Editorial: Eros in Rehabilitation

Abstract

My entry into sexuality education was an outgrowth of my psychotherapy work with persons with traumatic brain injury (TBI). When I first began working with TBI patients in 1983, sexuality issues were not being discussed overtly in team meetings, for instance, yet were appearing everywhere else in my daily practice. Sexuality issues seemed to be everywhere in the rehab setting except in the treatment plans and team conferences. The quadraplegic young man who could speak only by making a single eye blink for yes, and two blinks for no, was asking questions about his attractiveness, and talked about his sexual feelings toward one of the nurse's aides. The gay teenager who spoke fearfully about the risks of revealing his sexual identity to the staff and his peers, and tested out the reactions of others through provocative gestures like wearing nailpolish. The seductive young woman patient who laced her sexualized comments with threatening images, and later revealed a history of sexual abuse by a boyfriend of her mother. As this traumatic history started to emerge she projected this material onto another patient, falsely claiming that this patient was molesting her. The young wife who had lost the attentions of her loving husband to his severe TBI, and now was providing daily care for his bodily needs and having none of her emotional needs met. Her parents and in-laws were all out of state. She was alone at 23. She could no longer turn to her confidante, her husband, for solace and sharing in the midst of tragedy. Or the patient being wheeled down a busy hallway in a shower chair with his johnny opened in the back. The teenager who wanted privacy to masturbate but said he could not do this in his bed because the nurses kept the door open, or would pull back his bedside curtain with no advance warning. He couldn't use the bathroom either, because he could hold one unlockable door closed, but never knew if someone might suddenly come unannounced through the second door of his shared bathroom. The staff too were confronted with and struggling with issues of a sexual nature. The nurse who wondered if she had properly responded to the male patient who made a sexual proposition when she was giving him his nighttime medications. The nurse's aide who was angry with the patient who had an erection while she was helping him dress. The therapists who kept telling patients they already had partners or spouses when they were 'Mr. Medlar is the Chairperson of the Sexuality and Disability Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine, and is the Director of the Massachusetts Statewide Head Injury Program's Sexuality Education Program. 'Address correspondence to Tom Medlar, 5 Taylor Way, Middleboro, MA 02346-2500.