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Sex Is the Least of It.

Barbara M.'Roberts, M.S.W. Licensed clinical Social Worker Speech delivered May 21, 1976 at U.C.L.A. Conference on Professional and Legal Issues in 'the Use of Surrogate Partners in Sex Therapy

I am Barbara Roberts, a licensed clinical social worker, now in private practice. My specialization is Partner Relationship Therapy, often but not exclusively focused upon the sexual aspects of relationship. Partner Relationship Therapy includes couples who come in together for therapy or a single client with a partner provided for him to work with–commonly known as a surrogate partner. 

I was trained in 1973 in the first formal program for surrogate training and subsequently have worked as a surrogate under the supervision of five therapists representing a variety of disciplines. I took the training and practiced as a surrogate, out of my firm belief that intellectual understanding, supplemented by direct experience creates the highest potential for both personal growth and effective professional helping. Currently, as a therapist, I supervise from five to ten surrogate partners and conduct my own surrogate training. 

In order to understand the significance of surrogate sex therapy (who the surrogate is, motivation and training, the surrogate’s role with the therapist, the relationship with the client, the use of sensate focus exercises, and the effectiveness of this type of therapy) it is first necessary to look at some very tenacious assumptions, in my belief erroneous ones. I have listed sixteen of the most common assumptions made by professionals. I will have time to mention only several of the most pervasive ones. 

Erroneous Assumption #4: With a provided partner there is no possibility 

for commitment or a relationship which has any real meaning for the client. The association with the surrogate is not one of personal choice. 

Erroneous Assumption #5: The temporary nature of the surrogate/client relationship precludes real intimacy, because intimacy implies longevity. 

Erroneous Assumption #6: The fact that the surrogate works with several or 

many partners implies shallowness and promiscuity. 

Erroneous Assumption #7: Paying for an emotionally or sexually intimate relationship makes authentic interaction in possible. Payment makes the relationship impersonal and probably exploitive. 

Let’s stop here for a moment. I have used some very loaded words: commitment, meaningful relationship, personal choice, intimacy, promiscuity, authentic interaction, exploitive. What do these words mean to you? What images do they conjure up? What are their implications for human communion? Communication about sexuality is less confused by our discomfort in using words like cunt and cock than by the implications we infer from words like commitment and intimacy. 

Now, back to erroneous assumptions. The conclusion is drawn that because the surrogate/client relationship is arranged, temporary and purchased there is no possibility for commitment, real meaning, authentic personal interaction, and emotional intimacy. 

A second step in this circuitous reasoning is that since there is no personal choice of partner, and no commitment to the relationship, that we are treating sexuality as a physiological phenomenon only. The claim is that instead of helping clients to learn to use their sexuality as an emotional expression of closeness, we are perpetuating the view that sex is merely a perfunctory physical exercise, albeit fun. The further conclusion is then drawn that surrogate therapy cannot possibly help a client to learn to relate in more complete, meaningful, and satisfying ways in his own social milieu; and that surrogate therapy can only be shallow and mechanical. Unfortunately, therapists and surrogates who believe in these assumptions and the conclusions which follow do teach little more than techniques. This need not be so. 

Other assumptions are held which contradict the view that surrogate therapy is only mechanical. 

Erroneous Assumption #9: Nudity and sensual arousal are always sexually provocative. 

Erroneous Assumption #10: Once erotically stimulated we are helpless to 

control the urge toward sexual release through orgasm. 

If we believe that sensual and erotic stimulation automatically lead to overt sexual activity and the urgent need to release sexual tension in orgasm, then the obvious conclusion is that the surrogate can’t help but bę meeting personal sexual needs at the expense of the client and/or merely acquiescing to the sexual demands of the client. 

This first conclusion leads to two additional ones: that the client will become overly dependent upon the intimacy developed with the surrogate (perhaps an intimacy experienced for the first time in his life) and therefore will have a strong temptation to personalize the relationship and carry it beyond the therapy. This is usually stated in the question: “Won’t the client fall in love with the surrogate?” The second conclusion drawn from the belief that sex is a compelling urge over which we have no control, is that in order to avoid overt sexual expression and dependency, the surrogate must create distance by drawing the line at kissing, oral sex, intercourse, or other demonstrations of physical and emotional intimacy. 

Now we are back again, full circle, to the view that surrogate therapy can be nothing more than the teaching of techniques. Round and round we go! It’s wrong to be overtly sexual in a therapeutic situation and its wrong to be mechanical. We are damned if we do and damned if we don’t. 

