Is Sexual Intercourse a Valid Therapeutic Method?

[phoenix:\\]

A new movie based on the life of sex surrogate Cheryl Cohen Greene premiered at the Sundance Film Festival this week and received rave reviews.

Greene has intercourse with clients for therapy. She explained to Dr. Drew Thursday night exactly what her profession entails.

“My job is to help people who are confused and have a lot of misinformation about sexuality,” she said. “We don't live in a very sex-positive culture. help them understand themselves -- not try to have them fit into what they see in the media … help them to understand how to relax -- how to know more about their own bodies -- how to share that with a partner.”

Dr. Drew then asked Greene about her work with people who have severe disabilities or medical problems that may have no other way to engage in sex.

"Those people have just as much of a sex drive and interest in finding out what they can or cannot do," she responded.

Dr. Drew added, “So [it’s] not about changing a culture or changing people's thinking about sexuality.”

"That's true," Green replied.

Later, a clinical psychologist got into a heated debate with Greene, strongly questioning her work.

http://www.hlntv.com/video/2012/01/27/woman-has-sex-clients-therapy?hpt=hp_bn13

I found it interesting to say the least, but I would like to know what other people think about her way of helping people understand their bodies?

 

[DaveC426913]

We don't assume people know how to drive a car without having any tutelage at it, yet for some reason we just assume everyone knows how to have intimate relations. Kind of a silly double standard really.

 

[rootX]

Unfortunately, prostitution or similar sex practices are given a very bad name because of our Neanderthal traditions. So, I do see many legal/moral/political issues if sex were to be recognized as a therapy.

 

[lisab]

I think "Sexual Guidance Counselor" is a more descriptive title than "Sex Therapist".

And no, I don't think it's a bad idea. I can see a place for it. I've known people who grew up in incredibly repressive households, who would benefit from such "counselling".

 

[Topher925]

So would she still be called a 'shrink' or...

 

[Char. Limit]

Seems like a good idea to me. I really don't see how people should just be expected to know all that stuff. Perhaps it'd be a lot more pleasurable for both sides if even just one of them was properly instructed.

 

[Ivan Seeking]

So would she still be called a 'shrink' or...

Haha, good one!

CNN interviewed her and showed a bit from the movie.

I think all so-called victimless crimes should be legal, so this one is easy, especially given that she's actually helping people. The older I get, the more I see laws in this regard as archaic and absurd.

 

[chiro]

If the clients get something out of it, then why not.

I really don't know why sex is such a taboo topic. The romans have been having orgies for god knows how long, and at least the indians have been interested in positions god knows how long too.

I understand the issues about telling kids about contraception and potential diseases and other problems, but other than that the whole taboo that comes with sex IMO is completely unnecessary and might even be damaging.

It's a natural thing (both males and females have the gear given to them naturally) and unfortunately many people treat it as something that is unnatural and controversial.

 

[Ivan Seeking]

I would bet that at the core, all laws in this regard are a residue of religion.

 

[Pythagorean]

Now what would people think if the shrink was a man?

 

[Char. Limit]

Now what would people think if the shrink was a man?

I don't know how other people would think, but I wouldn't see a problem with that any more than if the shrink was a woman. I mean, if we're going to have this kind of instruction for men, why not for women?

 

[Pythagorean]

Me either, but I predict it would be less socially acceptable in the population.

 

[Ken Natton]

Sometimes, there is a significant gap between an idea, when it is no more than that, and the human reality of its application. The dubiousness of a male sex counsellor proposing engagement in actual sexual contact with a woman who is experiencing difficulties with her own abilities to express her sexuality in a way that is genuinely fulfilling for her, and in no way damaging for her, is inescapable. And I don’t accept that there is anything remotely repressed in recognising that. It seems to me that there is abundant evidence that very few people, these days, believe that there is anything inherently ‘wrong’ in their natural, sexual feelings. What is ‘right’ or ‘wrong’ is how we treat each other, and the bald reality is that sex remains, as it has always been, a tool of exploitation and of the exercise of power and control.

Exactly how that works in the reverse case, when the counsellor is female and the patient – would that be the right term? – is male, is different. What this woman’s motivations are I have no idea. I have not seen the film or read much about it to begin to form much opinion about it. Perhaps it might persuade me otherwise, but I doubt it. I cannot perceive of what a patient would gain from actual sexual contact with the counsellor that could not be gained with the maintenance of a professional distance between counsellor and counselled. These days, there is enough material, literature, film, discussion in the media, discussion in society at large, that it seems unlikely to me that many need much guidance in the physical act. If people want of education in this area, it seems to me that it is much more in the matter of how to live with a partner, long term, in a way that fosters the genuine intimacy required for fulfilling sexual expression. And I see no need for actual sexual contact between counsellor and counselled for that to be successfully taught.

