Mastectomy is a medical term referring to the surgical removal of one breast to treat breast cancer. One breast is removed in order to prevent the subsequent spread of cancerous cells (Bartle-Haring & Lal, 2010). Mastectomy has serious emotional as well as psychological effects on both the patient and her relations, especially her husband. Hoskins (1995) provides that mastectomy greatly affects marital function. In a mastectomy, the loss of a breast which many women see as erogenous makes a woman experience indifference towards her sexuality. This further affects her sexual intimacy with her partner. This essay seeks to critically analyze the literature review on mastectomy and its effects on marital function.
Problems arising from mastectomy and impacts on relationships and marriage
Mastectomy is traumatizing. Emotional trauma resulting from mastectomy is more than the physical trauma associated with this condition. This is because the woman’s recovery is affected by how her husband or partner responds to her predicament (Lewis, 2004). This evidently shows that mastectomy affects a couple’s marital relationship. It is also important to note that husbands of women who have had a mastectomy are also affected.
This is because the husband has to deal with the fact that his wife has one breast. Though the reactions to this fact vary, there is a common trend that has been witnessed in the majority of husbands whose wives have undergone mastectomy. Goldzweig & Andritsch (2010) provide that it is apparent that a husband suffers psychological distress in the event of a mastectomy. The husband first reacts to the absence of one breast. The experience is quite difficult especially when he sees a scar in place of a full breast. This is one of the biggest negative effects of mastectomy as most husbands become withdrawn and avoid their wives.
In most cases a husband is normally confused and does not know how to approach the issue due to psychological shock (Pierce, Sherman & Sheridan, 2010). Though there are husbands who take the whole experience positively, a large number of them experience a hard time.
To effectively understand the impact of mastectomy, two theoretical perspectives have been used. The first theory is the systems theory and the other is the attachment theory. The two vary both in scope and the level of analysis (Hoskins, 1996). However, they are complimentary in explaining the reactions of the husband when his wife has undergone mastectomy (Toseland, 1995). The family systems theory concentrates much on the processes or rules of transformation that occur between the couple when a stimulus enters this system. The system theory analysis deals with the effect that a spouse has on his partner.
The systems theory contends that the spouses will affect each other. The husband is affected by his wife’s condition of a missing breast. The husband, according to this theory, will react to what meaning the absence of the breast has for him.
At first, there are feelings of loss. The husband will often be sad because mastectomy is a painful experience to the woman and since they have shared intimate moments and mutual devotion for each other, therefore the whole experience takes a toll on the husband (Lewis, 2004). Feelings of frustration and helplessness also set in because the husband would want to help his wife but cannot. Such feelings are not expressed because the husband feels he is supposed to protect his wife. Consequently, he suffers silently.
On the other hand, the attachment theory is based on how an individual regulates his emotions with his wife especially in the event of a mastectomy (O’Mahoney & Carroll, 1997). This theory helps explain the effects of mastectomy on marital function. It assumes that a husband has developed internal affections with his wife and the breast is one of the parts of his wife’s body that he has become used to over time (Ptacek, 1994).
The removal of the breast consequently creates discomfort on the part of the husband and makes him avoid his wife. On the part of the wife, Most of the time she will feel incomplete as a woman because the breast is such an important part of the female anatomy. Its removal implies that the wife feels that she cannot fulfill her marital duties when it comes to sexual relations (Goldzweig & Andritsch, 2010). Though they have an attachment based on past sex experiences, the couple may face fresh problems as a result of a mastectomy. The wife may become withdrawn from her husband leading to a negative effect on their sexual relations.
Normally, the wife will take everything her husband does to be wrong and associate them with the fact that she has lost one breast (Hoskins, 1995). This aggravates the attachment that exists between them which may cause the husband to keep his distance from his wife. The result is that the sexual function in the relationship is affected.
Research has shown that mastectomy can be scary and also depressing to the wife. Often, she will feel as if she has lost control of her femininity because breasts are seen as symbols of sexuality. She will tend to keep to herself because she does not want to be seen naked by her husband. As much as her husband will try to reach her, the wife keeps drifting away to deal with her sorrow (Ptacek, 1994).
This normally makes the husband angry because when he tries to reach her, she runs away from him in defense. Another common problem that a husband will face is the loss of sexual emotions. A man is a visual being; his sexual arousal is based on what he sees (De-Nour & Baider, 1984). The fact that he has had moments with his wife with her two breasts and now one is completely gone is simply overwhelming. This presents sexual inhibition. He develops remote and cold feelings towards his wife. He finds it difficult to communicate with her and cannot admit openly how badly he is affected by the mastectomy. The absence of one breast may be a complete turn-off to a man.
