| Chapter 3 - The sex surrogates |
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The characteristics a sex surrogate needs to have Many of the issues which make a client unsuitable for surrogate therapy also make a potential surrogate unsuitable for working in this area. Surrogates need to be well-adjusted and resilient, with a healthy level of self-esteem and without personality disorders or substance abuse problems. Surrogates also need to be free from disease, especially hepatitis. Because surrogate therapy is too often confused with prostitution we prefer not to employ those with a history of sex work, especially as it is usually very abusive and damaging. If there have been any psychological issues such as abuse, the surrogate needs to have done therapeutic work so that they do not interfere with their ability to be present and feeling good about themselves when they are working with clients; it would be potentially destructive if they were prone to dissociating, as this is one of the major issues clients need assistance with. A surrogate who has abuse in their background but has dealt with it is in a unique position to empathise with the client; the development of a high level of perceptiveness about their own feelings and also other people’s is a common side effect of recovering from trauma and a strong level of awareness is vital for this kind of work. If a surrogate has had their own therapy as a treatment or has studied counselling it is helpful as they will have more of an understanding of how it works. In this instance they will also come to the training with their own philosophies and ideas, and be more inclined to want to assess and question the therapist’s methods. It is important for the therapist and surrogate to develop a relationship based on mutual professional respect, where both parties contribute ideas. It is exciting for two people to work together so closely on such an intimate and valuable common goal, and the sharing of the related successes is immensely rewarding. Obviously excellent communication skills and being assertive are vital, but having a caring outlook and a strong commitment towards helping people are crucial too. I am interested in the surrogate’s relationship history as well: whether they are able to have loving, stable and healthy relationships. If an otherwise suitable surrogate does have a few unresolved issues which may interfere with their work, I refer them for therapy before they embark on the surrogate training. And if issues come up during their work with a client, we offer a lot of support. Some surrogates come from a very spiritual angle, some are focussed on the therapeutic aspect, and some are interested because they are very sexually comfortable and experimental.
The characteristics a sex surrogate therapist needs to have The therapist has a huge responsibility with surrogate therapy, needing to take a very unequivocal ethical stance and maintain constant monitoring of each aspect of the process in order to ensure its success. Because of this the therapist needs to have fantastic communication and coordination skills, and also to be flexible and co-operative. They obviously need to have extensive experience as a therapist, with a very thorough understanding of counter-transference and how it operates, and extensive training and experience specifically in all aspects of sexuality. There’s a woman from the US who has made a lot of very detailed information available on the internet about the selection and training process for surrogates.
Surrogate training One of the most common questions I am asked by people responding to my advertisement is whether the surrogate actually involves sexual intercourse, even though the information posted on our website states that it is. The people most interested in this question are usually the ones who do not go on to apply. Those who do go on to become surrogates are usually clear from the beginning that intercourse is involved, but want to know in more detail about other types of sexual activity which may be required. They are often a little worried initially that there may be some connection to a prostitution ring or some other unsavoury and illicit implications, so we need to be transparent and reassuring. They are usually concerned that we will want them to do weird and wonderful sexual things, for example to engage in BDSM, but in fact the sexual activities they undertake will not be nearly as adventurous as the things they have probably already done in their own sex lives, so this is a fear that’s easily alleviated. They are relieved to hear that a large proportion of the work involves gentle sensual contact, such as holding hands and massage. Though they obviously need to be reasonably open-minded, they are not asked to engage in sexual activities with which they are not comfortable, since the success of the therapy is utterly dependent on their ability to connect emotionally with the client. They are free to refuse work with a client that they find extremely unattractive, as the therapy depends on the surrogate being able to respond sexually to the client. This can be a problem because the surrogate will often feel guilty for being repulsed by someone and try to ignore the repulsion, something that is likely to cause more problems further down the track. One surrogate was equivocating about a client and after considerable discussion admitted that she felt shallow for being repulsed by the client’s red hair. She decided to ignore it and work with him anyway, but after further discussion it became clear that a person with red hair was an abusive figure in her childhood. Although she had done a lot of therapy on this issue, it still affected her on a deeply subconscious level. Once this connection had been made the surrogate felt it was reasonable not to want to take on this client, and I agreed. Some surrogates do not feel comfortable working with clients who have a disability if they do not have any previous experience of this. Surrogates are also free to refuse to work with someone who has a comparatively confronting problem, for example a fetish. Even if they do agree to work with such a client they can terminate the relationship at any time, though once they commit to taking on a client i.e. after the first