EPISODE 12: A Conversation No One Wants to Have
Originally Aired: May 2, 2017
LET’S TALK ABOUT SEX. THERE IS SO MUCH TABOO AROUND THE TOPIC OF SEX. PART OF WHY WE DO THIS SHOW IS TO BRING THE TABOO THINGS IN RELATIONSHIP OUT INTO THE OPEN.
TODAY’S EPISODE FEATURES MARK AND DEB. MARK HAD PROSTATE CANCER, DEB HAD BREAST CANCER. AFTER DECADES OF MARRIAGE, RAISING TWO CHILDREN, AND RUNNING TWO SUCCESSFUL BUSINESSES, MARK AND DEB TALK ABOUT WHAT HAPPENED TO THEIR SEX LIFE AFTER CANCER.
Deb: I think the openness with which we have approached it, and laughed, and said, “Okay, well, that didn’t work. Let’s explore something else. Let’s try something new.”
MARK AND DEB’S MARRIAGE AND WAY OF LIFE ARE STRONGLY ROOTED IN THEIR FAITH. IT HAS BEEN A ROCK THROUGHOUT THEIR LIFE TOGETHER.
Mark: It’s grown our faith a lot because we’ve always had faith and Jesus Christ is our savior and we’ve always had, knowing that we’re surviving, we’re doing the right thing, but now we understand that we need to do more and we need to take advantage of the benefits we do have. We are quite blessed.
IN THE SECOND HALF OF THE SHOW I TALK WITH DR. SUSAN HEITLER, A CLINICAL PSYCHOLOGIST, WHO SPECIALIZES IN WHAT SHE CALLS, “RAPID ALLEVIATION OF MARRIAGE DIFFICULTIES, DEPRESSION, ANXIETY, AND ANGER.” DR. HEITLER HELPS COUPLES LEARN TO TALK TOGETHER AND PROBLEM-SOLVE CALMLY AND PRODUCTIVELY. SHE ALSO COACHES WAYS TO KEEP MARRIAGE AN ON-GOING SOURCE OF SUPPORT AND AFFECTION.
Dr. Heitler: So what I call positivity is anything that’s yes or appreciation or interests or agreements or smiles or a happiness in the voice, all of those are conveying positive energy. Positivity not only makes you more attractive and makes your relationship more attractive to both of you, more bonded, more fun.
MY NAME IS ANDY HORNING, AND THIS IS ELEPHANT TALK. IT’S ABOUT ALL THINGS RELATIONSHIP – THE SOULFUL, THE SILLY AND THE SEXY.
Deb I went for a standard checkup in the spring, ended up having to go for another mammogram then got a call that I needed to have a biopsy. And it wasn’t long after that I got a call that it was cancer and that I was going to have to have treatment and have surgery. And it was a pretty sobering moment for me. So it was very difficult and to bring up to you Mark that I had gotten the results and that it was cancerous and that we were going to have to figure out how to coordinate all of this and two kids and ran a business and do all of those things but still life still goes on.
Mark Being a man, it’s totally a different approach. We like to fix things, or do whatever we got to do to defeat a situation that comes up against us. I felt helpless. “Okay, what can I do to make things easier for my wife going through this time? How can I double down on my work? How can I double down on taking care of the bills that she feels less responsible for the success of our family?” So all I could do is just keep working. And I read a little bit, studied a little bit but of course everything I did was futile. And I really felt left outside not that you put me out there, but there’s just nothing I could do except listen. And that’s hard for a guy.
Deb It felt like you were outside, but I didn’t know how to let you in because I didn’t know what you could do.
Mark It was tough. When you had to go through radiation, that drive back and forth every day, sure, I love to have been there to sit with you and hold your hand to do that but because the economic situation we were in and the financial future, we were really up against the wall at that time.
Deb I didn’t want it to affect the boys. At that point, we had a 14-year-old and an 18-year-old. So it was helpful that you were part of Zack’s football team. It kept him grounded and our family kind of kept things moving normal.
Mark For our children, we wanted them to realize that life comes with problems and it’s how you deal with these problem is really how your success is going to be rated at the end. So we didn’t want this to define who we were in that time period of our life.
