A loving relationship without sex is like Valentine's Day without hearts and flowers. Perhaps that's the way you or your partner feel about intimacy now that multiple sclerosis is a part of your life. Have the symptoms zapped your passion or stymied your in-bed performance? Is your significant other afraid of making love-or seemingly put off by it? Most important, does the topic have you paralyzed? Do you feel you can't discuss it with your partner or your health-care providers?
Answer "yes" to any of these questions and you may be a good candidate for sex therapy. No, we're not talking about the stuff of TV sitcoms but serious sessions to remove serious stumbling blocks. "
The most important thing for people to do is probably the most difficult thing, which is to begin talking," said Fred Foley, PhD. He is director of Psychological Services at the Bernard W. Gimbel MS Comprehensive Care Center at Holy Name Hospital in Teaneck, New Jersey, and has worked with people who have MS for over 25 years. "People don't have to suffer in silence," he said. "They have a right to get help. If they do so, they can have a far fuller life."
If you see intimacy diminishing, or feel isolation building in your partnership, you may want to enlist a licensed mental health-care provider schooled in sex therapy. If your doctor can't refer you to a psychiatrist, psychologist, or psychiatric social worker also experienced in the unique issues of MS, ask your nearest Society chapter for a referral.
Whomever you tap should provide you with a non-threatening environment where you and your partner learn to initiate intimate conversation and activity. If you're like some of Dr. Foley's clients, you may even need to focus first on the idea of having such a discussion, before actually doing it.
Once the door opens, however, a therapist usually helps partners reduce their vulnerability. They learn to use words and phrases that are respectful and not accusatory. "It's not a matter of assigning fault," Dr. Foley pointed out. "Instead, both people have to learn how to deal with the relationship in ways that empower and enrich it."
From there, the therapist may provide basic education on how the physical problems of MS can interfere with lovemaking. You may learn, for instance, how to maneuver your spastic legs into a comfortable position during sex. Or you may establish a new framework to counter the sensations altered by MS damage in the central nervous system.
While there's no proven medical treatment for diminished sex drive, you'll find out that you can still experience pleasure. Dr. Foley teaches a technique called body mapping to help partners find new sensual points that make orgasm possible once again. "We can help people discover how to communicate emotionally after the rules have changed dramatically," he said.
One of his clients marshaled new pathways so well that she and her husband not only enjoyed sex again, they conceived a baby. While this particular couple took months to reconnect, therapy need not last forever. Another couple needed just one session to learn how to incorporate self-catheterization into foreplay. This ended the woman's troubling bladder dribbling at orgasm.
Sexual problems don't necessarily accelerate with advancing disease. But each symptom can potentially interrupt enjoyment, so it may be appropriate to pay return visits. Dr. Foley believes there's always room for improvement. Finally, he advises, don't deny yourself counseling because your partner refuses. Obviously, progress comes more easily if both individuals are committed. But if your mate doesn't approve, you can still pursue it on your own. Your enthusiasm for change might be contagious.
However you play the song, you need to believe that MS can coexist with a loving relationship of hearts, flowers ... and satisfying sex. You need to believe it is worth working for.