Let’s look at these assumptions from a different perspective. My own experience as a surrogate and as a therapist supervising surrogates leads me to the following conclusions. First, despite the assignment of a partner, the time limitation of the relationship, and payment for therapy which includes sexual expression, there is choice and it is a personal choice. The client chooses, for his own reasons, and hopefully for his own benefit, a therapeutic relationship with a partner he has never met before and may never see again after the therapy. There is commitment. Commitment to his own growth and learning, to risking himself in an intimate relationship. The commitment for the surrogate is similar: to share authentically with another human being in a helping process. There is meaning: meaning of the here and now interchange between two people, whatever the quality of that interchange may be. There is the possibility for an authentic experience in relationship, an opportunity for experimentation within a structure which is supportive, permits vulnerability, risk-taking, and the building of trust. The relationship is no less valid or meaningful for its brevity. It is possible for the therapist and the surrogate, with the therapist’s help, to deal with the impermanent nature of the relationship and the necessity for separation. These are aspects of life which for many people are difficult. What better way to learn to deal with them than in an intimate therapeutic process? 

Secondly, we need not be swept uncontrollably into sexual expression at the first touch. People do have options as to how they act upon their feelings. This is as true of sensual and sexual feelings as it is of any other feelings. 

It is not a question of the surrogate’s need to distance by setting limitations on the degree of intimacy. It is a question of the surrogate’s ability to sustain and contain pleasure without the necessity to escalate that pleasure nor dissipate it through orgasmic release. One of the most crucial aspects of sex therapy is helping a client overcome the fears which make him believe he has no alternative other than “turning-on” or “shutting off.” What better way to teach this than by surrogate modeling? It is possible; it can be taught; it can be learned. If the client is to have a real experience, the surrogate needs to express her real feelings, sexual and otherwise. These can be appropriate to the therapeutic needs of the client, just as in any other type of therapy. We probably all know this, but tend to forget it when it comes to sex. 

Take a close look at the premises behind these remarks I have just made. If you do, then the perception of what surrogate therapy is, and can be, will be quite different from the conclusions drawn from the original assumptions discussed. What premises you decide to adopt are your choice. I am only urging that you examine the assumptions, follow them logically to their conclusions and make your decisions based upon a value system of which you are as consciously aware as possible. This is not an easy task because when it comes to sex we don’t readily examine our attitudes. We, as much as anyone, are caught in the confused values of our culture. We react to sexual matters from a gut level, feeling ambivalence between titillating curiosity and guilt for taking pleasure in our bodies. 

But what of the surrogates? Those who have been trained during the past three years came to this work out of their own rich life experiences and personal growth. In the main, they are unusually mature, and seem to display a high degree of self-actualization, particularly in their attitudes and behavior regarding interpersonal relationships and sexuality. 

Training is important. We need better training than we have had up to now. But the initial screening of people who want to do surrogate sex therapy is of first importance. As a pre-requisite to surrogate training, I require participation in a twelve week group program titled “The Sexual Enrichment Experience.” This program is designed for lay people, professionals, and prospective surrogates. Through the experiential process, in interaction with other members of the group, I can assess whether the prospective surrogate has the qualifications necessary to continue in training. I am currently designing a study to determine what qualities a person needs to become an effective partner in surrogate therapy, and what the substance of the training program should include. I welcome your input. 

Many people have a very narrow view of sex therapy, believing that it is properly limited to treating only one aspect in the totality of human functioning. James Prescott of the National Institutes of Health has done a very exciting study linking somatosensory deprivation with feelings of alienation, and with violent behavior. He claims that “the negative effects of early deprivation can be compensated for by the enriched stimulation associated with sexual behavior.”* It is obvious that sex is often used as a substitute for meeting the basic hunger for a caring, warm, human touch. In my therapy many clients begin to accept their sexuality and begin to relate meaningfully only after some of their needs for nurturing have been met through non-sexually oriented touch. Then, as Prescott indicates, sexual activity in a caring relationship can continue to enrich the nurturing process. In this light, if we look at the implications of working in this most sensitive and conflicted area of human relationship, sexual therapy can have a very profound and far-reaching impact upon our society. Sexuality may be at the heart of it, but sex is the least of it. 

Barbara M. Roberts, MSW Licensed Clinical Social Worker Direcor, Center for Social and Sensory Learning 908 South Muirfield Road Los Angeles, California 90019 (213) 933-5939 Member: American Association of Sex Educators and Counselors Association of Certified Social Workers International Professional Surrogates’ Association Sex Information and Eaucation Council of the United States Society for the Scientific Study of Sex. 

Book in Progress: Strangers in Intimacy: Surrogate Sex Therapy 

*Paynton, Barbara, “Work in Progress–James Prescott: Touching,” Intellectual Digest, March, 1974 (Vol.36, No. 425), p. 8. 

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