Intimacy, Relationships & RA

Communication is an essential part of maintaining a healthy relationship – it’s how we share our thoughts, ideas, feelings, and desires with our partners. But, in a relationship where one partner is living with a chronic illness like rheumatoid arthritis, communication is likely even more important. Communication allows my husband and I to face chronic illness as part of a team with a united front. It allows us to address conflicts, cooperate through difficult times, ask for help, and assure that our own needs are met. It’s also key to intimacy and maintaining a healthy sex life. In short, good communication allows our relationship to weather the storm of chronic illness – and maybe even grow stronger in the process. My husband and I are always looking for ways to improve our communication, because we know just how important it is to our relationship – and to our family as a whole. But I have to admit that when I first heard about the idea of the five love languages, I wasn’t interested. It honestly sounded pretty cheesy to me! However, when both my doctor and my therapist recommended it, I decided to take a closer look. Using love languages to improve communication The 5 Love Languages is a book written by relationship counselor Gary Chapman in 1995. His theory is that there are five different “love languages” that people use not only to express love, but also to experience it. Chapman theorizes that people tend to naturally give love the way they prefer to receive it – which means that if you and your partner express love in different ways you may, more or less, be trying to speak to each other in different languages. What is your primary love language? By figuring out each partner's primary love language, you’ll both be able to communicate love more effectively. So, at my therapist’s suggestion, both my husband and I took the online quiz to determine our primary love languages. Here’s a brief rundown of Chapman’s five different love languages: Words of affirmation – this person needs words to affirm their partner’s love Acts of service – for this person, actions speak louder than words Receiving gifts – this person feels most loved when they receive a gift Quality time – this person needs their partner to give them undivided attention Physical touch – for this person, nothing speaks more deeply than touch Results from the online quiz Our results honestly surprised us. I turned out to have two primary love languages – equally split between acts of service (9) and words of affirmation (9). Those were closely followed by quality time (7). Less important to me was physical touch (4) and receiving gifts (1). To me, this score clearly demonstrates the impact of RA on my life: what I find most important is help getting things done and confirmation that I am worthy of love. And it makes sense that physical touch is near the bottom for me, as RA can often make it painful to be touched or touch my partner. While my husband also ended up with two primary love languages, they weren’t the same as mine at all. His primary love languages were physical touch (10) and quality time (10). Those were pretty closely followed by words of affirmation (7). At the bottom of his list he had receiving gifts (2) and acts of service (1). Differences in our love langauges Although we turned out to have similar opinions on the importance of receiving gifts, we were both pretty shocked to discover that one of my top love languages – acts of service – was at the very bottom of his list. Likewise, one of his top love languages – physical touch – was near the bottom of mine. And because people tend to express love in the way they prefer to receive it... How we use this information We realized that we were missing each other’s messages. Now that we are aware of each of our preferences, we each make an effort to express our love in the other’s preferred language. For example, while my husband certainly appreciates a clean house and a hot dinner when he gets home from work, what matters more to him is being welcomed with a hug and a kiss. And, while I certainly appreciate a kiss or a shoulder rub, what really makes me feel loved is for him to unload the dishwasher or put the kids to bed, taking the pressure off me. While I certainly don’t think the five love languages are the ultimate relationship solution, for my husband and I they have served as an excellent tool for improving our communication. And, in a relationship facing a chronic illness, communication is definitely key. [lead_gen showIfLoggedIn="0" campaign="shortcode_posts" source="site"] What happens when you meet someone you really like? Join Kat as she discusses some of the things she learned when she was dating and how meeting her husband taught her that feeling comfortable with your partner is paramount for a supportive, healthy, relationship. She talks about how using your energy wisely is so important, especially when you’re first starting in a relationship, and looking for benchmarks that will tell you that you’ve met someone who can help you to be more healthy and resilient as you go through life. [lead_gen showIfLoggedIn="0" campaign="shortcode_posts" source="site"],,In November, I attended a session entitled Sexual Issues in Rheumatology: Assessment and Intervention at the American College of Rheumatology’s annual meeting. The session presenters were Doctor Mijal Luria, of The Center for Sexual Health in Israel, and Sharon Peleg-Nehsre, a sexual counselor for chronic patients at the Tel – Aviv Medical Center. I must admit that the thought of having a sexual counselor specifically trained to help chronic patients made me want to get on a plane to Tel – Aviv! After the session, I sent Ms. Peleg-Nehsre an email. I introduced myself as a patient living with RA and thanked her for tackling a subject that plays such an important role in our quality of life. Hopefully, as healthcare professionals are encouraged to consider issues of sexual health, more rheumatologists will start to routinely include the types of suggestions Ms. Peleg-Nehsre and Dr. Luria made during their presentation. However, the presentation also included results from a study that found that 71% of rheumatology healthcare professionals seldom or never raise the topic of sexual health with their patients. That’s a lot of patients who may be struggling to figure out how to deal with sexual issues on their own! So I asked Ms. Peleg-Nehsre if she had any particular advice for patients in situations where doctors are not broaching the subject of sexual health, and she was kind enough to provide some advice for us. Ms. Peleg-Nehsre agreed that patients with rheumatoid arthritis face some challenging sexual issues. They may find that their partner tends to avoid sexual activity for fear of causing pain or patients may avoid initiation themselves because they are afraid of being rejected. Many patients living with chronic illnesses suffer from depression, low self-esteem, poor body image, pain, and other side effects of medications. This can very commonly cause sexual dysfunction. Some of these issues – such as depression – can be treated with additional medications, though it is important to work as a team with your doctor to make sure you find the right combination of medications to treat multiple conditions. Many of these issues can also be treated through therapy if they are not improving sufficiently with the help of your rheumatologist. Physical pain can affect lubrication and even cause erectile dysfunction. Luckily, there are many over-the-counter lubricant options, including water-based and oil-based lubricants so that each person can find their preference. Lubricants are safe to use and very helpful, particularly if each partner uses some. For erectile dysfunction, there are a few medications that are available with a prescription from your physician. It is particularly important to make sure you follow the instructions when using these medications. Ms. Peleg-Nehsre also emphasized that it is important to inform your partner and let him or her be involved in the process. For dealing with the pain of rheumatoid arthritis, it is very helpful if pain medication is taken 30 to 60 minutes prior to sexual activity. It is important for you and your partner to work together as a team to try to find the most comfortable positions. Pillows can be very useful for supporting your body. While certain positions may be unpleasant for certain types of pain, Ms. Peleg-Nehsre advises patients not to become upset that a particular position didn’t work out. Instead, she encourages patients to treat it as an opportunity to try something different and diverse. She also emphasized the importance of exploring other options, including oral sex, masturbation, and using toys or other accessories. Ms. Peleg-Nehsre also counsels individuals with chronic illnesses to make sure they work with their partner on open communication. This includes discussing with your partner the best time for having sex. For example, many patients with rheumatoid arthritis find the morning to be a less suitable time for sex due to morning stiffness and pain. Whatever time of day works best for you, it may be helpful to have a date with your partner so that you will be able to be prepared for a good experience. Sexual health is a very important aspect of a person’s quality of life. According to a 1999 study, 84 to 91% of married individuals ranked a satisfying sex life as important, and 94% said sexual enjoyment added to quality of life at any age. Although life with a chronic illness does present some challenges when it comes to having satisfying sex, there are things that patients can do pro-actively to work to improve their situations. I’d like to thank Ms. Peleg-Nehsre for her time and efforts on this important subject! 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