Download Help Me Build Intimacy With You Mp3
Antonette Hespe
Dr. Lori Lawrenz is a clinical psychologist and AASECT certified sex therapist. She has been a licensed psychologist since 2000, with licenses in Missouri and Hawaii. She currently practices in Honolulu, Hawaii. Dr. Lawrenz is passionate about addressing trauma, shame, grief, and mental health issues to assist her patients to live productive and happy lives free of shame.
Discussing sex, sexuality and intimacy can be uncomfortable, yet it is important to do so. Sexuality and intimacy are part of the human experience and have the potential to add great satisfaction and pleasure to our lives. When discomfort surrounding these issues is compounded by a diagnosis of systemic lupus erythematosus (SLE or commonly called lupus), challenges to a satisfying sex life and open communication may be multiplied.
Studies in patients with lupus suggest that they may tend to abstain from sexual activity and avoid intimate relationships for a variety of reasons. Some women have been known to reduce their engagement in sexual relations when faced with medical challenges. But the situation may be improved on both a physical and a psychological level to increase sexual and intimate satisfaction and overall quality of life.
Many factors impact sexual functioning in both women and men with lupus. Overall, changes in sexual functioning, desire and behavior related to lupus are often the result of multiple and interrelated factors, including:
Sexual intimacy is not only impacted by physical factors, but also emotional ones. In fact, studies suggest that the biggest factor leading to sexual dysfunction is not physical but emotional. People with lupus may avoid sex due to psychological factors.
When an individual is experiencing pain, vaginal dryness, limited mobility and/or other physical symptoms, the effects can decrease their desire and interest and lessen their enthusiasm to participate in sexual activities. One study of 120 women with lupus reported that depression and psychological factors were the primary factors contributing to a decrease in sexual function, including desire. Among this group, no other clinical factors related to lupus were shown to be significant with respect to decreased sexual activity.
Depression is increased in patients with lupus and may stem from immediate and long-term health concerns, ongoing pain, financial stresses and even the effects of the disease itself. Changes in one's appearance and associated feelings about body image, worries about partner interest, and other challenges can also lead to illness-related depression and anxiety. This can, in turn, diminish sexual activity and intimacy.
Individuals with lupus express concerns about whether their partner will leave them due to the disease or if they will ever find a partner to love and love them in return. These concerns related to lupus may compound the typical issues that couples deal with, including finances, loss of jobs, childcare, etc. Any of these can have a detrimental effect on physical intimacy, and not only for those with a chronic disease. But sex is a good thing when it comes to our physical and emotional health. Studies show that sex can reduce the risk of death, reduce stress, improve sleep and help to cultivate satisfying partner relationships.
A lupus diagnosis may prompt a shifting in roles and responsibilities within a couple. For instance, if someone with lupus can no longer hold down the job they formerly held, the responsibility for generating family income might fall to their partner. Many individuals will feel that they are bringing less to the table in the relationship, and feelings of guilt or shame may follow. A disease flare may also bring about guilt, shame, anxiety, and resentment or blame. In these instances, the sexual relationship could suffer. Couples need to share these emotions constructively in order to improve the quality of their sexual relationship.
Sensate focusing is a technique often used in couples therapy. This exercise focuses on attending to your body and the needs of you and your partner, engaging in sexual exercises that avoid the genitals. The aim of this method is not to achieve orgasm but to improve intimacy by helping couples learn about themselves and each other. It removes the stress of needing to have an orgasm.
Sexuality is often overlooked as a topic of discussion in the healthcare system. Doctors, social workers and nurses do not routinely ask patients questions related to their sexual activities and function because it is not normally part of a routine physical exam. Professionals are often silent about sexuality and intimacy because they are limited in time during one medical visit and may prioritize issues of disease assessment and treatment. Another reason might be that the subject is uncomfortable. Professionals are not sure if it is their right to ask and are often ambivalent about doing so. Many physicians are not trained in this area, so they may feel they cannot address it.