meeting they are encouraged to see it through so as not to cause damage. We aim to create a nurturing environment so that the surrogates feel totally supported at all times; we answer all their questions and supervise them at all stages, encouraging them to raise any concerns. When they first take on a client, the surrogates are encouraged to call or book a session with the therapist at least once a week so they can give feedback and raise any concerns so that they do not become major issues. The most crucial thing is to determine whether a client’s issue is more to do with the work or more a trigger for a personal issue which they need to have referred to an independent counsellor. The need for this level of contact usually diminishes as the surrogate’s experience and confidence grows. The surrogates need to create a nurturing environment for their clients, and we very much need to be practising what we are preaching; the therapist needs to provide an even higher level of care, professionalism and authenticity than the surrogates do. Of course there are a lot of admin. processes involved in taking them on too but in terms of the training, we start off by providing a clear explanation of how surrogate therapy works. We teach the surrogates-in-training the history of the therapy and provide information about the international organisation. We then educate them about the major sexual dysfunctions that we come across and how they can be treated, as well as teaching them some basic practical skills that they might be rusty on, for example putting on condoms. All through the training we emphasise the fact that the therapy’s success – and integrity – depend on a strict adherence to all the rules and regulations; it is the clear procedures and strong boundaries which make it professional and thus therapeutic. And all through the training it is demonstrated to the surrogates that we are completely open and honest because the therapy’s success also depends on this. We teach the surrogates about personality types and defence mechanisms so that they are less likely to take projections on board. They are so keen to be kind and helpful that we need to teach them to recognise when it might be more useful to step back, for example with an extremely passive client. We do lots of small group work in triads or groups of three, where two people do a role-playing exercise and a third person observes. These are similar to the exercises in counselling course training. They teach active listening, as well as sharpening the surrogates’ inter-personal skills, because it is of the utmost importance that they are confident in giving honest yet encouraging feedback to the clients. There has even been interest from the public in doing the surrogate training so people can learn techniques to use in their own relationships, even if they have no interest in actually working as surrogates. Surrogates need to be pretty comfortable in their bodies, but they still often have some minor insecurities. We may need to do some work on these because a client will pick up on a surrogate’s vulnerabilities. If a client says anything critical about a surrogate’s body, the surrogate needs to feel secure enough to assume that the comment is motivated by their feeling threatened and wanting to take away the focus from their own insecurities. Anything a client says is useful information in the process, but if the client has been making them feel bad in a particular way we can offer support and advise them on how to deal with it. One of the main concerns the surrogates have is about their anonymity. Not surprisingly, many surrogates want to keep their work secret in order to avoid the stigma of being labelled as prostitutes, especially as many come from professional backgrounds such as teaching and nursing and are worried that if their extra-curricular activities become public knowledge that it may harm their career. Many do, however, enjoy telling people about their other job at dinner parties to see what sort of reaction they will get! The other major concern the surrogates have is about their security. The surrogate-client sessions take place in a serviced apartment where anything unusual would be heard and the receptionist would intervene. And if a non-serviced apartment was used then there would be a security alarm so that in the event that a client behaved in a way that was outside the agreed boundaries the surrogate would be protected. We have actually never had a situation where a client has become unreasonably difficult or dangerous; the clients are so appreciative that they are able to have this kind of help that they are almost always very respectful. As a sex worker said to me, “In surrogate therapy you only see the guys who know they’ve got a problem but we see the guys who think they don’t have a problem – they’re the dangerous ones.” The other thing we need to do is to reduce the potential for a client to stalk their surrogate, so there is a procedure in place where the client leaves a few minutes before the surrogate. We have never heard of a client in our program following a surrogate. The surrogates also need to be strict with boundaries; they are chosen for their inclination to be very open and giving so we need to make sure to instil in them some very clear guidelines. They are not to tell clients their surname, give clients any of their phone numbers, nor tell them where they work. Because it is emotionally draining work and the surrogates often have other jobs as well, they would not see more than five clients a week – for an hour each time. Of course, the longer you do this job for, the more resilience you build up for dealing with the process. The surrogate is given little information about the client so that their perceptions are not biased, especially since clients are likely to behave very differently in a therapist’s office from the way they do with a surrogate. The surrogate often wants to know what problem the client has – and especially if there is any sort of perversion – but is reminded that the emphasis should be on the level of comfort between them and their ability to work together. The majority of men doing the therapy experience sexual anxiety and consequently have issues with premature ejaculation or erectile dysfunction.
