Oct 19

Sexual Surrogacy and Sex Therapy: Follow-Up to “The Sessions”

In the new film The Sessions (see yesterday’s post), the role played by Helen Hunt is based on Cheryl Cohen Greene, who actually provided sexual surrogacy to Mark O’Brien. Her new book, An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner, becomes available next month.

Greene is the current vice president of The International Professional Surrogates Association (IPSA), the principal surrogacy training ground. According to Newsweek, however, relatively few certified surrogates are actually available for the hiring—there are “only 25 IPSA-trained surrogates in the country, almost all of them located in California.”

What is surrogacy and what is it not? In the movie, one of the things Mark is immediately told by Cheryl is that surrogacy is not the same as prostitution; rather, it’s time-limited help for a fee. In an interview about her work, real-life sexual surrogate Linda Poelzl explained how she clarifies her role to clients:

…I have a confidentiality agreement. I spell it all out in a paragraph, differentiating my work from prostitution. It’s not a contract for sex:

‘CONFIDENTIALITY AGREEMENT: I understand that the surrogacy sessions are for the purpose of expanding my ability to feel physical pleasure and emotional fulfillment through greater intimacy and increased sensation and to overcome sexual dysfunction.  I acknowledge this session series is not for the purpose of sexual gratification or entertainment and may or may not include sexual intercourse, manual, or oral stimulation.  I understand and will abide by the above agreements.’

Some other interesting things about sexual surrogacy, as indicated by the above-cited Newsweek article:

  • The practice is not widely endorsed by psychiatric professionals or related professional associations, e.g., the American Psychological Association.
  • “More than half of IPSA’s clients are middle-aged virgins, and 70 percent of them are male.”
  • “Only 10 percent of IPSA’s clients are physically handicapped, and teaching them to embrace their sexuality is paramount to helping them find romantic partners. But even after a reaffirming experience with a surrogate, they may feel disconsolate and alone.”

Sexuality counselor Ian Kerner (The Chart, CNN) offers additional info about surrogacy, including its difference from sex therapy:

  • “…(L)ike a therapist/patient relationship, the question of whether a surrogate partner is sexually attractive to the client is not part of the equation.”
  • Sex therapy is different from surrogacy. Many sex therapists neither conduct “hands-on” sessions nor refer to surrogates. Sex therapy is more likely to be similar to other types of therapy—it’s about talking, not doing; it’s about encouraging the client to use his or her own real-life partner as the “surrogate.”
  • The practice of sexual surrogacy is “highly unregulated,” though IPSA does have a code of ethics. Who, though, watches over those surrogates who don’t affiliate with IPSA?

What’s the future of this profession? Surrogate Poelzl’s response (in her 2010 interview) to being so asked:

We are a dying breed. I think some of that has to do with the fear of liability that psychotherapists have; there are people who think this work is excellent, but fewer therapists want to risk their licenses. Maybe I’ll look into training people. We need young blood!

Apr 26

AJ Jacobs: Is Now the Time To Outsource Your Worries?

A 2005 article in Esquire entitled “My Outsourced Life” by writer/editor AJ Jacobs humorously details an interesting experiment he’d conducted about outsourcing to India his usual day-to-day life tasks, both personal and professional. He winds up with a couple female helpers named Asha and Honey.

Ultimately, after a few weeks, AJ Jacobs realizes that although he’s benefited from this type of remote assistance, he still feels too stressed. So now he turns his attention to his “inner life,” including his therapy.

The following article excerpt describes the ensuing process:

First, I try to delegate my therapy. My plan is to give Asha a list of my neuroses and a childhood anecdote or two, have her talk to my shrink for 50 minutes, then relay the advice. Smart, right? My shrink refused. Ethics or something. Fine. Instead, I have Asha send me a meticulously researched memo on stress relief. It had a nice Indian flavor to it, with a couple of yogic postures and some visualization.

This was okay, but it didn’t seem quite enough. I decided I needed to outsource my worry. For the last few weeks I’ve been tearing my hair out because a business deal is taking far too long to close. I asked Honey if she would be interested in tearing her hair out in my stead. Just for a few minutes a day. She thought it was a wonderful idea. ‘I will worry about this every day,’ she wrote. ‘Do not worry.’

The outsourcing of my neuroses was one of the most successful experiments of the month. Every time I started to ruminate, I’d remind myself that Honey was already on the case, and I’d relax. No joke—this alone was worth it.

No joke at all—I totally believe this could work. If anyone out there has found a “Honey” of your own, I’d love to hear about your experiences.

Oct 21

Therapist Boundaries (Violence): “Good Will Hunting,” “What About Bob?”

Do a Google search about therapist boundaries, specifically therapists and violence, and you’ll find plenty about clients attending therapy for being violent. From Psychotherapynotes.com:

…Psychotherapists can and do intervene to prevent hundreds if not thousands of acts of violence every day. We talk clients down from fits of rage, we help suicidal clients to find hope (or at least to understand what hurting themselves would do to their loved ones), we coordinate care with physicians to make sure those who need to be on medication stay on it, and when we assess imminent danger, we hospitalize or coordinate with law enforcement. The violence we prevent doesn’t make the news, but it saves many, many lives.

But can you find any reliable info about therapists being violent? Against their clients? No? Do we have to (misguidedly) look to the movies for such things?

Will (Matt Damon) in the movie Good Will Hunting (1997) is one character who has to attend therapy after an episode of violence. Finding the right shrink for Will, who trusts no one who tries to help him, turns out to be no easy feat. Well, maybe the less traditional, more directive kind of therapist we eventually find in Sean Maguire (Robin Williams) will fill the bill.

But before Will gets anywhere close to the meaningful catharsis the film wants him to have, he has to put Maguire through the usual hoops, in one instance meanly and provocatively maligning Maguire’s dead wife. What follows is this disturbing scene involving terrible therapist boundaries:

Lesson #1 (You Wouldn’t Pick Up From The Movies): It’s never okay to choke a client. (Or harm a client in any way.) (Unless, of course, in self-defense.) Even if the client then backs off and actually moves on to have one particular wowie-zowie life-changing therapy session.

Next up, there’s actually worse things a shrink can do. In the film What About Bob? (1991), the psychiatrist played by Richard Dreyfuss goes nuts himself dealing with Bob (Bill Murray), his dependent client who follows him, uninvited of course, on vacation.

Lesson #2 (You Might Not Pick Up From the Movies): Even unsuccessful attempts at killing one’s (annoying) clients are not allowed.