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Surrogate partner therapy definition


About Surrogate Partner Therapy | SurrogateTherapy.org

Surrogate Partner Therapy is a form of therapy based on the successful methods of Masters and Johnson. In this therapy, a client, a therapist, and a surrogate partner form a three-person therapeutic team who together work to understand and resolve difficulties that a client is experiencing in their lives. 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. The involvement of the team therapist, a licensed and/or certified professional with an advanced degree, is a cornerstone of this therapy process. 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 problems that motivate clients to seek Surrogate Partner Therapy range from general anxiety in social situations to specific sexual dysfunctions. Concerns for any gender might result from one of the following:

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  • Negative body image or physical disfigurement

  • Medical conditions

  • Sexual, physical, or emotional abuse and/or trauma (rape or incest, for instance)

  • Intimacy issues

  • Phobias and anxieties

  • Unresolved relationship trauma

  • Confusion about sexual orientation

  • Lack of social or sexual self-confidence.

 

Sexual concerns may include:

  • Orgasmic inhibition

  • Genital or pelvic pain

  • Avoidance of physical and/or emotional intimacy

  • Lack of experience due to anxious avoidance.

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Common sexual issues for male clients include:

  • Erection difficulties (ED)

  • Rapid ejaculation (PE)

  • Ejaculatory inhibition.

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Female clients’ sexual issues might include:

 

Clients of any gender may seek therapy to address problems relating to

  • Fear and avoidance of sexual and emotional intimacy

  • Lack of relationship experience

  • Shame or anxiety regarding sex

  • Low arousal or lack of sexual desire


Learning how to develop healthy relationships, how to touch and to receive touch, and how to be more accepting of one’s body and sexuality are important aspects of this process. Care is taken to assure that the client is ready for each new step as the client and surrogate partner gradually progress through experiences that are simultaneously diagnostic, skill-building, and healing. The surrogate partner models social skills, effective communication, and emotional honesty. The surrogate-client relationship offers experiences of shared physical intimacy that facilitate the development of healthy self-concepts and improved sexual functioning. As the work progresses, clients find themselves becoming more relaxed, more open to feelings, and more comfortable with physical and emotional intimacy. Genital-genital contact may or may not be therapeutically indicated. When it is indicated, it is often a minor part of the therapy.

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From the surrogate’s point-of-view
Most progress seems to occur during therapy when human caring and affection flow easily between surrogate partners and clients. In the context of this authentic connection, clients’ issues about emotional and sexual intimacy can be explored, and the client has opportunities for practicing and developing new relationship skills. Even personal conflict between the partners provides excellent opportunities for learning. The surrogate-client relationship serves as a model of every stage of a relationship, from beginning to end. The surrogate partner’s responses to the client and perceptions of the client, from inside this relationship, can be highly informative for the therapeutic team.


From the client’s point-of-view
Clients grow to trust and care for the surrogate partners, with whom they share honesty, intimacy, and meaningful emotional work. Through this genuine relationship, clients experience themselves and intimacy in valuable new ways. Clients learn how to develop trust and satisfying relationships. They are able to see that the same potential exists for their future relationships. Eventually, clients reach a point where they feel ready to begin new relationships with partners of their own choosing.


The decision to end therapy is made mutually between client, therapist, and surrogate partner when the revised goals of therapy have been met. The process of bringing the therapy and the surrogate-client relationship to a close celebrates the uniqueness of each relationship, honors the feelings of the members of the triad, and directs attention towards the client’s future.

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What They Do and When to See One

Written by WebMD Editorial Contributors

In this Article

  • Other Names for Sexual Surrogacy
  • Myths and Misconceptions about Sexual Surrogacy
  • How Sexual Surrogacy Works
  • Safety Advice and Special Considerations

Sexual surrogacy is a therapeutic practice designed to help a person become more comfortable with sex, their body, and/or the emotional and physical skills they need for intimacy.

The client works together with a licensed sex therapist and a sex surrogate, or surrogate partner. While other forms of sex therapy do not include the possibility of physical touch or intimacy, sexual surrogacy does.

Sexual surrogacy is a controversial and commonly misunderstood form of therapy. Due to its potential ethical and legal complications, there is a lack of published research on sexual surrogacy. But there is anecdotal evidence that it can be an effective part of sex therapy for some people.

Other Names for Sexual Surrogacy

Another term for sexual surrogacy is surrogate partner therapy (SPT). Sex surrogates also go by the title “surrogate partner.”

