Dating and Illness…The Ultimate Game of Truth or Dare

Exactly how honest should you be when you first begin dating someone? How many dates should you have before some of the “tough truths” are shared? Two dates or three? Or, as some experts say, perhaps you should be completely honest right up front.

No false illusions – both parties are clear about who they are and what they want right from the start. Other experts tell you to keep the mystery going for quite a while. You don’t want share too much of the “serious” (aka neurotic) stuff and scare off the other person. Others even state that, “getting to know each other over time is half the joy of dating.”


There are hundreds, nay, thousands of books and articles dealing with just these kinds of questions. There are answers everywhere. So why, no many how many years you have spent in the dating world, do you still feel like you are 15 years old and are unsure of what you should do, no matter what your age?

Dating can be like truth or dare: the game that sends shivers down the spines of adolescents and young adults. Do you select “truth” and answer the question proposed hoping it’s not too personal (like that ever happens) or do you go for the dare, praying that you won’t have to do anything too embarrassing (this game was safer before caller ID and instant messaging)? Do you answer the question honestly, hoping that this date will continue, or she’ll/he’ll call you for another, or do you go for the dare…perhaps avoiding the question or the truth for just a little longer?

Perhaps you don’t share right away that you continuously buy new underwear, sheets and towels to avoid having to do laundry more than every four weeks (Is laundry phobia in the DSM IV?), or that you get up in the middle of the night to get a snack which you proceed to eat in bed, or that there were quite a few dates that you don’t remember (a few too many margaritas) but you know they didn’t end well?

That’s the easy stuff to decide when to share. Right? What about the more “serious truths”? When do you bring up that you have suffered from a major illness that though unlikely at this time, may occur again? Or what if it’s a chronic disease which sometimes takes over your life?

Dating becomes about sharing some important truths about who you are without shame or embarrassment. Owning your story!

So what happens when you throw a serious illness, such as cancer into the dating mix? Do you go for the truth or opt for the dare? Or are they the same thing?
OK, I dare you to admit to your date:
• That you’re a single person of a certain age still (or returning to) the dating world
• That your weight, your looks (fill in the insecurity) is an issue
• That you’re a cancer survivor/deal with a chronic illness/have a physical disability

Pretty tough truths to share with a date. Which one is the hardest to share with someone? For many people, the last one is admitting to having an illness or disability.
So when do you share that truth? What will the other person’s reaction be to you? Will they be frightened, curious or pretend they did not hear you?

For years, people wouldn’t even say the word “cancer” out loud and to admit to a potential suitor of either sex that you had cancer, even though you had beaten it, was just not done. It was too scary for people to understand – wasn’t it contagious? What if it came back? Do people want to marry someone who could become sick again? What about sex?
Never mind that anyone can become sick at any time!

How about other physical challenges? When do you disclose those to someone?
So my clients say that they’re told to be proud to be a survivor/thriver. They’re not ashamed or embarrassed to talk about it. It’s now part of their life narrative. But so many still are challenged about when to bring these subjects up to a potential suitor? Ideally, perhaps on that second date (if it’s going well) or whenever it feels right. If the first few dates go well, then the Lucky Date is quickly going to come face to face with some body scars, “survivor/war souvenirs” that are bound to bring up some questions. Or maybe it’s the first meeting when you enter the room and some things are more visible?

Some people say that why waste their time if the other person is going to have a negative reaction later, better to do it upfront before your time and heart are invested.
What happens when they disclose something to you of this nature? How will you react?
There is no rule . . . no script . . . no true guiding principles to go by other than, this is all about you and how you deal and feel about you! It’s not going to be easy, as dating never really is or more generally, being vulnerable never is, but you put yourself out there and you try.

If the other person (or if that person is you) reacts with anxiety at first, or even “runs” away a bit, but returns to ask you more, then maybe you do give yourself and that other person a second chance. Because life can be scary and we never know how much we pry, or what assumptions we have been holding on to that are false.

