With February set to begin and the nation soon overcome with everything St. Valentine, so too comes the opportunity to contemplate love, significant others and intimacy. Stroke survivors are unique in this conversation because often their symptoms have physical effects that impact the way they see themselves.

Making matters worse, survivors regularly report that there simply aren’t many opportunities to discuss intimacy after a stroke, especially for older adults and seniors. But who says young people get to have all the fun?

According to Judi Johnson, the stroke support coordinator at North Memorial Medical Center in Minneapolis, the most important aspect to this part of your recovery begins with a renewed sense of self-love. Herself a stroke survivor, Johnson says recovery is not unlike building a house in that you have to start with a strong foundation. “If you don’t love yourself, how can you love someone else?” she asks.

Recalling her own recovery, Johnson understands what many stroke survivors are going through. “You look in the mirror and don’t like what you see,” she tells StrokeSmart. The problem, she says, is that when we see ourselves in this new state, we tend to not “claim” ourselves. This part of stroke often leads to depression, which can lead to self-esteem issues and a rejection of intimate encounters.

Johnson has spent years teaching stroke survivors what she calls “the art of love.” At its core is a three-step approach to help survivors discuss intimacy without embarrassment and remember how important physical love is to our very nature.

Start with affirmations, Johnson says, and remind yourself that you are lovable and you are beautiful. Write it down. Stick it on your bathroom mirror and refrigerator. Repeat it. “Your partner can tell you they love you, but it has to come from yourself,” she says.

Further, she says, survivors must allow themselves to do special things for themselves. In her class, Johnson has students write down what they’ve done for themselves that week,and “many can’t do it (because) they simply don’t do nice stuff for themselves.”

Once a survivor has worked on loving him- or herself, the second step in Johnson’s course is loving others. And hugs–lots of hugs.

“There are many ways to hug and be affectionate that aren’t threatening,” Johnson tells us. “There are studies that show the importance of touching. Nurturing is such an important part of childhood, and it’s just as important in adults,” she says. “Reach out and touch.”

And, just as hugging and touching can (and often does) lead to more hugging and touching, the second step of loving others naturally leads to the third: loving together.

Johnson understands there are obstacles when stroke survivors are ready for the third step. Some prescription drugs cause impotency (difficulty or inability to maintain an --------) in men or a lack of sexual desire in women. Compounding the problem, Johnson says, is that drugs prescribed to correct these issues are often dangerous for stroke survivors because they alter blood pressure. Additional hurdles include lack of feeling or mobility in some parts of the body, or paralysis that makes the practical part of “loving together” rather difficult.

To help overcome these issues, Johnson suggests focusing on “setting the stage” for intimacy. Don’t neglect simple details, she says, such as music, candles and pleasant aromas. “And communicate,” she says. “When we sacrifice intimacy, our partners can interpret that as not being wanted.”

Lastly, one of the most common concerns among stroke survivors when it comes to intimacy, and specifically sex, is a fear that the increased physical activity will lead to another stroke. Nonsense, Johnson tells us, as having sex typically spends the same amount of energy as it does to climb a couple flights of stairs.

This can be a difficult topic, but having an open, honest conversation about intimacy with yourself, your loved ones and even your rehabilitation team can be quite empowering and rewarding. And when we understand that “intimacy” doesn’t always have to mean “sex,” we begin to see the importance of rebuilding our love of self in order to nurture our own recovery. •http://strokesmart.org/article?id=295