Stepping In

 Dr K S Prasanna, Dermatologist, Institute of Applied Dermatology, Kasaragod, Kerala

A doctor's profession is a very noble, respected position in our society. Everyone becomes a doctor either by choice or by compulsion, but the ultimate goal is to help needy patients. In us together of 63 man-years of medical practice, we have come across thousands of patients with a wide variety of inconceivable marital problems. Separation, divorces are the after-effects of marital conflicts in some of the cases. Right interventions by the right persons at the right time are the key factors to prevent this. Society looks at these divorces differently, but there could be a severe marital problem. In some of these divorces, there is a face which the community can't see, and no one can reveal this. These could be due to a variety of sexual problems. Divorces could happen due to adjustment problems, stubbornness, economic independence at an early age, upbringing in a nuclear family, communication gap and suspicion, psychiatric illness, cheating, and extramarital affairs through smartphones and social media or mainly sexual problems.

Marriage has three main functions -1. Personal intimacy 2. To have family and children, 3. Companionship. Physical intimacy is a part of marriage that needs understanding and proper communication. Its frequency can change over time. This can lead to one or both partners not showing interest in each other sexually and, therefore, can result in extramarital affairs and unhappy marriage.

A lovely young couple entered my room with an anxious, helpless look on their face. It was the case of unconsummated marriage even after three years of marriage. For both of them, it is the second marriage. Lady divorced her first drunkard first husband due to physical and mental harassment. She never had sexual relationships with both divorced and present husbands. Her current husband's first wife and their only child committed suicide due to ill-health—a very traumatic marriage for both of them. Also, the lady had terrible traumatic sexual harassment in her teenage by one of her first cousins. This has resulted in a condition known as vaginismus, where she didn't allow her husband to touch her. And she is afraid of males due to childhood psychological trauma.  They had consulted psychiatrists, psychologists who advised yoga, psychotherapy, etc., but in vain. I recognized depression in the lady and referred the couple to another psychiatrist couple giving all this history in detail. The psychiatrists genuinely spent time with the couple and confirmed that the lady is under depression and needed treatment. Treated for depression in addition to counselling, in a stepwise manner which has resulted in a happy ending. This case could have ended in divorce, if we were not able to diagnose depression in her and seek the help of talented and committed psychiatrists.

There is a couple who has unconsummated marriage for 25 years and never consulted a doctor to correct this problem and adopted a child. There are couples with impotent husbands and living with the husband/ deserting him to find another potent husband. There are incidences where the wife comes and asks for a treatment to reduce the sexual drive of her husband, who is behind the girls all the time and vice versa. Some of the patients come with sexually transmitted diseases often because of the sexual dysfunction of husband/wife or because of poverty, ignorance, joy, and poor morality.

 Good parenting plays a crucial role in bringing up well-behaved descent teenagers who become good individuals later. Bringing up children with good morality makes a society good. Sometimes childhood psychological trauma also can cause marital failures later in life. Parent's behaviour plays a significant role in children's mental growth, which influences their future. An excellent behavioural solid foundation for respecting elders & ladies and primary healthy sex education is key to all successful marriages.