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Integrative Psychiatry

Integrating Sexual Health

By February 22, 2024March 7th, 2024No Comments

What comes to mind for you when you read “sexual health”? Such a sterile term–a sensitive and ambiguous one at that–loaded with emotional associations and opinions. The World Health Organization defines sexual health as “a state of physical, emotional, mental and social wellbeing in relation to sexuality.” This means that sexual health is more than absence of dis-ease; it involves cultivating deep respect and fulfilling relationships with ourselves, with our sexual nature, and with others. The way we relate to our sexuality encourages us to make informed choices about our bodies and experience empowered sexual pleasure. By this definition, sexual health and associated mental well-being are not confined to any specific sexual identities. Sexual health is a foundational part of human biology, the root of lineage and belonging; yet, it is relatively understudied and unaddressed in medicine. The disconnect between sexual health and other facets of Western healthcare speaks to a severance between the wholeness of the Self and nature.

Psychosexual Health

Sympathetic and parasympathetic branches of the nervous system innervate visceral organs of the thoracis, abdomen, and pelvic cavities. These fibers regulate states of activation and rest for the mobilization and conservation of energy. In particular, the parasympathetic nervous system (PNS) is deeply connected to psychological states of safety. Of the PNS, the vagus nerve and sacral spinal cord segments innervate pelvic floor muscles, fascia, and reproductive organs including clitoris, vagina, cervix, uterus, penile tissues, prostate, and seminal vesicles. In this way, internal and external sexual structures are directly tied to psychological wellbeing and feelings of security.

 

Cultivating Sexual Health

One measure of sexual health might be captured by a person’s relationship with their sexuality and sex organs. Sex (and the experience of sexual pleasure) is deeply intertwined with cultural norms and taboos, and as such is subject to shame, suppression of desire, and power dynamics. Our family of origin’s attitudes–whether implicit or outwardly discussed–deeply impact our ways of being with our sexuality, which, perhaps, makes it such a vulnerable topic. Complex cultural histories, societal biases, and stigmas can influence learned behaviors, experiences, and conceptualizations of sex that might be more positively or negatively associated. Cultivating sexual health is nurturing safety and trust within the body and through the nervous system. Safety and trust might be facilitated through neural repatterning like self-compassion practices and safe, slow self exploration of the many ways a body may experience pleasure. Positive sexual experiences with self and others can help foster feelings of intimacy, connection, and self-esteem. 

Sexual health is a basic human need, across all sexual identities. Engaging in sexual health practices is an act of resilience and social justice. Addressing sexual health as health promotes consent, sexual autonomy, and deep understanding of self. These practices encourage nourishing healthy relationships (with self and others), advocating for sexual rights, and fostering comfortable communication around sexuality. Increasing awareness and access to up to date comprehensive sexual health education and resources may empower individuals to make informed decisions about their bodies and relationships, enhancing physical, mental, and spiritual wellbeing.

Conclusion

Sexual health is intricate, influenced by individual experiences, societal attitudes, and access to inclusive care. Striving toward sexual health is an opportunity for creativity, generativity, and authenticity. We can reclaim a felt sense of belonging in the sexual body and strengthen right relationship within the unified Self. How might we orient toward supporting sexual health for all anatomies and identities? It’s time for sexual health to be included inside of our definitions of health.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.