New Beginnings: Relationships

Happy New Year! This is the start of a great year ahead of us. Hopefully, COVID will begin to fall behind us but do not slow your avoidance behaviors. Stay safe by wearing a mask if you are able, washing your hands, social distancing, and generally keeping yourself protected. Make the best of your protection abilities by becoming vaccinated if you choose for your own wellbeing and enhancing the lives of those around you.

Many individuals think about sexuality and reproduction as a new beginning. You might be thinking about starting a relationship that is a new beginning. Certainly, having children is a new beginning to a life as well as your life. It can be really intimidating to consider a relationship when your body has changed. Developing comfort in your own being is a challenge for everyone regardless of trauma or disease. Everyone has concerns about how they look, how they present themselves as well as what others think.

Individuals living with ability challenges generally have four overarching concerns. They may have personal and psychological issues related to their self-esteem. Sexual confidence may be low. They may be going through mental health issues such as depression, anxiety, negative body image, and even grieving. Some individuals are already involved in fragile relationships, which any changes can challenge.

A couple kissing on the sidewalk. The woman is using a wheelchair and the man is leaning down behind her.

Personal and Psychological Health Issues (Self-Esteem)

Finding confidence is not easy. A review of yourself is never pleasant if you are really looking to make improvements. Individuals that feel they look different for any reason can be a huge mental stumbling block. In reality, most individuals look for personality when seeking relationships. Many individuals meet other people and have very successful relationships. True, some people are not going to give you a second glance if you have a different look, but these same people will reject individuals based on all sorts of factors such as too tall, too short, chunky, skinny, religious beliefs, education, size of the nose, type of laugh, and on and on. I even know someone that passed by a relationship opportunity with a really great individual because they felt the person spoke too loudly. People make all sorts of judgments.

In our world of body perfection, differences in physical looks are all unjustly magnified. There are many news stories about advertisements that are altered to create unrealistic images of the human body. Social media influencers may photoshop their image to create false possibilities for the human body. Hopefully, as individuals learn and accept these false perceptions, our society will return to realism as a natural look because that is real life. We all look unique because that is human design.

People have all sorts of perceived shortcomings. I use the word perceived as people respond differently to themselves. How you deal with your perceptions is the issue. If you are comfortable in your own self, you are less apt to be worried about your perceived issues. Some people move on through life with no outward sign of self-doubt, whereas others are full of it. Many are somewhere in the middle.

Take an inventory of your strengths and perceived weaknesses. I will guarantee that your weaknesses will not be something that others see as a shortcoming. These are usually things that the individual is self-conscious about. We all have them. Often having physical or mental issues is not a shortcoming, especially if you are comfortable with your abilities. But some individuals who have not adjusted to their challenges are usually those that see them as huge liabilities. Interestingly, others are not concerned about their physical abilities while still others use them to their benefit.

Yes, some use their abilities to their benefit. An example is a couple in a very successful relationship. One uses a wheelchair for mobility while the other has some intermittent chronic metabolism health issues. The individual with the spinal cord injury employs an assistant to help with personal care. Because of their respective perceptions of life, they are able to provide emotional support to each other when needed because they understand the challenges, they each face. They live a life where their strengths aid each other. Neither let their perceived differences dictate their lives. This might not be the arrangement you are seeking, but it works marvelously for them.

If you are really having difficulty with your body image, talk with a professional that can assist you in finding positives about yourself. They can provide strategies for improving how you think about yourself, negative talk, and support you in exploring new ideas for making connections with others.

Sexual Confidence

In relationships, individuals think about sexuality. After a significant change in your health or body status, people wonder about the ability to participate in sex. Individuals with spinal cord injury from trauma or disease will have differences based on their level of injury. Those with upper-level injuries in the cervical or lumbar area may have tone (spasticity), which can affect sexual activity, making it more difficult or actually can enhance sexual encounters. You may want medication to relax your tone during sex or may reduce your medication to allow a bit more tone. Individuals with lower-level injuries in the lumbar or sacral areas of the spine may be flaccid; therefore, they enhance sex with different positioning techniques. Individuals with brain injury or stroke can experiment with different positioning as well.

