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Prostate Cancer and Narrative Therapy

In this article, I want to discuss Narrative Therapy (NT) and prostate cancer. I was given an article by a colleague who knows I write for The article is called ‘Utilizing a Narrative Approach to Increasing Intimacy After Prostate Cancer.’1 She knows me so well. After digesting the article, I figured it could be of some assistance to those who are looking for a different form of sexual therapy related to issues caused by prostate cancer. Well, let’s take a peek inside this article.

What is Narrative Therapy?

While using this form of therapy, the counselor uses a person’s ‘problem’ found through their personal stories to reveal how this ‘problem’ can be reevaluated in social, cultural, and political contexts.2 Therefore, healing and recovery is not defined by solving problems, but instead “on thickening the life stories so the stories not longer support the problem.”1 Because of this ‘thickening,’ people can develop new and healthy variations of their story with brand new possibilities for their future.3 Phew!!

In this article, the authors focused their narrative therapy questions on five themes related to sexual health and prostate cancer.

Themes of sexual health and prostate cancer

The 5 themes are as follows: sexual intimacy, masculinity, self-esteem, role change, and communication. I’ll try to break down these questions into smaller nuggets so you can get the gist of what these researchers are doing.

Sexual Intimacy

Depending on the type of treatment or surgery for prostate cancer, sexual functioning and general satisfaction can be severely impacted. Plus, satisfaction with your sex life can affect overall life satisfaction, for both partners in most cases.1,4 So, one of the early narrative questions could be something like, “How did having prostate cancer alter your sense of connection and intimacy?” A later question may look something like, “How will others in your life be able to tell that your sense of connection and intimacy is stronger than ever?”1


Because of the change in sexual functioning, many men report a negative impact on their self-esteem.5 The women in their lives reported a decrease in their self-esteem as well.6 The women reported they did not miss the act of sex itself but missed the affection.7 So, any early question looking at self-esteem may look something like, “If the problem that is stealing your self-worth, security, and self-esteem had a name, what would it be?” A later question might look like, “Who would have predicted that you would have gained a stronger sense of self and unity after cancer?”1

Sense of Masculinity

Men also report a decreased sense of self-confidence, self-definition, and self-worth, which is all related to sexual capability.8 Their partners also reported changes due to their partner’s sense of masculinity, including hormonal changes and a negative impact on their self-esteem.1 Therefore, some of the narrative questions may sound like, “How do you and your partner’s culture or society define what it means to be masculine?” A later question may ask, “If you were to continue on the new path, how would you predict your sense of masculinity would change you both for the better?”1

Role Change

After or during an illness, the change of role to becoming the caregiver of one’s partner has been reported to cause a sense of isolation, emotional distress, and reveal problems of maintaining the household.9 To explain, the wives reported they were often the go-between for her husband and the healthcare system while mentioning the emotional toll the change in role put them through.10,11 So, early questions may look like, “Since prostate cancer has come into your life, how have your gender roles or marital roles changed?” A later question may ask, “As you continue to redefine your roles to your relationship, how will you continue to show others how these new roles have positively affected your relationship?”1


Doctors also noted how miscommunication and decreased communication in couples with prostate cancer.12 One study found that in couples dealing with a chronic illness, the healthy partner kept their feeling inside in order to protect their partner from any more pain.13 Therefore, some of the early questions in NT might include a question like, “How has communication affected your relationship and sexual intimacy?” A question near the end of NT may sound something like, “When you talk to each other now, how do you know that she/he is really listening?”1

Applying Narrative Therapy

This is a lot of information and the original article was over 20 pages! There is plenty of material on this topic which I will explore in greater depth soon. I think the authors are onto something with Narrative Therapy. I’d like to know if they accounted for the type of therapy or surgery when it comes to NT. I still think Selfless Sex is a good alternative too.

Thank you.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. McCoy, M., Stinson, M.A, et al. (2013). Utilizing a narrative approach to increasing intimacy after prostate cancer. Journal of Creativity in Mental Health, 8, 48-69.
  2. Freedman, J. & Combs, G. (1996). Narrative Therapy: The social construction of preferred realities. New York, NY: W.W. Norton & Company Inc.
  3. Morgan, A. (2000). What is Narrative Therapy? An easy-to-read introduction. Adelaide, South Australia; Dulwich, Centre Publications.
  4. Mallis, D., Moisidis, K, et al. (2006). Moderate and severe erectile dysfunction equally effects life satisfaction. Journal of Sexual Medicine, 3, 442-449.
  5. Rivers, B., August, E., et al. (2011). Psychological issues related to sexual functioning among African-American prostate cancer survivors and their spouses. Psycho-Oncology, 20 (1), 106.
  6. Sanders, S., Pedro, L., et al. (2006) Couples surviving prostate cancer: Long-term intimacy needs and concerns following treatment. Clinical Journal of Oncology Nursing, 10, 502-508.
  7. Harden, J., Schafenacker, A., et al. (2002). Couples’ experiences with prostate cancer: Focus group research. Oncology Nursing Forum, 4, 701-709.
  8. Bokhour, B., Clark, J., et al. (2001). Sexuality after treatment for early prostate cancer. Journal of General Internal Medicine, 16, 649-655.
  9. Danhoski, M., Pais, S.P. (2007). What’s love got to do with it? Couples illness, and MFT. Journal of Couple & Relationship Therapy, 6, 31-43.
  10. Gray, R., Fitch, M., et al. (2002). Hegemonic masculinity and the experience of prostate cancer: A narrative approach. Journal of Aging and Identity, 7, 43-62.
  11. Heyman E. & Rosner, T. (1996). Prostate Cancer: An intimate view from patients and wives. Urologic Nursing, 16, 37-44.
  12. Badr. H & Taylor, C. (2009). Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psycho-Onocolgy, 18, 735-746.
  13. Rook, K., A, August, E., et al. (2011). When does spousal social control provoke negative reactions in the context of chronic illness? The pivotal role of patients’ expectations. Journal of Social and Personal Relationships, 28, 772-789.