So, you’re a cancer survivor/thriver, someone who faces illness or physical challenges head on and you want a relationship. Those are some of your truths.
As for your weight . . . well let’s just say, some mystery is a good thing!


A Tender Proposal for Valentine’s Day

For Valentine’s Day: A Tender Proposal for a Touchy Subject
The right to be touched, the right to love and be loved, the right to be viewed as a person with sexual, sensual and intimacy desires and needs—sounds basic, right? Sure, it’s not in the Constitution or any legal or governing document, but I wonder, should it be?

Too often, our society perpetuates a host of myths surrounding sexuality, sensuality and intimacy, and we buy into them! “Sex is easy…sex should be spontaneous…your sensual feelings never change…you shouldn’t talk about your needs.”

Or how about: “Sex is only for the able-bodied…Those challenged by disabilities and chronic and life-altering illnesses don’t desire sex, love or a partnership…They have a hard enough time just dealing with everyday life.”

You get the idea. These myths can strike at the very heart of who you are. They influence how you see yourself, your sense of self, your self-esteem and how you conduct your life. Worst of all, they silence voices, the ones that say, “Here I am, ready to be held, desiring to be touched and interested in love.”

With Valentine’s Day around the corner, I am here to say: Enough with these myths! It’s time for a change. Voices need to be heard, changes need to be made, and yes, everyone has the right to be touched by loving hands.

So what do you do about it? Well, you start the conversation. You educate. You show and tell the world the truth. You do it through the media, through writing, through your voice. YOU DO IT BY EXAMPLE!

One place they’re “doing it,” if you will, is in England. It’s ironic that in 1776, we fought a war to free ourselves from the oppression forced upon us by the English monarchy. We created our own laws, our own government and the most powerful of documents, the U.S. Constitution containing the Bill of Rights.

But where can we find a document or program that begins to recognize the rights of the disabled or chronically ill to be thought of as sexual beings? How do we begin to honor these kinds of sexuality, sensuality and intimacy rights?
Perhaps this is not a matter for our government but for individuals, groups and organizations who need to speak out and step up the process of change.

In England, changes are being made publicly that affect the intimate lives of individuals challenged by illness and disability.

Susan James Donaldson, in her January 10, 2013 article on, introduced the world to a woman (an ex-madam) in England ”who is investing $100,000 in a fully staffed, nonprofit brothel facility to serve those with physical and intellectual challenges, both men and women, gay and straight (she is already working with sex workers to provide services to this population). This woman envisions a sexual health center that would be handicapped-equipped, with transportation provided for clients who need it, as well as other services.”

Perhaps we’re not ready for this type of facility, yet. After all, the only state where brothels are legal is Nevada. And prostitution remains an incredibly controversial subject. There are those who support sex workers’ rights, while others feel this occupation demeans those who participate in it. That’s not what we’re here to debate.

What I’m here to do is to remind people that sexuality is a part of life, and though some have special needs that must be addressed for them to experience physical connection, these needs are nothing to be ashamed of or dismissed; they should be honored.

There are many wonderful people here in the U.S., professionals and non-professionals, who do incredible work everyday to better the lives of millions of individuals living with disabilities and illness, including helping them to feel the connection of touch. Together, we need to continue the fight for the cause, even though this remains in some circles a touchy subject.

More needs to be done, and on this Valentine’s Day, let it start with you. So embrace your sexuality and sensuous side. Most of all, believe you are entitled…you deserve to be touched, desired and to have love and intimacy in your life. We all do.

Eva Margot Kant, LCSW, is a speaker, educator and clinician in private practice; her website is:
For more, you can attend Ms. Kant’s lecture “Sex Takes Two But Starts with You,” on 2/7/13 at 7 pm, at the JCC, New York, NY. Or join her webinar, “Sexuality and Intimacy for Couples with Disabilities,” through United Spinal Association, on 2/14/13 at 3 pm.
Originally published 2/6/13;


Chronicity: Giving Voice to Patients

As a therapist working with chronically ill clients or those facing a life-limiting illness, one of the most important and powerful roles you are assigned is as a facilitator in the journey to “give your client voice”.

