We all have secrets. There are things that we don’t share with anyone, not our partner and especially not our children. We hold them close and hide them from the light of day or the dark of night. They are ours to keep because if let out, they can destroy things.
Such is the situation of a patient I talked to some weeks ago. A woman in her 50s with ovarian cancer, she has endured multimodality treatment and is now free of evidence of disease. She has returned to her pre-cancer life in many ways, but one. Her sex life, once vibrant and exciting, has almost disappeared. She has no interest in sex and a month ago, when she and her husband tried on his birthday, it hurt so much she almost cried. They’d used a lubricant and still it felt like she was being stabbed with a hot knife.
“I just gritted my teeth and waited for it to be over,” she admitted to me.
But she wanted to do something about this. This was her first marriage and she had waited until her mid-30s to settle down. Her husband was a few years younger than her and she was afraid that if their sex life did not return to normal, he might look for someone else.
“What was his response when you told him that sex was painful for you?”
“Oh, I didn’t tell him, of course! I don’t want to hurt his feelings. I would hate for him to know that he was hurting me!”
As we spoke, I silently cursed that I was counseling a patient on the phone and could not see her face. And she could not see mine either and I was pretty sure that the expression on my face would suggest to her that silence was not helpful.
“If he had a problem, would you want to know about it so that you could support or help him?” I asked.
“Of course I would!” was her response.
“So why is your pain a secret that you want to keep from him?”
I asked her to imagine if her husband developed problems with erections, but he did not tell her. Every night he would take “the little blue pill” in case she wanted to have sex. To her, everything was normal. What she didn’t know was that he got a terrible headache from the pills but he never told her. Sex was not that enjoyable for him with a pounding headache, but he continued, night after night, and never said a word. He stopped initiating but she didn’t notice. Then one day she found a small, empty blue box under the newspaper in the trash. She was shocked and her first thought was that he was having an affair. Why else would he need to take these pills?
“Oh, I get it,” she interrupted me. “I see what you’re saying… I guess I need to tell him what it’s been like for me…”
She couldn’t see me nodding so I needed to acknowledge her understanding.
“You’re keeping a secret from him and secrets destroy relationships. You said that you don’t want to hurt his feelings by telling him that sex is painful for you, but wouldn’t his feelings be hurt even more if he found out that you were in pain and didn’t tell him?”
I told her about the time I did a presentation at a breast cancer support meeting and one of the women in attendance asked me how she should tell her partner that when he touched her reconstructed breast, it felt like electric shocks. I asked her how long this had been going on and she told me, and the other women, that she had been keeping silent about this for 2 whole years. The silence in the room spoke volumes and I had a difficult time finding my voice to respond to her.
I wished once again that I could see this patient’s face. But her sigh told me that she knew that keeping this a secret was wrong.
“Okay, I’m going to talk to him tonight. I just hope I can get the words out right…”
“Speak from your heart,” I told her. “That’s where the truth lies.”
I strongly believe that and I really hope she did.