#45 Sensuality and Sex After Breast Cancer

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Dive into this episode featuring Dr. Angela Cooke Jackson PhD, a renowned authority on health behaviors and human sexuality.

Currently serving as an Associate Professor of Health Communication and Behavioral Science at California State University, Los Angeles, Angela's global research has spanned continents—from Australia and Italy to Peru and Hong Kong—focusing on sexual health literacy and health disparities.

Her significant contributions are recognized in numerous journals, including the Journal of Human Sexuality, Health Communication, and many more.

Angela's unwavering confidence in addressing sexuality lays a sturdy foundation for understanding the complexities of breast cancer, sexuality, and intimate relationships.

The journey of rebuilding life post-cancer is daunting, but it’s a path you needn’t walk alone.

Grateful for trailblazers like Angela and the supportive community of survivors, this episode aims to shine a light on this transformative journey. Tune in for invaluable insights on embracing your transformed body, redefining intimacy, and mastering those challenging conversations with your partner.

Resources:

Angela's Twitter account: @DrCookeJackson

www.omgyes.com

What Almost Dying Taught me About Living

 


 

Read the full transcript:

 

0:01
This is Laura Lummer, the breast cancer recovery coach. I'm a healthy lifestyle coach, a clinical Ayurveda specialist, a personal trainer, and I'm also a breast cancer survivor. In this podcast, we talk about healthy thinking and mindfulness practices, eating well, moving your body for health and longevity. And we'll also hear from other breast cancer survivors who have reengaged with life, and have incredible stories to share. This podcast is your go to resource for getting back to life after breast cancer. Hello, and welcome to episode 45 of the breast cancer recovery coach. I'm your host, Laura Lummer. And today, I'm really excited to bring you this show. Because I really feel like it's time to shed a lot of light on the truth of breast cancer recovery. And the fact that cancer treatments change the lives and the relationships that we live in, not just through loss, but also because of living through the disease and the treatments. And understanding that breast cancer treatment often goes on for five to 10 years after chemo radiation surgeries. We sister survivors have to talk about what we go through as a result of surviving cancer. And part of that is how we view and manage our sexuality and our intimate relationships in the aftermath of breast cancer treatment. So today I have an awesome guest, Dr. Angela cook Jackson is here with me to talk about how we deal with sex and sensuality after breast cancer treatment. Angela is an associate professor of health communication and behavioral science at California State University in Los Angeles. She has traveled the world to places like Australia, Italy, Peru and Hong Kong studying and researching sexual health literacy and health disparities. Her work has been published in journals including the Journal of Human Sexuality, health communication, communication, teacher Communication Studies, and the Journal of intercultural communication research. Angela is not only a brilliant scholar and research, but she's this warm, inviting, awesome woman who's just captivating to listen to and to talk with. And her insights on communication and relationships are gentle, but they're real, and they're actionable. And I could literally talk to her for days. So I'm really happy to share this interview with you, and to have you hear her insights. So let's just get right into this. And let's do this. Angela, welcome to the breast cancer recovery coach. And thank you so much for making the time to talk with us here today.

2:51
Thank you for having me. I'm excited to have this conversation with you. Yeah,

2:55
great. So we're going to talk about this space after breast cancer that really doesn't get much attention or acknowledgement and it's you know, you're done with cancer treatment, people look at you, they say you lived great, everything get back to normal. But for many women, you have had significant changes in the breast, if you've had even a lumpectomy or a mastectomy, maybe a bilateral mastectomy, could have multiple surgeries. Some women choose reconstruction, some not. So we've got all this going on. And all these different ways that we have changed our body or our bodies been changed really kind of against our We didn't choose that. But you know, you have to make a choice between cut it off or die. And so we cut it off. And that doesn't make us very happy, right? And then you have to get back into the way that you felt. And obviously, your breasts right are a big symbol of femininity in our society, especially in Western society. It's like an obsession with breaths, right? And so there's just so much that goes around it. How do I present myself? Do you feel comfortable being unclothed? Do you feel comfortable in an intimate romantic relationship with someone? And so a couple of topics I'd like to cover today is one how do you take steps towards accepting and feeling sexy about yourself again after these changes physically that had been made to you? And then to how do you deal with the romantic or intimate relationship in that maybe you have questions? How does this other person perceive me Now does this other person think that I'm sexy or attractive now? And then finally, is a lot of that stuff just in our own head because as you know, I've talked before the show here how we may see ourselves one way but our loved ones just love us right? And regarding kind of drive that wedge by saying oh you can't possibly the I'm attractive now because I look like this. So Let's start off with what's some steps that a breast cancer survivor can take to feel sexy about herself again, after changes had been made to her breasts?

