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Surrogate partners, formerly referred to assex surrogates, are practitioners trained in addressing issues of intimacy and sexuality. A surrogate partner works in collaboration with atalk therapist to meet the goals of their client. This triadic model, composed of the client, talk therapist, and surrogate partner therapist is used to dually support the client and the surrogate partner therapist. The client engages with the surrogate partner therapist in experiential exercises and builds a relationship with their surrogate partner therapist while processing and integrating their experiences with their talk therapist or clinician.
The modality in which surrogate partners work is calledsurrogate partner therapy. This modality is used to address obstacles to physical and emotional intimacy that a client is unable to resolve through traditional therapy and requires the involvement of a partner. Clients' presenting issues have commonly includedsexual dysfunctions, lack of healthy intimate experiences, or traumatic history.
Masters and Johnson introduced the practice in their bookHuman Sexual Inadequacy, published in 1970. They believed that people could learn about sexual intimacy only by experiencing it. In their research, subjects that were partnered used these partners to aid in a series of exercises designed to help overcome sexual dysfunction. Unpartnered subjects were paired with "surrogates" who would take the place of a partner, work under the direction of a trained therapist, and act as a form of mentor for the client. In their research, all of the surrogates were women who were assigned to work with single men. Today, most surrogates are women, but a few are men.[1] The practice of surrogate partner therapy reached its peak in the early 1980s, with a few hundred surrogate partners practicing in the U.S. Since then, the therapy's popularity has declined but reentered social consciousness after the 2012 filmThe Sessions, which depicts one surrogate partner's work with a disabled man. As of 2014, those practicing surrogate partner therapy were still very few in number.[2]
Patients frequently present with these specific problems:[3][4]
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There are people who have experienced a change in sexual lifestyle due to an acquireddisability (accident, paralysis, disease, trauma), and a surrogate can help them explore and develop sexual potential.[5] The causes of sexual concerns are numerous, and the methods a surrogate might use to help improve a client's sexual life are varied.
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The course of this therapy involves continued communication with both the talk therapist and the surrogate partner. The talk therapist is responsible for addressing the client's concerns and helping them explore ways to overcome their sexual problems throughtalk therapy. If the therapist and client deem it necessary that they need additional assistance, they can explore the option of working with a surrogate partner. Talk therapists are limited only to talk therapy, which is why a surrogate partner can be beneficial in helping address the client's concerns throughexposure therapy, without the same limitations on touch. The talk therapist is responsible for relaying critical information and treatment goals to the surrogate partner for the meeting with the client, so that they may fully address their concerns during the interaction. The therapist, surrogate partner, and client work together[6] to create their course of a treatment plan, the interaction between the client and the surrogate partner is essentially for the client to practice what they've learned with their therapist through talk therapy.
The methodology of this therapy is described to have four phases to achieve a successful treatment:
The first step in Surrogate Partner Therapy is for the surrogate to verbally create an emotional connection and bond with the client, to create a safe environment and address any boundaries and expectations. During this step, the surrogate and client can get to know each other as individuals and create a meaningful relationship. This first step is essential in making the client feel comfortable in pursuing this new type of therapy and laying a good foundation for practicingemotional intimacy.
The next step involves exploring the client's sensuality. This step may involve physical touch and nudity to help the client overcome their sexual concerns, but would not involve sexual arousal or interaction between one another. In this step, the surrogate partner may work on exercises with the client to help them feel more comfortable in their own body and near someone else's body, this may involve hugging, or cuddling.
In the third step, which more often than not, is not completed as it is not necessary to achieve the therapeutic goals, the surrogate partner and client focus on sexuality, this may involve:
The fourth step is universal to all therapy and is closure, to close out the therapy once all parties are satisfied with the results.
Since sexual problems can be psychological rather than physical, communication plays a key role in the therapeutic process between a patient and the surrogate partner therapist, as well as between the surrogate partner therapist and the talk therapist.Surrogate partners offer therapeutic exercises to help the patient. These may include, but are not limited torelaxation techniques,sensate focusing, communication, establishing healthybody image, teachingsocial skills,sex education, as well as sensual and some sexual touching. Surrogate partner therapy begins with a meeting between the client, talk therapist, and surrogate partner therapist in which the goals of the client are discussed and the scope and arch of the therapy are established. Throughout the process, communication between surrogate partner therapist-client, client-talk therapist, and surrogate partner therapist-talk therapist is maintained.[7]
By definition, Surrogate Partner therapy is solely performed with single (unpartnered) persons. The surrogate partner therapist engages in education, often intimate physical contact, and only very rarely sexual activity with clients to achieve a therapeutic goal.[8] Some surrogates work at counseling centers, while others have their own offices.
The 2003Salon.com article "I was a middle-aged virgin", by Michael Castleman, discusses a middle-aged American virgin (Roger Andrews) and his therapy with the surrogate partnerVena Blanchard.[9]
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