Sexuality, Intimacy, and Multiple Sclerosis

To conduct a “sensory body mapping” exercise (15 – 20 minutes): Begin by systematically touching the body from head to toe (or all those places you can comfortably reach). Conduct this exercise without your clothes on, in a place that is private, relaxing, and a comfortable temperature. Vary the rate, rhythm, and pressure of your touch. Note areas of sensual pleasure, discomfort, or sensory change. Alter your pattern of touch to maximize the pleasure you feel (without trying to obtain sexual satisfaction or orgasm). Next, inform your partner of your “body map” information and instruct him/her in touching you in a similar fashion. Have your partner provide the same information for you (about his or her “body map”). Take turns providing pleasure to each other, without engaging in sex or trying to orgasm. Remember, the emphasis is on communication and pleasure, not sex or orgasm.

Changing Roles

Changes in family and societal roles secondary to disability can affect one’s capacity for intimacy and sexuality. The person with MS who has difficulty fulfilling his or her designated work and household roles may no longer feel like an equal partner. The partner of a severely disabled individual may feel overburdened by additional caregiving, household and employment responsibilities. The couple’s intimate relationship can be threatened by the growing tension that results from these feelings.

In addition, the caregiving partner (either male or female) may have trouble switching from the nurturing role of caretaker to the more sensual role of lover. As a sexual partner of a woman (or man) with a disability, a man may begin to think of his partner as too fragile or easily injured, or as a “patient” who is ill and therefore unable to be sexually expressive. If it is practical or culturally acceptable, having non-family members perform caretaking activities helps minimize this “role conflict.” When caretaking must be performed by the sexual partner, separating caretaking activities from times that are dedicated to romantic and sexual activities can minimize this conflict.

Accompanying these role changes may be an increasing sense of isolation in the relationship and less understanding of the partner’s struggles and perspectives. The diminishing capacity to understand and work through these issues creates greater isolation and misunderstanding, leading to increasing resentments.

Intimacy and Communication

A satisfying, intimate relationship rests on a broad foundation—of trust, open and honest communication, shared goals and expectations, and mutual respect and concern. Intimacy refers to all of the ways, both verbal and non-verbal, in which partners connect with one another and enjoy their unique closeness. Often the biggest problem is the inability to discuss sex and intimacy with one’s partner and learning to talk more comfortably about sexual issues is a process.