Tuesday, April 15, 2014

Getting Out Of The Narrow Places

Jews all over the world are celebrating the holiday of Passover this week, as it's been celebrated for thousands of years.  One of the rituals is to hold a meal called a seder, complete with readings and songs.

The core theme of Passover is the journey from slavery to freedom.  And the story that is told at the seder and passed on from generation to generation is the story of the Jews exodus from slavery under the Pharaohs in Egypt to freedom as a people in the Promised Land.

The Hebrew word for Egypt is Mitzraim.  Mitzraim (in Hebrew) is closely connected to the phrase "Narrow Place."  In a metaphorical way, this means that the holiday of Passover is a time to recognize and honor the ways in which we have all escaped from whatever narrow places we have been in - in our environments and in our souls.

About a year and a half ago, I was knocked flat by a massive relapse of my chronic pain condition.  It's taken until now for me to climb out of it - with the help of some wonderfully wise and talented health care clinicians.

However, I'd still be in that narrow place if it weren't for the outstretched arms of my husband, Richard.  My clinicians got me better, but Richard heals me.

During this period of pain and darkness, I read and re-read one of my favorite poems.  It's by Emily Dickinson and this is the first stanza:

“Hope” is the thing with feathers -
That perches in the soul -
And sings the tune without the words -
And never stops - at all
 Richard is the holder of hope for me.  Without that, while I might have less pain, but I would still be in the narrow place
What are your narrow places, and what helps you find some light?

Monday, March 24, 2014

Sex and Coping in Older Age

Excerpt from the Washington Post:


"Among older couples, physical illnesses can strain a marriage, but maintaining a healthy sex life could make a difference in how happily both partners cope, a new study suggests.

Researchers have long known that the illnesses that come with age are linked to poorer marriage quality, but exactly why has not been clear. According to the new analysis, sexual intimacy is the link that keeps partners positive about their marriages in the face of difficult times, and a lack of sex makes matters worse."

Yes, but......

What if illness interferes with your physical ability to have sex?  And the medications you take flatten your libido into non-existence?  And let's not forget that the well partner's sexual-ness may be very different than the ill partner's sexual-readiness.

So what can a couple already coping with illness do to heighten their sexual connection?

Before touching, talk.  Tell each other what you want and don't want.  And if you've started touching, continue to tell each other what feels good and what doesn't.  The power of the sexual connection won't work if one partner is enjoying it while the other is faking it.

Don't assume that sex = intercourse.  It may; and it may not. Closeness and arousal can happen without penetration.  Sometimes touching and talking can be powerful sexual connectors.

Start with small steps.  Try stroking the back or legs or arms or face before moving onto the more traditional erogenous zones.

Keep talking.

Here's a giant dilemma.  What if nothing is possible and the well partner is still interested in being sexually active?  Once again, keep talking.  Perhaps the well partner can find contentment in a life without sex.  Perhaps the ill partner can touch the well partner, even if he/she isn't interested in receiving any form of sexual contact.  And, perhaps the couple can make peace with the well partner having just sex with someone else.

There is no one size-fits all solution for how to maintain a sexual connection with each other.

But no matter what, keep talking.

How have you managed (or not) to have a sexual connection in your relationship?

Thursday, March 13, 2014

My Upcoming Book Talks In San Francisco and Oakland

I wanted to let you know about upcoming talks I will be giving about our book, In Sickness As In Health: Helping Couples Cope With The Complexities of Illnessby Barbara Kivowitz and Roanne Weisman (Roundtree Press, 2013). 

Here are the dates, times and locations:

March 15, 2:00-4:00pm,Oakland Library, Main Branch, 125 14th Street, Oakland 
March 22, 3:00-4:00pm, Sunset Library, 1305 18th Avenue, San Francisco
March 29, 3:00-4:00pm,Bernal Heights Library, 500 Courtland Avenue, San Francisco

When illness and tragedy strike, they don’t ask if you’re ready.  In Sickness As In Health is a deep and practical guide to help couples, and those who care about them, best manage the upheavals that happen when sickness or accident turns life upside down.  And while most couples are quite capable of dealing with the In Health part of their commitment, few couples are prepared to cope with the In Sickness part, together.