Deb When I went to the radiation treatments, every day, day in and day out. It just felt really lonely. Cancer has that way of making you think of your own mortality. But I think the drive was good for me because then I could… we’re about 45 minutes from the center and just gave you that time to reflect on what is good in life. And I think that’s one of the things that we’ve always had in our relationship is just that ability to say, “Okay, this really stinks right now, but here’s some good that’s going to come out of it or that is coming out of it.” As the years went by, the timeline crept up and I was coming up on that five-year magic mark that you’re cancer free and then in 2014, you had your surprise.
Mark I got the call that I had prostate cancer. It doesn’t happen to me. It happens to other people, stuff like this just seems to affect, and I’m not talking down, but I always looked at life as… it affected the weak. It affected the ones that aren’t proactive with their life and I’ve always tried to be one step ahead of the person in the room or the situation that I’m in. So when my turn came up, I really wanted to get it right. I didn’t want to do anything that was going to hinder my family.
It’s always been situation, “Okay, we’ll deal it. What’s next? Step up.” This one, I couldn’t beat. I couldn’t work harder. I couldn’t be smarter. I couldn’t be faster than what the cancer was. So when I told you Deb, it was a few days after the call and it wasn’t to keep you out, it was set I had a plan in place on how to move forward and not adversely affect our family
Deb Your options for treatment changed nine months later when I was then diagnosed again. And I don’t know if you remember, but one of the calls that I got when we were out there was that my cancer was back and it was just pretty incredulous to think, “Oh my word! Here we are at the Cancer Center and looking for options for you and here now I’ve got cancer again.”
Mark The unique thing about going to where we went was that they could treat us both at the same time, same facility, same travel. They merged our treatment together and there was a lot of hope given in that. I’m glad that we had started training years before this to get ready for this, not knowing cancer was coming, but the way we’ve treated each other, the way we built our home and our faith and exercised what we believed in. The reason this has been successful is because is because of what we did, setting up rules of engagement, even on how you’re going to have a fight or how you’re going to handle money or family and doing these things ahead of time I think it’s made our treatment so successful.
I am glad that we chose to as a couple and as individuals to look at the blessings of cancer, not the negativity of cancer. The world is going to spin with or without us and what we can do to keep this world spinning while we’re here I think is very important. So how we handle those bad news defines again who we are as a couple and what we’re going to do and what God wants us to do.
It’s grown our faith a lot because we’ve always had faith and Jesus Christ is our savior and we’ve always had, knowing that we’re surviving, we’re doing the right thing, but now we understand that we need to do more and we need to take advantage of the benefits we do have. We are quite blessed.
Deb Once you had experienced that diagnosis, that phone call, that moment in time when your world just kind of stops, it changed one of both of us so that this time around it does feel like I’ve got a partner in this. Not that you weren’t on board, that you weren’t supportive, it’s just different. You understand. You understand the good and the bad of it, the scary parts, the parts that aren’t so scary. I guess it’s just an understanding that you can’t expect of someone that has not gotten that call.
Mark It’s made me realize, “Let’s speed up our retirement. If we don’t have enough money to retire, that’s all right. I can go back to work if something were to happen to you. My job is to take care of you and our children and my community around me and that’s what I want to continue to do.” So let’s just make sure that we do the best with what we’ve got for now. For now, our hand is cancer. We got to deal with it, but we haven’t let it change our work, our life, our love. The only thing that’s changed with me being more time off and put more emphasis on making a difference in the world today while we can.
Deb I think a huge part of our relationship too though that is invaluable to me at least is we’re relatively young people but with prostate cancer and mastectomy breast cancer, it’s made our sex life a little interesting at times, but we just laugh and make it work. So that’s something I’ve always appreciated is that you’ve been able to make me laugh even in the midst of the storm.
Just a disclaimer, I hope our children don’t listen to this, but I’m sorry if they do. We do still have sex though. So there you go.
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Mark It’s a conversation no one wants to have about the sexual life. That’s probably the biggest reason that I’ve been so vocal on this. We’re not talking about prostate cancer.
