According to the Stroke Recovery Association (SRA) the possible and normal sexual consequences of a stroke include:
Bruce and I had been seeing each other nearly every night for only a few weeks and it was obvious to both of us that we were on a fast moving train to a lifetime commitment. One evening, after our nightly ritual of me tending to his infected toes, I was still seated on the floor at his feet. We had been discussing life, limitations and survival. He became overwhelmed with emotion and began to pour his heart out.
- A diminished self-image and self-esteem,
- Fear of being rejected or no longer being loved,
- Emotional and relationship changes that may alter interest in sex,
- Fear of and anxiety about sexual failure,
- Social change (the way that the disabled are viewed by others - this particularly applies to single, widowed, divorced or separated stroke survivors).
"I didn't think," he said. "I didn't think anyone would want me."
The tears welled up in his eyes as he continued.
"Every day. I looked at myself. Every day I asked who would want this?"
He reached across his body and touched his paralyzed arm and crumbled hand. He stood and stooped over in an imitation of his stroke-effected stature. He emphasized his point by pulling his right hand up to his chest in a seized and clenched position.
"Who would want to touch this?" he had made his point and he sat again.
The SRA report further states "Fear, frustration, the need to adjust to a self-image which has been shattered, adapting to a new, often very different "self", disappointment in terms of performance in many life areas, and doubts about one's capability of dealing with these changes - all these are part of recovery from a stroke. "
Bruce was always dressed in clean clothes that were tattered and worn. He had gained a significant amount of weight since quitting smoking six years after his stroke and his pants were noticeably tight around the waist. The neckline of nearly every T-shirt was ripped at the binding. He wore a slogan bearing T-shirt and conservative trousers nearly every day. His shirt was always tucked in and he cinched his pants with a belt. His shoes were Velcro closed tennis shoes and his socks were always pristine clean and white.
A National Stroke Association report states, "dressing oneself is a basic form of independence. The added value of being neatly and attractively dressed enhances a stroke survivor's self-image."
Bruce was living in a one-bedroom apartment with little modification for his disabilities. He walked across a common yard to the laundry room every Sunday morning to do his laundry. He had a closet full of clothes ranging from size 36 to 44. The styles covered an even wider range, dating from the 1970's to the late 1990's thrift store bargains. He wore the same pair of pants for three days straight and then they would go to the laundry basket. His shirts would last at least two days before laundering. That evening as I sat at his feet, Bruce continued sharing his self-assessment and wonderment at my presence.
"I thought no one would look at me. Well, not a woman." His statement caught my full attention again. Tears were now spilling down his face.
"And here you are. Right here. In my apartment! Talking to me, looking at me, smiling at me and fixing my toes." His voice was catching in his throat and I was feeling the strength of his words deep in my heart.
In a report entitled "Love, Sex and Disability: Maintaining Interest and Intimacy" co-authored by polio survivor, Harlan Hahn, Ph.D., he shares personal insights. "I can also offer some thoughts derived from my own experience. One suggestion concerns what I call the dysfunctionality of denial.
I found, for example, that when I was wrestling with the issue of my acceptability to the opposite sex, therapists and others gave me one of two messages. One message was, "There is nothing wrong. Disabled people can find suitable partners as easily as nondisabled persons. I don't see why you're troubled by this." The other was, "There's nothing that can be done. That's just the way things are. You can't possibly change them."
Neither message was true, and neither was particularly comforting. What no one gave me was a way to work within the gray area between these extremes. There was no value in denying that my disability reduced my chances of finding a mate, or that the situation was hopeless."
For seven years Bruce had dealt with shattered self-esteem, damaged self-image, bouts of depression and social rejection (events to which I'd been an occasional witness). Now, in total disregard for the odds against him, he continued to gaze deep into my eyes and bare his soul.
"I don't know why you're here. I've been by myself for seven years. I had two relationships. Then I was done. No more. But here you are." He was looking into my face with amazement.
Citing the previous report, Dr. Harlan continues, "Any disability has a strong effect on a relationship. It can bring out a couple's devotion to one another so that they build on their existing strong relationship; or it can pull a couple apart, intensifying existing conflicts. A disability is an added stress to any relationship. How you've handled stress in the past will affect how you'll handle this particular stress. It is important not to blame anybody; it's no one's fault."
So many things were weighing on Bruce's heart as he sat in the safety of his familiar surroundings with this very unfamiliar female at his feet. For ten minutes he poured out the years of fear and frustration at having been alone. He explained how he had decided to fix himself and make himself attractive to women.
"I taught myself to walk properly, " he said sitting straight up in the chair, "and to talk properly."
He didn't mention how he had learned to groom himself and to make himself attractive. But I had noticed. He had more bottles of mouthwash, tubes of deodorant, toothpaste, soap, variety of colognes and after-shaves than a corner drug store. He had a sewing kit beside his chair but couldn't thread the needle or mend the tears in his clothes with only one fully functioning hand. He had made every conceivable effort to improve his behavior, his speech and his appearance.
Dr. Hahn also stated "My research and my own experience tell me that many adults with disabilities who seek an appropriate mate are not operating on a level playing field. Like most activities in modern society, the search for conjugal partners is a competitive process in which men and women who approximate cultural ideals of physical attractiveness enjoy a decided advantage.
Ever since the concept of romantic love replaced arranged marriage as the basis of family formation during the enlightenment, physical attraction has been considered an indispensable foundation for intimate relationships."
With stubborn determination, and though his words were catching in his throat, Bruce continued,
"I decided to be ready. I never thought anyone would see. But you see. You see how I've changed. You see how I'm better."
Dr. Hahn's report continued. "Even persons who have difficulty in forming such relationships are usually advised to concentrate their attention on someone whom they find attractive. And yet, the perceptible signs of physical differences or disabilities are commonly regarded as unattractive. In fact, as the concept of asexual objectification indicates, conspicuous disabilities may be viewed as synonymous with unattractiveness. Obviously, this context poses mammoth obstacles for women and men with disabilities."
He sat there, emotionally exhausted and vulnerable. He had laid all of his hopes and fears, bare, before me. He had said words he never even hoped to speak to a woman again. I knew that he was even more afraid than he had been when he began his confession. Silently he waited for a response.
Without the slightest second of delay, I smiled back at him and replied "Oh, Bruce, I love you too."
A smile began to form across his face as he took a deep breath and relaxed. The twinkle returned to his eyes. He began to lean forward with his left arm outstretched to take me in a hug and I sat up, leaning forward, to meet his embrace.
I looked him in the eyes with all the softness and nurturing comfort I could portray.
"So?" I stopped the hug before it began.
"So, what's my name?"
"No!" he said. "Don't do that! I don't know!"
He slumped back in the chair, horrified at being caught in his ignorance and ashamed of himself.
I was laughing to the point of wetting myself. I took his face in my hands and kissed him strongly - full on the lips. Then I kissed the tears on his cheeks as I struggled to restrain the giggles. He was paralyzed from shock. I could hardly speak. The honesty of the moment was exhilarating.
"No worries! You've got plenty of time to learn," I whispered in his ear as my body melted against his.