Dating, Love, And Chronic Illness: An Interview With Dr. Saltz (Famous Psychiatrist & Relationship Expert)

Recently I had the pleasure of interviewing Dr. Gail Saltz, M.D. about a very important issue that affects more than 100 million individuals in the United States suffering from various chronic illnesses: dating and maintaining satisfying intimate relationships while living with illness.

Dr. Saltz is a renowned psychoanalyst, columnist, bestselling author, and television commentator who Tom Brokaw has regarded as "a voice of wisdom and insight in a world of confusion and contradictions." You might recognize Dr. Saltz from any of her repeated appearances on The Oprah Winfrey Show, ABC’s The View, Dateline, ABC’s 20/20 and Primetime, Fox New's Bill O’Reilly and Glen Beck, CNN’s Larry King Live and Anderson Cooper 360, HLN’s Jane Velez-Mitchell and Joy Behar, among others. She has also been featured or quoted in the Associated Press, Newsweek, O Magazine, Parade, Redbook, Woman’s World, Town & Country, New York Magazine, The New York Times, The New York Daily News, The New York Post, The Los Angeles Times, and WebMD. 

Dr. Saltz also hosts a series entitled "Strength of Mind" at the famed 92nd Street Y where she interviews celebrities and extraordinary individuals about psychologically interesting issues. To date, she has spoken with such luminaries as Woody Allen, Tom Brokaw, Katie Couric, Jane Pauley, Howie Mandell and Rosie O'Donnell, among others. She is an Associate Professor of Psychiatry at The New York Presbyterian Hospital Weill-Cornell School of Medicine, a psychoanalyst with The New York Psychoanalytic Institute and manages a private practice on the Upper East Side of Manhattan. I mentioned before that Dr. Saltz is a best-selling author, so be sure to check out all of her fascinating books and articles on a wide variety of issues (including a weekly column on MSNBC.com addressing questions about all kinds of relationships).

As Dr. Saltz worked toward her degree in Psychiatry, she did her residency in Internal Medicine and Psychiatry at Cornell-Weill School of Medicine and The New York Presbyterian Hospital. She explained, "I became particularly interested in the impact that illness had on the mind" and went on to do a fellowship in treating sexual dysfunction - a topic that she says was rather taboo at the time. Since illness has such a broad impact on an individual's life, medical and mental health professionals tend to just focus on the disease itself rather than the impact it could have on a person's sexuality and intimate relationships. Dr. Saltz explained, "The topic always ends up at the bottom of the priority list. How illness impacts sex was very important to me and I began doing a lot of couples work as well as individual work...there are many people who don't currently have a partner who still need to feel good about themselves as a sexual being."

Between keeping appointments with doctors, filling prescriptions, sticking to a medical regimen, and getting enough rest, coping with illness can feel like a full-time career. Add in work, school, volunteering, or maintaining relationships with family and friends, and it's hard to see an open space for dating. And then once you're on the date, a plethora of new concerns arise: When and how is the right time to bring up my illness? How can I make the other person feel comfortable? In the midst of falling for someone, how can I still do what's right for my body (i.e. ending the night earlier)? Dr. Saltz said, "In the dating world, it's really about when you choose to discuss the topic of illness. It's important to be thoughtful about when might be the best time; not disclosing this part of yourself too early or waiting too long." She also emphasized the importance of communication, even in these early stages. Since it's easy for people to take things personally (especially in the beginning), we shouldn't be insecure about explaining the real reason we may need to call it an early night. After all, if that person doesn't care to listen, then you've dodged a bullet anyway.

