Christina Mitchell MS,CNM

2. Rebuilders – the finale Human Sexuality 12-14-08

3. Christina Mitchell MS,CNM • Registered Nurse • Masters in Nurse Midwifery • Certified Nurse Midwife • Employed with Kaiser Permanente

4. david o. thayer m.d. THAYER GROUP FOR WOMEN’S CARE P.C. Board Certified in Obstetrics and Gynecology Specializing in women’s health, hormonal and menopausal issues, minimally invasive women’s surgery, and the new field of Robotic surgery

5. Chris– how did we get here? And why are we here? • Next some ground rules.

6. Ground Rules • Serious nature of what we are about to discuss. We will be sensitive to the needs of different people and try not to be offensive to anyone. • First – Remember – Chris and I are professionals. • Second – we are not in Junior High School. • No Joking around • No Giggling, Laughing • No Sneering, Snickering, Sideways Glancing

7. Summary Slide – male vs. female sexual function

8. Summary Slide – male vs. female sexual function

9. Safe Sex Vs. Safer Sex TOTALLY Safe sex

11. Human Sexuality • Not just SEX • Whole range of human emotions and being, of human existence. • Complex interactions of human beings • Complicated, volatile, difficult!!!! • Why do we even bother?

12. Our goals • To provide you with useful information regarding human sexuality. • To provide a forum for your questions – anything you’re brave enough to ask. • This is the who, how, why, what , where, and when of basic human interactions. • To provide a live demo.

13. What we won’t do: • We will not be able to answer all your questions!

14. If there is useful information here tonight and you want to review it: • Please see our website: www.thayermd.com

15. If you still have more questions: • Visit www.webmd.com • Make an appointment to see your PCP • Make an appointment to see Chris or myself

16. Four Basic Human Needs For Survival – only three • Air • Water • Food To THRIVE • Human Bonding This seems to be a biologic imperative. You are destined to try again (and again)

17. Human Bonding • Bonding is a term implying Companionship and Intimacy. • We have a basic need or instinct that draws us together. That damn biologic thing. • Healthy humans will be attracted to other people. • It is one of the most complex and difficult of human undertakings. • It is fraught with hazards – in case you hadn’t noticed. • It is one of the most rewarding.

18. Where do we begin? How do I let myself begin? Am I sure I want to begin?Where is the nearest exit? You may be asking yourself these questions. • How can I possibly start over? • How can I avoid the pitfalls, the dangers, the risk of pain? • How can I increase the odds of my own success? • How can I be most effective?

19. Method One The EASY way

20. Buy our recent book

22. Method Two The not so easy way

23. First understand that it’s a process, not a one word answer. • Look at yourself. Deep into yourself. • Take some responsibility for who you are and how you got here. • Learn as much as you can about what makes you click. “What do I like and dislike? What do I want?” • You’ve already begun this process by joining Rebuilders. Don’t stop now!

24. Accept yourself • You are a Human Being! • You have a right to be here! • Stop listening to that nagging inner critic • You are good enough, just the way you are! • You deserve to be loved! I do not care who you are or what you have done. Or should I say, who you were. • START LEARNING TO LOVE YOURSELF !

25. Forgive Yourself • Perhaps you have been upset with yourself that you are not better, more successful, more beautiful, smarter. On and on and on! PLEASE - let it go! • Accept that you are not “perfect”. It’s OK! None of us are. Even when you see someone that seems so much better, sooo successful. • Entertain the POSSIBLILITY that maybe you really are OK.

26. Improve yourself • Just because you are ‘good enough’ doesn’t mean you haven’t made mistakes. • Look at your mistakes! • Learn from them.

27. Improve yourself • Repeat this mantra- “I am not a bad person. I am a good person who has made mistakes.” • Don’t keep making mistakes! At least not the same ones. • BE that good person. • FORGIVE YOURSELF for past or future mistakes. • But don’t keep repeating those negative behaviors!

28. Remember! . If I do what I do, I will get what I get. • Let’s try something different if we’re not pleased with what we’ve gotten. • Remember-one definition of insanity-repeating the same thing over and over and expecting different results!!!!

29. Learn to communicate For example, its OK to say how I feel. It’s usually not OK to tell someone else how they made you feel. • Learn the difference between dirty fighting and fair fighting. There are better tools available. • Ask Norm. • Take other courses such as PAIRS, FEARLESS LIVING • Work with a therapist. • Read and study.

30. KNOW YOURSELF Don’t expect to get what you want or need if: • YOU don’t even know what you want or need • or if: • YOU don’t even ask for what you want or need.

31. Needs and wants • Learn the difference! • You have a right to your needs! • You have a right to have wants, but you’ll have to learn to negotiate for them. You won’t always get what you want! • If you are not getting your needs met, or enough of your wants met – what are you doing in this relationship?

32. Lets assume you’ve done YOUR homework Now its time to get involved

33. SEX

34. Getting to “First Base” Ok - YOU want to score a home run! • Let’s start with first base. • Let’s say you’ve got a potential partner, and that it is an actual living, breathing human being. • Now what? • A. It’s not 1970 anymore! (or 1980 or 1990!)

35. Keeping score in this millennium • Start with a conversation. Unzip your mouth, not your pants! • Don’t let alcohol or drugs get in the way. • If you decide to have sex, you will be sharing a lot more than just your bodies. • “Whip it out” now means your STD score card – i.e. your STD results.

36. STD Facts • CDC states that 75-80% of sexually active adults already has genital HPV. • Genital Herpes is frequently silent, so many people have it, that don’t even know. • Chlamydia, gonorrhea, and syphilis are still present – and treatable. • HIV is still dangerous, injurious and deadly. • Hepatitis C is silent, transmissible, and dangerous • CRABS are ugly.

37. We recommend serum testing for: Herpes 1 and 2 HIV Syphilis Hepatitis C Genital swabs for: Gonorrhea Chlamydia Pap testing for HPV (and precancers) Other – dependent on symptoms (e.g. discharge) STD Testing

38. Safer Sex • Avoid unplanned pregnancy-THINK birth control • Remember--STD’s are passed via physical contact with an infected person. • Consider avoiding the 4 M’s.-- What you ask? • Mixing and Matching of Mucus Membranes. • Or use barriers.

40. Degrees of safer sex • Safest may be sex with oneself. • Next safest may be phone or internet sex • Limit exposure by limiting partners and checking STD status first • Limit the types of sex to those activities that can be protected • Use barrier protection – male or female condoms – latex or plastic, not skins • Or – cast your fate to the wind

41. CONDOMS CAN BE FUN Just ask Chris! Always Remember!

42. Demo time • Volunteers?