What are the basic human needs—and where does sex fit into the picture whether or not we live with chronic illness?

I’ve been considering these questions in light of Maslow’s hierarchy of needs, a highly-respected theory that views basic human needs in a hierarchy of importance, with the most basic on the bottom of the pyramid. Here ‘s a diagram I put together of the hierarchy:

Physiological needs – air, food, water, shelter, sleep, clothing—are the most important for human beings. Without these, living gets very hard—even impossible. Some argue that sex should fall here as it is so integral to human life. I disagree and believe it belongs under love and belonging–but I get ahead of the hierarchy.

Moving up the pyramid, we find ourselves at safety or security. This type of need includes family, property, income, and health. As chronic illness patients, we especially know what an important role trying to achieve a healthy state plays in our lives.

That middle step is where we find love and belonging. This involves our social ties and friendships, family, connection to others, and intimate relationships. This is where I personally place sexual intimacy. Please note that that’s just my personal hierarchy due to the nature of my relationship with my husband and sexual partner.

Others, again, can and do place sex in with the physiological level. There is a good reason for that – sex is a primal urge. It is a part of an instinct that drives us, just as it does any other animal or being, to procreate and continue the species. For some, it guides a lot of what they do. I think we all tend to experience time periods where that is the case as well. It can be high school, college, or even much later on in life.

It doesn’t hurt that sex can be fun! The endorphins your brain releases during sex, whether or not you orgasm, can become very addicting. It’s a release from our physical pain as well, which is why myself and others with chronic pain occasionally treat sex in any form as pain management. I’m lucky enough to have a partner who can tell when I need that relief and doesn’t mind helping out.

It’s so much more than that for me personally though.

Growing up with Systemic Juvenile Idiopathic Arthritis and in an abusive home, I thought and was led to believe I would die long before I ever was able to date. If I did live longer, I was sure no one would find me attractive. That isn’t something that always goes away, especially for me and my anxiety disorder. Being intimate with my husband, with or without sex, has led me to come leaps and bounds away from that seven year old hiding behind a couch and crying in the dark over this existential identity struggle.

It’s a reassurance that I’m worthy of love, and that means the world in regards to my health.

The top two levels of the hierarchy are esteem (confidence, self-love, etc) and self-actualization (purpose, acceptance, etc).

A young adult thriving while living with chronic illness, you can read about Kirsten’s struggles and enjoy her musings and wit at notstandingstillsdisease.com.

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