1. Dr. Annette E. Brissett Clinical Psychologist Director, Houston Psychology Consultants October 11, 2014 RECLAIMING SEX & INTIMACY AFTER BREAST CANCER: PSYCHOSOCIAL CONSIDERATIONS Sisters Network Annual National African American Breast Cancer Conference

2. A Simple Question SINGLE OR MARRIED?

3. Cohabiting couples are 5 times more likely than singles to have SEX more frequently--at least 3 times per week!!

4. OVERVIEW TALKING ABOUT SEX: TABOOS PHYSICAL & EMOTIONAL BARRIERS TO SEX AND INTIMACY BREAST CANCER & SEXUAL SELF ESTEEM/BODY IMAGE COUPLES AND COMMON PSYCHOSEXUAL ISSUES A MAN’S PERSPECTIVE HOW DO COUPLES RECONNECT AFTER BREAST CANCER THE NEW NORMAL: CREATIVE WAYS TO RECONNECT – BRINGING SEXY BACK!! RECOMMENDATIONS FOR MAINTAINING SEXUAL VITALITY IN YOUR RELATIONSHIP HELPFUL RESOURCES

5. Let’s Talk about Sex Taboos Having a serious illness of any kind can affect your sex life 200,000+ new cases of breast cancer reported annually in U.S. Medical doctors/Oncologists concerned with saving your life Breast cancer can affect intimacy in your relationship National Cancer Institute study found 1:2 women report persistent sexual dysfunction after undergoing treatment

6. Sexual Problems and Breast Cancer A National Cancer Institute Study found 50 % of breast cancer survivors report sexual concerns or problems after undergoing Breast Cancer treatment

7. BARRIERS Effects of Treatment VS. Psychosocial Factors

8. Barriers EFFECTS OF TREATMENT Medication Vaginal dryness Painful intercourse Chemotherapy Fatigue Radiation pain Surgery Pain Functional deficits Loss of sensational Changes in body image

9. Barriers PSYCHOSOCIAL FACTORS Emotional impact anxiety depressive symptoms Breast within our culture Endearing Characteristics Sexuality Sensuality negative feelings Body image/Sense of Self

10. In our culture, Society puts emphasis on beauty and perfection breasts often define who we are A change in shape or loss of ones breast has major impact on self- esteem sense of self and body image Perceived unattractiveness can affect ones sexual self esteem SEXUAL SELF ESTEEM If you do not feel attractive before Breast Cancer, you may struggle with low self esteem and body image issues after treatment. Having no breast or one breast or limited sensation affects self- image and creates feelings of inadequacy and shame How you view yourself as a sexual person serves to increase positive sexual self esteem

11. PHYSICAL & EMOTIONAL BARRIERS I am unhappy with my looks I miss my breast I am not sure I can ever be naked in front of him again I don’t want to look at my scar I am alive but I feel sad and guilty I want to be touched -breast cancer survivor

12. A Man’s Perspective Sex, after Cancer-What’s That? Most Spouses don’t know how to approach the subject of touch or sex after breast cancer and may be confused about intimacy and sex Struggles exist between wanting to support wives and a desire to demonstrate love Fear exists such as “will I harm my wife” or will I cause her added pain Spouses may feel neglected or rejected and may temporarily lose their connection

13. Depending on how strong or weak the relationship bond is prior to diagnosis Partners fear they may be insensitive if desiring sexual intimacy Survivor may be interested in touch but not sexual intimacy When couples retreat sexually, touch may feel odd or different after a long sabbatical Sex is often low on the “Honey Do” list after Breast Cancer diagnosis or treatment Common Issues For Couples

14. Bringing Sexy Back! Redefine Intimacy

15. RECOMMENDATIONS FOR MAINTAINING SEXUAL VITALITY Make sex and intimacy a priority Consider sexual therapy – sensate focus Increase touch – it helps with coping/stress reduction Seek psychological support/relationship counseling Keep lines of communication open and allow partner into the trenches shift your focus away from breasts and identify other sexual areas of the body

16. RECOMMENDATIONS FOR MAINTAINING SEXUAL VITALITY Use humor to diffuse stress Don’s be afraid to ask for what you need Relaxation skills meditation, prayer, exercise Love and accept your body

18. SUMMARY Breast Cancer affects your intimate relationship Physical and emotional factors affect intimacy Men and Women experience Effects of Breast Cancer differently Embrace your body to increase self esteem Communicate openly and honestly Seek support

19. HELPFUL RESOURCES Dr. Annette Brissett: www.houstonpsychologyconsultants.com Sisters Network www.sistersnetwork.org Breast Cancer Husband, by Marc Silver The center for intimacy after cancer therapy inc. www.renewintimacy.org Intimacy After Cancer: A woman’s Guide, by Kydd & Rowett Look Good Feel Better Program, Baylor Facial Plastic Surgery Center Your shoes 24 hr hotline / peer support www.networkofstrength.org

20. Thank You!