In my talk I will:
  • Expand our sense of what happens to couples when illness becomes the unwanted third partner in the relationship
  • Offer powerful strategies for helping couples live with illness and engage their own strengths
  • Discuss how couples can work as a team to best deal with the medical system
  • Suggest ways health care providers can engage the significant other in the treatment

I bring to this discussion not only the research we did with couples and experts, but my own personal experience living with illness with my husband.  This talk and the book, In Sickness As In Health, will benefit couples, caregivers, family, friends, co-workers, counselors, clergy, and health care professionals.  There will be time for Q&A.

Please send this link along to others you may know who would be interested coming to one of the talks or knowing about the book.

Click on the dates and times above to see the official announcements of the events. And for more information about the book, please go to:
www.insicknessasinhealth.com .  You can read the introduction by clicking on the “Peek Inside” tab.

Thank you.  Hope to see you there.

Wednesday, March 12, 2014

My Favorite Book About Illness: ILLNESS AS METAPHOR by Susan Sontag

In 1978 Susan Sontag wrote ILLNESS AS METAPHOR.  Two decades later she wrote AIDS AND ITS METAPHORS and the two are now published together.

At the very bottom of my blog is a quote from Ms. Sontag:
"Illness is the night-side of life, a more onerous citizenship.  Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.  Although we prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

Writing these books was an act of courage from Ms. Sontag, and reading them was an act of illumination for me.

From her website:
'Sontag shows how the metaphors and myths surrounding certain illnesses, especially cancer, add greatly to the suffering of patients and often inhibit them from seeking proper treatment. By demystifying the fantasies surrounding cancer, Sontag shows cancer for what it is -- just a disease. Cancer, she argues, is not a curse, not a punishment, certainly not an embarrassment and, it is highly curable, if good treatment is followed."

Also from her website:
"Susan Sontag's Illness as Metaphor was the first to point out the accusatory side of the metaphors of empowerment that seek to enlist the patient's will to resist disease. It is largely as a result of her work that the how-to health books avoid the blame-ridden term 'cancer personality' and speak more soothingly of 'disease-producing lifestyles.' . . . Sontag's new book AIDS and Its Metaphors extends her critique of cancer metaphors to the metaphors of dread surrounding the AIDS virus. Taken together, the two essays are an exemplary demonstration of the power of the intellect in the face of the lethal metaphors of fear." —Michael Ignatieff, The New Republic

I'd always believed in the power of words -- the ones spoken and the ones left unspoken.  Ms. Sontag shows how the metaphors associated with illness tended to blame the victim and provoke them into feeling self-blame and shame.

Having read her work long before I became ill with a chronic pain condition helped me hold my illness in a neutral way.  I never wailed, "What did I do to deserve this?" or "Why me?"  Instead I asked, "What can I learn from being in this state?"  and "What do I need to do to get better?"

I believe her worked helped me be more of an activist around my illness for myself, and on behalf of others who also have that passport to the kingdom of the sick.

What's your favorite book about illness?

Saturday, March 8, 2014

My Partner, My Memory

I don't know if it's growing older, or New England winters, or the meds I take, or watching Homeland and Downton Abbey in the same week -- but my memory isn't as crisp as it used to be.

When I was doing my psych internships, I had to write up a  (wait a minute, I'll remember what it used to be called.... oh yeah..) progress notes on each session with my clients.  Progress notes were verbatim captures of what was said during the entire hour, by the client and by me.  These were then used in supervision to help me understand in deeper, more psychologically correct ways, what was going on for the client and for me.  Back then, I could remember just about everything I said and he or she said.

This activity even helped sharpen my memory for decades.  I could remember conversations, titles and the story lines of books and movies, shopping lists, and jokes.