Patients feel discomfort when approaching the subject as well. That discomfort may come from cultural influences, how we were brought up, the society in which we live, and how our parents display affection. Fear may be another factor. A patient may think that it is best to keep this issue to themselves out of fear about how people will react if they discuss such issues. However, it is appropriate to open a conversation about sexual function with your healthcare team if it is not already being discussed. It is appropriate to address these issues with your rheumatologist, gynecologist, primary care provider, therapist or social worker.
The physical and emotional health status of lupus patients can be improved through collaboration with their healthcare team and with support from social services. This can help open the door to improved intimacy and sexual relations.
Learn about the SLE Workshop and get more information on support services at HSS available for people with lupus and their loved ones by visiting LupusLine, LANtern (Lupus Asian Network), and Charla de Lupus (Lupus Chat).
* Links with an asterisk (*) next to them will take you outside the VA website. VA is not responsible for the content of the linked site. This link does not constitute endorsement of the non-VA website or its sponsor.
Many couples do not openly talk about sex and intimacy, relying on predictable, nonverbal patterns of sexual expression (such as a look or touch). Given that PD may result in physical or emotional changes that can change these established patterns, maintaining open communication about feelings and emotions is essential.
A strong friendship, based on caring and communication, is vital for any relationship. Share your thoughts, feelings and concerns, and encourage your partner to do the same. If you can learn to express your frustrations with one another, you will be less likely to build up anger and resentment.
One out of every six people with PD taking a dopamine agonist drug will develop compulsive behaviors. Known as impulse control disorders, these behaviors may include compulsive gambling or shopping, hoarding or hyper sexuality.
People living with PD who are taking dopamine agonists and have developed hypersexuality should discuss it with their neurologist. Usually decreasing the dose or complete discontinuation of dopamine agonists resolves impulse control problems.
Emotional intimacy is when you are able to connect on a deeper level. When you and your partner both feel safe, secure, loved, and trust each other, this is when you know you have an emotional connection. It can take time to build emotional intimacy and it often comes from actions that convey feelings. Being emotionally intimate is often more challenging than being physically intimate because it involves building a foundation of trust.
Empirically, customer intimacy and centricity can be measured by metrics such as word-of-mouth (more), product adoption rate (high), churn (low), and NPS (growing relative score + higher than benchmark for your industry).
Customer intimacy has never been more necessary than it is today either, because growth is only getting tougher: Sales and marketing channels are 50% more expensive than five years ago, buyers have more power than at any other point in free market history, and many markets like software are hyper-competitive.
Maintaining customer intimacy saves you a fortune by doing the hard thing first: habitually talking to your customers and keeping their changing and evolving needs, desires, and problems front and center.
Think about how most people can watch violence in movies without batting an eyelash, but witnessing it in person often leads to stress, shock, and sometimes more complicated and long-lasting psychological issues. Reading and hearing about customer stories, problems, and complaints secondhand is not the same as experiencing them firsthand.
Formal customer interviews allow you to quantify customer conversations into accurate and reliable insights everyone can use to maintain customer intimacy. Software companies that pursue ongoing customer development achieve 30% more annual revenue growth, too. Get key people in marketing, growth, and product to conduct (or at least sit in on) at least 10 customer development interviews a month. Need more guidance on talking to customers more formally? Check this out.
The downside is that maintaining customer intimacy on the company side requires contact with customers, so there is less of that here than if you were hosting. However, you can mitigate this by encouraging local team members to attend as much as possible and to watch out for meetups when traveling.
Companies with high customer intimacy have a shared understanding of needs and values, driving a more loyal customer base that has higher customer lifetime values and receives more of word of mouth growth, which greatly improves metrics, investment attractiveness, and revenue.
Farmers who work closely with the land are perhaps the most familiar with the seasonality of life. Nala Jakor and her husband Nakorn have endured several drastic ups and downs. The two of them are primarily growers of maize, though they also earn an income from the sale of avocado in their community.
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