Reestablishing Intimacy after a Severe Injury

Men and women who have experienced disabling injuries are often concerned about how their condition will affect their intimate relationships. It’s natural to worry that others will no longer find you desirable, that you won’t experience emotional closeness, that physical changes mean you won’t be able to have or enjoy sexual activities, or that having children may no longer be a possibility. While every situation is different, there is no reason why your injuries should keep you from being in an intimate relationship. By talking openly about your concerns with the appropriate health care providers and your loved one, you can learn ways to maintain a long-term, loving relationship.

What you may be concerned aboutYou may be concerned that:

  • Your spouse will no longer find you desirable or want emotional closeness
  • Sex will no longer be possible
  • Sex will be awkward or painful

These concerns may seem so overwhelming that you decide to avoid intimate relationships altogether, but research has shown that people who share both physical and emotional intimacy are less depressed and healthier than those who do not. Depending on your injury, sexual relations may be different than before, but the emotional connection between you and your spouse can remain strong.

What intimacy meansAn intimate relationship is more than a physical relationship. Certainly physical attraction is what brings us together in the first place, but even that is complicated and unique to each person. In a significant relationship, both people feel emotionally connected to each other. A relationship can be based on many things, including mutual respect, common interests, shared life goals, common culture and ethnicity, and love.

  • Be friends first. Many long-lasting romantic relationships have grown out of friendships. Good friends enjoy each other’s company, like to do things together and are able to talk freely, support each other and value each other. Good friends don’t have to do everything together, but they aren’t threatened by their differences.
  • Have conversations and allow silence. Not all conversations need to be around tasks like who takes out the garbage, if a restaurant is accessible or what to have for dinner. Ask about opinions, the meaning of money, how the disability has affected physical desire and the logistics of sex. Intimacy is often reflected in a couple’s ability to be with each other without talking. This may take some practice, as you may have done things in a different way before the onset of the disability.
  • Treat your disability as part of who you are. It’s natural to compare your life with what it was in the past. You may focus on that in the beginning, and that’s okay. It’s also okay to be angry about the changes you have to make. They probably aren’t easy ones. Your way of doing things may certainly have changed, but your disability is just one part of who you are — it doesn’t define who you are.
  • Treat yourself well. You may not feel confident at all, but you can work on that. Focus on things about yourself that you are proud of. Maybe it’s your sense of humor, your intelligence, your unparalleled knowledge of movies, your ability to play guitar or your caring nature. Whatever nurtures you also nurtures others.
  • Play. This is easily forgotten in adults, whether they are able-bodied or not. Laughter is a truly human activity. It feeds the mind, body and soul. A well-defined sense of humor is attractive, necessary and wonderful and shows up in the most unlikely of places.

Communicating openlyTalking openly with an appropriate health care provider and your spouse about your disability and how it will affect your intimate relationship will help you and your spouse become comfortable with the change. Not every health care provider is comfortable or knowledgeable in this area, so it may take time and effort to find one who is.

  • Ask your health care provider how your injuries may affect your sex life and your ability to have children. You may feel uncomfortable with the subject, but often the only way to get the information you need is to ask for it. If your health care provider can’t answer your questions, ask to speak with someone who will talk openly with you.
  • Answer your spouse’s questions openly and honestly. It may be uncomfortable for both of you at first, but encouraging such conversations makes it okay for him or her to continue asking questions — improving trust, sexual intimacy and emotional closeness.
  • If your spouse doesn’t ask questions, bring up the topic yourself. Show that your disability is open for discussion. Ask your spouse whether he or she would like to know anything specific about your injuries. What it feels like, for instance. Ask whether he or she is afraid of what other people will think of your relationship. Get these issues out into the open, where you can discuss them and ease each other’s fears or doubts about the relationship.
  • Discuss with your spouse who will see to your health needs when you are back home. Your spouse may volunteer to perform the tasks related to your care, but you may be uncomfortable and view this as intrusive and private and wish to keep it separate from your relationship. You can ask another family member or find a home health aide so you can keep those two parts of your life separate. Military OneSource, the injured support program for your Service (Army Wounded Warrior Program, Marine Corps Wounded Warrior Regiment, Navy Safe Harbor, or Air Force Wounded Warrior Program) and the Department of Veterans Affairs (VA) can assist you in finding a home health aide.
  • Acknowledge that your injury has changed your spouse’s life as well as yours. Your loved one will have his or her own thoughts, feelings, expectations or beliefs about the changes to your body and will have to find a way to deal with this in your new life together. Let your spouse know that you will support him or her during this process.
  • Ask your health care provider about medical treatments. In some cases, medications that treat erectile dysfunction have been known to help men with spinal cord injuries. Talk with your health care provider about these and other possible treatments.

Reestablishing trust and intimacy can take some time and will certainly require openness and patience. Remember to communicate with each other and to reach out for support when you need it. Enjoy each other’s company and continue to grow your loving relationship.