 

[chiro]

If both parties consent and are old enough and able enough (this is a subject of debate in itself) to understand what it means to give their consent, then why not.

Legally kids can't purchase alcohol, cigarettes, or go to brothels unless they become legally able to by age.

I can't see why this can't be used in this situation.

 

[MarcoD]

Normally, patient/counselor relations are forbidden because in a lot of cases you can assume the patient not to have an 'adult' mind, so the 'two consenting adults' argument doesn't stick.

I don't have the feeling there's a lot wrong in this situation, though.

 

[ICreateSafety]

Now what would people think if the shrink was a man?

The articles about the movie and about Cheryl don't point out that Cheryl is not a "shrink" or a therapist, but that she WORKS WITH a therapist. All legitimate surrogate partners with in conjunction with a therapist who oversees the therapy and helps to design the treatment plan.

 

[Pythagorean]

ah, thanks for pointing that out ICreateSafety.

 

[ICreateSafety]

The dubiousness of a male sex counselor proposing engagement in actual sexual contact with a woman who is experiencing difficulties with her own abilities to express her sexuality in a way that is genuinely fulfilling for her, and in no way damaging for her, is inescapable... Exactly how that works in the reverse case, when the counselor is female and the [client] is male, is different.

A surrogate partner (not sex counselor!) is willing to create a real-life situation for experiential learning by partnering with a client within the therapist-surrogate-client framework (see the website of the International Professional Surrogates Association www.surrogatetherapy.org) for more information.

So if the surrogate partner is male, it's "dubious", but if the surrogate partner is female, it's "different." This illustrates a double standard. We seem to have the cultural stereotype that in matters of intimacy and sexuality that men are the takers and women are the givers. This idea is disempowering to both genders. It can pressure women to give when they don't want to and it can prevent male sexuality from being recognized as the gift that it can be and often is.

As a professional male surrogate partner, I have experienced times when people question my motivations. They question whether a man can work with intimacy as an offering, with the genuine intention to help and support people be more accepting of themselves, their bodies, and their sexuality. Yet all surrogates know that this is not a job anyone would do to "have a good time."

 

[ThomasT]

I found it interesting to say the least, but I would like to know what other people think about her way of helping people understand their bodies?

I don't think it's so much that she's helping people to understand their bodies, but rather helping people to accept who they are and being comfortable with it. Learning to relax and not be anxious about intimacy. She seems like a thoughtful person doing a worthwhile service for certain people. The therapist who was arguing with her was hot but seemed to have a bit of a bug up her posterior region, and perhaps a candidate for the very sort of therapy that she's criticizing.

 

[lisab]

A surrogate partner (not sex counselor!) is willing to create a real-life situation for experiential learning by partnering with a client within the therapist-surrogate-client framework (see the website of the International Professional Surrogates Association www.surrogatetherapy.org) for more information.

So if the surrogate partner is male, it's "dubious", but if the surrogate partner is female, it's "different." This illustrates a double standard. We seem to have the cultural stereotype that in matters of intimacy and sexuality that men are the takers and women are the givers. This idea is disempowering to both genders. It can pressure women to give when they don't want to and it can prevent male sexuality from being recognized as the gift that it can be and often is.

As a professional male surrogate partner, I have experienced times when people question my motivations. They question whether a man can work with intimacy as an offering, with the genuine intention to help and support people be more accepting of themselves, their bodies, and their sexuality. Yet all surrogates know that this is not a job anyone would do to "have a good time."

How do you deal with emotional entanglement - either your client towards you, or you towards your client?

 

[ICreateSafety]

How do you deal with emotional entanglement - either your client towards you, or you towards your client?

Great question! Thanks for asking. I hear similar questions a lot, so it's great to be able to respond in public. There are several aspects to my response.

1. I rely on the expertise of the referring therapist for their professional evaluation of whether this particular client and their goals would be appropriate for surrogate partner therapy. Clients with attachment disorders, for example, would probably not be good candidates.

2. Inherent in the work is the agreement and understanding that the surrogate and client are forming a temporary relationship for the purpose of reaching specific therapeutic goals. It is understood from the beginning that our interaction is time-limited and will be discontinued when those objectives are met.

3. Even so, it is a real relationship and genuine feelings do arise. This is not only OK, but it can be an important part of the therapy. Typically, clients who most benefit from surrogate partner therapy do not have their own partners and face some sort of emotional challenge which prevents them from having the intimacy they wish to have in their lives. So, if they feel safe enough to open their hearts and experience genuine feelings, then this is a step in the right direction.

