Tammy Ruth Tucker, MA, LPCC

During an EMDR therapy session, patients are encouraged to access upsetting memories and to reprocess them. Reprocessing is achieved by repeated and rapid bilateral (side to side) eye movements, tapping one's chest and face, and auditory and visual stimulation. These techniques can desensitize patients to their traumatic memory. By reframing how a patient interprets a memory, EMDR is believed to weaken the fight-or-flight response and to rebalance the nervous system. For patients with PTSD, EMDR can treat recurring flashbacks and triggers by reducing the hyperarousal response and promoting emotional regulation.

EMDR patients are first asked to identify a specific memory to reprocess, called the ?target event.? Patients can discuss their feelings, sensations, and beliefs about the event, and may share a picture or use descriptive imagery. Therapists usually employ a set of measurements called the Subjective Units of Disturbance (SUD) scale to assess the patient's distress. Later on, therapists and patients may compare the patient's initial SUD score to their score following an EMDR session. Unlike other forms of therapy, EMDR patients are not prompted to analyze and reflect on details of their traumatic memory at length.

With a target event having been selected, therapists may begin the desensitization process. They instruct patients to perform eye movements, body taps, or sounds while capturing the target event in their mind. These techniques are called dual attention bilateral stimulation (BLS) and can help a patient feel calm and aware, while simultaneously invoking the brain's processing system. Patients may continue these techniques until their SUD distress level has decreased. Patients are then asked to derive a positive thought or affirmation about the target event, and to repeat or strengthen it until it feels sincere. A final ''body scan'' is where patients focus on both the target event and positive cognition to evaluate their physical response and identify any remaining distress. If the traumatic incident is not fully processed in one session, patients are asked to contain the memory and to avoid returning to it until their next EMDR session.

EMDR may greatly improve quality of life in people who suffer from latent trauma and adverse life experiences. EMDR may also be effective for those whose prior experience with talk therapy was unsuccessful.

Sexual intimacy disorders are those that cause problems with the act of sexual intercourse, such as erectile dysfunction or vulvodynia. Erectile dysfunction, the inability to get or maintain an erection hard enough for sexual intercourse, is extremely common. It affects fully half of men over 40 to some degree. It is treated with medications, devices, or surgery. Vulvodynia, burning pain in the vulva that can be made worse with sexal activity, has no known cause. It is treated with oral or topical medications.

Sexually transmitted diseases, including HIV/AIDS, herpes, gonorrhea, and chlamydia, are bacterial or viral infections that are contagious in the bodily fluids exchanged during sexual contact. Barrier methods of contraception, such as condoms, help prevent the spread of STDs. HIV is a virus that can be caught from an infected person's sexual fluids or blood. When the virus infects the body, it interferes with the immune system and causes the disease known as AIDS. There is no cure, but anti-viral medications can help people with AIDS live a long and healthy life. Herpes is also a virus found in sexual fluids, called HSV-2. It causes blisters that come and go on the genitals. There is no cure for herpes, but anti-virals can minimize outbreaks. Gonorrhea and chlamydia are both bacterial infections. They are extremely common and often have no symptoms. The most common signs of an infection are burning pain and discharge. Gonorrhea and chlamydia can be treated with medications.

Reproductive health refers to both contraception and infertility treatment. Contraceptives prevent and plan the timing of pregnancy. Some, such as a vasectomy or tubal ligation, are extremely effective at preventing pregnancy. Others, such as spermicides, are less reliable. Popular contraceptives include condoms, birth control pills, IUDs, and diaphragms. On the other side of reproductive health, infertility is the inability to carry a pregnancy to term after one year of trying. It can be due to problems in either the man or the woman, and both genders are affected equally. In total, about 15% of the population suffer from infertility. Infertility treatments include medications and surgery.

Gay and transgender people have a few specific health care needs that may sometimes fall under the sexual health umbrella. First, many LGBT people still face discrimination from healthcare providers, so providing supportive and appropriate care is an issue. Because of social attitudes surrounding sexual orientation and gender identity, many gay and transgender people struggle with their identities. Rates of depression, substance abuse, and suicide are all higher in this group. Providing mental health support and counseling to those in transition is critical. Finally, transgender patients who are undergoing gender affirmation require sensitive medical health care, including surgical and hormonal treatment.

Sexual violence can be defined as any unwanted or non-consensual sexual activity. It ranges from sexual harassment to touching to rape. It affects women more than men and is widespread: 1 in 4 women report being victims of sexual violence at the hands of a partner, and as many as 1 in 3 girls report their first sexual contact as being violent. Sexual violence has lasting physical and emotional consequences for victims, but educating both girls and boys can prevent violence. Care for those who have endured sexual violence includes counseling and mental health support, medical care, and legal support.

Sexuality is more than a reproductive requirement -- it is a form of expression and identity. Sexual health blends all these aspects of experience together and helps people lead sexually fulfilling lives.