They don’t understand for a man to lose his sexual ability is monstrous. There are men that would just rather die. As a matter of fact, one of my friends did commit suicide that had prostate cancer. He just couldn’t take the idea that he was no longer a man of what men consider men to be.
Deb I think our sexual struggles were most evident when he was afraid of losing that part of our relationship. I wasn’t concerned about losing that part of our relationship because I want you whether you had that ability or not and I think that’s easier for a woman to say. I know it’ll be harder for you as the prostate cancer person to say as a man. Then at 50 I got dropped into the deep end of the menopause pool. So now we’re dealing with that too but having dealt with those issues, having dealt with a double mastectomy with scar tissue, with nerve damage and then you come along and have to have your prostatectomy, I think just the openness with which we have approached it and again laughed and said, “Okay, well, that didn’t work. Let’s explore something else. Let’s try something new.” I think we’ve navigated those waters pretty well just trying to do something different to get to the same result and I think because we’ve been that comfortable with each other, yeah, on the other side of this has been an even better sex experience.
Mark Even with the medical world, they ask me about my blood pressure. They ask me about my count, am I constipated, and my diarrhea. They ask that stuff, but they never ask you how you’re doing sexually. Okay? I almost had to bring it up because we don’t want to talk about it. God designed our bodies. He designed marriage. I think even the church has it backwards. They don’t want to talk about it either, but I think we’re making a big mistake. It needs to be talked about. It’s the biggest part of a relationship. For guys being tough we’re not so tough.
Mark They certainly don’t want to talk about impotency. They certainly don’t want to talk about that they can’t perform anymore. And my message to the world is even after prostate is gone, yes. You will have a dry orgasm. It is more intense than the other one.
You can make the best of a bad situation. Do I want cancer? No. Lord no. My wife having cancer? Oh heavenly no. But am I going to let it beat me up and am I going to let it kick me to the curve of life? No, it’s not going to. I guess I could say to the world that it’s been a blessing. It’s made me closer to my wife. It’s made me more aware that I don’t quite know it all and I can’t fix everything myself.
Mark Some of the problems that I think people run into, they don’t want to burden their spouse and by telling them what’s up. The impotency, the scar tissue for a woman, the different problems that you’re going to have. I never thought I could drain a bulb on someone side after a surgery, but because I love you, I found to way to –
Deb Remember when you had to pull the tube out? That was nasty.
Mark Yeah. It’s not that we had bad health care, it’s just that we would have to fly back to Chicago to have your tube taken out of your stomach, so I snip the stitches and pulled your tube out for you not thinking as I’m standing there in the bathroom in my bare feet, in my boxer shorts that it’s going to drain and it went all over my foot, but it didn’t make me love you any less. It made me love you all the more and knowing that I’m helping. We’re bettering the situation and we’re going to get through this.
I think the Holy Spirit has guided us greatly through this is become a ministry in itself. You were there when a man said to me, “Where is your God?” I said, “What do you mean?” He said, “You got cancer.” I said, “I was getting cancer with or without God.” Sure, it has a lot better to deal with a good wife and having a God behind you than it is to just going alone on your own.
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Deb On our wedding invitations, I remember distinctly it says something about marrying my best friend, but I really had no idea what that felt like. When you say that for sickness and in health, I don’t know that I thought that completely through because who could have perceived or anticipated what was yet to come. And if I did know, I don’t know that I would have stood at the end of that aisle because just to think ahead of what we’ve gone through would have been completely overwhelming. But we having done it now, I wouldn’t change it. I wouldn’t change who I went through all of this for anything and absolutely in sickness and in health, whatever is ahead, as well, I want to do it with you.
Mark You’re sitting at a wedding now that we’re the old people at the sitting and watching these kids exchange their vows. I’m like, “If you guys only knew what’s coming up that you’re going to be talking bowel movements, you’re going to be talking sexual problems, you’re going to be dealing with you’re not the man you used to be and you’re not the woman you used to be.”
Mark If you want to have a good marriage, if this world is to understand, it’s not going to be kisses and roses. It’s going to be some tough times. It’s going to be draining a catheter bag. It’s going to be some sexual impotency due to stress or an accident or cancer. I’ve got a lot of investment into this and I want to keep that investment going.
