Surrogate Partner Therapy is a form of therapy based on the successful methods of Masters and Johnson. In this therapy, a client, a therapist, and a surrogate partner form a three-person therapeutic team who together work to understand and resolve difficulties that a client is experiencing in their lives. The surrogate participates with the client in structured and unstructured experiences that are designed to build client self-awareness and skills in the areas of physical and emotional intimacy. These therapeutic experiences include partner work in relaxation, effective communication, sensual and sexual touching, and social skills training. Each program is designed to increase the client’s knowledge, skills, and comfort. As the days pass, clients find themselves becoming more relaxed, more open to feelings, and more comfortable with physical and emotional intimacy. The involvement of the team therapist, a licensed and/or certified professional with an advanced degree, is a cornerstone of this therapy process. Clients often experience apprehension as they begin therapy and when they begin to experience changes. The team therapist assists the client with these and other emotional issues. Sessions with the therapist are interwoven with the surrogate partner sessions in order to facilitate understanding and change. Open, honest, consistent communication between all team members is a fundamental ingredient of successful surrogate partner therapy.

Who Needs Surrogate Partner Therapy?

The problems that motivate clients to seek Surrogate Partner Therapy range from general anxiety in social situations to specific sexual dysfunctions. Concerns for any gender might result from one of the following:

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• Negative body image or physical disfigurement

• Medical conditions

• Sexual, physical, or emotional abuse and/or trauma (rape or incest, for instance)

• Intimacy issues

• Phobias and anxieties

• Unresolved relationship trauma

• Confusion about sexual orientation

• Lack of social or sexual self-confidence.

 

Sexual concerns may include:

• Orgasmic inhibition

• Genital or pelvic pain

• Avoidance of physical and/or emotional intimacy

• Lack of experience due to anxious avoidance.

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Common sexual issues for male clients include:

• Erection difficulties (ED)

• Rapid ejaculation (PE)

• Ejaculatory inhibition.

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Female clients’ sexual issues might include:

• Vaginismus (involuntary contraction of vaginal muscles resulting in painful penetration)

• Vulvodynia

• Limited or non-existent orgasms

 

Clients of any gender may seek therapy to address problems relating to

• Fear and avoidance of sexual and emotional intimacy

• Lack of relationship experience

• Shame or anxiety regarding sex

• Low arousal or lack of sexual desire

Surrogate and Client Interactions

Learning how to develop healthy relationships, how to touch and to receive touch, and how to be more accepting of one’s body and sexuality are important aspects of this process. Care is taken to assure that the client is ready for each new step as the client and surrogate partner gradually progress through experiences that are simultaneously diagnostic, skill-building, and healing. The surrogate partner models social skills, effective communication, and emotional honesty. The surrogate-client relationship offers experiences of shared physical intimacy that facilitate the development of healthy self-concepts and improved sexual functioning. As the work progresses, clients find themselves becoming more relaxed, more open to feelings, and more comfortable with physical and emotional intimacy. Genital-genital contact may or may not be therapeutically indicated. When it is indicated, it is often a minor part of the therapy.

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Surrogate and Client Attachment

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From the surrogate’s point-of-view
Most progress seems to occur during therapy when human caring and affection flow easily between surrogate partners and clients. In the context of this authentic connection, clients’ issues about emotional and sexual intimacy can be explored, and the client has opportunities for practicing and developing new relationship skills. Even personal conflict between the partners provides excellent opportunities for learning. The surrogate-client relationship serves as a model of every stage of a relationship, from beginning to end. The surrogate partner’s responses to the client and perceptions of the client, from inside this relationship, can be highly informative for the therapeutic team.

From the client’s point-of-view
Clients grow to trust and care for the surrogate partners, with whom they share honesty, intimacy, and meaningful emotional work. Through this genuine relationship, clients experience themselves and intimacy in valuable new ways. Clients learn how to develop trust and satisfying relationships. They are able to see that the same potential exists for their future relationships. Eventually, clients reach a point where they feel ready to begin new relationships with partners of their own choosing.

When Therapy Ends

The decision to end therapy is made mutually between client, therapist, and surrogate partner when the revised goals of therapy have been met. The process of bringing the therapy and the surrogate-client relationship to a close celebrates the uniqueness of each relationship, honors the feelings of the members of the triad, and directs attention towards the client’s future.

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