The space where the surrogacy sessions are conducted The clinic where the therapist conducts sessions with the clients is located in a quiet area with no signage. The room where the surrogate conducts sessions with the clients is in a serviced apartment and is comfortable and plain, without being too clinical. The existence of private entrances and several exits, as well as disabled access, ensure confidentiality and safety. There is a double bed, a toilet, a shower, heating and cooling, and a security cameras. To make the sessions more relaxed and enjoyable, tea and coffee making facilities and a stereo are provided. The surrogate arrives early and makes the space comfortable by organising the music and the heating or cooling.
The sequence of surrogate therapy 1. The client and therapist meet for an assessment.
The initial meeting The first meeting between surrogate and client usually takes place in a coffee shop where they can talk and get to know each other in a relaxed environment. They have both been instructed to talk about themselves, to listen, to look for things they have in common and are encouraged to share feelings if they are able, though they have been reminded about confidentiality and warned not to reveal information that may identify themselves. Surrogates are instructed to help make the client feel at ease and clients are told to be themselves and to approach the liaison as a working relationship rather than as a date. The purpose of this initial contact is for both people to decide whether they feel comfortable enough to be able to work together, and they need to discuss this at some point during the meeting, after which they both need to also inform the therapist. If the surrogate and/ or client have concerns these are discussed at length with the therapist. The potential working partners are then encouraged to utilise the information and make it a focus for the therapy. The matching is very successful and rarely is the relationship deemed to be unworkable so that a second surrogate needed. Many of the clients are expert at forming romantic relationships and have no difficulties listening or being close until a sexual component is introduced, but for others the first session generates considerable anxiety. The client is not permitted to avoid the situation but must remain with the surrogate and make a decision. Clients usually also have a number of assumptions which need to be challenged.
Client expectations of the surrogates Surrogates are often seen by their potential clients as elite prostitutes who have secret techniques that result in the most fantastic sex ever. Clients are at once aroused and terrified by this idea. For a client who is a virgin, a professionally trained sexual expert with years of experience and a grounding in psychological and tantric techniques is daunting. For other clients it is an exciting prospect to be in the presence of a confident professional who is genuine, honest, willing to help and who is also having fun. Clients about to embark on surrogate therapy are very concerned about the level of attractiveness of the surrogate they will be matched with. They worry that if the surrogate is not good-looking enough they will have difficulty becoming aroused, and they fear that if the surrogate is stunningly attractive they will be intimidated, treated with condescension, feel unattractive in comparison or be far too vulnerable to falling in love. These feelings relate to the client’s own relative level of self esteem, level of anxiety and past experiences, but they are reassured that falling in love and out of love can be regulated by a therapist so that the usual disastrous endings clients have experienced can be avoided. Indeed, it is common for a client to idealise or fall in love with their therapist, as well as developing other strong feelings. All the feelings which are generated are carefully managed by the therapist in a way which is designed to help the client, so that by the end of the therapy the client has become independent and is able to move into the real world with new skills and understanding. A surrogate is matched with a client according to temperament and cultural commonality, as well as to their skills in relation to the client’s needs. They are not matched according to their looks, though a similarity of height and physical build is useful for compatibility. Indeed, the most common concern for clients, especially if they are overweight, is that they may squash a petite surrogate. Typically clients expect to see photographs of the surrogates when they are accepted into the program and are surprised when this is refused. The strong emphasis in our culture by men on a woman’s physical attributes is often even more pronounced in surrogate therapy clients than it is in the general population – the low priority they put on the emotional aspects of a relationship has usually contributed to the problem they have come to be treated for. A client needs to learn that working together towards a common goal, sharing feelings and developing intimacy are the crucial factors in building a healthy relationship, and that these elements contribute significantly to generating physical attraction and chemistry with another person. Unfortunately there is usually an assumption that a successful relationship is dependent on there being an initial physical ‘wow’ factor, so this is usually a totally new way for clients to approach beginning a relationship and circumvents many of their past traumatic experiences and thus anxieties. Clients ask many questions of the surrogates during the early meetings to establish trust. Most want to know why surrogates do this sort of work and how they got involved in it. They are also curious about whether the surrogate’s job means that they have had lots of sexual partners and whether they have been checked for diseases. They are also interested in finding out how many clients a surrogate sees in a week and how much they are paid, as well as wanting to know how secretive they are about their work eg. whether their friends know they are doing it. They often also ask whether the surrogate has seen other clients with the same problem. The basis of this is that the clients feel vulnerable and want to know are they special and that the help they are getting is just for them. This need for a client to feel as though their emotions will be reciprocated is common to all forms of therapy. The surrogate’s practical answer is that “when we are together you are the only one, the special one for me now, and I am not thinking about anyone else.”
