Life on Wheels (69 page)

There are two ways in which genital arousal takes place in the body. A psychogenic response is brought on by sensual thoughts—-the presence of your partner or fantasies, for instance. Psychogenic response relies on a connection from the brain to the lower thoracic/upper lumbar area, between the 10th thoracic and 2nd lumbar vertebrae. For example, for those with complete spinal lesions at or above these levels, sensual thoughts are unlikely to produce erection in men or clitoral enlargement and lubrication in women. With impact below this area or incomplete lesions, the psychogenic response is likely to remain.

Reflexogenic stimulations work from the other direction. They travel a direct route from the genitals to the T10-L2 portion of cord and back. They can occur in the presence of varying types of genital stimulation, intended sexually or not. Some men experience reflexogenic erection during catheterization or from the weight of bedding. Persons with complete lower lumbar and sacral injury to the spinal cord will not have a reflexogenic response.

Discovering your capacity for orgasm is a matter of experimentation, time, and patience. Your body might even go through changes over longer periods of time after a disabling trauma. In this case, it is true that practice makes perfect. If orgasm is difficult or seems doubtful, don’t give up trying. You’ll discover how best to stimulate yourself and what kinds of sensations are possible. The right moment might arrive when you least expect it.

If genital sex with orgasm is impossible, difficult, painful, or just not satisfying for you, what’s left? There are many adaptations and options to consider. You are a sexual being, not a sexual body part.

What sexual activities remain possible? Start with kissing—an extremely enjoyable and underrated pastime. Don’t limit yourself to each other’s lips. The face, the ears, the neck, the shoulders, the back—so many places that even the most significant disabilities leave capable of sensations—are extremely erotic. For example, many men find great pleasure in having their nipples licked.

Touch alone is very powerful. A gentle touch of a hand on your face or the slow exploration of each other’s body is very erotic. Caressing expresses loving feelings and promotes the relaxed, take-your-time approach to lovemaking that helps a couple reach deeper levels of passion and intimacy.

Sensual massage—in which you incorporate erogenous zones such as nipples and genitals—is an excellent way to sidestep the pressure of performance. People with limited grip strength can use vibrators or gloves. You can take turns with this and allow each other the absolute luxury of receiving totally, knowing that you will be able to return the favor. Sensual massage is also a great way to continue to find those previously undiscovered areas of sensitivity.

There are usually many undiscovered places, such as the palms of the hands, inside the elbow, or behind the knee. There are thousands of nerve endings in places like this that light up when kissed or touched but that many people take for granted. Research has shown that, when parts of the body lose sensory function, the brain turns up the volume elsewhere. Parts of the body that still have feeling become more sensitive.

Women usually have the option of sharing genital intercourse, even if they might not perceive sensation from it. There may be a need for additional lubricants. Water-soluble products such as K-Y Jelly should be used rather than petroleum-based lubricants, which can promote infection. Men having intercourse with a disabled woman might experience less friction as a result of weakened vaginal muscles. Yet the reverse may also be true: a woman with spasticity could have very active vaginal muscles during intercourse.

Women’s fear of not pleasing a partner because of lack of tightness in the vagina can interfere with pleasure, just as men can be concerned about maintaining an erection. However, less friction might extend the amount of time a couple can participate in intercourse before male ejaculation occurs; if intercourse becomes tiring, the couple can use other options to achieve satisfaction. Regardless of the muscle tone of vaginal muscles, intercourse is a very intimate experience but doesn’t have to be the final act of a lovemaking session.

Options change, of course, over time as we age, or according to the progressive nature of certain disabilities. Just as with your disability in general, a continuing mind of adaptation and exploration—and acceptance— is what will allow the most options to remain open to you. (Acceptance, it is understood, is not immediate but demands going through some associated feelings of loss. The process of grieving, as discussed in Chapter 3, The Experience of Disability, is part of the challenge of keeping sexual options open and appealing.)

As preferences shift, oral techniques can rise in priority in the context of disability. Oral sex may not have been part of your sexual repertoire; you may imagine it is inappropriate or unpleasant; you may even feel it is taboo. Younger persons might not be comfortable with the idea if they have never participated in this kind of contact. Yet, once over their initial hesitancy, many consider oral sex as enjoyable a form of lovemaking as they would ever experience.

Some women report that intercourse is less stimulating than genital stimulation with the mouth, tongue, or lips. This may be exactly the forte of a partner with a disability.

There has been some concern expressed that oral contact can transmit sexually transmitted diseases such as AIDS. Mitch Tepper explains:

New sexual possibilities open up when you are willing to reconsider previous beliefs, redefine your sexual priorities, and keep your focus on what is pleasurable. You might discover new levels of gratification as the giver of pleasure and perhaps discover a surprising degree of stimulation in that role. You can use sex toys, view adult videos, or read erotic material together.

If you are with a fully orgasmic partner, you can “ride the wave,” drawn into the intensity of their climax. The deep, shared connection with your lover is itself an orgasmic experience, a shifted consciousness. If your attention is fully with them, and not thinking about what you aren’t feeling, very rich levels of emotion and sensation open up to you.

Although some more of your attention might shift to your partner, that doesn’t mean giving up the idea of being the recipient of direct pleasure for yourself. Mitch Tepper writes:

The visual experience is often amplified for the disabled lover. Choose positions in which the partner with the disability can see what is going on, with enough light for the purpose. Perhaps leave your glasses on or your contact lenses in place. A man with limited genital sensation who cannot see what is happening might not be certain of the state of his erection. This can be discouraging and distract from the ability to relax into the moment. Being able to participate in intercourse at all is gratifying, and being able to also witness intercourse is particularly stimulating.

Anything that is pleasurable is fine. You are in the privacy of your own relationship. Whatever you choose, in any order, at any time, is entirely up to you, just so it is consensual and safe. The more you can drop your expectations and assumptions, the more possibilities will reveal themselves to you, and the more satisfying your sexuality can be.

Sex can be physically demanding. Your disability may preclude your ability to move in certain ways. For example, without the ability to use your legs, hips, and bottom to assist in pelvic movements, the typical movements of intercourse become tiring very quickly. An ablebodied partner needs to understand that certain motions have a time limit. The partner can take on more of the physical work, and you can relax and enjoy, moving as your capacity allows.

Use pillows or various sized cushions to help get your bodies into comfortable positions—and within reach. Pillows can also help stabilize you so that you can remain in a given position longer. The strain of needing to shift your weight or fatigue from bracing with your arms can distract from your pleasure.

Educate your partner about your ability to balance yourself and in what directions and positions you are able to bear weight. If your upper-body balance is limited, your partner will need to know when not to lean weight against you, such as when sitting up, straddled together. This position can work with the proper support, possibly even in your wheelchair.

You need to change positions regularly to prevent pressure sores. This takes attention, since you may not have sensations to tell you when to move. Hugging with your partner in the wonderful aftermath and glow of lovemaking, you might not want to break the spell to shift positions. But, at some point, you must; this is an important point for your partner to be aware of. You can just say, “It’s time,” and find another lovely way to lie together.

Explore the world of sensual products, which are now quite easy to acquire without the stigma of being in poor taste. If you are uncomfortable going into a shop, there are catalog suppliers who are very discreet in their packaging.

Sensual products include:

Vibrators. Available in many shapes and sizes and can be sexually satisfying or used to give massage to either partner.

Penis stiffeners. Worn as a supplement to ease the pressure of having to maintain a full erection.

Dildos. An artificial penis that a female partner might enjoy as a supplement to whatever capability a disabled male partner may have for erection. Lesbian relationships benefit, too.