Sex and chronic illness or disability

In current times it can be very challenging for people to find the time for intimacy. Just as couples might head for bed they will check their phone or iPad looking at emails and social media sites. So distracted by news from friends or demands from managers at work all thoughts of sex or intimacy which might have been brewing vanish with the thoughts of the report now due tomorrow or news of a friend's pregnancy or illness.

Think how much harder this is for clients who also have the challenge of changing a central line dressing before bed or having to link up to a machine in order to obtain food intravenously overnight because they are unable to absorb sufficient nutrition via their digestive system. They may need dialysis or portable oxygen. The actual logistics and mechanics of trying to have sex while connected to a machine is really difficult to negotiate and the anxiety around dislodging dressings or tubes is alone enough to kill any chances of arousal. Chronic fatigue or pain can often overwhelm people and much as they would like to be intimate, even a cuddle is too problematic and sadly people can withdraw just when it might be the most comforting thing they could do. A practical pragmatic therapeutic approach can be very helpful. A therapist can support the client to look at the logistics and think about how to manage their concerns. Yes they will have to be flexible and compromise, as will their partners, but with the right preparation a multitude of physical challenges can be overcome so that clients can again be touched, cuddled and sexual with their loved one.

Side effects from medication can also interfere with energy levels, cause unwelcome weight gain and other side effects. Sometimes looking at how and when medication is taken can be helpful to optimise energy levels. The opportunity to discuss body image concerns with a therapist can help clients see their worries from an alternative perspective and working with a couples therapist can support both partners in coming to terms with the challenges they face. I advocate urging clients to look at what they would like to do and then practically at what they can do. Sex and intimacy doesn’t have to be an all or nothing activity. It is a continuum and partners can evolve unique and creative ways of making connection. They don’t have to be slaves to what the media and latest magazine articles dictate as good sex or frequency. What is possible and how can they make it possible is what is important.

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London N6 & WC1E

Written by Selena Doggett-Jones

London N6 & WC1E

Selena Doggett-Jones is a COSRT accredited relationship and psychosexual therapist working in private practice in north and central London. She has also worked within the NHS for many years as a therapist and specialist nurse in sexual health and general practice. Website is

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