Surrogate feedback to the clients Some clients are under the misapprehension that sex surrogate therapy is a mechanical process of rigid training in difficult physical exercises – a sex boot camp. Indeed, many clients are very disappointed to learn that the exercises practised with a surrogate are likely to be less sexually adventurous than things they may have already experienced. It is, however, likely to be far more intimate and emotional than they have previously experienced. During the first session the clients and surrogates usually hold hands and caress each other fully clothed, something almost all clients feel silly doing because it is so low-key and reminds them of being a teenager. But it is precisely because this type of activity is so low-key and thus not very likely to induce a high level of anxiety that it can foster the basic skills of intimate relating which may never have been learnt as a teenager, and eventually lead to sex that is probably more mind-blowing than they had previously dreamed possible. Indeed, many clients have to have the pace at which they want to work slowed down in order to reduce the pressure they have put on themselves, as their expectations are part of the problem. The skills of relating intimately that the clients are taught include being able to engage and listen, having a connection to their own body, being able to give and receive meaningful and pleasurable touch, and being able to give and receive feedback in a whole host of verbal and non-verbal ways. It is emphasised to the clients that this initial low-key activity has very important therapeutic effects, and they learn to trust this approach. A young man who had had sex mostly with prostitutes began therapy by holding hands with the surrogate and it was a revelation to him that he was able to feel more intimate with her than he had ever felt in his life with anybody else. At first he couldn’t cope with any more intimacy than this but he slowly worked towards engaging in activity that was more sexual. When he finally was able to have an emotionally intimate experience during intercourse he said: “so that’s what all the fuss is about!” The sessions are individually tailored to the clients needs, past experiences and motivation level so that each case is unique, something that makes the work interesting and creative for the therapist and surrogate. The surrogate listens carefully to the client’s fears to assess whether they are projections of past experiences. For example, one man joked that he wasn’t very good at marriage but was good at putting his three ex-wives in very expensive houses. This client would discuss his business and his money, describing how easily misled and gullible he had been. He was totally unaware that he was inadvertently providing the surrogate with detailed instructions on how to take advantage of him until he was alerted to this by the therapist. This is a common fear and destructive acting-out strategy of very successful people as so much of their identity is wrapped up in their possessions. This client’s paranoia about being ripped off again even extended to the surrogate; he was convinced that she would propose marriage in order to get her hands on his money. One week she was sick and had to cancel and he flew into a paranoid rage, believing that we were trying to rip him off. By having his anger strongly confronted he was finally able to see that we had no intention of being dishonest and that it was his problem with trust. The client successfully completed the therapy but couldn’t help offering the surrogate a present, something he had already been made aware was against the rules.
