Who sex surrogate therapy is suitable for

Sex surrogate therapy can be used to learn new relationship and sexual skills. It is suitable for a range of sexual and relationship issues, though most people who want it are primarily focused on resolving their sexual problems. The list of sexual issues people experience is endless but this particular form of treatment is most useful for problems where people are distressed. Once having established that a client might have a sexual problem – as opposed to a medical condition – they then need to be thoroughly assessed for other psychological and relationship issues by a qualified practitioner. The major issue for the therapist is to ascertain whether surrogate therapy would be in the best interest of the client.

Many people who are looking into sex surrogate therapy are very depressed about their chances of resolving their sexual and relationship issues and have already unsuccessfully spent many hours engaged in counselling, complementary therapies and personal development courses. One client said “I have fixed every other problem with years of therapy and just want to fix this sexual one” Many have read extensively about therapy and some have been tantalizing close to resolving their issues with other therapeutic approaches. Clients often underestimate the chances of anything being able to help them, so they need to consult someone who can help them get a clearer view of the issues and the potential for resolving them. It is a great joy for the therapist and the surrogate to see a client go from being utterly dejected to being able to experience the intimacy and fulfilling sexual relationships which many of us take for granted.

Some men and women experience such high anxiety that they cannot have a conversation with a potential partner that has any sexual innuendo, flirting or intimacy. Often this anxiety manifests as flushing or intense sweating, and the embarrassment about being anxious makes social encounters traumatic so that the cycle of anxiety continues. Some people are able to go on a few dates but terminate relationships before they become sexual. One client was totally surprised that a woman wanted to kiss him and had to leave the city for four days due to the intolerable anxiety he experienced.  A client I treated would have spontaneous erections every time he spoke to a woman regardless of her age or looks because of  childhood taunting by his older sister, and he was understandably deeply distressed by this. He was able to be successfully treated in a few sessions as he was able to gain control of the surrogacy meetings and reduce his anxiety without being judged for having an erection.

Often the clients who present wanting surrogate therapy have recently met someone they are interested in, or they may be in the early stages of a relationship - before it has become sexual - and want to break stressful and destructive patterns. Typically these clients are very anxious and feel pressured to have sex soon so that their potential partner will not become suspicious and wonder whether they are really interested or gay. These clients may have previously given up on relationships but find the motivation to tackle their problems because they have met someone.

Indeed, clients presenting for surrogate therapy tend to be much more motivated than clients presenting for other forms of sex therapy, as they have usually tried many other options and are inspired by the unique potential of surrogacy. Often they are sick of merely talking about the problem and want a more practical approach. Clients who have tried other approaches are usually already familiar with the rules and boundaries involved.

Some men have poor coordination and are clumsy – which they may have had reinforced repeatedly in many areas of their lives, - especially with sport - as well as the sexual arena. If this is the case they are likely to be insecure and have very low confidence. But there is also a type of man who presents for surrogate therapy who actually seems very confident and may be wealthy and/or very good-looking. Clients from this group may seem, on the surface, to ‘have it all’ but present for therapy with a very hidden pain and inarticulated longing or yearning for something unknown. Others tend to be extremely cautious and negative, making frequent rationalisations and putting the therapy down because they do not believe that the surrogate will be able to offer any real help. Some clients behave as though they are superior ie. that it can only help if it is best treatment available, or that they are too important to be engaging in it, that it is not worthy of their precious time.

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Couples and sex surrogate therapy

While sex surrogate therapy is most suitable for single people some couples have been helped as well. In this case the couple would be instructed to refrain from sex (couples in this situation are usually not having sex very frequently anyway) and practice the exercises learnt with the surrogate to consolidate the learning. The relationship dynamics with couples are considerably more complex than with singles; the more people involved the more complicated it is. A female surrogate can often teach the male partner how to please their partner.

In a couple one partner may have been manipulated into feeling that they are the only one with a problem, in which case surrogate therapy can be a way for the other partner to attempt to lay blame and be absolved of any responsibility. Therapists need to be very careful not to be caught in making the problem worse by colluding with one partner, as with all types of triangulation.

Same sex surrogacy

There is much debate as to whether gay and lesbian issues in psychotherapy are the same as heterosexual issues,  especially where early childhood is concerned. Usually it is the straight therapists saying that the issues are the same and the gay/lesbian therapists saying the issues are very different. With sex surrogate therapy sexual orientation has significant implications.

A huge misunderstanding is that a heterosexual man must use a female heterosexual surrogate. In some cases it is less disturbing if a client knows there is no possibility of sexual contact occurring because the surrogate is another heterosexual man. Men who have been sexually assaulted often have confusion about what constitutes normal sexual behaviour and about homophobia that a surrogate can help with. Other men want to be able to compare their bodies with that of another man in order to deal with body image issues, for example penis size and how quickly they can obtain an erection. Surrogates in this context behave like coaches in order to help normalise such feelings and to provide instruction on sexual technique, for example demonstrating touching and masturbation techniques.

Which clients sex surrogate therapy is not suitable for

Surrogate therapy has a wide application for a range of sexual disorders and relationship problems but in many instances it is more appropriate to focus on other issues that a client has before tackling the sexual one, particularly those which are likely to be exacerbating or complicating the sexual problem, for example, a general high level of stress. Clients with a fragile personality may not be emotionally resilient enough to cope with the level of intimacy engendered by surrogate therapy so, for their own protection, they would not be allowed to proceed. Those who are inclined to act out and take things out on people so that they become aggressive are unsuitable for undertaking surrogate therapy until they have achieved a greater level of stability, more for the protection of the surrogate than for themselves. But self selection helps weed out unsuitable candidates as well; clients who are violent or perverse (as opposed to neurotic) don’t usually present for surrogate therapy in the first place, but instead are inclined go to prostitutes. Clients involved in any form of substance abuse would not be considered suitable for surrogate therapy until they had undergone rehabilitation.