Q & A - Communication with a partner
These questions were suggested by people in Ireland who have been impacted by cancer. The answers were collected from experts based in Ireland.
“I don’t know how to tell my partner that I don’t know when I’ll want sex again. I’m afraid to even hug or kiss now in case he thinks it will lead to something else. He’s trying so hard. What can I do / say?”
Emily Power-Smith Sexologist & Educator
“This is a really common worry for any person who’s libido drops. If hugging and kissing has usually been a precursor to a bigger sexual encounter, and you’re not feeling able for that, of course you’re going to avoid the precursor. But it can leave both of you feeling pretty lonely and bereft of affection. The first thing to try is setting a boundary around kissing and hugging. Tell your partner that for now, it’s all you are able for, so for now, you’d love to enjoy that intimacy and affection but in order to do that, you need to know that nothing more will be expected. Then you can really relax into some lovely embraces. Ironically, putting in a boundary can provide a lot more freedom to be close. Emphasise that you see all he’s doing and love him and want to have as much closeness as you can manage right now, and that as much as you can manage. Usually when you frame it with love and appreciation, it’s a lot easier to talk about.”
Mary Rogan Retired General Practitioner and Psychosexual Therapist
“In a word - talk! Talk to him, share your thoughts, share your fears. If you have unspoken fears or reticence, your partner will pick up on your body cues and make inferences as to the meaning of those cues.
There are many different types of intimacy and the intimacy of a shared space and conversation could be where you begin. Sometimes it's easier to talk when you're walking or out having a meal.
Ask your partner to be content with the intimacy of conversation and exchange of thoughts and fears. Agree that there will be no pressure to have sex until you feel able. You may or may not be able to proceed to a type of sensate focus programme which involves gentle touching and learning to take pleasure from touching each other without any sexual touch and no demand for sex. Take plenty of time because not everybody is ready for this, but you can have it as part of your plan to proceed to when you feel able. You will both need to agree that if arousal occurs it does not mean you need to go ahead and have sex. Removing the demand for sex reduces anxiety, and makes it easier to connect. In this context, you need to take very small steps so stay at the shared intimacy of conversation and companionship for as long as you need and only move on when you're both comfortable.”
“My partner sees me differently since my treatment. He sees me as somebody who survived cancer and somebody whose body has changed. He loves me no matter what but he is more cautious and careful now when touching me. How can I get him to be relaxed with me?”
Emily Power-Smith Sexologist & Educator
“This can be a really precious journey together. It’s very common for a loving partner to worry about hurting their loved one in this situation. I’d start with some breathing together and I’d ask that you explore touch together with only pleasure on the agenda. No trying to turn each other on, or reach orgasm. Just share pleasurable touch. You may not have done much talking or sharing before around what feels good. So it’s easier to learn this when not in the throws of passion. Practice alone if that helps so you can confidently show your partner where to start. This can be a wonderful opportunity to get to know each other in a new way, and is a fantastic way to enliven sex lives with or without illness. You can reciprocate if you don’t want to have all the attention on you. That can normalise things.”
“My partner is concerned about her safety because of my chemotherapy. What can I say / do to maintain our sex life while in treatment?”
Yvonne O’ Meara Psychosocial Oncologist & Systemic Psychotherapist
“Navigating a sex life during treatment can be challenging for both partners not as a result of toxicity, more around fatigue and low desire. As your partner is specifically concerned with her safety, encourage her that you both attend the next oncology appointment together and ask what recommendations they would suggest, if any. In general it is safe to have sex during chemo but use protection against pregnancy.”
Mary Rogan Retired General Practitioner and Psychosexual Therapist
“Often oncology specialist nurses, and indeed specialist nurses in general, have more time and interest in addressing their patients care in a holistic manner and will have more information about the topic of sex during chemotherapy, than the oncologist may have. The other observation I would make is that unfortunately you will probably have to break the ice and ask about approaching sex during chemo as the medical professionals unfortunately are reluctant to broach the subject, so don't wait to be asked. Ask the oncologist and if you're not happy with the degree of detail supplied, follow up with the oncology specialist nurse.”
“What are the main communication issues that affect couples with / after cancer?”
Emily Power-Smith Sexologist & Educator
“Cancer isn’t usually the problem. Couples who already have the skills around communication tend to do better. If you didn’t communicate much before, that’s going to remain the same and might even get worse as more difficult issues arise. Therapy can be excellent to provide you both with a safe space to start talking, where you can also learn communication skills.”
Mary Rogan Retired General Practitioner and Psychosexual Therapist
“Understanding the need for gradual reconnection - learning to experience the intimacy of a shared space in silence first and move on to conversation... Baby steps are needed - only go as far as you're comfortable with. Remember that unspoken thoughts and fears give the wrong impression to your intimate partner. They will pick up on your body cues and make inferences as to the meaning of those cues. It's better to talk.”