Surrogate feedback to the therapist The written observations provided by the surrogates after each session are a very powerful part of the therapy. Early on clients often react with great surprise and strong defensiveness when they learn that the surrogate’s perception of how the session went is radically different from their own. One client attended a session just after a major argument with his ex-wife and denied that it had had any effect on him or on the session, but the surrogate clearly felt his anger and agitation. Often clients may not have had useful or honest feedback from previous partners, especially since women have been conditioned to protect “fragile” male egos and may be fearful of the reaction they will get if they are honest. A man may be able to tell he was not sufficiently arousing his partner, but may not have a clear idea about why. Initial surrogate feedback about a client might be that “he touches like a wet fish - clammy” or “his touch is just rough” or “so soft it scares me” . Indeed, it is not uncommon for a client to think a session went well and for the surrogate to have written that the client was anxious and distant, describing their sweaty palms, rapid speech and distracting behaviours. Where the surrogate’s role is to be gentle and supportive as well as honest, it is the therapist’s role to be more confrontational and strongly challenge the denial clients have about their behaviour, understandably placing more importance on the surrogate’s observations than on the client’s perceptions; the fact that the feedback is in writing adds to its weight and gives it a power that clients have to acknowledge. The therapist also reinforces the fact that the new way of interacting is not easy to learn when there is a long history of anxiety. In dealing with a client’s denial or resistance the therapist explains to them that although it feels like the therapist is replicating the bad treatment they suffered from their parents, the therapist is actually trying to get back to the source of that pain with a different intent, which means there will be a different outcome. The client at some point in their life – often when they were very young – needed to build a whole lot of defences around their pain in order just to survive, but in the present, to hold onto those defences drains a lot more energy from the person than allowing themselves to feel the original pain in order to grow. They are not aware of how uptight they are, how depressed they are, how sad or angry they are until they start to let go of their defences in a safe environment. Having said that, a therapist needs also to be very open to the client and to taking on board feedback that may be valuable. Of course therapists are human so they make mistakes, but it is important to be able to admit them and be creative so that you are open to trying different techniques with your clients. Therapists vary a lot on this but most nowadays use a broad range of techniques and are more flexible. When a client is in a session with a surrogate and all kinds of feelings are emerging they are in the middle of the experience and it is the best time to be direct and even forceful – it generates the biggest improvement. Even in more “normal” sexual relationships where the client is not involved in surrogate therapy they can benefit from forceful feedback. I had a client who was beginning to feel that he was losing his attraction to his 30 year old wife because they had been married for ten years and he felt she was getting a bit overweight.. The next week he brought her in and she was very physically attractive, and not overweight at all. I spent a small amount of time trying to gauge her personality and communication skills and pretty quickly told my client that he had a big problem. Luckily he understood but he needed that really strong feedback in order to understand his projections and underlying insecurities.
The three way relationship Transference involves all the thoughts, feelings and fantasies that the client has towards the therapist and counter-transference involves all the thoughts, feelings and fantasies that the therapist has towards the client. With surrogate therapy, transference and counter-transference are much more complicated because there are now three people involved; you might have double counter-transferences so that in your head there are six people in the room. With me as the male therapist and a female surrogate seeing a heterosexual male client, it is easy for the client to project their parental dynamics onto us and enact those dynamics unconsciously, which means that you are likely to get more information about the person’s family set-up than you would in a one-to-one relationship, where such dynamics are merely described with whatever level of conscious awareness the client has. If the connection is good and the transference works well, a female surrogate will be the significant mother figure for the period of the therapy. It actually creates a strong sense of security for a client to see that the surrogate and the therapist work really well as a team by agreeing on the boundaries, sharing information and backing each other up, while both being trustworthy i.e. obviously wanting what is best for them and treating them with respect and sensitivity. This is especially helpful if there is a lot of inconsistency or game-playing in the client’s background and between the parents and it is therapeutic not necessarily only for the client’s sexual problem. The therapist has to monitor it all quite carefully, constantly thinking about what is occurring, meditating on it and processing it. This is because anything that happens with the client could be related to any number of things, or to a combination. It could simply relate to the client’s parents or it could be about the therapist and my reaction to them. Alternatively it could be about the surrogate’s reaction to the client, or the surrogate’s reaction to the problem or to the client. And that is why it is so important to a strong structure to the therapy, and to have excellent, intuitive surrogates who are trained well and with whom the therapist has a good relationship. Sometimes, for example where a relationship problem is the issue, I have worked with another therapist and a couple. Occasionally there can be two therapists working with one client, especially where disability is involved, but this is rare, partly because of practicalities such as cost. If, for example your client is deaf and they have a therapist who can sign, they may need to be involved and can help the client deal with other issues so that they are ready for the sexuality component. You need to be quite flexible and always do what is best for the client. The issue for the therapist in the standard three-way surrogate therapy is that they are likely to feel like the odd one out – perhaps a little excluded – because in a sense it is the surrogate whose work is the most important; they are the ones who are doing the most intense work, especially after the client’s initial defences and resistances have been broken down by the therapist. In the usual situation where a therapist works one-to-one with a client the interaction is much more intense for the therapist in an ongoing capacity.
