Making Love Again: When a Medical Problem Imperils Your Sexual Life

An interview with sexual survivors and authors Virginia and Keith Laken "If a guy's impotent, he's powerless!" Keith Laken recalls his one-time mind-set in the book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy (Ant Hill Press, 2002), which he cowrote with his wife of more than three decades, Virginia. After being diagnosed with prostate cancer in his 40s, Keith wrestled with the knowledge that the prostate surgery that could save his life could also deal a deathblow to his sex life as he knew it. Fearful, too, that the prostatectomy surgery and its side effects would lead to lost respect professionally, Keith was torn about whether to even go ahead with the procedure. In Making Love Again, Keith and Virginia recount the story of their fight to regain physical intimacy after Keith chose to undergo radical prostatectomy. Discovery Health spoke with the Lakens about the sexual dysfunction that tested their relationship and about their multifaceted approach to restoring their treasured intimate bond, still standing strong as the Lakens approach the 10-year anniversary of Keith's surgery. Q: Rather than risk impotence, Keith initially considered not having surgery at all for his prostate cancer: "If my choice is to live longer and be half a man, or to live a shorter life with all my capabilities, you'd better believe I'd rather live a shorter, more fulfilling life!" he said. Why did Keith feel at one point that sexual impotence translated into lack of power and fulfillment in life generally? A: Keith: I felt at the most basic level that I would not be able to perform sexually as a man and satisfy my partner. And, at the same time, I had risen in my job to a point where there were hundreds and hundreds of people depending on my ability to maintain leadership in the presence of an unknown future. Envisioning myself as a leader, I was concerned because the word impotence is almost always used in the public domain to describe someone who can't get the job done — like a lame duck politician — or as the brunt of a joke. As a sexual partner on one hand and a person trying to be effective in my job on the other, I drew the conclusion that I would just as soon have a shorter life that has not been tampered with than a longer life in which I am no longer effective and am a prisoner in my own body. Virginia: I was the person who couldn't quite get this, how he would make the bargain for a shorter life as long as he felt more "empowered." Now, after hearing the same theme repeated over and over by many, many men, I'm certainly a believer. -------------------------------------------------------------------------------- Q: You speak in the book of your "new rules of lovemaking" — what is your redefined approach to intimacy that saved your sexual life? A: Keith: Once I had this traumatic surgical intervention, there was a period of time spent establishing a new norm. It opened up our minds to redefining intimacy. Intimacy is what two people agree to do to provide pleasure to each other. That doesn't have to be penetration. Prior to the surgery, our sexual menu had several different facets — oral sex and other things — and we allowed ourselves to go back there again and find new degrees of satisfaction. It opened up a whole new world, and it's an ongoing, ever-changing process. I don't have an urgency now to arrive at orgasm, but instead I have an overriding desire to please my partner. Virginia: Keith and I have a very satisfying sexual relationship right now, but it was an evolutionary process for Keith. And I actually felt impotent for a while, when Keith rejected me and seemed to be no longer attracted to me. I had a sense of that feeling of powerlessness. People need to know that can be a temporary condition between partners. I could live without having intercourse with Keith, but I couldn't live without having him touch me, hold me, caress me, hold my hand. That's what women are saying to their partners: "Yes, I need to be held." Many women will tell us that their partners are much better lovers now, when they take time and their goal is to give pleasure to their partner without rushing through or feeling pressure. -------------------------------------------------------------------------------- Q: What restored a feeling of sexual wholeness after the physical and psychological traumas associated with your illness, and what do you want others who have been struggling with illness-associated sexual dysfunction to learn from your experience? A: Keith: In the process of life, the first thing we try to do is go back and get what we lost. Part of the process of healing is to reestablish a new baseline that defines what is meaningful to us. At what point did I start feeling whole again? Probably about four to five years after surgery, I started feeling pretty comfortable with our relationship and our intimacy. I was no longer judging each contact relative to prior to the surgery. I stopped recording each intimate encounter on a Richter scale. Our seminar is billed as hope for couples. Men have a sense of feeling inadequate, traumatized, injured and hurt. They think "she will expect more of me than I will be able to provide." When they transition to "this is about us as a couple, not me as an individual," it opens up communication and is a real breakthrough for them and their relationship. Virginia: In any change, we have to first mourn what we lost. I think we began the healing process the night we cried over the fact that we would never be the same as we were. We realized that people's physical intimacy is always becoming — it changes dramatically when a first baby comes, the second baby, a move, a job change, a death in the family. And the aging factor is a part of this that affects every couple. Our definition of intimacy — giving pleasure to each other with our bodies in ways on which we both agree — allows the freedom to increase the pleasure within the physical limitations we have now. Our message to people is, don't stop being intimate. Sometimes the medical community approaches sexual dysfunction purely as a physical dysfunction — for example, focusing only on helping the man achieve an erection. But to redefine a relationship, sometimes we need to take more initiative for our own health and look beyond medical procedures to the psychological. That may mean a couple needs to seek help from a person who deals specifically with sexual dysfunction, such as a sexual therapist.