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The Renewed Interest and Rekindled Debate Regarding Surrogate Partner Therapy or Sexual Surrogacy The movie, The Sessionsis based on an essay by Mark O'Brien, a poet paralyzed from the neck down due to polio, who, in his 40s, hired a sex surrogate to have his first sexual experience.
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Helen Hunt plays the role of the sensitive, intelligent, trained sexual surrogate and John Hawks plays the role of the physically disabled, talented, educated poet. The movie has rekindled interest in the controversial topic of Surrogate Partner Therapy, or what also has been called, Sexual Surrogate Therapy.
The original concept was developed and studied by Masters and Johnson in their work, Human Sexual Inadequacy, in As with many issues related to sex, this is a highly controversial topic. While sexual surrogacy was popular and practiced in the s and s, the idea of psychotherapists, marriage and family therapists, social workers, counselors, and mental health professionals referring clients to Surrogate Partner Therapy is highly controversial and very little examined in current times.
What is Surrogate Partner Therapy? Following are two descriptions of Surrogate Partner Therapy. In this therapy a client, a therapist and a surrogate partner form a three-person therapeutic team.
The surrogate participates with the client in structured and unstructured experiences that are designed to build client self-awareness and skills in the areas of physical and emotional intimacy. These therapeutic experiences include partner work in relaxation, effective communication, sensual and sexual touching, and social skills training.
Each program is designed to increase the client's knowledge, skills, and comfort. As the days pass, clients find themselves becoming more relaxed, more open to feelings, and more comfortable with physical and emotional intimacy.
Clients often experience apprehension as they begin therapy and when they begin to experience changes. The team therapist assists the client with these and other emotional issues. Sessions with the therapist are interwoven with the surrogate partner sessions in order to facilitate understanding and change.
Open, honest, consistent communication between all team members is a fundamental ingredient of successful surrogate partner therapy. The practice was formally introduced by Masters and Johnson with their work on Human Sexual Inadequacy in The team may also work independently of diagnosis and treatment plans based in traditional medicine, for example providing services to the disabled or to couples whose sexuality is a source of distress.
While some people have a knee-jerk reaction to the concept of mixing sex and therapy, others can see how such interventions can be humane and healing. Yet others view SPT as "a guided in vivo exposure" Binik, Since the work of Masters and Johnson in the s and the practice of surrogacy in the s, there has not been much discussion of these issues.
One of the few exception has been a debate at a major international sexological conference entitled "Surrogate Therapy Has No Place in the Treatment of Sexual Dysfunction" Assalian, et.
That has changed since the release of the recent movie, The Sessions. Following are eight questions and ten most important considerations that seem to be most relevant to the exploration of whether therapists may refer to surrogate partner therapy. Main Questions How does surrogate partner therapy or sexual surrogate therapy differ from prostitution?
See discussion at Bullet 2, below What are the legal issues relevant to surrogate partner therapy? See discussion in section on legality, below Does this type of referral fall within the standard of care, i.
See discussion in section on Ethics of Referral, below Is it ethical for a mental health practitioner to refer a severely physically disabled client, such as the one depicted in the movie, The Sessions, to an IPSA certified surrogate for surrogate partner therapy if the client requests it?
See discussion in section on Ethics of Referral, below What would be involved in a risk-benefit analysis when considering referring a client to work with a certified surrogate partner? What is the ethical decision-making process regarding a referral to, and follow up with, a surrogate partner therapist?
Are there any legal precedents, case laws, licensing board rulings, or professional associations' guidelines that are relevant to the practice of psychotherapy and referrals to referrals to surrogate partner therapy by a practitioner of psychotherapy.
See information regarding these matters, below. Are there certain psychiatric symptoms or lack ofdiagnostic categories, or certain clients that would indicate the possibility of higher clinical risk to the client, or legal or ethical risk to the referring therapist? Does a mental health practitioner have an obligation or ethical duty to make a referral i.
See direct quotes from professional organizations codes of ethics, below Important Considerations It is extremely important to differentiate between psychotherapists or counselors who are licensed, mental health professionals who conduct sex-therapy, and surrogate professionals who provide surrogate partner therapy or sexual surrogate services.
Obviously, it is illegal and unethical for psychotherapists, counselors and licensed mental health professionals to have sexual relationships with their clients.
The differentiation between SPT and a sex worker or prostitution is, obviously, extremely important for the discussion of the legal, ethical and clinical considerations of therapists referring a client to SPT. The main difference between surrogate partner SP and prostitution is that prostitution is focused on sexual gratification, while SPT does not necessarily focus on sexual touch, sexual stimulations, or sexual satrisfaction.Self-affirmation processes are being activated by information that threatens the perceived adequacy or integrity of the self and as running their course until this perception is restored through explanation, rationalization, and/or action.
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