Profile of a surrogate A warm and softly-spoken middle-aged woman, Shauna has a background in advertising but has been working for the last 10 years as an erotic massage therapist in Melbourne’s northern suburbs. Her seventy-six year-old mother is well aware of what her work entails and is very supportive. Shauna has an almost exclusively male clientele and sees many men who have low self esteem and are very disconnected from their bodies but are longing to experience sex in a more intimate way. She has had a lot of success with clients who have erectile problems. Most of her clients are in their 30s, 40s and 50s. “I found a lot of men were coming to me because they were sexually wounded or feeling shamed or rejected around their sexuality, and so I gradually realised over the years that what I was doing was really a sexual healing on them. And I felt that if I could heal the men then they would be able to in turn heal women as well. ” The number of clients Shauna sees in a week varies – the maximum is 10 or 15. It is work which requires a lot of energy and focus so she has developed a system where she doesn’t book appointments till the day, something she has found also reduces cancellations. Shauna advertises in the local paper and says it is not uncommon for a potential client to make an enquiry about her service after flipping through looking for a plasterer and finding her ad just jumped out at them. Her ad is unusual given the section in which it can be found as it stipulates “no sex” i.e. no penetration, and any men who ring up and try to negotiate on this point are speedily screened out as potential clients. As an added security measure she insists on obtaining a landline phone number from a potential new client rather than just a mobile number, and calls them back to verify their details. Shauna also talks for quite a while on the phone to new clients before giving them on appointment and relies on her very acute inutition when deciding whether they are suitable – she has never had any trouble whatsoever. A few months ago she realised she could better target her service by approaching sex therapists. She has had several sex surrogacy clients and is now a member of the sex therapy association, so other sex therapists have sent her clients as well. She does not see intercourse as being a compulsory part of surrogacy but has on occasion had sex with clients: “ I think it’s about being tactile with men and using sex play depending on what they need and how they need it. The client Brian sent me was a 42-year-old virgin who was drop-dead gorgeous – just delightful! He had a stunning body and was well-educated, but was just petrified of women. As a teenager he would get drunk a lot as an avoidance and he got good at palming off any woman who approached him. He didn’t know what a woman would expect from sex and was fearful of not being able to get an erection. We ended up having sex during the second session because we felt so comfortable with each other, and I felt very honoured that I was the person who could do that for him. It was very rewarding.” Sex surrogate therapy involves the use of tantric techniques, something Shauna specialises in. A few months ago she did a workshop followed by a one-to-one session with a tantric expert visiting from the US, Nityama. He uses a couple of different modalities, including activating pressure points to open people up and evoked an energy in her that has completely changed the way she works on clients. Now she is able to take them on a journey inside their own bodies, something designed to remove blockages and which often includes full body orgasms. “Before when I was the sexy erotic healer they were focussing on me, which meant they had to go into their mind and their fantasy world, but to go on this very cathartic tantric journey they have to be totally present in their own bodies. Sometimes it takes a few sessions.” “One client hasn’t been able to talk to his wife about what he’s been doing so she has no idea. They’ve been married for 32 years and they still sleep in the same bed but they haven’t had any intimacy or sex for ten years. And because he has completely opended up and changed and cleared out so many of his blockages through the tantra, their relationship has shifted. About two weeks ago she initiated sex with him for the first time in ten years. One of the worst cases was one guy who still sleeps in the same bed as his wife but hadn’t had any sex or intimacy with her for 30 years – mind you he was 80! But we are sexual beings until the day we die. It would be great to have much better holistic sex education for children reaching puberty so they don’t grow up with shame and fear around thier sexuality. There are so many little boys who are caught playing with their penises and are told that they are being disgusting and it goes straight into their subconscious.” If you touch anyone’s genitals for money it is an act of prostitution, so Shauna has always had the threat of police interference hanging over her head. She had a visit from them once and they said they had had an anonymous tip that she was running an illegal massage parlour, because technically she is not allowed to work from home. “The police had a look at my massage room and it’s so holistic and nurturing and clean that they just told me to keep a low profile.” |

