Talking about Intimacy

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

JANUARY 16, 2017

I have written numerous times about sexuality and intimacy, but am motivated to do so today because of an article from Oncology Nursing. I note, first, that I was a bit surprised that this very good piece was written by a nurse. Realize that sounds demeaning, and I surely don't intend that reaction. It is just that, in my experience, oncology nurses are so skilled and so busy with a thousand other things that a conversation about sex just isn't likely. Those discussions tend to take place with doctors or, more often, with social workers.

The second thing that I hope you will find interesting is that this article is written for nurses and other caregivers. When I have written in the past, it has been to share information or to encourage you to bring up this sometimes tender topic with your doctor. Here Pam McMillan, RN is gently instructing her colleagues how to bring up the subject. This is quite a different perspective!

PS: I disagree with her that intimacy is the biggest elephant in the room although it surely is a large one. I think that distinction is shared between the outlandish cost of some new therapies and difficult honest end of life conversations. And a second PS: I am going to share this article with my wonderful nursing colleagues.

The Elephant of Intimacy

What do you think is the biggest "elephant in the room" for cancer patients? Why is "the elephant" so hard to talk about? Why doesn't someone else bring "the elephant" up? Is "the elephant" making you or the patient uncomfortable?
As a nurse, I believe we hear just about everything, and sometimes that can make us feel awkward. Have you ever been told something by a patient and you just could not get out of the room fast enough? Why is that? Maybe it's because we as healthcare providers believe that in order to talk about a subject with a patient, we should be an expert on it. However, when we are uncomfortable talking about something, those subjects tend to get pushed aside. How do you react and what do you do to help patients address their "elephant in the room"?
I hear it often when talking to survivors that one of the biggest changes they experience after diagnosis is in relationships. Cancer can have an effect on every relationship in their life including their partner, their children, their parents, and even close friends. But I think the one relationship that can be affected the most is the intimate relationship. So, how do we help our patients with this "elephant"?
Intimacy is a fundamental and life-affirming element of human experience, and it's not just intercourse. Intimacy is a multidimensional experience. It's the touch of a loved one, a kiss from your partner, or it can be a simple compliment. There is significant evidence that describes the negative impact of cancer treatment on intimacy. It has been associated with anxiety, depression, low self-esteem and relationship distress. And not to mention the barriers that it can have between patient and healthcare workers.

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Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
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