November 26, 2003
The Billings Gazette
Billings therapist Amber Ussin-Davey recently earned her master's degree in marriage and family therapy from Pepperdine University in Malibu, Calif. While in Los Angeles, she focused her training on women struggling with depression, body-image issues and relationship problems. One of her specialties is in the issue of disfigurement and sexuality.
What fueled your interest in the issue of disfigurement and sexuality?
I began researching the issue during my graduate years at Pepperdine University. I saw during sessions with clients coping with disfigurement that the issue of their sexuality and intimacy often went unaddressed. Our sexuality is an important part of our personhood, of who we are in the world.
I felt it was important to spread education on the subject, to let people know that any sexual problem is actually an opportunity for increased sexuality and intimacy. Too many people struggle alone.
How does disfigurement impact sexual relationships?
Much depends on the coping skills and intimacy problems the person faced before the disfigurement. Physically, genitals may no longer be the primary source of stimulation. Paralysis may have left them numb. Illnesses such as multiple sclerosis may cause hypersensitivity and/or numbness as well as problems with lubrication. Breast cancer treatment leaves scars due to lumpectomies and mastectomies. Breast reconstruction brings its own emotional and physical challenges. Facial disfigurements caused by tumor removal, burns, and other trauma may impact functioning such as kissing and oral intercourse. Audio-visual impairment includes the loss of hearing whispers, sensual comments and eye contact. Even aging changes the body and impacts sexuality: testicles shrink, skin sags, rheumatoid arthritis and osteoporosis are disfiguring and painful, strokes can result in the loss of control of facial muscles, and scars accumulate from biopsies and other surgeries. Emotionally, there is the struggle to feel connected with a partner, to feel whole, to feel sexual. Grieving and coping with their loss is primary.
Do many people seek therapy because of disfigurement?
It is important to first address the person's medical needs. But there comes a point when the person is no longer solely focused on survival. This is when they have time to turn inward and reflect on how they are functioning in their relationships and how they feel about their bodies. They turn to family, friends, and counselors for help. Therapy then proceeds with a team approach. Medical professionals address the person's physical needs and counselors provide a safe, supportive place to work through the person's emotional and relationship problems.
What can be done to help a person reclaim a positive self-image?
Reclaiming a positive self-image is a journey of emotional growth that leads to a more mature sexuality and a deeper level of intimacy. Among other techniques, therapists help clients focus on the feelings of loss, anger and trauma associated with the disfigurement. It is also vital to expand the view of intimacy beyond physical penetration. Humans have more to give to one another than just a physical touch. There is the opportunity for a connection of the spirit, for sharing, being vulnerable, and giving.
An emphasis on communication helps couples share their fears and remind each other of their continuing love. This is the type of communication that all couples strive for. It gives further evidence that a rewarding, deep, intimate sexual relationship is entirely possible.
There are also physical means of reclaiming a positive self-image such as prosthetics and reconstruction surgeries. It is important to know that these procedures can greatly increase self-esteem, but that they come with their own hardships and take time to adjust to.
Could you share some success stories?
I often think of a brave woman I worked with who was in her second year
of recovery from breast cancer and a mastectomy. She had also survived
two abusive relationships and was in recovery for alcoholism. She came
to therapy to work on preparing to re-enter the dating world. She was very
conscious of her scars and was struggling to be at peace with her body.
Aging issues also came to play as she was in her 60s. She amazed me in
the way that she charted how she was growing in her feelings of herself
as a whole, sexual woman. She kept photographs of herself on her bathroom
mirror to remind herself of where she had come from and how she had evolved.
She grew to love her resiliency and felt powerful in all that she had overcome.
In a self-portrait she drew near the end of our time together she stood
beautiful in her colorful jewels, a stylish skirt and a proud, scarred
Copyright © 2003, The Billings Gazette