Maintaining and Regaining Intimacy
ARLINE KALLICK: Welcome everyone to the ShareRing Network Teleconference this evening. And again I will remind everybody that, as you probably most of you know, Y-ME National Breast Cancer Organization is now the Breast Cancer Network of Strength. Our call will begin with tonight’s speaker, Emily Harrell. Emily is the licensed professional counselor and sex therapist, and she began her professional career at the University of Georgia where she received a Bachelor of Science in Psychology and a Bachelor of Arts in Sociology. Following her undergraduate work Emily moved to Chicago to pursue a Masters of Science in Marital and Family Therapy at Northwestern University. She stayed in Chicago and continued her training with well-known sex therapist Dr. Laura Berman. Currently she also works at the Berman Center, providing therapy and psycho education to couples and individuals using the Mind-Body Perspective to help clients repair and enhance intimacy and sexual functions.
Our topic tonight is “Maintaining and Regaining Intimacy”. Following Emily’s presentation there will be a question and answer session, and we will end with small group discussions. We realize it’s difficult to answer everyone’s question in a one-hour teleconference, so if your question does not get presented during the question and answer or the group discussion please call the Breast Cancer Network of Strength. Our hotline number is (800) 221-2141. The hotline is answered by certified peer counselors who are breast cancer survivors, and it is available to you 24/7. When presenting a question to Emily please be courteous to other callers by keeping your question brief and realizing this isn’t a private consultation. A transcript of each call will be available at our website one week following the call, so visit our website at www.networkofstrength.org. Also podcast recordings will be available online at networkofstrength.org/podcasts . And there is a link to podcast page from the ShareRing page. And that would be at networkofstrength.org/ShareRing.
We’re very happy to have Emily Harrell with us this evening, and we will now begin our program.
EMILY HARRELL: Thank you for everyone for being here. Let me start by just saying that I recognize that every woman’s experience with breast cancer is different, and your ability to manage diagnosis and treatment commonly changes over the course of the illness depending on medical, psychological, and social factors. So keep in mind that when I’m speaking that some of the concerns or issues I discuss may not reflect your experience, but I will try to highlight the concerns that I feel are most common and the ones that I see most frequently at our office.
The topic itself of sexual function and intimacy is one that is often overlooked when people talk about cancer. Most people think that the cancer will just affect their breast, but by now you mostly know that probably, how far from the truth that is. Even the medical field is programmed to focus on our physical health, and they often have received little education regarding sexual impact and how to address them. Sexuality and intimacy are very complex and multifaceted. Sexual function can include issues that are medical, emotional, and relational. Most of the time it includes all three since these areas overlap in several places. So I’m going to try and address all of these areas and explain some of the connections to you tonight.
I think we should start by just focusing on the physical. I do want to remind everybody before I start this section that I’m not a medical doctor, and that even though I feel it’s important to discuss the medical treatments and options today in regard to sexual function, I encourage all of you to make these decisions with the support of your oncologist or the doctors that you are working with. I do want to address them, however, because I think they so frequently get un-addressed or questions don’t get asked to the doctors, and sometimes doctors don’t have the answers.
To begin the obvious physical changes are usually involving the breast. And you know, as you know there are several procedures to remove the breast cancer so there are a variety of possibilities of the type of change you may have experienced or currently are experiencing. Some of you may have had a lumpectomy on one breast, others may have had a double mastectomy, some may have opted for reconstruction, and others may have not. Either way, the breast is a prominent, personal, and social sign of femininity that can be very difficult to lose or feel is negatively altered. Some of you will also lose your hair or have lost your hair. Even though that’s temporary, we know how difficult this period of time can be. Body image is something that many women struggle with before they begin the process of breast cancer, and often have not been given tools to focus on healing.
One of the things that we talk about here when we get someone who has breast cancer, and sometimes people who don’t, is really preparing yourself and your partner for the changes your body may go through. Some people find it helpful, and others don’t, to look at pictures of what your breast may look like after a lumpectomy or a mastectomy, and sometimes even sharing that with your partner. It can, you know a lot of women have said to me in my office they really, that moment that they first revealed their breast to their husband or their partner was one that they will always keep in their mind. And sometimes the partner’s really shocked by what they see because they really had no idea what to anticipate or expect. Something to alleviate that first initial shock and can be helpful with that is sometimes preparing for what it may look like.
Another thing after you’ve gone through the process of change is something we recommend doing here may sound counter-intuitive to some of you is standing in front of the mirror and trying to learn to accept your body just the way that it is, focusing on the things that you love about yourself. Even if you struggle, even if it’s something really small like, you know, the curvature of your shoulder or just the way that your eyes are shaped, really trying to emphasize those beautiful things that you really embrace about yourself physically. You know maybe even hopping out of the shower and rubbing lotion on your body very gently and really trying to appreciate all the things that our body does for us, and all the different purposes that it serves. And for the parts that we struggle with, whether that be your breast or a part you struggled with before, we try and talk about coming up with a positive refrain. I had a woman and she was talking about how she really just couldn’t come up with a positive refrain for her stomach. It was something that really bothered her. She had all these stretch marks from having her children, and she just felt like it was something she was so ashamed of. After a little bit of work and a little bit of struggle, she finally came up with the frame of calling it her love map, of calling her stretch marks her love maps because they led her to so much love. This is just a simple example, and everyone is different and unique in what they come up with, but I challenge you to be creative because this is something that is very difficult.
It’s also really important to talk to your partner about the struggle you’re having with your body image and the things you’re feeling. As you go through them, the fears that you have that maybe your partner won’t find you as attractive anymore or, that there’s certain parts of your body that your partner is disturbed by or grossed out by. I’ve heard all sorts of language. So you know, making sure that you talk through those fears with your partner. A lot of times we assume too much; we project onto our partners all the things that we think about ourselves or the dialogues we’re having with ourselves at our worse moments. And sometimes our partner, if we give them the opportunity, is thinking actually a really beautiful thought or a wonderful thought. When you’re trying to be intimate and you’re first beginning the process of attempting to get close again, this can be really difficult. You know no longer, maybe, can your partner hold onto your breast the way that he used to or caress them, or maybe that was an area of great sensation for you or pleasure.
One of the things we talk about to make you more comfortable might be, you know, using appropriate lighting, maybe candle lighting, wearing lingerie to help you feel more comfortable when you start to be intimate again. There’s nothing wrong with this process. Getting comfortable is something both of you are going to be doing together. Some couples even find it helpful to laugh about it, to talk about it, to talk about how, you know, this can be difficult, and some couples can really join on how this is a loss for both of them. I’ve heard of couples even having their last boob hurrah, you know. If the woman’s going in for her mastectomy and maybe they have sex one last time and really enjoy and embrace that breast and say goodbye. You know that doesn’t fit for everyone, but you have to find your path and your journey together.