Just as with any stressor, Dr. Saltz says that the key to a functioning, long-term relationship in the face of chronic illness is good communication. She explained, "If a couple is able to communicate about and cope with illness, it's really a testament to the overall skills of that couple." We also discussed the anxiety surrounding chronic illness. Dr. Saltz explained, "Often when you're anxious about your illness, you tend to project that on to your partner...since you have the experience of being uncomfortable, you believe your partner will be uncomfortable too. Of course, you haven't asked them. The only way to know is to ask. It is equally important that both partners are able to be open about his/her feelings and concerns, so Dr. Saltz suggests a way that the sick partner may choose to invite honesty from their significant other. One might simply ask: "I'm thinking I'd like to talk to you more about something, but how do YOU feel?" She went on to say, "For the caretaker, it's often very difficult to say anything about their needs...they can feel so overwhelmingly guilty, not entitled, and concerned about keeping the focus on the patient. However, both partners need to give and receive; getting to stand in both shoes is important."

Of course, chronic illness can strike both males and females, and each gender must cope with certain insecurities about their health. Dr. Saltz reminds us, "people tend to underestimate how insecure men can feel. They can be just as insecure about how their bodies look and perform as women can be. Physically speaking, men have added pressure. If they're anxious about the sex act it will effect their erection and then they may start to avoid intimacy altogether." There is also the added factor of societal pressures. Dr. Saltz continues, "Admitting when there is pain can be very difficult and is seen as a factor of masculinity. Today's 30 something’s might have an easier time being open than today's 60 something’s because our society is becoming more open, but still there is the very real concept that real men don't complain and can tolerate pain. Men often don't want to go to the doctor and this can also be a real struggle for a couple."

As our conversation continued, Dr. Saltz added, "if you look at the 'happiness data', giving back is a big piece of satisfaction and both partners need to experience this. If one has the feeling that they're constantly on the receiving end it can make them feel useless. When people feel let in and listened to, they feel trusted and more trusting - those things lead to intimacy and don't require joint movement; they're really about communicating." I asked her about some typical romance issues experienced by couples coping with chronic illness to which she responded, "the nuts and bolts of having a sex life while living with chronic pain should be discussed. These changes can be scary, but again, it's about communication. What is okay for each partner to ask? What changes would embarrass me? Am I going to be less desirable or attractive to my partner now?" She continued, "Without talking about it, things tend to go poorly." She maintains that "each partner must be flexible about the definition of sex and open to different forms of stimulation and other sexual acts that don't necessarily involve intercourse. They may need to change the time of day and accept being less spontaneous. Maybe they could plan a candlelight breakfast if the mornings are better. It's all about remaining open to the possibilities. If you want to be successful as a couple don't just give up or let the issue go. It's important not to let [chronic illness] end your sex life because then you may lose the relationship." She added, "illness or not, when it comes to long-term relationships, change really is your friend."

We also discussed Dr. Saltz's involvement in New Way RA® (www.newwayra.com), a fantastic, one-of-a kind online talk show hosted by Deborah Norville and intended for people living with Rheumatoid Arthritis. It provides support and information for patients in a new and exciting way, and seeks to help people live well despite the challenges posed by their disease. The show enables viewers to "learn how to best manage their RA with advice from a leading rheumatologist, watch RA videos featuring people living with RA who share their experiences and inspiring stories, and understand the importance of feeling your best, both physically and emotionally." They've rounded up a series of well-known experts in their respective fields to ensure that the highest quality information is being delivered.  From relationship advice to valuable nutritional information to arthritis-friendly fashion, New Way RA® truly deals with the patient as a whole. In my opinion, the beauty of this program is that it provides convenient, useful, and free information that is pertinent for anyone living with chronic illness (and not just RA). Dr. Saltz is excited about participating in this initiative and said, "as much as I love the one-on-one work that I do in my office, I also love public education. It's great to be able to reach all kinds of people."

I want to thank Dr. Saltz for taking the time out of her busy schedule to speak with me. More importantly, thank you for all the important work you're doing to better the lives of people who are living with chronic illness and for all of those who love them.

Here are some websites associated with Dr. Saltz that may be of further interest: 

The Official Website of Dr. Gail Saltz

Dr. Saltz on Facebook

New Way RA® Online Talk Show