EMOTIONAL ISSUES

 

When the issues faced by women whose menfolk were diagnosed with prostate cancer was being discussed in September of 2010, long time survivor ALAN MEYER posted what was, I think, an excellent piece on some of these topics. This what he said:

I don't have any statistics to support this and wouldn't know whether they exist or where to look for them. However, if I had to guess, I would guess that half or more of married couples of all ages have never worked out a fully satisfactory sexual relationship even before cancer intervened. I would further surmise that the great majority of older couples in that boat gave up long ago and no longer try to work things out. They either have no sex at all, or have it in rather formal, simplified, unchanging patterns that they worked out years before as minimally acceptable and stuck with because any attempt to progress was rebuffed by the other partner. Tired and humiliated by the psychological pain of rejection, they turn to other pursuits instead.

Now add impotence to this relationship and a difficult relationship becomes impossible. It can be an excuse for either partner to completely give up even minimal efforts at physical intimacy.

It may sound like I am talking about women who reject sex with their husbands, or accept it only under specific and not very common circumstances. That certainly happens. However I'm sure that the problem exists very much on the male side as well, for example with men who have never really tried to find out what their partners might like or how to satisfy them, or perhaps tried briefly and quit very quickly when they found out that what they were doing wasn't working or that their embarrassed wives didn't respond very quickly.

If I'm right about this then, for a great many couples, achieving a successful adaptation to impotence has very little to do with injections, pumps, pills, or implants. Sometimes those things just enable them to re-establish an already broken relationship that has to be re-established as it was, even if it requires major surgery on the penis, because any change, for example oral and manual sex, is unthinkable.

Sex and physical intimacy are so complicated, so psychological, so fraught with deep desires, so burdened with past history, that the physical issues related to impotence just can't be addressed as if the inability to get or sustain an erection is fundamental to the issue. There's no doubt that it's significant, but I believe that other issues are much more fundamental.

The most fundamental requirement is an ability to communicate with each other about these issues with love, candour, and acceptance. With that, a couple is on the road to success. Without it, they're stuck.

So, by all means, cancer survivors should share information about pills, pumps and the rest of it, but we shouldn't imagine that, in sharing this information, we are addressing basic issues. The basic issues remain deeply personal and deeply founded in the whole history of a relationship. More often than not I think what people really need is serious communication. They need to talk freely with each other about how they feel, about what the effect of impotence has been, about how to work around the problems and help each other, about how to retain and grow their intimacy in spite of the effects of the cancer.

Sometimes a good counselor can help facilitate this for couples who want things to work but are having trouble communicating on their own.

At any rate, and for whatever it's worth, that's my impression.