If you have a partner from pre-injury, your partner may be willing to try different techniques to see what works well for sexual stimulation. It can be more of a challenge if you are in a new relationship. People are often embarrassed to discuss their needs but, in a relationship, this should be done anyway. Some individuals will experiment on their own before entering into a relationship with another person to see where there is sensation, responses, and what is arousing.

The idea of falling in love, at first sight, is not really a thing. People might see someone they find attractive or have a great conversation which causes them to meet again. It is sort of a dream fantasy that love at first sight occurs. You have to get to know someone first. It is usually a successful courtship that will be looked back on fondly as love at first sight.

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Mental Health

Mental health consists of emotional, psychological, and social wellbeing. This is how you view the world and think about yourself. Issues such as depression, anxiety, negative body image and even the grieving process about changes in function can interfere with sexuality if you have a chronic health issue or not. If you have depression, are anxious about a relationship or other issue in your life, your sexuality can be affected, usually resulting in a lack of interest. Some individuals are so emotionally connected to their differences that they develop a negative body image. After catastrophic trauma or disease, some individuals go through a grieving process for what they have perceived as a loss.

All these mental health issues affect sexuality. This is a time to call in your resources to help transition through these issues. Mental health experts can lead you through these times with strategies to improve your outlook on life. This is an effective and proven treatment to improve your life in general and in relationships, including family, friendships, and sexual relationships.

Fragile Relationships

Individuals beginning new relationships can have challenges, but those already in relationships may have concerns, especially if the relationship is not strong. A life-changing or catastrophic relationship highlights the weaknesses in relationships. They tend to go in either direction, strengthening the relationship or challenging or even ending a relationship.

There are many individuals who have discovered what they thought was a great relationship was actually not. When the person you thought to be your support is now waning or absent, a whole new level of challenges follows. It is a huge jolt when an individual discovers the relationship, they were in is not going to survive. The world thought you knew was not there. This leads to significant adjustment. It may include depression.

Many individuals will go through counseling with positive outcomes. However, some will find their relationship to end. Suddenly, the individual is alone with a dream shattered. All relationships are somewhat fragile, but there are those that do not survive. This will trigger the grieving process. It is important to work through the issue, so you are protecting your mental health.

If you do have a relationship, be sure to be kind and considerate to your partner. Do not take your health frustrations out on them but nurture your commitment to the other person. Life changes: move with it together or adapt to your new normal.

You may experience these situations in relationships. Sometimes seeking mental health support to move through them is needed. Other times, just identifying the issue for yourself will help you understand your feelings and adapt to moving forward. Nurse Linda

Pediatric Consideration:

Children can face the challenges of parent’s relationship challenges. Be sure to offer them support and express your love to them. Some children feel falsely responsible for the relationship challenges. Let them know that they are a loved part of your family, no matter how it develops or changes. They can easily be in the middle of significant issues. Older children may be asked to help out a bit more. Be sure to explain to them what is going on, at their level of development.

Adolescents are particularly challenged by sexual development and changes. Typically, they are not willing or embarrassed to discuss sexuality with their parents. As a parent, you may not know their sexual progress. Be sure to include a therapist or counselor that is educated about sexuality in their treatment team. Integrating sexuality into the general therapy session is a good way to reduce some of the embarrassment that may be a part of the issue. Your teen might not be working with a mental health specialist, but keeping a known, comfortable person on their team will help the conversation flow naturally.

If your teen has a sexual response during the care that you are providing, treat it as a matter of fact. Some teens might want to know about their response, and others will not want you to mention it. Know your child so you can help them understand this time of life.

About the Author - Nurse Linda

Linda Schultz, Ph.D., CRRN is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

Nurse Linda

The opinions expressed in these blogs are the author's own and do not necessarily reflect the views of the Christopher & Dana Reeve Foundation.