Now, if I'm lucky, I can remember the punchline of a joke and work my way backwards to reconstruct the lead-in to the punchline.  This does not make me particularly funny.

It gets even trickier when medications enter the picture.  I take 6 different prescribed medications and a handful of vitamins and herbal supplements.  Some have to be taken with food, some without.  Some have to be taken in a particular sequence, not near others.  And I have to space the meds out evenly throughout the day so I get good pain coverage.

I used to scratch my head several times a day trying to remember if I'd taken the 1:00pm dose, or forgot it, and should I double up on the 4:00pm dose.

My partner, Richard, who is a scientist and engineer, must solve problems.  He has become part of my cerebral cortex.  He comes with me to appointments with new doctors and takes notes on his iPad.  He keeps track of how I'm doing (sometimes through his memory and sometimes through a spreadsheet) so we can provide doctors with an accurate accounting of my symptoms.

But the best solution he came up with was to program my cell phone so that I get a text message whenever it is time to take a medication.  He also suggested that once I take the medication on time, I delete the text message so I know I've indeed taken the med.

Now, I remember things for him too.  Particularly when it comes to the location of objects - like keys, cell phone, check book, passport, and runaway socks (this is what  we call single socks that mysteriously disappear).

It's actually a great comfort to be able to lean on each other in this way.  My partner, my memory.

Do you and your significant other remember things for each other?  What sorts of things?  Is this helpful, or annoying?

Sunday, March 2, 2014

Is There A Connection Between Sex And Healthier Aging?

From an article by Michaeleen Doucleff: A Strong Sex Life helps Couples Cope with the Trials of Aging on the NPR site

"Health problems can put a strain on a marriage at any age. But as we get older, chronic illnesses can make it even tougher to keep the spark alive.

Scientists at the University of Chicago have uncovered one way couples can offset the stresses of illness and aging: more physical intimacy.

Couples who continue to be sexually active over the years report higher levels of satisfaction in their marriages, the sociologists last month.

And it doesn't take much to give a relationship a boost. Going from essentially no sexual activity during a year to sex once each month or so was associated with an increase in marital quality, according to those surveyed.

"To protect marital quality in later life, it may be important for older adults to find ways to stay engaged in sexual activity, even as health problems render familiar forms of sexual interaction difficult or impossible," sociologists Adena Galinsky and write in The Journals of Gerontology B.

And intercourse wasn't necessary to maintain intimacy. "As individuals age, the means of sexual expression may change," the researchers write. "Our measure of sexual behaviors was designed to be inclusive; it asks explicitly about any activities with one's partner that were sexually arousing, noting that they did not need to result in orgasm."

To figure out the relationship between sex, marital happiness and health, Galinsky and Waite analyzed data from nearly 500 couples between ages 58 and 85. Most of the couples had been married for at least 40 years...."


What have you experienced in your relationship?   To the extent that you are able to be intimate with your partner -- does it make quality of life and health better?

Saturday, March 1, 2014

Book Review of IN SICKNESS AS IN HEALTH by Paul Levy

I'm writing to share with you a review by Paul Levy of our book: IN SICKNESS AS IN HEALTH: Helping Couples Cope with the Complexities of Illness

Paul is a well known health care blogger and a stalwart advocate for patient-centered care.  He was CEO of one of the major Harvard teaching hospitals in Boston, Beth Israel Deaconess Medical Center.

To read Paul's review of IN SICKNESS AS IN HEALTH, go to his excellent blog, Not Running a Hospital

Here is Paul's concluding paragraph:

So, how ironic and telling that a book designed to help couples is also an advisory to doctors who serve for and care for those couples!  My advice is that this book should be read by physicians as well as those of us who might need it for our families.

I hope you enjoy his post.  If you like it, please feel free to forward, tweet, or otherwise share it with your own networks.  We are on a mission to get the word out that if you're part of a couple, the illness may reside on one person's body, but its two lives that are dislocated and two will that can be enlisted to deal with the upheavals illness introduces into the relationship.
Thank you.