5:10
Exactly, I guess as I think about all of that, for this conversation, one of the things that I think is important for us to do a step to take all of us as women generally is that we do have to do more to stop buying into what the commercial marketing world tells us about who we are, and what we look like and what we should look like. It is so hard to transcend that. And so I'm not calling your listeners to, you have to turn off the television, you have to stop looking at your phone, you have to get off of Instagram, you have to get off of Facebook, you have to get off of these blogs, I'm not calling them to that. But I am calling them to a more conscious awareness of how much that impacts them. Because it is a step that must be taken and must be attended to, if you're going to actually move towards any thoughts of seeing yourself as a being and an individual who is beautiful, and who is sexy. A lot of that capacity comes from within us and it is our souls that are important. It is the spirit of who we are, that is important. But we are oftentimes barded by so much other information and so much other data that we don't really take time to understand that or to know that anymore. So that sounds like a really simplistic first start and a first step. But I think it's a critical critical start. And a first step is that we begin to think about our souls, and the significance of who we are as beings in this world and what we bring to the world. And then we also think about seeing our souls is not a part of what the rest of society says they need to look like. So that's a step towards understanding yourself. Yeah, your sense

6:59
of self worth. Yes. So important, because we know that one of the biggest sexual attractors is confidence. Exactly. You see someone confident, and you're like, oh, okay, who is this person. And if we don't feel worthy any longer because of changes had been made that make us not look like whoever is be bopping around on Instagram, right? Then it's like, okay, I'm not good enough, who's gonna want me. And so definitely self worth is that foundation right to feeling good about yourself.

7:29
I also think that we have to be careful about instituting a timeline for when things have to happen. And when they have to be done. When we institute this timeline to arriving at feeling sexy, or feeling confident in ourselves, again, it's a misnomer, it doesn't really work like that. That's, that's a, that's a process that happens over our life course. And when you've been so drastically changed in your life, especially with our physical bodies, when something happens to our physical bodies, whether it's the loss of our breasts, or if the loss of a limb, whether it's even the let's say you were made a smaller person in your your body is now putting on weight, any of those things that happen, your body has to take time to acclimate to that new state of being. We have to be careful to not fight against that we have to move into it. And we have to understand what that looks like whether it's journaling, whether it's self affirmation, whether it's yoga, whatever it is, that makes us get back to our soul, we have to find that way back. But we also have to be careful about assigning a timeline to when that will happen, and how it will look because we really don't know. And one person's process is different than another person's process. And that's the beauty about who we are as human beings that we all get to have our own process, we all get to have our own journey, as I like to call it. But take your time, and find ways to ensure that your time looks like what you needed to look like to help you heal. Because as you do that, that might mean your timeline. It might mean over your timeline. At one point, you used to love to wear really sexy lingerie, and now you don't feel confident in anymore, because you have had a breast or both breasts removed. Maybe your timeline says I'm gonna go back to wearing my sexy lingerie at some point in time. And it might not be something that I can do right away and put on in front of my husband because I don't feel comfortable in it or my partner. But maybe over the next month, I'm going to go buy myself something and I'm going to put it in my drawer and I'm going to keep it there and maybe then the following month, I'm just going to look at it and I'm going to take it out and I'm going to hold it and I'm going to remember that I loved to do this. I loved putting sexy lingerie on and then maybe in the next month after that you're going to put it on and don't look in the mirror just put it on and touch it and feel good at it. And remember that feeling that you had, again, it's a process, maybe month five or six, you're able to actually look at yourself in your beautiful lingerie, because your head is shifting even. And you're giving yourself time to think about this new normal that you're trying to live in. And so again, I think, and, you know, not to cloud this too much. But some of this comes by, again, the judgment that society has about who we should be and how we should look. And when we should get there, how we should look over the life term from being a 20 year old to a 50 year old how our skin should age, we are just inundated with all of this stuff. And we don't take time to go through our own soul searching, we don't take time to think about what was beautiful to us what was important to us at a point in time, and maybe has even existed there for the majority of our lives. And then when we shift when we get a little older, when we get a little more wrinkled, when we've lost some of the the resiliency in our skin, as we go through that shift, that we have to also take that thing that we loved and move it through the process of this new space that we're in now that were occupied. And again, it's not an easy task to do it. But I think it is an important hot task to give ourselves that time and to allow ourselves to move and progression through that time. And everybody on an individual basis, they get to decide what that looks like from that for them. But I do think it's an important thing for us to do.

