Transcript Sexuality/Sex & Palliative Care

Sexual Surrogacy (SS) and
Body Work (BW)
Dr Margaret Redelman
Sydney Men’s Health
Bondi Junction
5th Sexual Dysfunction Conference
Queenstown, 4.2012
Sexual Surrogacy and Body Work
Contentious topic
Regularly comes up in media
Relevant to our work
Opportunity for collegiate discussion and
? “expert opinion” consensus position
Sexual Surrogacy and Body Work
Session rules
1 No personal attacks
2 Differentiate personal religious / ethical
position from the therapeutic utility
3 Separate therapeutic utility from governance/
lawfullness positions
Sexual Surrogacy and Body Work
 Unregulated
 Self proclaimed gurus
 Self interested individuals
 Various backgrounds
 Various motivations
 Varying levels sexual and psychological education
 Varying levels of supervision
Definitions
 Sexual surrogacy
IPSA “ A surrogate is a member of a 3-way therapeutic
team(therapist, client, surrogate) who acts as a partner
for a dysfunctional patient in experiential exercises
involving sensual and sexual touching as well as social
and sexual skills training”
 Body work
“somatic sex educators, assisting individuals, couples
and groups deepen their experience of embodiment”
IPSA = International Professional Surrogates
Association
www.sexologicalbodyworkaustralia.com
Australian groups
 SSEAA (Somatic Sex Educators Association of
Australia)
http://somaticsexeducators.org
 ACSB (The Association of Certified Sexological
Bodyworkers)
www.sexologicalbodyworkersaustralia.com
Courses $6000
genital touch but ? no intercourse
 Sexual surrogacy is classified under
sex work, under Australian law.
 Sex + money= wrong - bad - evil
Dr Brian Hickman opened clinic in Melbourne 2004
Limited supporters:
? $600/session
power imbalance
patient ‘feelings’ for surrogate
regulation and control
Sexual Surrogacy and Body Work
Masters & Johnson in 60s
Explosion in 70s
AIDS, Viagra, explosion of sexual information,
mainstreaming of sex therapy → ↓ surrogacy
Sexual Surrogacy and Body Work
Surrogates problematic - respectability
Issue of surrogacy “just about split AASECT
board. Could not get a consensus. Worried
about legal implications. AASECT never
adopted a formal policy and debate relegated
to the shadows.”
Dr Howard Ruppel academic dean Institute for Advanced Study of Human Sexuality 2009
AASECT = American Association Sexuality Educators Counsellors and Therapists
Dr Stephen Conley executive director AASECT 2009
Rationale for surrogates
Single individuals who don’t have “study buddies” to
do “homework”
“can only teach how to ride a bike for so long before
giving them a bike”
Reality- we teach children most important things by:
showing
talking
allowing to practice with correction
On the spot ‘teacher’
Sexual Surrogacy and Body Work
 No rigorous studies testing whether using a
surrogate is any better than other forms of
therapy
Efficacy for women
 Ben Zion et al, Surrogate vs Couple Therapy
in Vaginismus was accepted for publication in
JSM 2007.
 100% of the women who were treated with
surrogate succeeded vs 75% of the women
who were treated in couple therapy
Sexual Surrogacy
Sexual surrogacy is not a contract for sex.
It is a contract to work on a problem that
requires emotional and physical intimacy
and practical sexual skills.
Intent behind ss separates it from sex work
Safe environment to practice
Difference between surrogate and prostitute
1. Surrogates are professionals
2. Surrogates receive supervision for every session.
3. Sessions focus on the therapeutic goals set by the
therapist for the client/patient
4. Sessions focus on the SF exercises + a variety of
intimate/social skills
5. The patient never pays the surrogate
6. Most time is spent on non sexual activities
7. It is a process of 12-20 sessions
8. Completed when therapeutic goals have been met
Special circumstances
Disabled – learning difficulties
Disabled – rehabilitation
Experience in shared physical intimacy while
working with client’s sexual self concept and
body responses
Modelling for sexual closeness and social skills
Genital – genital contact may be minor part
In vivo adaptation to patent’s abilities
In vivo encouragement
What is “well trained”?
International Professional Surrogate Association
(www.surrogatetherapy.org)
Mare Simone – calls herself a “sex surrogate”
has had penetrative sex with 1,500 men
10,000 clients
took a 4 day course in sex therapy
sex with husband in front of wife to show
them
www.thesun.co.uk/sol/homepage/woman/2637533/Sexual-healer-hasslept-with-1500-men.html
Interesting ?
 Young couple who wanted to learn more about
themselves and each other
Training surrogates in Israel
1. Ads in newspapers or professional journals.
Each candidate interviewed. Comprehensive
information about proposed role. Biographical
information.
2. Battery of psychological tests.
3. Interview by sex therapist with full sex history.
4. 50 hour training program for surrogates
3 workshops:
a. SAR
b. Touching workshop
c. Nudity workshop
 Lectures on:
 Anatomy, physiology of sexual organs, human sexual
response, sexually transmitted diseases, sexual
dysfunction in men and women, treatment of sexual
dysfunctions, role of the surrogate in sex therapy,
code of ethics for surrogate partners, case studies.
 Rules of conduct agreed on for duration of
surrogate therapy
Dr Ronit Aloni
http://www.dr-aloni.co.il/english