Myths and Misconceptions about Sexual Surrogacy

The biggest myth surrounding sexual surrogacy is that it is a form of prostitution. But there are important differences. Sex workers focus only on giving sexual gratification to a client. But a surrogate partner’s goal isn’t around sexual satisfaction or stimulation -- they aim to help a person overcome troubles they have around sex and intimacy, whether they are physical, social, or emotional. They may focus on areas like relaxation, communication, and social skills training. In some cases, surrogate partners never have physical contact with their client.

Still, the legality of surrogate partner therapy is complicated. There are no specific laws against it. But major professional organizations in the fields of psychology and social work have also refrained from making any official statement about the ethics of surrogate partner referral. Many people agree that the key is to work with a licensed sex therapist who can guide the process.

The International Professional Surrogates Association, a professional organization for those in the field of surrogate partner therapy,  ensures that its members receive training, achieve competency, and maintain a specific code of ethics.

Some people believe that surrogate partners should only be part of therapy for people with physical limitations that affect their sex lives. However, SPT can treat a variety of issues.

How Sexual Surrogacy Works

Sexual surrogacy involves a three-person team: sex therapist, sex surrogate, and client.

Surrogate partner therapy begins when a licensed therapist determines with their client that their goals would best be met with the aid of a sexual surrogate. They might recommend this approach to help with several types of conditions:

  • Physical or mental disability
  • Anxiety or fears around sex and intimacy
  • Body dysmorphia
  • Sexual identity questions
  • Conditions like erectile dysfunction, early ejaculation, or vaginismus, a problem with the muscles of the vagina
  • Sexual trauma

More recently, some experts have proposed SPT as a potential tool to help people who have recently undergone gender confirmation surgery.

Depending on the goal, the licensed therapist and client work with the surrogate to design therapeutic experiences. According to the International Professional Surrogates Association, these experiences include “partner work in relaxation, effective communication, sensual and sexual touching, and social skills.”

The sex therapist maintains an active role throughout the process. In the most common arrangement, the therapist meets with both the client and the surrogate, independently, each week. After these meetings, the client will meet with the surrogate. When the therapy process is concluded, the relationship between client and surrogate partner ends as well, allowing for no further contact.

Safety Advice and Special Considerations

If you believe that surrogate partner therapy might be a good fit for you, talk to a licensed sex therapist about the possibility. You should only pursue this therapy with the guidance of a qualified professional, never on your own. Use only trusted referrals that maintain a strict ethical code of conduct.

Surrogate partner - sex work or therapy?

Surrogate (from German Surrogat - substitute). A surrogate partner of an ersatz relationship or a beautifully packaged form of prostitution - let's figure it out.

You may have come across the term surrogate partner for the first time. I suggest you look into it right away. This is a professional who in practice helps to solve issues of intimate and sexual intimacy, always works in close conjunction with a psychotherapist.

This form of therapy is based on the methods of William Masters and Virginia Johnson. You may have seen the series "Masters of Sex" - this is about them. The website of the International Organization of Professional Surrogacy Partners (IPSA) claims that the profession dates back to 1973.

Despite this, in many states of America, as well as around the world, their activities are not regulated by law in any way. Perhaps also because, according to the president of IPSA, today there has not been a single appeal to the court with claims about the poor performance of work by surrogate partners. There is an internal ethical code, and the members of the organization rely on it in their activities.

Stages of building a therapy

Client, therapist and surrogate partner form a therapy team of three. They try to understand and resolve the difficulties the client encounters during physical and emotional intimacy. For example: negative body image, problems with intimacy, fears of a sexual nature, lack of orgasm, premature ejaculation, and many others.

Therapeutic sessions are intertwined with meetings with a surrogate partner. The client gets an experience that includes work on relaxation, gaining communication skills, sensual and sexual touch.

Each session is designed to enhance the client's knowledge, skills and comfort. As time goes by, they find themselves calmer, more open to feelings, and more comfortable with moments of physical and emotional intimacy.

Through sincere relationships, clients see themselves and intimacy in a new way. Learn how to develop trusting and pleasant communication. They can see that the same potential exists for their possible future intimate encounters.

The final point of therapy is for the client to feel ready to start a new relationship with any person of their choice.

The surrogate partner coordinates all his actions with the therapist, is in touch with him and makes decisions himself, only if the therapist was not in touch. And most importantly, what can cause controversy or nervous chuckles, sex is possible between the client and the surrogate partner, but not always and is not the goal.