11:35
Great point. I think it's a great point. And I think you brought up a really good point about aging, because as you age as you have children, right, your natural breasts change also exactly how many women do you know who are dissatisfied with their natural breasts

11:52
at 5055? Children a lot, right?

11:55
Yeah. So that's the difference being that that did slowly happen, right? And slowly change. And even though, you know, not really, like more of these are hanging right now. You it's still you exactly. And they still have sensation as well. Whereas when you're talking about someone else, forcing a change on you, that could very easily affect an intimate relationship. Right, exactly. So what are some steps? If you're thinking, Okay, well, my breasts don't feel the same. Maybe my partner, you know, maybe I feel so self conscious. And like you're saying, take those steps to get comfortable in what used to make you feel sexy. How important is having open conversations with someone else about their feeling or how you go about, but having that intimate relationship with someone, because that can be a really daunting idea is to sit down and say to somebody, Hey, my breasts don't feel good anymore, or they don't have any feeling at all anymore. So is it a good idea to talk to somebody about changing up the way you interact? You know,

13:00
so I want to say two things before I delve into that. And one of them is I'm not giving a plug for this company or this organization. But it is, to me a beautiful space that I think your listeners might find an understanding of pleasure in and understanding that all of our body is essential to touch, to be engaged with all aspects of our body, our skin is an organ, and how we feel and being able to actually understand that for yourself. All of it, not just your breast has sensation and has the capacity to find central connections with your romantic partner. So a plug for this one website that I love. It's called O M G, Y e s o m g yes.com. Check it out. If you get an opportunity to, I asked you to check it out. Because I think it's important to think about how central our body is how central our vagina is how central our clitoris is how central we are as being how central our skin is, our feet are our neck, our ears. There are so many elements of our body that have sensual connection to them. And yes, our breasts are important are an important part of it, but they are one part of it. And we are a culture again that puts a lot of emphasis on that so as women we don't get to know that part of it we get to know what it means to have sexual intercourse and pleasure our husband but we don't oftentimes even understand how to talk back for our own pleasure for having our own sense of what that means in if you don't want to be pleasured by having Pino sex or having sex with your your lesbian partner. That's not how you find pleasure through your, your, your vagina, then maybe you find it through your inner thighs being touched. What is it and again, if you don't know what it is, then you don't really know how to talk about it, to ensure that your partner can give you that love that you need. So one plug for OMG. Yes, check it out, you might find that there are a variety of different ways that women have found the capacity to feel and be love, but that they are working to understand their own bodies. I think then when it's when it goes to talking to your romantic partner about that, whether you're in a same sex relationship, whether you're in a heterosexual relationship, you have to have those conversations. And again, if you have now had reconstructive surgery, or if you have decided not to have reconstructive surgery, and you feel like you have scar there and the scar tissue is sore, tender to the touch, your partner doesn't know that if you don't explain that to them complaint, I do believe again, that's a part of the journey, that's a part of taking time to begin to create the language that you want to use with that intimate person to let them know what you feel and what you need, it's not going to happen overnight. And it's going to be clunky. And it's going to be problematic at times, and it's going to feel like you have this great wall between the two of you. But if that is the relationship that you're in, and you value it, and it's important to you, then you need to have that conversation, because your partner typically usually loves you that much to give you that time and values you that much to want to hear that from you. So that they know how to give you pleasure in the way that is most exciting for you. But we have to be the initiators of that language and have that dialogue. And when we withhold that from our partners, without speaking those words out loud and assume that our partner understands, we get into a lot of dysfunctional communication.