Deb That’s what’s been also a blessing in having cancer is that I’ve seen you moved to tears more often in the last probably 24 months than I have in our entire life together and I don’t take as any kind of an indication that you love us more now than you did before or anything. I just think that when you’re faced with this kind of a mortality issue that there’s more of a tendency to have the expression and I appreciate that you’ve been willing to wear that on your sleeve
Mark Deb, I just hope we can somehow, in our old age, teach younger couples, younger people what it really is like to be married and what it is really like to be make a marriage successful.
Deb I think it was a God ordained thing that we both just finally figured out that we had to put ourselves aside. It’s been a really rekindling of a love. So whether our future is another year or ten years or thirty years, I think we got it going on.
Host: There is something in the way in which Mark and Deb keep a lightness and add humor. Deb’s statement of “We’re friends with benefits,” highlights their humor. I honor Mark’s commitment to educate men and to get men talking about prostate cancer. Men don’t get vulnerable, in general, which I saw in my therapy practice. Mark is courageous in his educating men about prostate cancer and how to deal with the challenges and vulnerabilities associated with sex after cancer. I was clueless about the impact of prostate cancer on a sex life. I had never heard of a dry orgasm. I’m grateful for them to step out there and put themselves out there, they are a remarkable couple. This is an issue that is not easy to be vulnerable about.
MARK AND DEB’S STORY ILLUSTRATES THE BEAUTY OF LONGEVITY IN RELATIONSHIPS AND HOW TO TAKE ILLNESS AND MAKE IT WORK FOR YOU. DESPITE THEIR ILLNESSES, THEIR SEXUAL EXPERIENCES ARE BETTER THAN EVER. THEIR HONESTY AND OPENNESS ARE KEY FACTORS IN THAT SUCCESS.
SUSAN HEITLER IS A CLINICAL PSYCHOLOGIST AT THE ROSE MEDICAL CENTER IN DENVER. SHE TEACHES COUPLES HOW TO SUSTAIN A WARM AND LOVING RELATIONSHIP. HER WORK HIGHLIGHTS THE IMPORTANCE OF KEY WORDS THAT CREATE TENSION, LIKE “BUT,” AND WORDS THAT ENHANCE TOGETHERNESS, LIKE “AND.”
Susan How to be more attractive by giving more positivity, positivity not only makes you more attractive and makes your relationship more attractive to both of you, more bonded, more fun, so then the question is: what is positivity?
So what I call positivity is anything that’s yes or appreciation or interests or agreements or smiles or a happiness in the voice, all of those are conveying positive energy. There is another huge form of positivity that people tend to overlook. It begins with ‘Y’.
Susan You got it.
AH Say more about ‘yes’.
Susan So ‘yes’ says ‘I agree with you.’ Any form of agreement or highlighting gives a positive vibe, it says ‘oh! What you said was worthwhile. It was meaningful to me, I agree.’ By contrast, what are the words that convey negative energy?
Susan Exactly, ‘no’ or “n” apostrophe ‘I don’t, I won’t’. All of those ‘no’ words are downers and then there’s one other word that is basically a subtraction sign. ‘But’ is a qualifier. It deletes what came before.
AH So what about ‘and’ would that be a better replacement?
Susan ‘And’ absolutely is addition, it’s an upper in the sense that it says ‘I accept what you say and.’
AH So, Dr. Heitler, is this what you do with couples? Will you help them break down language in this specific way?
Susan Absolutely. I can have a couple come in for their first session, they’ve been at each other for weeks. Let’s say the issue was what to do about their child who’s having troubles. I give them a template for more collaborative dialogue. All I give them is sentence starters. ‘I feel…’ and then they have to fill in one word. And it can’t be an anger word, so ‘I feel… worried’ ‘I feel discouraged’.
AH So why can’t it be an anger word?
Susan I feel angry and immediately makes the other person defensive, invites defensiveness.
AH You’re looking to highlight connection and a different kind of energy between the two of them.
