Tag Archives: code of ethics

Oct 19

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

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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!

Oct 21

Therapist Boundaries (Violence): Two Movies

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

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?

I. Good Will Hunting

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.

JC Schildbach, LMHC, RespecttheBlankie.com: “Despite what the filmmakers would have us believe, this is not a valid technique for establishing rapport or ensuring appropriate transference with clients who have suffered abuse–even when therapist and client are both from south Boston and the client just shit-talked the therapist’s dead wife.”

II. What About Bob?

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.

Well, at least Leo Marvin’s “death therapy” doesn’t work, and while there’s an unhappy ending in store for him—catatonia and psychiatric hospitalization—there’s a happy ending for Bob, who marries Lily,  becoming Leo’s brother-in-law. And there’s more: We find out in the Epilogue that Bob goes on to get his psychology degree and to write the bestselling Death Therapy.