Important qualities of a surrogate partner

There are currently no diplomas in this area, but there is a certification that can be obtained from IPSA. To do this, you must complete a 100-hour course in the study of sexuality and sexual therapy. And then move on to an internship.

A number of personal qualities are also important and, in our opinion, above all rich life experience, which provides a valuable basis for the skills of a surrogate partner. Intelligence, patience, the ability to show compassion, give warmth, provide comfort, show love for your body and understanding of personal sexuality. And of course knowledge of the principles and practices of sex therapy, as well as good communication skills. All this will be needed at work.

Also important is an open mind about sexual orientation, lifestyle choices and consensual sexual activity. The surrogate partner must himself be in an independent, satisfying social and sexual relationship.

Important differences from prostitution

First, the focus of the surrogate partner's work is on education and healing. Of course, situationally, when visiting a priestess of love, a rethinking of one's sexual experience and relationships can occur. But it will be rather spontaneous and unforeseen. Whereas a professional moves in a certain pattern and has a plan for recovery and education, and not just getting sexual experience.

Secondly, the number of sessions with a surrogate partner is always limited. You can visit a prostitute as many times as you want. This is due to the fact that the client starts looking for an object of desire in the future and does not shift this role to a surrogate partner.

And, thirdly, the visit does not always involve the completion of sex, this is not the purpose of joint meetings.

Surrogate partnership in popular culture

Partnership has already been discussed in popular culture. The most famous book is “Sex is my life. The Frank Story of a Surrogate Partner. This is the autobiography of Cheryl Cohen Green. Based on the book, a film based on real events, "The Surrogate" in 2012, was made. Tells about a guy who spent his whole life on a hospital couch and connected to a breathing apparatus. At 38, he decides to lose his virginity and explore the sensual aspects of life.

There is also a feature film about a male surrogate partner, Bliss, 1997. This is a story about a married couple. A woman tries to deal with traumatic sexual events in her life, a man learns sensitivity and accuracy.

Surrogate partnership in Ukraine

This practice is not widespread in the world. However, in Israel, such treatment is available at public expense for military personnel undergoing rehabilitation.

In Ukraine, today, we do not know a single representative of this profession. Perhaps there is someone who spontaneously engages in this practice, but has not been found working in tandem with a therapist. It is doubtful today and the emergence of a surrogate partner. Perhaps this is due to the fact that the movement of sex education is only gaining momentum. And also with the difficulties of formalizing such activities at the legislative level.

The path of knowing your sexuality is interesting and endless, no matter who you go with. And on your way you will meet many more new interesting terms. Learn more deeply, it can open the door to a new you.

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Do as I do: what is surrogate sex therapy and who needs it

« I want you to look at me. Let's try. Open your eyes. Starting from this moment, you will listen to the signals of your body, ”instructing the man in bed in the voice of the teacher, the woman pulls off her T-shirt, jeans and underwear. She is about forty. She doesn't even try to be sexy. She has another task - to teach a man to have sex. Ben Lewin's The Surrogate was nominated for an Oscar in 2013. This nominee had every chance to repeat the success of Forrest Gump even without Tom Hanks in the credits. John Hawkes brilliantly played the lead role - the role of 38-year-old journalist Mark O'Brien, who survived polio at the age of six. His partner is the gorgeous Helen Hunt. But it's not about the casting. Case in point: disabled people and sex. And how this problem is solved with the help of surrogate therapy - in a civilized society, of course. The film is based on real events. It was based on the biography of the real Mark O'Brien, who, having been ill with polio in childhood, was almost motionless for many years, but, despite his physical weakness, lost his virginity as an adult and established his personal life. You can read about it in his essay "Looking for a Sex Surrogate" or in a book by his partner Cheryl Cohen Green, which she co-wrote with psychotherapist Lorna Garano. “Sex is my life. The Frank Story of a Surrogate Partner provides an opportunity to look beyond surrogate therapy.

The founders of this method, scientists William Masters and Virginia Johnson, in the late 1960s and early 1970s, conducted a series of studies that showed that sexual dysfunction is not such a rare thing among American Puritans. Sex education helped, but only partly. Against shame, fear and anxiety - the cornerstones of most sexual disorders - all American TV educational channels taken together were powerless. Then scientists developed techniques for treating various disorders based on the principles of behavioral therapy. The couples had to do the homework given to them by the therapist, and that would solve everything. But here a new problem arose - many patients with sexual disorders did not have partners for doing homework because of these same disorders. To break this vicious circle, someone was needed to act as a permanent lover or mistress. This is how the profession of “surrogate partner” appeared.

