The reason for starting with the mechanical question is to get it out of the way so that you can look at the more important relationship issues, for these are the areas where disease and handicap have their most profound influence. If we keep taking our banged-up cars into body shops for repair without looking at how we drive in traffic, we will end up with more and more banged-up cars. So it is with disease that, as one paraplegic man stated, “The system is more important than the thing.”
“I just sort of became the chicken-soup type. I mean, I turned over my life to everyone else. My wife became a caretaker, and caretakers are not supposed to screw their patients.” This statement from a husband with multiple sclerosis illustrates the importance of sexual self-concept. Try to answer question two not in terms of skill or attractiveness but on the basis of “how” you are as a person when you are trying to be intimate. If you are experiencing disease, what has the disease process done to your relationship skills. Have you become more dependent, more aggressive, less assertive, more or less withdrawn? What has been the major impact of your illness on you as a person? How people experience disease and illness tells more about how they really are as persons than how they experience health.
I have my patients who are experiencing disease calculate their “N/S Quotient.” This is the balance between nurturance—taking care of someone else—and succorance—being taken care of by another person—that I discussed in Chapter Four. One of the most healing of human experiences, one of the healthiest things you can do, is to help somebody else. When you are sick, you must continue at some level to help others. How would you say your balance is? Do you still profit, even if you are sick, from all the good healing internal chemicals that come from the joy of supporting and helping someone else?
There have been research articles (not many) describing the impact of disease on sexuality. There have been very few articles about the impact of sexuality on disease, on sex as healer, on sexual shamanism. Maintaining and enhancing intimacy throughout the challenge of disease is not only possible but necessary for getting better. Remaining sexually active can actually slow some aging orocesses, protect the genitals to some degree from aging changes, and possibly offer a boost to your immune system. Research has clearly shown that immunoefficiency increases when you love and are loved.
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