Susan Right, exactly so I’m looking to enable them to stay collaborative, to have lots of positive energy, lots of ‘I agree’ and sharing about themselves, not finger pointing towards the other.
AH So the dialog, instead of becoming oppositional and simplistic, it sounds like the ‘yes, and’ opens it up for a more deeper, nuanced understanding.
Susan Yes, because you’re adding like in a puzzle. If you put down one piece in this big puzzle and then I remove and just put down a piece, and you remove my piece, what do we end up with?
AH None [Laughter].
Susan No pu- [Laughter].
AH No puzzle [Laughter].
Susan We don’t get any.
AH Not enough pieces.
Susan If you put down a piece and I say ‘Yes! That’s a good piece’ and then I add mine and you say ‘oh, yes, I like that piece.’ And you add yours, now we have three pieces, so that’s what gives more nuance, more complex understanding. Additive dialogue is what I call it, as opposed to negating each other. When couples have a new format for their discussions they can learn from that format how to be collaborative. Here’s what I call Six Safe Sentence Starters.
Susan Number one ‘I feel’ and it needs an adjective. Number two ‘my concern is,’ very potent, because when people are arguing, they’re just offering action plans, they’re not looking at what the underlying concerns are. Number three, that begins to suggest an action plan ‘I would like to.”
Susan Number four is a question ‘What’ or ‘How.’ ‘What do you think about that idea?’ or ‘How would you feel about?’ So any ‘how or what’ question are very productive.
Susan Five and six are response sentence starters. Number five ‘Yes.’ It’s up to the listener to think what’s right about that, Number six begins with ‘And’ or ‘And at the same time…’ as oppose to ‘But.’
AH So you really are using dialog helping couples really relearn how to talk to one another.
Susan Right, re-pattern.
AH Re-pattern their communication…
Susan So that they can get what they want which is a loving, joyful, harmonious, fun relationship, exactly. Much like a football coach re-patterns his players if there’s something wrong with their footwork or if it’s something missing in the way they throw.
AH Why do you think couples don’t do that?
Susan Marriage is a high skills activity. So when my husband and I first married, all we had was the skills that were relatively limited that we observed between our parents. They weren’t terrible, they were limited to what we know and do now. So yes, it’s a high skills activity. Second is, marriage is for grownups. In addition to the skills of interacting, people have to be self-sufficient, confident, self-accepting individuals. Most people don’t have that skills set. You have to make decisions about all the most sensitive issues in your life: sex, money, children, in-laws. Life and death, health.
AH Life and death, for some people. These are heavy hitters, these aren’t light issues.
AH But, by that token I could be a good friend and have lots of deep friendships and yet still not have the skills set developed for intimate partnership.
Susan Right, you never with your friend had to decide on division of labor, who’s going to do the dishes? Who’s going to put the kids to bed when we’re both exhausted? Who’s going to pay the bills when neither of us likes doing it? There’s need to be much more of a theoretical basis, a structured basis on what couples need to focus on where are the difficulties in this couple’s life? And then guide them to resolution. It’s about them and the bumps in their lives, I call it bumps theory.
AH How would you explain bump theory?
Susan This is my basic theory of emotional wellbeing versus distress. I’m putting my arm out and with my other hand I’m walking my fingers down my arm from my shoulder down towards my hand ‘Oh! I hit a bump!’ A bump is that lump at the beginning of your wrist. Life has all kinds of bumps. So once you hit a bump, what are your options? Turns out there are five, take a look at your hand. From the wrist, moving forward to your fingertips there are five possible roads: four fingers, one thumb. If you’re skilling in figuring out what to do with a bump in your life, if you’re good at that then you go up the thumb route of finding solutions Now notices that ‘find solutions’ begins with F, if you Find solutions you would turn to the round of wellbeing and then you walk down that arm again and again. Every time you hit a bump you find a solution and circle back to wellbeing. If you don’t have ‘finding solutions’ as your extended response to a bump, the four fingers routes are all detours away from wellbeing. ‘Fight’ that makes anger, ‘Fold’ that’s a recipe for depression. ‘Freeze’ that perpetuates anxiety. Or ‘Flee’ that heads you off to the bar and stop to have a drink, whatever ,or get obsessive compulsive about working all the time, that’s a flee response also.
