I have been seeing this couple for a while. They both have a history of cancer; she was treated for breast cancer 2 years ago and he had testicular cancer in his 20s. They are now in their early 50s with a 17-year-old son who is in his final year of high school. She was referred to me for sexuality counseling by her oncologist. She ticked the box about problems with intimacy on the screening tool we use in our facility. As is my usual practice, I saw them together for the first visit. He is a “talker” and dominated the conversation; she is much quieter and spent most of the appointment twisting her wedding ring around her finger. I saw them each separately after that to talk about family-of-origin issues and anything else they wanted to share privately. It was in my appointment with Shirley* that she disclosed to me that she had not been happy in the relationship for years and that she had thought many times about leaving her husband. Jim* told me that they had not had sex since her breast cancer treatment, and he didn’t know how long he was going to be able to stay in the marriage. And of course, neither of them had told the other what they were feeling and thinking.
Sexual problems related to cancer treatment do not exist outside of the context of the relationship and I knew that this couple were on the verge of separation if they were not able to work through their individual discontent. The sexual problems were going to be relatively easy to resolve but first this couple had to address their individual issues within the relationship. They both stated that they were remaining together for the sake of their son; they did not want to ruin his senior year.
And then the COVID-19 pandemic happened.
We had booked an appointment for them to see me as a couple about 4 weeks after I saw Jim by himself. They both had high-stress jobs and usually it was not easy for them to find time to attend appointments with me. Due to the pandemic I am no longer seeing patients face to face and called them to offer a video appointment. I had a feeling that they were going to cancel our appointment but was pleasantly surprised to hear that they were looking forward to meeting with me. They were both working from home and I thought that perhaps our appointment would be a distraction for them.
They looked different on my computer screen; they were both smiling and sitting close together, their shoulders touching. As with most interactions these days, we started by talking briefly about how they were doing at home under the COVID-19 restrictions. I am concerned about what this forced companionship is doing for couples in conflicted relationships and I braced myself to hear about arguments and stress.
“We’re doing great!” Jim declared with a broad smile on his face. He looked over at Shirley and she nodded in agreement. For a brief moment I wondered if they could see the surprise on my face.
“That’s wonderful,” I replied. “Please tell me more…”
They told me that somehow, in the close quarters imposed by the pandemic, they had begun to relate to each other differently. It started when they spent an evening together, watching old videos of their family. Seeing themselves as new parents with their newborn son and then again and again on family vacations reminded them of how happy they were then, despite having far less money back then than they do now. Their first home was so small compared to where they now lived, and yet they didn’t argue in those days—or at least not that they remember. Watching the videos brought back memories of the time they had invested in each other and their relationship that was once loving and vibrant.
I asked them about anything else that had stood out for them as they watched themselves.
“We always seemed to be touching…” said Jim, with a wistful look on his face.
“And we also seemed to be talking a lot, talking to each other from in front and behind the camera” added Shirley.
They were no longer looking at me on the screen, and instead had shifted position so that they were facing each other. I kept quiet, letting my silence give them room to consider what they had just said. It’s often like this in counselling; allowing silence is when the real connection happens, and I was happy to sit and observe the unspoken feelings that had emerged. This couple had forgotten how to talk to each other and without communication, there is misunderstanding and assumptions that fester and create greater problems. This couple needed to be reminded of what they had rather than what was missing, and they had taken the first steps by watching old home movies. I know that we will get to the sexual problems at another time and I have a feeling that they will work together to resolve them and create a new sexual relationship, one that is gentler and forgiving of what cancer and time has changed. The pandemic can create joy for some, even when it takes away so much.
*Names changed to protect anonymity.