Another setback that the husband has to deal with after mastectomy is breast sensitivity. The breasts are normally sensitive organs of the female anatomy. This is the reason why they are considered to be erogenous zones that greatly affect sex. Breasts are one of the organs that are used to arouse a woman sexually. After mastectomy, the remaining breast may become insensitive (Hoskins, 1995).
This may be due to hormonal changes in the body of the woman or it can simply be an emotional aspect. Adversely, the wife may not like to be caressed on her remaining breast because it is a reminder of the painful experience of mastectomy (Pierce, Sherman & Sheridan, 2010). This becomes a distraction to healthy and fulfilling sex. The husband then develops a fear since he does not want to offend his wife. In so doing, there is a likelihood that the sexual function in the couple’s relationship will slowly die.
However, it is not all mastectomy cases that result in adverse effects. Some couples may have an exciting sex life after mastectomy (O’Mahoney & Carroll, 1997). De-Nour & Baider (1984) provide that many couples who love each other will have the husband support his wife in all the ways he can. This results to a better close relationship with a stronger bond. Here, a sound relationship can survive any trauma including mastectomy. Without this fundamental ground of understanding of mastectomy and how to deal with it, the husband is bound to fail miserably.
How to deal with problems arising after mastectomy
The above critical analysis presents problems that need to be solved. To attain sexual fulfillment after a wife has gone through mastectomy requires an effort by both parties (Lewis, 2004). The most essential way to pull through a mastectomy is to communicate. Silence in any relationship or marriage is never valuable. When words are spoken, comfort and reassurance is enhanced. A wife gets to know what her husband’s inner feelings are towards her.
Since she cannot read her husband’s mind it is prudent for the husband to reassure her that he loves her. When the couple is able to communicate freely, they are able to regain and maintain a great sex life (Goldzweig & Andritsch, 2010). It is advisable that the couple be honest in sharing their feelings and concerns after mastectomy. Accepting and acknowledging the feelings between husband and wife is a major stride towards regaining sexual intimacy. Patience also plays a big role in this case.
Another way to deal with sexual dysfunction after mastectomy is engaging in sex therapy. This approach aims at assisting the married couple to confront issues caused by the mastectomy experience.
There are sex therapy exercises that are recommended such as body imagery and sensate focus which allow the couple to confront and accept each other despite the removal of one breast. Bartle-Haring & Lal. (2010) suggest that sexual intercourse be tried as soon as possible. In cases where physical weakness or psychological trepidation occurs, the husband should still express his desire and care for his wife. Emphasis is paid on the couple sharing all their emotions as opposed to biases that exist which point to one spouse being reluctant to fight for sex rejuvenation.
References
Bartle-Haring, S & Lal. A. (2010).Using Bowen Theory to Examine Progress in Couple Therapy,The Family Journal, 18(2), 106 – 11.
De-Nour, A.K. & Baider L, (1984). Couples’ Reactions and Adjustment to Mastectomy: a Preliminary Report. International Journal of Psychiatry Medicine14(3), 265-76.
Goldzweig, G. Andritsch, A. (2010). Psychological Distress among Male Patients and Male Spouses: What do Oncologists Need to Know? Ann. Onc, 21(4): 877 – 883.
Hoskins, C.N. (1995). Adjustment to breast cancer in couples. Journal of Psychology, 77(2), 435-54.
Hoskins, C.N. (1996). Adjustment among Husbands of Women with Breast Cancer. Journal of Psychosocial Oncology 14(1):41-69.
Lewis, F.M. (2004).Family-focused oncology nursing research: a Healing Paradigm for Future Studies. Journal of Oncological Nursing, 31(2), 288-92.
O’Mahoney, J.M & Carroll, R.A (1997). The Impact of Breast Cancer and Its Treatment on Marital Functioning Journal of Clinical Psychology in Medical Settings, 4 (4), 397-415.
Pierce, T., Sherman, L. & Sheridan M. A. (2010). Social Support, Social Constraint, and Effect in Spouses of Women with Breast Cancer: The Role of Cognitive Processing.Journal of Social and Personal Relationships, 27(1), 5 – 22.
Ptacek, J.T. (1994). Coping with Effects of Breast Cancer: Husband and Wife Perspectives, Journal of Psychosocial Oncology, 12(3), 47-72.
Toseland, R.W. (1995) A Problem Solving Intervention for Care-Givers of Cancer Patients. Journal of Social Science Medicine.40 (4), 517-28.