Aloni R. Katz S.;2003; Sexual Difficulties After Traumatic Brain Injury and Ways
to Deal with it, Charles C. Thomas, Pub. Springfield USA, chapter 9, pp,153-190.

(Aloni R., Dangur N., Ulman Y., Lior N., Chieger M.; A model for surrogate
therapy in a rehabilitation center, International Journal of Adolescent Medicine
and Health, vol. 7, no. 2 1994.)

Apfelbaum B; The myth of the surrogate, Journal of Sex Research, vol. 13, no. 4
pp.234-249, Nov. 1977.

Ben Zion I, Rothschild S. Chudakov B. Aloni R. "Surrogate versus Couple
Therapy in Vaginismus" JSM Vol. 4, issue 3, start page 728-33 may 2007
Blackerby, W.F. (1988,1994). Head injury rehabilitation: sexuality after TBI. The
HDI Professional Series on Traumatic Brain Injury.10, Houston, Texas. HDI Pub.

Blackerby, W.F. 1990; A treatment model for sexuality disturbance following
brain injury, Journal of Head Trauma Rehab. 5(2) pp. 73-82.

Brown P.T. Jan. 1986; Comment, Surrogate Therapy, British Journal of Sexual
Medicine, pp. 5.

Cole M, March 1982; The use of surrogate sex partner in the treatment of sex
dysfunction and allied condition, British Journal of Sexual Medicine, pp. 13-20.


Dauw D. Nov.19, 1983 ; Re evaluating the surrogate assisted sex therapy: Myth,
experiences and research findings, Society for the Scientific study of sex, 26th
annual meeting,

Davis D. Schnieder L.K. 1990; Ramifications of traumatic brain injury for
sexuality, Journal of Head Trauma Rehab. 5(2)pp. 31-37

Dunlap D. Roberts M.B. June1984; Surrogate partner therapy, clinical, ethical
and legal concerns: A 1984 update, AASECT/SSSS National conference, Boston
MA

Johnson W. and Kempton W., Sex education and counseling of special groups,
Charles C. Thomas Pub., pp. 224-231, Springfield, 1981.

Joseph Robert; A case Analysis in Human Sexuality: Counseling to a man with
severe cerebral palsy, Sexuality and Disability, vol.9,No.2, Summer 1991

Kilman P.R. Mills K.H. 1983; All about sex therapy, Plenum Press pp.67-69

Herbert d'H. Lee; Surrogate wife; Dell NFpub.

Len M. Fischer J. Feb.1978; Clinicians' Attitudes toward and use of four body
contact or sexual techniques with clients, The Journal of sex research Vol. 14.No.
1 pp. 40-49.

Lief H.T. 1981; Sexual problems in medical practice, American
Sexual Surrogacy and Body Work
Thank you
DISCUSSION
Dr Margaret Redelman