Masters and Johnson soon realized that many solutions to sexual dysfunction problems needed intense coaching, as in being there and providing a helping hand so to speak. For example, one technique created by Masters and Johnson was called sensate focus. This is where the couple is asked to focus on sensations and the exploration of these sensations without any particular goal in mind other then having the couple be sensually together in the moment with each other. To accurately demonstrate this technique would require so-called hands on participation and the laws governing such things for therapists forbid this.

How about providing someone who could demonstrate these techniques competently who would not be governed by the laws that restricts therapists to engage in actual sexual coaching of their patients? This led Masters and Johnson to employ sexual surrogates. In this way the therapy will involve the client, the therapist and a surrogate partner. A three-person therapeutic team. A whole new way of looking at the traditional threesome?

The surrogate is trained in knowing about anatomy and physiology, the sexual response cycle, sexual dysfunctions, sensate focus philosophies, communication skills and more science based sexology data. A difficult important part of the surrogate's task is to aid the patient in effectively communicating needs, likes, dislikes. This requires emotional honesty. The patient - surrogate interactions represent a model relationship wherein the sharing of physical experiences will facilitate development of a more secure self-concept.
The International Professional Surrogates Association, www.surrogatetherapy.org provides this type of training. According to the American Association of Sexuality Educators, Counselors and Therapists (AASECT) there are currently about 2000 sexual surrogate practitioners actively working.

How does it work? The client is introduced to the surrogate by the therapist and commences to develop a healthy relationship that will serve as a model for the patient. In the initial stages the surrogate usually teaches the patient to touch and how to receive touch. The surrogate helps the patient to become more comfortable in accepting his or her own body. Most importantly the patient is taught how to accept sexual activity as a natural process.

This therapeutic process is a step model process. No step can be skipped or not completed. This is based upon the stage theorist data. Many people will know about the stages of life that one must pass through sequentially such as crawling comes before standing up and walking. The treatment will aid the patient to become more relaxed and more open to physical intimacy. Genital to genital contact may or may not be the goal. When it is the goal it is usually a minor part of the therapy.

Satisfactory sexual activity requires the involvement of the whole body. This is the reason why the surrogate begins most trainings with simply touching.

When the patient returns to the counseling session with the therapist the surrogate experience is analyzed. Feelings about the process are explored. The comfort level of the pace of this process will be assessed. The data gathered by therapist from the patient serve to make adjustments to the treatment, if required, which is relayed to the surrogate.

From the client's point of view this the surrogate - client attachment serves to grow trust and care for the surrogate partners. This leads to learning how to share their intimate thoughts and feelings in a safe way. This relationship, although clearly structured and confined, does provide a genuine relationship, which permits them to experience their sexual persona and intimacy in worthwhile new ways. The patients will be able to see that these new ways of being sexual and intimate and trusting with the surrogate can be transferred to their current or future relationships. The ultimate goal of this type of sex therapy treatment is for the patients to reach a point where they feel ready to enter into new relationships with either their current or prospective partners of their own choosing.

So just who are these sex surrogates and what is required of them? First of all it stands to reason that sexual surrogates male or female need to be comfortable with their own sexuality and nudity. They will have done their own personal therapy and are ready to handle a close physical, intimate relationship professionally.

Emotional boundaries must be adhered to since becoming emotionally and romantically involved is not part of the mission. Sex surrogates must also be able to withstand the social judgments about the work they do that are sure to come their way. Legal sex anyone?

Some questions are sure to come up about this new twist to the oldest profession. Things such as: what if the actual partner will simply never be as good the surrogate? What if the surrogate gets as much pleasure from the "trainings"? In this case who should be paying the fees? Will surrogates who are not called back be eligible for unemployment insurance coverage? How would you the reader, if you were interested, put on your resume which would ensure that you would be hired as a surrogate? What would your mother say if she found out that you were a sex worker? I would love to read about your feelings and comments about this subject matter.

 

Dr. René Hollander is a California State Licensed Clinical Psychologist specializing in psychotherapy for individuals, couples, families and groups. He lives and works in the Los Angeles area.