Sex with a Chronic Condition: An Interview with Sex Therapist Lauren Dicair – Part 1

September is Sexual Health Awareness Month, and this is part 1 of 2 of our series, Sex with a Chronic Condition. We had the opportunity to interview Lauren Dicair, a clinical sex therapist. We thank her for addressing all the questions we have about sex but might not feel comfortable asking. Let us dive in.

What is a sex therapist?

"A sex therapist is a psychotherapist who has a distinct specialty in supporting individuals and partnerships with their sexual health and the health of their intimate relationship(s). Some examples of concerns that we can address include:

• Challenges around sexual function (otherwise known as the sexual response cycle)
• Sexual interests
• Sexual orientation
• Compulsive sexual behaviors
• Intimacy challenges related to a disability
• Chronic illness (including chronic sexually transmitted infections)

Sex therapists also focus on communication with one’s sexual partner(s) and concerns regarding the influence of past traumatic sexual experiences on present-day sexual intimacy and relationships."

What should people expect if they decide to talk to a sex therapist?

"An initial session with a sex therapist typically involves taking a sexual and relationship history and assessing a client’s current concerns that they wish to address in sex therapy. Sex therapists do not make physical contact with clients but may provide behavioral homework exercises for clients to work on between sessions, when relevant."

How do you recommend people to stay positive about sex while living with a chronic illness?

"One of the biggest reasons why people experience distress around sex is due to their internalization of society’s misguided and harmful messages about what sex should look like. One of the more popular ones is the equation of penis+vagina or penis+anus genital orgasm, and that anything else isn’t 'real' sex or 'good' sex.

The key to staying positive and finding sexual fulfillment is twofold: broadening one’s definition of what sex is and discarding the belief in goal-oriented sex."

Are there any tips on how to get started or how to get comfortable communicating your needs to your partner?

"To engage in safe, healthy communication, it is important to consider the what, where, when, and how. First, comes the what. Before entering into a serious conversation with your partner(s) about your needs, it’s important to first be clear with yourself on what your needs are. Take some time on your own to write out a list of your mental, emotional, and physical needs.

After making this needs list, you will then want to go through each item and either labels them as “musts,” meaning that you cannot compromise on that need, or label them as “compromises,” meaning that you are able and willing to fully or partially sacrifice that need. By doing this exercise, you’ll feel more confident and prepared for what you want to say."

So what comes next?

"Now we turn to the where. The best place to have a serious conversation is in person, face-to-face. If you and your partner have a long-distance relationship, then having a conversation by video is the next best option. Texting, DMs, and e-mail are not good mediums through which to have serious conversations.

There can be a lot of contexts lost when you are not able to convey or read body language or vocal intonation, which can result in misunderstandings. Even communicating by phone is a poor option because it doesn’t allow you to see each other. More than 50 percent of communication is through body language.

Moving into the when. It’s best to have serious conversations when there are no distractions that will interfere with the flow of the conversation. This means scheduling the conversation at a dedicated, agreed-upon time when you will be alone in private, away from other people, away from social media, television, and work, with no strict time limit.

Finally, comes how you want to communicate the needs list that you created. There are 3 styles of communication: passive, assertive, and aggressive. Of these, the assertive style is the one we all want to strive for."

What are some traits of an assertive communication style?

"Assertive communication emphasizes the importance of every person’s needs involved in the conversation. During an assertive conversation, a person stands up for their own needs, wants, and feelings, while also listening to and respecting the needs of the other person(s).

Listening without interruption, clearly stating one’s needs and wants, being willing to compromise (where safe and appropriate), standing up for one’s rights, using a confident tone of voice and body language, and maintaining good eye contact with the other(s).

'I' statements are an important part of assertive communication in that they provide a structure for you to communicate something upsetting while minimizing the chances of the other person feeling blamed or judged. The format for an 'I' statement goes like this: 'I feel ____ when you _____ because _____.'

Assertive communication isn’t the default style that most of us are accustomed to using. To become more comfortable with it, you should look for opportunities to practice the verbal and non-verbal aspects of assertive communication in everyday, mundane situations."

Read Part 2.