16:53
I love that. And I think that's a really important topic is if we don't speak up for if we don't first take that step to realize what it is we need, or what it is that's bothering us, as well or concerning us. And then express that we're leaving that other person to tell themselves their own story. So maybe this other person thinks, oh, you're not interested in sex anymore, since you have changed. And then we create this distance, because we're thinking, Oh, you don't find me attractive anymore, which is probably not the truth. And then the other person's thinking, Okay, I want to be gentle, she's been through so much, and she's not ready to feel this way again. So it's, you know, it's, we're telling ourselves a story about how people perceive us, which is based on how we perceive ourselves. And then we're allowing them to have their own story about what's going through our heads so that that communication is so important, and so vital, that we say this is what works, this is what's not working anymore, this is what's changed. And how do you see that? How do you? How does that work

17:59
for you? So I automatically hear all of you saying, Yeah, I know, I hear you saying this. And it sounds really good. But how do I actually make it work? How do I actually do it? Money's in it is not easy. And one of the things that came to my mind as you're talking, Laura, is, there's two different types of communication. And one of them is called intra personal communication. And one of them is called interpersonal communication, and an inner interpersonal communication, we are in an intimate relationship, and it's a dyadic relational exchange. And so that means that I know that person pretty well, I'm very comfortable with them. Whereas an intra personal communication that is oftentimes referred to as the talking that goes on inside of our head. And so you, we both we do both of those things, we actually do them simultaneously, and we can do them in conversation with someone, I can be talking inside of my head. So your boss says something to you, it makes you a little bit upset, you might be talking in your head about what you think about him, but he's actually hearing you say, and I probably shouldn't use the example of a boss, but let's say your partner says something to you. Um, because again, interpersonal communication is up between two intimates in a dyadic relationship. So you're talking inside your head, and you're actually communicating with them what you feel, but maybe what you're saying inside of your head is, you know, why are you saying that to me? Who do you think you are in the first place and you don't understand me, but as you're speaking out loud, you might be saying, Okay, I understand. You have to one be willing to pair those two things together. Your partner needs to hear what's going on inside your head, that intrapersonal conversation that you're having, so that they can understand and better the interpersonal relationship and communication that you guys have together. One of the ways that my partner and I did this early in our relationship was we created this space in our house called the round table, and the round table became a space for us to say, everything comes out whatever we're feeling, whatever we're thinking and everything gets resolved. To set the table we're going to talk it through, we're going to sit here till we have some closure on it. For me, that was a beautiful visual and literal space that I knew I was not going to be holding on to something for for months upon months, the round table became a space for us to have our conversations. And to be honest and transparent with each other. Those were the rules, because we renew we loved each other, but we were new to each other's ways. And so again, I say to you, ladies, you have to think about what that looks like. You might have to create it, your partner might not but create it and use it is a way for you to think about what's going on with you and your body and how you feel about not having breast now how you feel about having breast implants, how your how your breasts actually feel how the skin tissue feels, talking about any of those things that you're pining over, or your intro personally, just musing over or frustrating over, you have to do that with your intimate partner. And they need to know so that they can help you move forward. And so that they can feel like you're not holding something against them, or you're upset with them about something that it's it's about what you're trying to figure out and move through in this process,

21:25
right? Where you said, you and your husband, you loved each other, but you were new. And in this situation, you've gone through breast cancer treatment. So it's kind of new again, it's like, okay, where are we at now? Like, like, let's find out,

