will be a whole lot more sympathetic to your issues and attuned to your predicament than even your closest friends and family. Sometimes, people who have yet to experience a life threatening illness or a disfiguring surgery don’t have a clue about how to interact with those that have. It’s not their fault; it’s just the way things are.

I suggest looking into a support group, if you haven’t done so already. Once you make that connection, you will find, that you are not alone. The other men in the group will be experiencing many of very same things you are. And to my mind, it’s a whole lot easier to face and handle life’s difficulties when surrounded and supported by others. That being said, I want to give you a heads-up about support groups, particularly if you’ve never participated in one before.

Each support group has it’s own personality and dynamic. If the group is not lead by a skillful facilitator it’ll, no doubt, degenerate into a bitch and gripe session. No surprise there, I suppose. Folks frustrated by what life throws at them are often filled with rage and self-pity, a lethal combination. A group like this, you should pardon the pun, will be a death trap. If you find yourself in such a group leave it and look for another. A successful group, on the other hand, will be transformational; it will challenge and motivate as well as support you.

Another caution; beware of the lowest common denominator. If you are in a prostate cancer group, you can be certain that every man in the group has sexual issues he’s dying to talk about. Unfortunately, few if and of these men will be so bold as to admit that. It’s how us guys are conditioned to behave. We can endlessly brag about our sexual exploits, but, God forbid, we ever seriously discuss our sexual issues. I have plenty of experience leading these sorts of groups and I can assure you, I have to drag the sex stuff out of the participants until they get the hang of it, and then I can hardly get them off the topic. If you find yourself in such a group, I hope you will take the lead and help break the ice, so to speak. You’ll do everyone, yourself include, a huge favor.

Next I suggest that you try connecting with people on a sensual level as opposed to a sexual level. For example, I firmly believe in massage as the best way to accomplish this. Think about it. Imagine the good you’ll be able to do for others, as well as yourself with therapeutic touch. And in my book therapeutic touch also includes sensual touch.

Massage will soothe so much more than the jangled nerves and disrupted muscle tissue caused by radical and invasive surgery. It gives the one doing the touch a renewed sense of him/herself as a pleasure giver, which is so very important to us all. When you receive the touch, it will begin to reawaken sensory connections you thought were lost for good. And your libido as well as your erection will surely bloom again. I promise. To keep that erection going once it starts, I encourage you to use a penis ring. And if you don’t know what that is, do an internet search. It’s a brilliant, low-tech solution to erectile dysfunction, which happily doesn’t involve pharmaceuticals.

Now if you feel your massage skills aren’t up to par, why not take a class or workshop in massage. You might want to look to something like the Body Electric School Of Massage. They have load of training options and there are chapters all over the world. In their modality, learning is a hands-on experience. What could be more liberating than that?

If a class is a bit too intimidating at first, you might consider purchasing a book on massage. I have two exceptionally good ones in mind. The first is: Male Erotic Massage: A Guide to Sex and Spirit, by Ray Stubbs, Ph.D. This is a holistic approach to bodywork, including the sexual and the spiritual aspects of Male Erotic Massage. There are over 200 photographs in this volume that reveal both massage techniques and the beauty of the male body embracing the male body. The strength, the joy, the gentleness, the ardor, the tenderness, the equanimity, and the pleasure — they are all included.

The second title is: Erotic Massage, The Touch of Love also by Ray Stubbs, Ph.D. This is a more inclusive volume of erotic massage. It describes long, flowing strokes for the whole body, including female and male genitals. By the way, this was the very first massage book to explicitly illustrate genital massage. The techniques described are simple and easy to perform. It’s superbly illustrated, and the text is both tender and playful.

Finally, your gift of massage is the ideal way to connect with another humans, be it a friend, a partner, lover, or even a relative stranger. Your touch can be either seductive or non-seductive, or maybe a little of both. You can count on this purposeful touching to open new doors to what is possible for you now, post surgery. The mistake that many people make at this point is to compare what is going on for them now to what they were used to before their diagnosis and/or surgery. That won’t do. You now have a new normal. Find out what it is; embrace it; and then slowly stretch those boundaries. You’ll discover new pleasures, both subtle and profound, as you give as well as receive touch.

I encourage you to push beyond the isolation I know you are feeling, Doug. Purposeful touching, like massage will change your perceptions about sex, sensuality and intimacy. And like I said, it will, more likely than not, revitalize the arousal phase of your sexual response cycle. I know this can happen. I’ve seen it happen. And now, Doug, it’s your turn to make it happen!

October 22, 2013October 22, 2013

Practical Considerations

“Now there’s a million dollar idea! Someone ought to write a no nonsense instructional booklet for the men folk, one that we would automatically recognize and understand. One that would help us, step by step, through the harrowing experience of having a person we love at death’s door.”

