"What do you do?" It’s one of the questions we often ask other people when in new social gatherings to try to connect with them, to see if there are any similarities that may give us a better connection. Or even just to try to stop any awkwardness of not knowing what to say to someone new.
So, recently I was at a barbeque and someone asked me this question. It’s a question I really have pride in answering but also sometimes with a bit of trepidation too. My true answer of my job description can either really excite or interest some, or all of a sudden they see someone they really must say hello to and make a swift exit.
I unconsciously but with intent fell into my job in my late 30’s. There was a sign on a bus I was driving behind saying ‘Join the Samaritans’ and that was it really, the journey had started.
After volunteering for the Samaritans I saw an advert in the local paper saying ‘University taster evening’ with a list of options. Bearing in mind I left school in the mid 80’s with not one CSE to my name and all my jobs were practical ones (I was a fab wedding florist); going to University wasn’t on my agenda in terms of me being capable enough.
There was an entry level award to get in to university - Tick, then a foundation degree - Tick, then my BA (Hons) degree - Tick, plus additional stuff on the way too. But it was during my 4 years at Hull University that I really knew where my passions laid. Whilst other trainees talked about wanting to work with children, alcohol and drug abuse, bereavement, and other ways of helping people, I knew what my passion was... Sex.
I had a strong feeling that I would be good working with couples, I knew I would be able to stay objective and stay with them both in that moment. I was curious about how couples met, their unconscious motivations, their fit, how they worked together, what happens when they didn’t work together, how did they communicate with each other, and what was the really interesting part for me was their sex lives.
So my next learning was to train as a couple therapist first, then I completed the 2 year PG Dip in Psychosexual therapy with Relate. If someone had said that my taster evening would have led to 7 years of training I would have laughed and probably not believed them. But it did and I’m here now, doing my dream job.
As my practice has continued, I have been lucky enough to be asked to speak at different conferences. These have included palliative care, Diabetes UK and Macmillan health and wellbeing days. It was here at these days, talking to the professionals and the patients that I noticed the sexual gap in the holistic care and I found that I felt a need in me to be able to close these gaps if at all possible in the areas I live and speak at.
Sometimes, the focus of care was on the survival of the patients or the comfort of those in palliative care. What I saw was missing in this care at times was the mention of sexual intimacy for these patients and their choice in their treatment, regarding future sexual functioning and the effects of that on their long term relationships too.
Some treatments are unavoidable and necessary but if patients understand a little bit more about the impacts that these medicines and treatments could have on their sex lives and long term relationships they can start to take control more too. Some of these gaps in talking about sex were due to funding, or time restraints. Also, it seemed that what was having an impact on talking about sex with a newly diagnosed patient was whether the professional diagnosing them saw sex as an important part of a relationship.
Sex isn’t for everyone I know, and what I have heard some people ask is that, "why would older patients or those in palliative care be bothered about sex". That isn’t the problem though. The problem is why sexual intimacy isn’t being talked about more openly with patients. If the subject isn’t raised in the first place then we take away patient choices, we don’t allow them to take part in their ongoing recovery. If everything is left as an unasked question it could be assumed that someone in palliative care would be too ill to think about sex, or the 75 year old with prostate cancer wouldn’t even be thinking about sex either.
This can be changed though; by talking to the patients about what ‘some people’ find happens in ‘their relationships’ the problems can be generalised and permission given to patients to talk about their fears, also to be able to take charge over what they want if they want it. It could be that a couple would just like an intimate cuddle alone and some hospices may have limited double beds, but if there is a request I know that nurses have done whatever it takes for that couple to regain their intimate relationship.
Sometimes people are ok with no sexual intimacy, but when it’s taken out of their hands by illness, or medication, then this can cause frustration and greater loss and at times they may want it back.
As a relationship and sex therapist I tend to see clients when they are already at crisis point, and at times I wish I could take them back in time to before the crisis. With any long term diagnoses this is a crisis point and things can be put in place for them at that time, which can help with further crisis points ahead. Long term relationship problems can at times, be avoided, and by helping to give patients/clients all the options available and the support that they may need, then hopefully things can be different for their future.
I really love my job, and this is a subject close to my heart, where differences can be made. Where there is a chance of helping people make choices in their own recovery, when it may seem that they have little choice because of the illness. I hope that I can help people though some difficult times in their lives, I listen to what they want and we will see if we can get there and if not - then we go for a ‘good enough’ place for them.
Karen Parke is a qualified relationship and psychosexual therapist working in private practice and for Relate in North Yorkshire and is passionate about her work. She also works for the Relate digital response team. Karen gained her degrees at Hull University, and then continued to train with Relate in couples therapy and psychosexual therapy; she also delivers workshops in the Yorkshire area. You can find out more about Karen's work via her website or get in touch with Karen via email or Twitter