21:38
we're starting over, right? Yeah, here's a

21:39
starting point. So let's move forward. And then also I see the benefit, and not only getting that out of your head and improving that communication. But when it's stuck in your head, you're kind of beating yourself up, right? It's just going in circles. Yeah. And something I see in my revivify program, where this group of women come together in this private Facebook community. And they identify with each other so quickly, right, and they get each other. And so I think to that an important part of building up to that tougher conversation, which is with this person, I don't want to hurt their feelings, or maybe I don't want to hear their real thoughts, afraid of what their real thoughts might be, is bouncing that off of other women that had a similar experience asking, how did you handle it? You know, what tips do you have an engaging in community right with other survivors I just found is amazing that when I see the results from that,

22:35
and that's super important for our own sense of well being to have that community, I also think it's important to be careful about taking that back to your partner in assuming that it will work the same way that it did in the conversation that you had in your community. Again, that's where I go back to understanding and knowing your own soul, and knowing how you and your partner communicate, and what makes the communication relationship that you have with that person, really, really viable. And so then you are able to take the information that you receive and your your inner group, your network of women who've experienced it, and you're able to then pair it up to what you would do with that person, and how you would communicate with that person. So you're using the data, but you're not necessarily trying to model exactly what this other woman said she did her husband, because it doesn't necessarily mean it's going to work that way. My husband's a different person than some of the male friends that he has. And when I would bring things even back to him like, well, well, Valerie and Peter did it this way, or Rochelle and Bill did it this way. He would say, do Rochelle and Bill live in this house with us? Do they sleep on our bed, and it was his way of saying to me, which often made me laugh, we need to have our way. And it's okay for us to have our way. It's okay for us to cherish our way and to love what it looks like. That's why you share and you communicate with them. And you struggle through it. It's not easy. We're also dealing with relationally, someone who has not had the experience that we had, or been on the journey that the way that we've been on the journey, and they can't. And so how do we help them come through this process? What what tools do we give them and what words and conversations must we have with them? To help them understand how we're feeling? They don't have to reconcile it. You should be able to say to your husband, I don't need you to do anything about this. I just need you to know what's going on in my head. Right? That's most husbands are pretty comfortable with that.

24:46
And they're like thank God. Yeah, right.

24:49
Exactly. And a lot of times, you know, we don't want to be told what to do. So it's okay to say to that partner, I don't need you to tell me what you think I should do either. I just needed I just need you to understand what's going on in my head. That's a very freeing, it heals us, it's a healing balm, to our souls to be able to communicate, to be able to share ourselves, especially with the people in our lives, who we know love us the most in our most dear and near to us, and especially with what I would call that intimate partner, that person that we have a relationship with. And when you so so so maybe there's some of you out there who are like, Well, I'm not in an intimate relationship with anybody right now, by working on these things in your life and working on them with your friends, and finding ways to pull those things out of yourself and to talk about them with these people. I believe when you move into what potentially could be an intimate relationship, you have a lot more context in which to talk to that person. Absolutely. To keep them aware, you know, of what's going on in your head and how you feel you have a lot more context to say to that person, when the time was right. You know, if you've been dating, you have a lot more to say to that person about you know, I need to tell you about my journey that I've been on and that you know, maybe I've had a mixup mastectomy or for Miss like me, and this is what's going on in my life. And I just want you to know about it, because I love myself. And I've put a lot of time into loving myself, and I won't be with somebody who doesn't love me the way that I am. And the way that I look. Being able to say that out loud. To somebody that might be new in your life is important.

26:28
Oh, absolutely. Because I sadly hear so often. Who's going to want me now? Right? Exactly. That just kills me. And I think one who's gonna be lucky enough to have the right this is our second shot at life. This is we made it you lived through cancer. And that mentality has to shift from I'm damaged goods to, you're either gonna love me and appreciate me for the treasure that I am or you know, exactly not and so that it's so I love how you're saying, you know, work through that, definitely. And you know, and be competent. And be sure of yourself that you're even more you've had so much more life experience, you had so much more to offer.