Too often clients and their family members, as well as the clinicians around them, do not provide a safe environment from which the client can express their thoughts, feelings, questions and concerns. They don’t feel they can talk about their pain, their fears, ask those most intimate questions, and share their concerns about dying.

As some theorists have posited, the defense mechanism of “denial” is often a very productive one and should be maintained. In the case of a serious illness, it can serve as a very effective survival mechanism, one that may be needed to move forward during treatment or in some cases, enable patients to move on to another day.

Many people mistakenly believe that by talking about things, acknowledging feelings, etc. “it/they become too real to ignore” – can no longer deny what is happening and therefore “if I don’t talk about it, then it does not exist”. Clinicians can inadvertently support this belief with their actions.

As a child, a major factor in the development of self-esteem and a sense of self-worth is the recognition of “being heard”, both literally and metaphorically.
With an unbelievable sense of loss of power manifested by serious illness, by “giving your client voice”, you are empowering them, ressuring them that in fact, they are being heard and re-establishing their sense of self. Through this process, you are symbolically taking the journey with them and together you can confront their fears.


NYT: The Rules of Cancer, Slow Down/Exhale

Great advice and suggestions. And important article for both professionals and patients! When you receive that cancer diagnosis it can be an out of body experience — your ears may ring as you find yourself stuck in a very strange movie– you watch the doctor talking but can barely hear him/her — it’s as if he/she is talking in slow motion. Ironically, this all happens as your heart races and you feel your life changing in front of your eyes.
As Ms. Gurland so aptly stated, SLOW DOWN! Exhale!

Some food for thought: 1)make sure you bring someone to all your visits with medical professionals. You need that extra ear. 2)have that person bring in the questions you have prepared and have he/she take notes and most of all: 3) don’t get trapped in the “white coat syndrome”. The doctor is a human being just like you. Tell the physician how you prefer to receive your information — in small doses, in a language you can understand and of course, empathically.

Take back the power. As you can see from Ms. Gurland’s powerful article, This is ALL ABOUT YOU!

As a medical social worker/psychotherapist working with cancer patients and others challenged by chronic illness, I have developed a series of workshops entitled “Asking the Tough Questions”. I conduct workshops for patients and their loved ones and other seminars for healthcare professionals.

Both sides need help in communicating when it comes to issues such as cancer.

The 20-minute doctor visits do not produce collaborative relationships between patients and their healthcare teams. Information is lost and patients are not sharing information that is essential to living their lives and addressing their illness. Too many patients are intimidated by medical professionals and the medical professionals don’t have the time or are overly committed to maintaining that “professional distance”. What do you do if the questions you have are not only about issues directly related to your illness but also include how your illness affects your daily life – work, parenting, relationships – sexuality and intimacy?

Give yourself voice! It will serve you well.

Read the full post > 


NYT: Mental Healthcare on a Dime

Many of us in the mental health profession are committed to providing services on a sliding scale — after all, our goal is to help people in crisis as well as those who want to affect change in their lives. We are also challenged by rising costs and feel torn in that we want to offer more of those services but are restricted in the number of people we can help at very reduced fees.

Yes, in metropolitan area such as NYC there are many training institutes where you can receive excellent services at very reduced costs, Ackerman was mentioned, in NYC, another excellent choice is the Institute for Contemporary Psychotherapy.

However, outside of the major areas, you can contact your local hospitals and ask to speak to a hospital social worker – ideally someone who works either in the ER or mental health services area. They may be able to direct you to individuals or centers where you can receive services at a reduced cost or if they have an outpatient clinic either on-site or one they are work with at the time of your call.

Support groups are extremely helpful for so many reasons as mentioned in the article and on this blog, not the least of which is that individuals in the group as well as the facilitator may also be able to direct you to resources (lower cost) that can be helfpul.

The challenge for all of this is that when you may be feeling at your worst is the time you need to advocate in finding resources that can help you move forward.

If you can’t do it on your own, reach out and ask a friend/loved one to help you find someone.

Read the full NY Times piece