Keeping intimacy alive when ill

I first met Irene and her husband Jonah 12 years ago. At that time, they were going through a conflict because Irene was tired of being the initiator of sex in the marriage. The moment she stopped initiating it, their marriage became sexless. This made her hit the roof.

“I expect you to do to me the one thing that neither I or any of my relatives can do to me,” she said when they came to the Sexology Clinic, “if you are unable to have sex with me, I have no business calling you a husband.”

I attended to them at the time, resolved the conflict and got them back on their feet. First forward ten years later, two years ago, Jonah was involved in a road traffic accident smashing his spinal cord. He got paralyzed on both legs, could not control urine or stool and was unable to have penetrative sex. Irene was devastated.

“I visited him twice a day at the hospital, cleaned him, and collected and disposed of his wastes,” she explains, “but what did I get in return? Harsh words, insults, and hate. It was all very strange to me.”

After four months in hospital, Jonah was discharged on a wheelchair. His legs were numb and lifeless. He was put on a urinary catheter too to avoid him soiling himself.

Sexual intercourse was out of the question. According to the doctor, chances of Jonah regaining his lost leg, sex and urine functions were slim. The spinal cord was badly damaged leading to the waist downwards becoming lifeless.

“I sympathized with the man I had loved all my life, it was a difficult time for us,” Irene says, “I made a promise to myself that whether he recovered or not, I would remain true to him and serve him all my life. Little did I know that he would betray my trust and do what I had never imagined in our relationship!”

Jonah’s insults towards his wife worsened after discharge from hospital. He showed no love to her at all. He eventually became violent.

“He would wait for me to get to bed; he would then ask me how many men I had slept with from the time he got disabled. Within no time he would be punching and slapping me and many times I had to run out of bed for safety.”

Jonah used every opportunity to accuse Irene of unfaithfulness. He did not allow her to talk to her male colleagues through the phone, even when it was work related conversations. Jonah checked her phones daily for messages sent and received and for calls made. Occasionally he would call back some of the numbers and would warn them to keep off his wife. Irene was so embarrassed. It is for this reason that Irene came along to the Sexology Clinic for the second time.

“You very well remember her saying that if I cannot have sex with her then I am not worth being considered a husband,” Jonah said reminding me of the first time they came to the clinic, “don’t you see why I am concerned? Who is her new husband now?”

I got it! Jonah took Irene by her word; that the marital relationship ended the moment sex became impossible. This made me reflect on the many instances when a marriage cannot be consummated; cases such as road traffic accident affecting organs vital for sexual function, disease such as cancer affecting sexual function, diabetes or a nerve disease affecting erection or loss of sex desire in women etc.

The unfortunate situations may make the affected person develop severe jealousy, sometimes becoming pathological in nature. In pathological jealousy the affected person constructs mind pictures of infidelity, most of the time the infidelity being non-existent. The affected person may have strong beliefs that their spouses are cheating on them and construct unbelievable stories about the infidelity. They admonish, warn and even punish their innocent partners for the imaginary unfaithfulness.

One other gap is that in treating some of these health problems, changes in sexuality are rarely discussed. The couple is left to figure out what to do.

“Yes, but also in my case my wife already said that I am not a husband to her if I cannot have sex,” Jonah said looking down and dejected.

“I am sorry,” Irene interjected sobbing, “I cannot do that to you, the context is different, please understand.”

I had a few more sessions with the couple. Counseling and therapy helped clear the psychological trauma they were going through. The difficult aspect of the treatment was to explore new ways of satisfying each other sexually. This was done and sex resumed, even though not in the form that they were used to. What was important was that sex continues in whatever form to keep the family going.