27:08
If you are that woman that is not in a relationship right now. Make sure that you prepare yourself and that you ready yourself so that you arrive at a relationship, ready for it. And if you are, if you do not arrive in a relationship to all my sisters and girls out there that aren't in relationships and are older and aren't finding that love of your life, then you need to be happy with who you are, and what the opportunities that will avail themselves to you will look like. You need to find satisfaction in that so that if you go to your grave as a single woman, you go to your grave as a single woman, but you've had, you have friends, you have people who love you, you've traveled the world, you've seen the things that you've wanted to see, you've taken care of yourself in the way that you wanted to take care of your filled person, we have to stop this narrative that we got to get married, and we got to have a partner and but that's the only way to live in this life. And and if we don't ever get it, we should be sad and reduced to a secondary. I don't even remember what they used to call them. But like an old maid, no, no, no, no, you live in the fullness of your life and you live in the fullness of your life, to the capacity that you're able to regardless of whether you get to have an intimate partner or not.

28:20
I love that. Yeah. You know what I want to make just one more point that you and I talked about before the show, that is when you are in a relationship and that intimate person is saying to you, I love you. I don't care. You're sexy, you're great, right? And we have to accept it and fight it. Right? That's easy. No, you don't. And that's not really your thing, right. And we have to let not let our own head Zhang drive that divide, but accept what people are saying and appreciate their perspective as well.

28:49
Yeah, we have to stop putting that energy out there. We want to go through our list of things. When that person says they love us, and they accept us. And they're even physically intimate with us. We're going through a list of things and saying it out loud. But yeah, but my butt's too big, and my breasts are too long. And we go through this list of things. And we speak them out loud to this person who has said that they love us and they want to be in our lives. Yeah. And that's very daunting for that person. And oftentimes, they don't even know what to do with that, because there's no there's no recourse for them. They can't come back and tell you. No, that's not true, because you're talking about yourself. So we have to begin to figure out ways to say when that person says to us, who they see us to be and how much that we love. They love us. We have to begin to say out loud, thank you. Thank you for loving me this way and thank you for seeing this beauty in me and then shutting up. Literally shutting the girl up and taking it in and accepting it into our souls is the reality. Because we are so so hard on ourselves. Yeah, yeah. Well, thank

29:55
you. Thanks for your time. I can talk to you for hours. This podcast could go on all day long. But I really appreciate it. Thank you.

30:04
Thanks for having me.

30:05
Wow. Okay, I just have to say I love talking to Angela. And I love the way she presents herself because she's just so secure and confident and calm when she talks about ourselves, our sexuality and our sensuality. And I wish that every woman could be as comfortable not only with herself in this topic, but in supporting each other in this topic as Angeles, I love, love, love talking with her so happy she could be here today. And I hope that you not only heard some things that will support you in feeling good about yourself, and working through anything that might be troubling you about physical and emotional changes that you've been through as a result of cancer treatment. But more than that, I really hope you realize on a real and deep level here, that you are not alone, know that you can reach out, you can become part of a community of women who are working through the issues that you face, and you can find support on my Facebook page, you can reach out to me in my revivify program. And I know that there's also lots of local programs in many places all across the country. So look for them and reach out, don't go through this struggle alone. There are other people that can support you and give you ideas and give you direction. And my mission is to support you in living your best life. So please take advantage of the resources that I can put out there. And I also have an announcement coming about additional ways that you can work with me and be a part of our community of thriving survivors who really are just doing an amazing job of working together and supporting each other and thriving in their best lives. So I will include the links to the website Angela referred to in the show notes as well as some other resources that she thought would be valuable. And you can find those at Laura lummer.com forward slash 45. And thank you so much for listening. If you are not already a subscriber of the breast cancer recovery coach, please take a moment now and go to the iTunes Store or actually you can just right where you're listening subscribe so that you never have to miss an episode. And so it helps make this show easier for more people who want to hear and need to hear this information to find. Alright, thank you so much for listening. Thanks for taking the time and I look forward to talking with you next week in a great episode about coming to terms with impermanence, and how impermanence is such an important thing to face, to understand to process in order to live your happiest life. Alright, have a great rest of the day. And I'll talk to you again soon Until then be good to yourself.

32:52
Use courage to the test laid all your doubts. Your mind is clearer than before your heart is full and wanting to more your futures Give it all you know has you been waiting on yours this is your

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