|
Stories for Reprint
It's All in Your Head
How to deal with the emotional challenges of arthritis and enjoy a healthy sex life
By Petya Stoeva, MARRTC Staff
For Lyn Gottschalk, 50, from Green Bay, Wis., living with rheumatoid arthritis for the past 20 years has meant not only constant pain and loss of motion, but also the loss of a marriage. When Gottschalk first got married, the disease had just begun to disable her and had little effect on her daily life or sexuality. As the rheumatoid arthritis progressed, it started taking its toll on her body and her sexual experience.
"I was certainly interested in him [her husband] and wanted to please him but I couldn't do the 'acrobatics' of it," she says. "Some days I couldn't at all. Although he said it was OK with him, it wasn't." Tensions in the bedroom went unaddressed and soon transferred to other aspects of daily life until the marriage slowly disintegrated. "I know what he wanted and he wanted the me that he first met," Gottschalk says. "In retrospect we should have sat down and talked about it."
Indeed, for some experts talking is such an integral part of the sexual experience as are kissing and fondling. "My favorite four-letter word for sex is talk," says Dr. Jackson Rainer, a psychologist in Valdosta, Ga., who councils individuals and couples with a chronic disease. "If a couple can't do this on their own, they can talk to a specialist that can walk them through the ways to talk intimately. It's a learned skill. If a couple is willing, they learn it just like they can learn a news dance."
Talking is a healthy way to communicate the physical and psychological problems associated with arthritis, but it's often seen as a last and much dreaded resource. In his long practice as a rheumatologist, Dr. Carter Multz of San Jose, Calif., has seen lots of patients who are embarrassed to talk about sex. For him that resistance comes from a combination of fear, apprehension and maybe some embarrassment. "People don't want to admit that they are having a problem with sex," he says. "There's an emotional apprehension that they are a failure or just a psychosocial reluctance."
Problems with sexuality can arise not only from the physical challenges of arthritis but also from the psychological problems it often triggers such as depression, low self-esteem and lack of desire. "Depression is defined as a numbing effect and so when you feel numb, it's hard to have any sense of liveliness and sexuality," Rainer says. "And sexuality is based on liveliness. And many medications are going to contribute as a side effect some type of depression."
Rainer says that many physicians will not interview for depression and so it's underreported among people with a chronic illness. "If they [people with arthritis] begin to lose any appetite for pleasure, zest for life, have difficulty concentrating or are sleeping more than it's normal for them, those may be markers for depression," he says. "A family practitioner or rheumatologist can prescribe an antidepressant and often that can be an excellent get-together drug. If it completely disrupts all activities of daily living, that's the time to turn to specialized help."
A lack of desire and low self-esteem are other common side effects of arthritis, which can be attributed to both certain medications and a person's emotional and physical pressure from the disease. "Loss of sexual desire is in many ways like a thermostat that's turned to low," Rainer says. "It's not unusual when people have experienced a change in health status and perception of themselves or a sense of disability, they'll find that their sexual energy is diminished." Rainer recommends talking to the partner and explaining the situation, as well as consulting a specialist who can help with the loss, limitations from the disease and ways to regenerate sexual energy. If a partner gets defensive or takes some of those problems personally, then they can't speak with any degree of authenticity and that's a red flag for couples to seek professional help, Rainer says.
The thing to remember is that you need to redefine what means to be sexual with your partner, Rainer says. "There's no one sex life. Every couple has its own sex life. You need to sit down with your partner and talk about how it can happen. There's no right or wrong answer. Touch, feel, shower together, all of that is very sexual."
"It's All in Your Head" is the second story of the four-part series "Sexuality with Arthritis."
|
|
