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Q: This is not a happy time in my home. My wife's father, nearly 90, is slowly dying in a local nursing home. My wife is an RN and has been sharing the care with him with my sister-in-law. My problem is that we haven't been intimate in at least 3 months. I can ask, but it's like talking to the wall. I've told her all she can do is to make him as comfortable as possible. This is getting more difficult every week. I would like to start looking at pornography again so I might have some release, but our church strictly forbids it, and we live in a small town where anything that comes through the post office, others in my circle seem to know about it. HELP!!! -- Howard, 53

Dr. Susan: If your church is against you finding relief in certain ways, then perhaps you could ask your wife to come with you for a session with your pastor or priest. Avoid putting pressure on her when she's feeling so intensely burdened by the care of her dying father, but be honest with her that you're at a loss as to how to handle your feelings of frustration. Many women really don't know the extent of some men's physical needs, that they can be urgent and overpowering and totally distracting until they're dealt with. Your wife may consider your requests to be merely selfish at this hard time in her life. Reassure her that you don't mean to add another burden to her already heavy one, but that you love her and are feeling unloved and that you need her to be there for you occasionally as well as being there for her father. You're right that she can't do the impossible and "save" her father, and maybe she needs to talk to someone about her expectations of herself. Offer to help with her father or the house or anything you can do that would reduce her burden. Even if your small town makes it hard for you to have any privacy, surely no one can see into your imagination, if it comes to that.