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Reclaiming Intimacy After a Stroke

Make Your Marriage Peaceful and Loving Again

A caregiver kisses her husband, a stroke survivor.

Strokes can wreak havoc on your sex life. Sex presents difficult challenges and is a huge issue whether caring for a husband or a wife. How do you even broach this sensitive topic with your spouse? Whether you want to have sex or don’t want to have sex, there are practical strategies for raising the issue, and then resolving it, so your marriage will be more peaceful and loving. 

One Scenario: You want sex, he doesn’t.

You may want to reclaim the love relationship you thought was gone, and don’t know how. Your husband may have lost function because of the stroke, be afraid of having another stroke or he may no longer have much sex drive. His sense of himself as a man may have changed, or he simply may be too angry or depressed to have any interest in sex.

That’s what Alice found with Albert. Now in their 60s, they had been high school sweethearts. Even though they weren’t kids anymore, some form of intimacy was still important to them. One day, Alice awakened to a beautiful sunrise and thought, “Oh great! Albert and I can go hiking and have one of our romantic picnics. But then she remembered that they didn’t do that anymore.

Albert was a stroke survivor, and even though he could do most everything he could before, he was angry and depressed and chose to stay in bed. He didn’t want to talk, and mostly snarled at Alice if she tried to, or suggested he do anything. So, instead of going on a hike, Alice went out onto her deck and cried.

Solution: Avoid being adversarial.

Alice began to identify and clarify her concerns in order to decide which ones she really needed to discuss with Albert. Rather than faulting Albert for his lack of interest in her, his poor hygiene or how he wasn’t a good husband any longer, she realized what bothered her most was that she missed Albert. So that’s what she decided to talk to him about.

Not knowing how to approach him about anything these days, she learned simple ways to begin a conversation. Rather than starting with the dreaded, “We need to talk,” she used the more effective approach of “Honey, I’d like to talk…”, or “Honey, I’m concerned about…”.  

Now using collaborative communication techniques, she and Albert worked together. She discovered it was all right to start simply by just agreeing to get together to talk about an article they both read. A seemingly unimportant activity, it was the starting place for restoring civil conversation on their path to intimacy. Through simple agreements such as this, they created ways to put intimacy and romance back into their marriage. 

For instance, they agreed that one night a week, Alice would make a lovely meal, and invite Albert to join her. When he did, they reclaimed some intimacy. When he didn’t, she said nothing. She’d either eat alone or would leave to eat elsewhere with friends. Previously she’d scream at him, which made intimacy more unlikely. Now there was a more relaxed atmosphere in the house for both of them, creating the opportunity for intimacy to return.

Another Scenario: He wants sex, you don’t.

You may not want it, but after a stroke your husband could require more intimacy, physical contact, and sex, no matter what his physical condition. He’s had a big scare, recognizes his mortality, doesn’t want to miss a moment of living, doesn’t want you to ever doubt his love for you, or wants to prove he’s still “got it”.

As the caregiver, you think “Who has the energy to have sex on top of my other duties!” And how can you think of having sex with someone you now spoon feed, or clean after a visit to the bathroom – someone who looks bad and smells bad? Besides, since you probably have avoided self-care in order to care for your spouse, it’s been a long time since you pampered yourself in order to feel sexy.

Paulo and Patricia are in their 50s, and have been married for 20 years. Paulo’s stroke left his right arm limp, unable to move easily in bed, and unable to hold Patricia. Nevertheless, he wants sex and nags Patricia about it constantly. Patricia still teaches high school science and has committee obligations at school. Yet she has to take care of Paulo’s cooking, cleaning and special needs when she gets home, along with caring for their two teen-age daughters. Patricia finds Paulo’s limp arm, the resulting poor hygiene, and perpetually having to clean up after his "accidents" have become a turnoff to her. What can she do?

Solution: Make agreements that work for you.

Women as nurturers are able to overcome the turnoff a little more readily, since they can physically comply more simply. Men caring for wives have a more difficult problem. Men tend to be visual, so are impacted more by the appearance of their wife. On a very physical level, arousal can’t occur if they are turned off by what they see. In either case, collaborative communication is the answer.

Using the same learned communication tools as Alice, Patricia and Paulo arrived at very different agreements. Sex had been a major battlefield, and bad feelings from their arguments spilled into every area of their life. Patricia was tired of the constant pressure for sex. They both had their opinions on the subject, and those would not change.

In order to reclaim the friendship part of their intimacy, they reached an understanding that sex would not be discussed again. But in order to maintain physical intimacy in their marriage, for Paulo’s sake, Patricia conceded to make love once a week. This created peace and calmness where once there had been anger and turmoil. So, even though the outcome was not ideal, they found hope for reclaiming some level of intimacy in their marriage.

Of course intimacy can exist in many forms from intercourse, to just lying next to your love, to holding hands, or just looking into each other’s eyes. Whatever is appropriate for and acceptable to you sets the standard.  Whatever that may be, collaborative communication will provide the hope, and the key, to keeping your marriage, and ensuring the love you shared will not disintegrate.

By: Diana B. Denholm, Ph.D., LMHC, author of The Caregiving Wife’s Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself

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"Collaborative communication will provide the hope, and the key, to keeping your marriage, and ensuring the love you shared will not disintegrate."

About the Author

Diana Denholm, PhD, has been a board certified psychotherapist for more than 30 years. For 11 years, she was the primary caregiver to her husband during a series of grave illnesses. Her critically-acclaimed book, The Caregiving Wife’s Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself, offers hope, advice and resources for women and men caring for their spouses with long-term illnesses.

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