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One Step at a Time

Reframing Intimacy After Cancer

by Melanie Davis, PhD

Wellness image

You may have crossed sexual intimacy off your priority list when you found out you had cancer. If you’re in active treat­ment, you may not feel like being sexual in the same ways you were before diag­nosis. After treatment, sex may still seem unappealing or even painful. This is all normal. But if you’re ready to bring sexual intimacy back into your life, you can work through the challenges – one small step at a time.

Defining Intimacy
Many people think of sexual intimacy as sexual in­tercourse or other genital stimulation resulting in orgasm, including any ac­tivities that lead up to it. However, if you broaden your definition of intimacy to include other pleasures that may or may not lead to orgasm, you can be sexually intimate without the pressure to engage in activities that aren’t com­fortable for you right now.

Sexually intimate activity can be goal oriented or non-goal oriented. Goal-oriented activities are considered complete when they end in orgasm. The problem with goal-oriented sexual inti­macy is that there’s a chance of failure if you or your partner do not experience orgasm. Failure can be frustrating, es­pecially if it happens on a regular basis.

You and your partner both need to agree
to change the way you define sex.

Author of Article photo

Dr. Melanie Davis

On the other hand, non-goal-oriented sexual activity can’t fail because there is no goal, other than pleasure. Orgasm may happen, or it may not. There is no pressure to do more than you can comfortably do, given your interests, level of desire, and physical capability. Examples of non-goal-oriented intimate activities include kissing, fondling, body rubbing, massage, watching or reading erotic material, taking a shower or bath together, recalling past sexual encoun­ters, envisioning future encounters, reliving your favorite dates, cuddling with or without clothes, holding hands, walking arm in arm, or engaging in any other activities that you enjoy. They can also include genital stimulation or pen­etration as long as you and your partner agree to stop the activity if it becomes anything other than pleasurable for either of you.

Reframing Intimacy
Changing your mindset from goal-oriented sex to non-goal-oriented sex doesn’t happen overnight. It takes some time to get used to the idea that even though you or your partner may be aroused, sexual activity could end prior to orgasm. Communication and trust are crucial because you need assurance that you will not be pressured to do more than is comfortable or desirable for you.

New Jersey-based “reinvention catalyst” Gailann Bruen, LCSW, suggests making changes in imaginary 1/16-inch increments – tiny steps so small you are almost guaranteed success.

“My husband and I always planned to travel, but when he developed heart issues, he chose not to fly,” Gailann says. “A friend advised us to create local memories together. It turned me around. Now I tell people, ‘Don’t focus on what you can’t do, but on small things you can do together.’”

Gailann suggests taking a drive, going out for coffee, and hugging and touching throughout the day. “Work within what’s possible, and focus on all the tender intimacies. Touch and sweetness are so important,” she adds.

Redefining intimacy in this way requires communication. You and your partner both need to agree to change the way you define sex. Start by discussing how you can maximize closeness and intimacy within your levels of energy, desire, and physical ability.

“Talk to your partner about what’s possible for you now,” says Melissa Donahue, LCSW, of the New Jersey Center for Sexual Wellness in Bedmin­ster, NJ. “If intercourse is off the table, say so, and make sure your partner agrees not to push for it. Once you know that your boundaries will be respected, you won’t have to be anxious when your partner touches you.”

It’s also important to make the most of what you have by eating a healthy diet, getting ample sleep, finding ways to reduce stress, following your doctor’s post-treatment plan, and getting regular exercise. Take pain medications 30 min­utes before you begin any type of sexual activity if you typically experience pain during intercourse, and arrange for inti­mate encounters to coincide with your most comfortable, energetic times of day.

You can put sexual intimacy back on your priority list once you realize you can do it on your own terms. Take things one step at a time – you can make changes in tiny, 1/16-inch increments.

♦ ♦ ♦ ♦ ♦

Dr. Melanie Davis is an AASECT-certified sexuality educator and partner in the New Jersey Center for Sexual Wellness (njsexualwellness.com) in Bedminster, NJ. She offers private consultation to teens and adults and specializes in sexual decision-making, health, pleasure, and sexual concerns related to aging and cancer. You can contact Dr. Davis by calling (908) 722-1632.

This article was published in Coping® with Cancer magazine, May/June 2013.