4. During the therapy, the client overcomes hurdles, builds skills and confidence, and often develops a better sense of themselves and their inherent worth than they have ever had before. It's natural for them to attribute these good feelings to the surrogate. It's the responsibility of both the surrogate and the therapist to help them take ownership of these feelings and to realize that I am just the catalyst. With this new inner sense of themselves, they will be able to re-create these feelings in relationships of their own choosing. Overall, I view all feelings that arise as part of the therapy as an opportunity for communication and education.

5. We all have relationships that end. In fact, all of our relationships will end in one way or another. Sometimes the fear of what might happen at the end of a relationship can even keep us from entering into that relationship in the first place. In surrogate partner therapy, we have an opportunity to experience all phases of a relationship, including the ending, in a conscious way. Even if there is sadness, it leaves the client with the knowledge and EXPERIENCE that relationships can be ended with respect and gratitude.

As far as my own “entanglement,” the first and foremost intention in my work is that I not use the surrogate/client relationship to satisfy my own needs. I am personally involved in a very fulfilling and committed long-term relationship and also have a very supportive and loving community. I am trained, skilled, and have a lot of self-awareness around intimacy, boundaries, and communication. Although the possibility is unlikely, if I did ever feel like I was falling in love with a client, or for any reason suspected that my own feelings were interfering with my objectivity or my ability to keep the welfare of the client as my primary objective, I would discuss the situation with the therapist on the case, with other surrogates, and possibly, with the approval of the therapist, with the client. If unable to continue to adhere to the IPSA Code of Ethics, I would have to remove myself from the case.

Disclaimer: The opinions expressed above are those of its author and not necessarily those of IPSA.

 

[Ken Natton]

So if the surrogate partner is male, it's "dubious", but if the surrogate partner is female, it's "different." This illustrates a double standard. We seem to have the cultural stereotype that in matters of intimacy and sexuality that men are the takers and women are the givers. This idea is disempowering to both genders. It can pressure women to give when they don't want to and it can prevent male sexuality from being recognized as the gift that it can be and often is

Your comments, I Create Safety are certainly very interesting. I have a couple of responses to them.

When I replied above in post #13, I thought I was discussing an abstract idea, not withstanding the film referred to about a particular individual providing this service. I did not realize we were discussing something that is actually practiced, and I am astonished to learn that it is. Firstly, however, I must point out that the situation you refer to has a subtle, but important difference from the idea I believed was being discussed. As you have pointed out, you are not the counsellor, therapist, whatever term you prefer. So the professional distance between counsellor and counselled is not compromised. That is not to say that the difference entirely removes my concerns, but it does change the emphasis significantly.

Secondly, I reject absolutely that there is any double standard in recognising the reality of the difference between a male patient, client, whatever and a female one. In this day and age, plenty of women have no difficulty whatever expressing their sexuality. A good number are perfectly comfortable living lives free from the complications and general baggage of emotional and sexual relationships. But such women would not be seeking the kind of therapy we are discussing here. A woman who is seeking this kind of help is, fairly inevitably, going to have some degree of vulnerability. That is not to say that an equivalent male client wouldn’t have vulnerabilities, but there is no double standard in recognising that they would be very different. I have strong doubts that such a woman is likely to be helped by engagement in an emotionally stilted, short term relationship. Such an idea does not accord with my experience and understanding of the women I know. I acknowledge that I am neither trained therapist nor trained surrogate.

If you tell me that there are women that you have helped that have subsequently found themselves better able to form lasting and fulfilling relationships, then I cannot deny the genuine value in the service that you provide. But perhaps the best way I can put it is to say that I would be interested in the results of a study of a broader demographic of women who have used such a service.

 

[ICreateSafety]

I would be interested in the results of a study of a broader demographic of women who have used such a service.

Due to the fact that the treatment plan is often customized for each specific client, and that there are not many surrogate partners (IPSA estimates around 20-30 practicing in the US, many of whom work with male clients), there have been very few studies of women who have gone through a course of surrogate partner therapy. There is only one that I know of: a study done in Israel in 2007 regarding the use of SPT for women who suffer from vaginismus. There is a lot of acceptance in Israel and SPT is much more common there than here. You can see the abstract of this study here: http://www.ncbi.nlm.nih.gov/pubmed/17433089. This study concluded: "Treating vaginismus with a male surrogate partner was at least as effective as couples therapy. Surrogate therapy may be considered for vaginismus patients who have no cooperative partner."

I have personally never participated in any studies. I have only anecdotal evidence that women benefit from it. An example is given on the home page of my website under the heading "Carol's Story." www.surrogatepartner.us