AH Fight, Fold, Freeze or Flee. I love the metaphor of the arm, the wrist bump, the hand, the thumb, hopefully if not than the other four.
Susan We learn patterns of response from the language of response of our parents. Every time I hit a bump, either I can get very anxious about it and just freeze and do nothing or I can give up on getting what I want how my mother always did and feel depressed. If your initial experience of bonding with one or both of your parents was a positive one, what therapists call a secure attachment, odds are pretty good you’ll have a secure attachment. If you instead have a hostile attachment –
AH You might end up creating that.
Susan – replicate that, right. One of the intriguing parts about a couple relationship is each of you bring your prior relationships model with your head like a script, bit by bit, your relationship will have elements of both family origin of patterns.
AH I’m really drawn to the very specific nature of it because it helps people who want that concrete path forward.
Susan People will often say, ‘I don’t like when you’ or ‘I don’t want you to this’ or ‘I don’t want to.’ So I say ‘maybe not- what do you want? Let’s flip the negative to the positive and here’s why. If I say to you: I need one of the books that is behind me now, I’d love it if you would get for me. You would say –
AH Which book! Right!
Susan Right, it’s not one of the ones with the white cover.
AH That leaves a lot of choices.
Susan Yeah, I really want that book, would you please get me the book? I don’t want one with the white cover!
AH I’m looking at a lot of books that are not white so I’m confused as to which one it is.
Susan Uh-huh. If I say I would like, the book with the red cover and the word Symptoms in big letters and white. What happens when you look?
AH Now I know exactly which book to get, I walk over, I see a fewer number of red books, that makes it much easier, and then, of course, of the few numbers I see one that says symptoms so I pull it off the shelf.
Susan Right, so that’s an example of why ‘I would like’ is much more effective than ‘I don’t want’. Ok, so having said that…
AH And in your experience, people naturally say what they don’t want rather than what they do want?
Susan If they grew up in a family that spoke negativity that said ‘I don’t like’ ‘I don’t want.’
AH Then they just learnt it so that’s-
Susan That’s the pattern that they learnt, yeah.
AH Yeah, that’s the relationship blueprint that they got.
Susan Exactly, the verbal blueprint.
THAT WAS AUTHOR AND CLINICAL PSYCHOLOGIST DR. SUSAN HEITLER. SHE HAS AUTHORED THE BOOKS FROM CONFLICT TO RESOLUTION, THE POWER OF TWO, AND PRESCRIPTIONS WITHOUT PILLS. TO LEARN MORE ABOUT DR. HEITLER’S WORK VISIT THERAPYHELP.COM AND HER BLOG “RESOLUTION, NOT CONFLICT” ON PSYCHOLOGY TODAY.COM.
THANK YOU TO MARK AND DEB FOR SHARING THEIR STORY. PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION AND RESOURCES ABOUT BREAST AND PROSTATE CANCER AWARENESS, TALKING ABOUT SEX DURING AND AFTER CANCER TREATMENT AND MORE.
WE WANT TO HEAR FROM MILITARY COUPLES. IF YOU OR YOU AND YOUR PARTNER ARE CURRENTLY IN THE MILITARY AND WANT TO SHARE YOUR RELATIONSHIP STORY, CONTACT US AT HELLO@ELEPHANTTALK.ORG OR SEND US A MESSAGE ON OUR WEBSITE, FACEBOOK OR TWEET US @ELEPHANTTALKPOD.
OUR PRODUCERS ARE LISA GRAY AND KIM POLETTI. OUR THEME MUSIC IS BY ROB BURGER. AUDIO PRODUCTION ASSISTANCE PROVIDED BY LESLIE GASTON-BIRD AND JOSH KERN.
ADDITIONAL MUSIC BY JEFF WAHL, KAILA FLEXER, AND FRANCESCA TORELLI.
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THANK YOU FOR LISTENING. I’M YOUR HOST ANDY HORNING. THIS IS REAL LOVE. THIS IS ELEPHANT TALK.