The first thing to understand is that the surrogate partner is not a prostitute. This is a professionally trained instructor who makes physical contact with the client to help him work through the sexual cramps and problems that prevent him from building a healthy intimate relationship. Becoming a surrogate partner is not easy at all. First, you need to pass the casting. Psychotherapist Dr. Roitman from Israel, who has worked with 20 female surrogate partners for fifteen years, describes this profession as follows: “They are usually women aged 25-40 years with education in pedagogy, sports or medicine (primarily ). All candidates undergo a two-hour interview that tests their mental health, relationship building skills, character stability, and even punctuality. It turns out motivation, attitude towards sex, the ability to deliver and receive sexual pleasure. The criminal past is excluded. Former sex workers are categorically not suitable for surrogacy therapy - the attitude towards the client is completely different there. It is easier to teach a woman with no experience than to retrain a prostitute. After that, candidates undergo a 20-hour course in basic psychology and sexology, during which there is also a dropout. Both the patient and the surrogate partner undergo a medical examination before starting treatment to exclude sexually transmitted and other contagious diseases. Of course, sexual intercourse occurs only with the use of condoms - by the way, it is also an important skill for an inexperienced patient.

Therapist is the gray cardinal of surrogate therapy. He meets once a week with each of the participants in the process separately and, after listening to both sides, outlines a plan for the next meeting, gives homework, using elements of psychotherapy and Ericksonian hypnosis in his work. Within the framework of one method, each therapist, like each partner, has his own tricks and tricks. The act of physical love in this case is a goal that still needs to be reached (many clients, by the way, quit already in the first sessions). It occurs already at a very advanced level of therapy. At the first stage, the client and the surrogate partner are limited to simple touches. Practicing basic exercises helps people relax and focus on their sensations. Cheryl Cohen Green, for example, taught clients how to breathe correctly and used the "spoon" exercise, during which the man lies on his side in the fetal position, and she presses against him from the back, as if protecting and reassuring.

Over time, clients are admitted to more advanced practices depending on the task at hand. “When a woman is ready to get naked, I move on to the strip game,” explains Michael, a London-based surrogate partner. - Not to the end. Let's say I take off my shirt. And in this case, the fact that I don't have a perfect figure - my stomach is not as flat as I would like, and my biceps are not as strong - helps the client, a woman, cope with her own bodily inferiority complex. Then I can invite her to examine my genitals, as if she were an alien who has never seen human genitals. She doesn't need to please me. In no case. This is a kind of game that allows a person to discover the body of another person and, in time, their own.”

In the next stage, the surrogate partner may touch the client's genitals. “Sometimes I use the 'mapping' technique, just touching various points with a finger - the clitoris, vagina, outside or inside the anus - so that the client can create a mental map of his body and the sensations that give different points of it," Kian explains. de la Cour, a somatic specialist who acts as a surrogate partner and often works with blind people.

If the session is successful, the surrogate partner can give the client oral sex or hand stimulation. Ideally, a full-fledged act should take place in the last classes - an extremely important event. Especially when it comes to adult and very adult virgins and virgins with serious sexual disorders behind them. Cheryl mentions Larry, a 70-year-old virgin in her book. Dr. Roitman had experience with a patient who lived as a virgin until the age of 50. “A fifty-year-old mathematician in his youth was hospitalized several times in a state of acute psychosis. The discharge diagnosis was schizophrenia. He never worked in his specialty, rarely left the house. He was treated in a psychiatric clinic by my colleague. He received various antipsychotics, says Dr. Roitman about his patient. – A native of China from a Russian-speaking family, he lived all his life in Israel, but spoke Russian quite well. He was suspicious and a little aggressive. He immediately told me that in order to be treated by me, you have to be a “new Russian”. It was funny to me, but I thought it was not worth joking with. And yet, the word “or” escaped me: “Or the old Chinese!” It cleared the atmosphere. We started work. I saw that he was in a good mental state, and for various reasons suggested that the thirty-year-old diagnosis might have been wrong. After discussing the situation with my colleague, I decided to gradually reduce the doses of antipsychotics. The man came to life, joked, demonstrated erudition, but at the same time seemed like an alien from another era. He boasted of his knowledge of the Russian language, quoted Pushkin, gave flowers or sweets to a surrogate partner, which is generally not accepted in Israel. In the classroom, she could not get enough of him. When the process reached full sexual intercourse, she said that there had never been such a man in her life. The mathematician quickly mastered all sexual positions and even performed standing intercourse, which was not included in the “mandatory program”. In parallel, he first got a job in his specialty. I was extremely pleased with such successes and was already thinking about the next stage - the search for a permanent partner. But then he told me: “Thank you for teaching me about sex. All women are the same! Everyone wants the same thing - to take over my savings and leave me. I have already found a place where for less money than I pay here, I can be with a new woman every day!”

