What is a Surrogate Partner? 

You might be familiar with the term ‘surrogate,’ which means a replacement, substitute, someone standing in for someone else. So what does it look like to have someone stand in as a partner? Many people jump right to the assumptions that surrogate partner work is all about sex, and yes, that can be a component of this work. But it is so much more than that. 

Surrogate partners work with clients to build a relationship. It is a professional relationship, but like therapy sometimes serves as an opportunity for the client to feel what it is like to be in a relationship with someone safe and supportive, the surrogate partner allows the client to experience this in a physical way. A client’s work with a surrogate partner might include sexual intercourse, other forms of sexual touch, and nonsexual touch. Unlike sex work, there is no agreement of certain sexual acts; instead the surrogate works with the client to find the best path forward and what type of contact will be most beneficial. 

You might be asking questions like ‘is this even legal?’ or ‘what are the ethical considerations of this type of work?’ For many, this is likely a grey area that might feel uncomfortable or too edgy. For some, this type of work has had incredible healing potential, and the risks are well worth the rewards. Some might even argue that the way this work is practiced is often more safe and ethical than many of the consensual sexual activities people engage in. If you are curious and interested in learning more about what this work might look like, read on! 

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What Happens in the Session? 

I had the privilege of watching a demonstration of what an early session with a surrogate partner might look like. It involved very little physical touch, and was largely about communication,  figuring out what you want and asking for what you want. A large portion of the session focused on how it felt to say ‘yes’ and ‘no’ to your partner, and how it felt to receive a ‘yes’ or ‘no.’  The demonstration moved very slowly, and there was substantial time for the client to reflect on how they were feeling through each step of the process. 

One activity demonstrated was called will you/may I. The surrogate partner and client took turns asking ‘will you,’ or ‘may I,’ the questions were only hypothetical, and no matter what the question was the partner had to respond ‘no.’ The surrogate asked ‘May I touch your head?’ the client responded ‘no.’ The client asked ‘will you drive me to the airport?’ the surrogate responded ‘no,’ back and forth a number of times. They reflected on how this felt to say no to everything, even if they wanted to say ‘yes.’ They also reflected on what it felt like to hear ‘no.’ This activity continued on to answering ‘yes’ to every question (without actually acting on any of the requests), then to saying both yes and no to everything, and reflecting on the different feelings that come up for each response. 

After extensive experimenting and feeling into the idea of giving and receiving a ‘yes’ and ‘no,’ the activity moved towards actually giving and receiving touch. The surrogate asked ‘may I squeeze your toes?’ The client thought about it, and answered ‘yes.’ The surrogate then squeezed the client’s toes. The client asked ‘will you hold my hand,’ the surrogate thought about it, and answered ‘yes,’ they then held hands. The surrogate asked ‘may I place my hand on your shoulder,’ the client thought about it, and said ‘no,’ to which the surrogate replied ‘thank you.’ 

The touch never went further than this, and the demonstration concluded with further reflection and conversation on how this experience felt. When asked about how realistic this demonstration was, the surrogate partner explained that often the work looks very similar to this, with sex being an element that only comes in much later in the process (if ever). 

Surrogate Partners and Mental Health 

So what does all of this have to do with therapy and mental health? Quite a lot actually!  It might already be clear from the descriptions of this work that surrogate partners can have a large impact on mental health issues such as attachment, intimacy, and trauma. The work of the surrogate partner is itself potentially therapeutic and can help heal attachment wounds and create new neural pathways around physical touch and safety. 

Surrogate partners can also work in conjunction with mental health therapists, giving their clients an opportunity to work on the physical aspect in surrogate partner sessions, and talk through the cognitive and emotional experiences in therapy. The surrogate partner and therapist also have opportunities to check in with each other and share insights and observations. Surrogates, therapists, and clients have reported finding this type of work transformational. 

If you happen to live in a state like California, where much of this work has been legalized, finding a surrogate partner and therapist to work collaboratively with may be fairly easy. If you are in the midwest (like me!) it may be more difficult to find people working in this way, and the legality of the work is sometimes unclear. But as the benefits of this work become more widely known, the field is growing and gaining credibility. 

There is currently minimal research in this area, but there is some preliminary work looking at how effective surrogate partner work is, and what some of the risks may be. Emilianchik-Key and Stickney (2019) looked at the potential benefits of this type of work, and noted that it can often help people working on sex therapy, issues with intimacy, and issues with trust. Likely more research will be coming in the future, and there will be more information available on both the benefits and risks of this type of work. 

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Conclusion 

There are ethical and legal questions still up in the air around surrogate partner work (especially depending on what state you are in), but it has the potential to be a very powerful and impactful form of healing. Whether or not you ever want to try surrogate partner work, I think the conversations being had in these sessions and the activities and communication skills being learned are invaluable, and we can all take away something. 

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Resources & References:

• Surrogate Therapy 
• Ardent Emergence
• Embrace
• Using Surrogate Partner Therapy in Counseling: Treatment Considerations

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