Sex therapy and mastectomy

Because the emotional trauma associated with a mastectomy exceeds the physical trauma, the recovery of the woman is greatly affected by the response of her husband or lover. Sex therapy, therefore, involves the couple. The approach described here is aimed at assisting the couple to confront and intergrate the mastectomy experience. The use of a prosthesis is discouraged during intercourse because it delays such confrontation; certain sex therapy exercises (body imagery and sensate focus) are usually recommended because they facilitate confrontation and acceptance. These, modified for the circumstances, are described. It is suggested that intercourse be attempted as early as possible, and that if physical weakness or psychological trepidation intervenes, the physical desire and caring of the husband be expressed nonetheless. The "professional" attitudes that psychotherapy is always indicated for mastectomy patients and that the proper role of the husband is matter-of-fact denial are rejected; emphasis is placed on the beneficial consequences of sharing of all emotions.