Apparently, surrogate sex has unique possibilities and helps where other therapeutic approaches fail. The spectrum of its action is quite wide, as are the problems of people who resort to the help of a surrogate partner. And the matter here is not limited only to physical disabilities - there is another movie about this, the film "Surrogate" by Tali Shalom-Ezer, in which a surrogate partner works with a young beautiful social phobe Eli. Client problems can also be related to experiences of abuse, toxic relationships, infidelity, or even trauma at birth. Many suffer from inferiority complexes related to appearance - often far-fetched, like the classic female "I have an ugly labia" or the classic male "I have a small penis." In the practice of Dr. Roitman there was such a case. A 25-year-old student of model appearance came to the appointment complaining that he had a very small penis and there was no chance that any woman would want one. During the conversation, it turned out that his father had been seriously ill throughout his childhood, and then died. The mother, a grumpy woman, criticized her son for every little thing. The guy grew up insecure, unable to assess his attractiveness, and somehow got a job working in a sex shop. The assortment of giant rubber dildos and vibrators on the shelves only added to the feeling of inferiority. Clients - self-confident, assertive women - flirted with a pretty salesman, but this only caused panic attacks in the guy. Just in case, the doctor sent the “imaginary patient” for a consultation with a urologist and received a written response with assurances that the patient’s penis was absolutely normal in size. Several months of work with an experienced calm surrogate partner developed his self-confidence, and after six months he had sex with almost half of the students of the art school, which he enthusiastically reported to the doctor at the end of therapy.

However, surrogacy is not without risks. And if a condom protects against venereal diseases, then it’s not so easy to fence off feelings. There is a real danger of becoming emotionally attached to a surrogate partner. To prevent this from happening, there are rather strict rules of the game in therapy: the patient must not know the real name and phone number of the surrogate partner. They don't communicate on social media. Sessions take place either in a clinic or in a hotel and last exactly two hours. Also, the client should not pay directly to the partner, show signs of attention and, of course, fall head over heels in love with him. All in all, easier said than done. Therefore, a professional must constantly monitor the emotional state of the client and not let him get carried away. But you also need to keep yourself in hand. “When you share a lot of pleasant moments and you meet regularly for several months, a certain closeness is established, endorphins are released, which makes your relationship look like falling in love. Here you need to be very careful,” says Anna, a surrogate partner. She is not married - simply because she does not have enough strength or human warmth for her own personal life. Oddly enough, it is kindness, sensitivity and patience that Lorna Garano calls the main qualities of a surrogate partner. According to the book, her colleague Cheryl Cohen Green had enough heat for 1,000 people.

Psychiatrist and psychotherapist Mark Roitman (HaSharon Clinic, Kfar Sava, psych.co.il) about whether it is time for you to seek surrogate sex patients' problems. Even though I took courses in sexology, while studying at the Institute of Psychotherapy at Tel Aviv University, I felt that the skills to work in this area were not enough. In the early 90s, I watched with interest the programs of Elena Hanga "About It" and Bob Berkovich on the CNBC channel, which repeatedly invited the sexologist Barbara Kisling. She has not hesitated to talk about her work as a surrogate partner in her youth and has written several books on the subject. During another raid on Barnes & Noble on 5th Avenue, I bought these books and many others on sex therapy. At the same time, I received an invitation to a seminar on surrogate therapy in Tel Aviv. It turned out to be a new clinic created by a sexologist who had returned from the United States, and I agreed to cooperate with her. In 15 years of practice, women have hardly approached me. The main female problem - vaginismus - is rare. Pain during sex comes in varying degrees of severity. Some tolerate, others avoid sex. Many women simply hide anorgasmia. Erection problems or premature ejaculation in a relationship are harder to hide. 90% of my patients are men aged 22-40. Most of them look normal, have a good education and status in society. It can be engineers, lawyers, doctors, students, young officers, whose main difficulty is the inability to establish an intimate relationship with a woman. We live in a competitive society. And it is the successful young men who feel they have to be first in everything, including sex. I can hear from a 22-year-old guy that his "train left a long time ago." Some are sure that they should have an erection as soon as they see a girl, and at least - when they touch her.

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