“Can’t you see I’m starving? For as much love as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I would have joined a convent. Your sex aversion is making me sick.”

I want to introduce you to my friend Holly.

She is 43 and a graphic artist. She had a double mastectomy three years ago and has been cancer-free since. She shares a home with her wife, Jean, and their teenage daughter, Annie.

A beautiful smile radiates from Holly’s full, mocha-colored face. Oodles of thick jet-black braids spring from her head as from a fountain gone mad. Her frequent laughter is like music, making her whole body dance and shake. However, her levity masks a somberness and apprehension.

She tells me: “I have become consumed with worries about getting sick again. My fears can turn into a paralyzing dread that takes days and sometimes weeks to shake. I know that until I can accept the possibility of my own death, I’ll never be able to embrace all the great things that are right in front of me.”

Later in our conversation, she lets me know she’s struggling with her body image. The mastectomy scarred her not only physically, but psychologically as well. “For a good six months after the surgery, I was so sick from all that poison, that the thought of sex of any kind made me nauseous,” she says. “I didn’t even want to have Jean in the same bed with me, and it was awful.”

Over time, the nausea diminished. Holly was able to resume some semblance of intimacy with Jean. They watched TV while holding hands, as long as it was not sexual.

A couple of months ago, however, Jean and Holly had a blowout. “We were screaming and yelling when she finally blurts out, ‘Can’t you see I’m starving?’” Holly recounts. “Jean tells me, ‘I have needs too, you know. For as much intimacy as I get from you, I could be living on the moon. Are we ever going to resume our sex life? Because if I wanted to live like a nun I would have joined a convent. Your sex aversion is making me sick.’”

The intensity of Jean’s outburst blew Holly away. She had completely forgotten about her needs. After the surgery, Holly didn’t feel like a woman.

When things simmered down, Jean could tell she wounded Holly deeply. But she knew Holly needed to address it.

Jean was right- Holly was starving too, but she was too afraid and ashamed to admit it. The pair made attempts to move past the status quo, but it’s not like the old days.

Holly wonders how she can make a gift of herself to someone if she’s not feeling much like a treasure. She still feels shame about losing her breasts. “I’m not a whole person anymore,” she says.

That’s where Holly is mistaken, and I jump in.

“Where did you lose your breasts, at the laundromat?” I laugh. “You didn’t lose your breasts- you had cancer, and they were removed to save your life. There’s no shame in that!”

It doesn’t sound like Jean thinks of her as “damaged goods,” and the attraction remains.

The couple needs to let their love heal Holly of shame and self-doubt.

Has Holly ever taken the time to grieve the loss of her breasts? Could she ask Jean to hold her while she weeps for what is no longer hers? “Share it with her,” I tell her. “Don’t carry this alone.”

Holly counters that her sex drive is non-existent.

The first couple of months after chemo and radiation, she experienced a weird feeling when Jean would attempt closeness. “It was like a bad acid trip,” she says. “I felt as though my body was there with her, but I felt nothing. I would lie there asking if I would ever feel normal again, and wondering how many more opportunities I would have to be with Jean before I died.”

Back then, Holly was fighting for her life. That fight is bound to alter a person’s perspective.

I suggest that she talk with Jean about her concerns. A neutral time- not during an intimate moment- is best. Then, Holly can speak freely without fear of Jean misinterpreting her comments as sexual rejection.

“But what if I screw up?” Holly asks. “If this somehow scars Jean for the rest of her life, I wouldn’t be able to forgive myself.”

Holly needs to reassure Jean that she is committed to working through this impasse. In return, Holly could ask for her patience. She needs to give Jean some sort of timeline- or Holly may put this off indefinitely.

“You didn’t lose your breasts- you had cancer, and they were removed to save your life. There’s no shame in that!”

I recommend they begin to explore what is possible now in their sex life together. Avoid comparison to the past. Keep the exploration simple. Don’t create a goal to be achieved.

They can start with cuddling and spoon breathing- Jean’s front to Holly’s back. They can match one another’s breathing pattern. First, Jean will try to match Holly’s breathing. Then, they switch positions. It’s the ideal place to start rebuilding a sense of confidence about being physically together.

Spoon breathing embraces could become more adventuresome. When Holly is feeling up to it, she can take one of Jean’s hands in one of her own and guide it over her body in a way that feels pleasurable and comfortable. This will be a very effective way of reestablishing a threshold for what is possible now, as well as moving forward.

“Keep these exercises playful and honor your limits,” I remind Holly- and ask her to let me know how it goes.