On Pleasure Principles, host Avik gets tactical about intimacy beyond sex when chronic illness enters the chat. Licensed Marriage & Family Therapist Lisa Gray, who lives with Ehlers-Danlos Syndrome, lays out an actionable playbook: separate sex from intimacy, center attunement over performance, and rebuild connection through presence, curiosity, and clear communication. We unpack grief on both sides of the partnership, values-led choices (Acceptance & Commitment Therapy), and simple practices—from a six-second kiss to silent co-regulation—that revive closeness without risking flare-ups. If pain, fatigue, meds, or fear changed what’s physically possible, this convo shows how to pivot without losing the relationship thread. 

Lisa Gray, LMFT, is a San Francisco Bay Area couples therapist specializing in high-conflict dynamics and the unique stressors chronic illness brings to relationships. As an author and clinician, she blends lived experience with evidence-based frameworks to help partners rebuild connection that lasts.

Chronic illness impacts the system (both partners) — expect grief on both sides and name it to avoid resentment.

Separate sex from intimacy: treat connection as the main event; sensuality ≠ intercourse.

Start small to reduce pressure and pain risk: eye contact, hand-holding, cuddling, mindful breathing, unhurried make-outs.

Use Acceptance & Commitment Therapy (ACT): accept hard feelings, then behave from values, not moods.

Rebuild attunement: slow down, track each other’s cues, and prioritize soothing touch over performance.

Conversation sequencing matters: lead with curiosity and validation before problem-solving.

Caregiver/partner guilt is common; surface it early to prevent isolation and scorekeeping.

Micro-rituals create momentum: Gottman’s six-second kiss, scheduled “no-goal” connection time, weekly check-ins.

Identity drift is real; don’t let diagnosis define you—rebalance life so partnership isn’t always “after the illness.”

Define your new intimacy menu together: boundaries, energy windows, meds timing, comfort positions, and aftercare.

Website (books): https://www.lisagrayauthor.com/

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