EMDR Effectiveness in Treating of Sexual Dysfunctions

Why Do People Have Sexual Dysfunctions?
Sexual functioning involves biological, relational, emotional, and psychological factors. For this reason, sexual health is conceptualized using the biopsychosocial model. Biological conditions that can lead to a reduction of sexual desire including testosterone deficiencies, thyroid problems, endocrine disorders, or medications.  A general rule of thumb is to always see a medical doctor to rule out medical causes of sexual dysfunction prior to pursuing psychological solutions or sex therapy.

Counseling, psychotherapy, and sex therapy treat the relational, psychological, and emotional causes of sexual dysfunctions.
Psychological factors play a significant role in sexual functioning. Changes in sexual desire are usually explained by psychological and interpersonal factors. Anxiety is the most reported factor that can lead to low sexual desire, performance anxiety, fear of pleasure, or loss of control. Other factors that impact sexual functioning include:
• Depression
• Cultural influences
• Psychosexual trauma
• Ineffective sexual techniques
• Emotional factors
• Problems in the relationship
• Lack of sexual skills
• Irrational beliefs, including unrealistic expectations

Performance anxiety is perhaps one of the most common aspects of all sexual dysfunctions. Whether it’s the anticipation of loss of functioning as experienced in erectile dysfunction, the loss of control of functioning as experienced in premature ejaculation, or the anticipation of pain such as experienced in vaginismus or painful intercourse for women may lead to a cycle of performance anxiety and subsequent intensification of symptoms.
In general, performance anxiety is the anxiety concerning one’s ability to perform behaviors, especially behaviors evaluated by others. Many times, performance anxiety puts one in a spectator role, where the focus is on negative thoughts and feelings, self-evaluation, and self-doubt, and not on the physical experience and sensations of pleasure. 

The Role of Thoughts in Sexual Functioning
One common factor in almost all causes of sexual dysfunction is negative thinking or negative cognitions. Negative cognitions are negative thoughts that a person has after having a negative experience. Such negative cognitions can impact the perception of future experiences and how one relates to themselves, others, and the world around them.

Some negative thoughts may be clear while others may be more subtle. Here are some negative thoughts to consider:
• “I’m not good enough.”
• “Masturbation is wrong.”
• “I’m too fat.”
• “I won’t get hard.”
• “I have to get an erection.”

Negative thoughts like this can take one out of the present moment, and out of their body. Additionally, negative thoughts tend to fuel negative emotions, creating a negative feedback loop in which the physical body is responding to the negative thoughts and feelings and a symptom of sexual distress and dysfunction is maintained. 

EMDR in Treating Sexual Dysfunctions
Eye Movement Desensitization Reprocessing (EMDR) was developed in the late 1980’s by Francine Shapiro to desensitize traumatic memories and change the way individual’s thought about and experienced those memories. EMDR therapy can only be performed by a trained EMDR therapist and involves utilizing bilateral stimulation or alternating left to right eye movements, sound, or tactile stimulation, while recalling a negative or traumatic memory and associated negative cognition.
During the course of the EMDR therapy, which one session usually takes place in 60-90 minutes, one negative memory and negative cognition can be effectively treated, leaving the patient with fewer negative feelings and more rational thought, e.g. moving from “I’m not good enough” to “I’m fine as I am.”
Working through negative memories then results in the individual being more present in situations that used to remind them of the negative memory. EMDR is a highly effective therapy, producing significant results in a short period of time.
Individuals with sexual dysfunctions have higher rates of performance anxiety and negative thoughts. Individuals with sexual dysfunctions commonly have a history of negative experiences ranging from significant childhood maltreatment and trauma, including childhood neglect and abuse, to other forms of negative experience throughout the life span that leads to developing negative thoughts about sex. Developing an understanding of what negative thoughts accompany symptoms of sexual dysfunctions is part of a comprehensive treatment plan.