My first column under this heading of Relationships and Intimacy was titled, It Never Entered My Mind. It recounted a conversation I had with a woman who told me of the very painful personal experience she had while attending the death of her beloved husband in a Midwest hospice. Apparently it struck a chord with some. I don’t get a lot of correspondence from people who read my columns, but every now and again the odd email or letter will show up and I am reassured that my efforts haven’t been for naught. I love when that happens.

Not long after that first column appeared I got an email from a fellow who may have seen that column. He didn’t reference it directly, but it would have been quite a coincidence had he not seen it. This fellow wanted some practical tips on how he might broach the subject of sex with his wife who had been recently diagnosed with ovarian cancer.

The man’s name was Alex. And what struck me most about his message was his manner. In typical male fashion, he got right to the point. He even laid out his questions in bullet points, again a very typical man thing to do. Even though he made no mention of his anxiety I could easily tell he was supremely worried that he might fail his wife in some way during her hour of need. His email reeked of the kind of performance anxiety I so often see in my sex therapy private practice. His wife’s disease process shook his confidence to the core.

Basically, he was looking for a “how to” guide. You know, like the kind of owner’s manual one would find included in the box of a new power tool. I thought to myself as I read his email. Now there’s a million dollar idea! Someone ought to write a no nonsense instructional booklet for the men folk, one that we would automatically recognize and understand. One that would help us, step by step, through the harrowing experience of having a person we love at death’s door.

SAFETY INSTRUCTIONS AND INSTRUCTIONAL MANUAL
WARNING
IMPROPER OR UNSAFE use of this power tool can result in death or serious bodily injury.
This manual contains important information about product safety. Please read and understand this manual BEFORE operating the power tool. Please keep this manual available for other users and owners before they use the power tool. This manual should be stored in a safe place…

There would be lots and lots of diagrams and symbols and even a schematic or two. Of course, there’d be pages and pages of dos and don’ts as well.

NEVER touch moving parts.
NEVER operate without all guards in place.
ALWAYS use the right tool for the job.
NEVER use a power tool for applications other than those specified.
NEVER use a tool that is defective or operating abnormally.
ALWAYS use protective eye gear.

Alex’s message was a manly cry for help. And it was clear to me that even though he loved his wife dearly, he had some deep misgivings about his capacity as an effectual lover, even under the best of circumstances. And now that his wife had undergone radical gynecological surgery, well, he was even more adrift than ever.

It didn’t help that Alex couldn’t or wouldn’t use even the medical terms for his wife’s “parts.” I couldn’t tell if he didn’t know the vocabulary or if he was just too embarrassed to type them out. When words failed him, he used that universal euphemism, “down there.”

I had my work cut out for me. I was tempted to do some remedial sex education. Hell, I could have included some diagrams and symbols and even a schematic or two. In the end I decided to forego an elaborate response that might have overwhelmed him. I decided to answer, as succinctly as I could, each of his questions.

“I don’t know what your wife wants or needs. But there is a mighty good way to find out. Ask her!”

“Discussing sexual concerns in a crisis is never going to be easy, especially if you guys don’t have a history of doing so.”

“Maybe that’s a question you and your wife could bring to her oncologist.”

“Yes, I can assure you that both the surgery and the chemo will affect your wife’s interest in sex. Don’t take it personal.”

I answered all the question he posed as best as I could. Then I added a personal note.

“Alex, my friend, may I suggest that before you approach your wife with this discussion, you might do a little homework by yourself. Maybe if you knew your mind about what it is you are looking for in your intimate relationship with your wife at this time in your marriage, at least one of you would have a leg up on the upcoming conversation.”

I directed him to my book, The Amateur’s Guide To Death And Dying; Enhancing The End Of Life, not because I wrote the blasted thing, but because it contains an entire chapter on sex and intimacy concerns for sick, elder, and dying people and their intimate partners. It’s a s close to a “how to” guide as I’ve ever seen. To prep my readers for Chapter 6, the sex and intimacy chapter, I invite them, at the end of Chapter 5, to consider — Some Questions about Sexuality and Intimacy.

I posed 5 simple questions to help my readers focus their attention on their own sexuality and intimacy needs.

How important is sexuality in your life?
Is there’s a difference between sexuality and intimacy?
Do you have a range of options in which to experience your sexuality? If yes, what are some of them?
How well are you able to communicate your needs for sex and/or intimacy to your partner(s)? Are there any specific issues that get in the way of asking for what you need?
What are your biggest concerns about your sexuality as it relates to your disease, aging and/or dying process, or the disease, aging and/or that of your intimate partner?

I had great confidence that if Alex took my advice and answered these questions honestly, he would be ready to approach his wife to find out what she wanted and needed from their intimate life together post diagnosis and surgery. I suggested that, once he had answered the five questions, he could offer her the opportunity to do the same. Once they had both answered the questions they could set up a time to discuss their answers.

While this approach wouldn’t make the experience any less daunting, at least they would have a roadmap to get them where they needed and wanted to go.