When Kai Wu was stuck in an unsatisfying romantic relationship, she began having physical, as well as emotional pain — particularly in her pelvis.
It was an ache that was difficult to ascribe to anything in particular — she hadn't pulled any muscles she could think of, but the pain was strong.
Rather than work solely with a therapist who would analyze her situation and talk her through it, she decided to take a somatic — or body-based — approach to healing.
After a massage therapist helped her release the mysterious cramp in her pelvis, Wu realized its source: She had been carrying sexual trauma in her body for years.
“I didn't know I had trauma, which I thought was due only to rape and molestation,” she says. “But we all carry sexual trauma.”
Wu defines “trauma” broadly, as an accumulation of discomfort, rather than a response to a cataclysmic or violent event. She realized her relationship was not satisfying to her sexually, and that her body was sending a clear message about her sensual and emotional life. Her trauma was an experience of being sexually undernourished.
Expressing herself sexually was of central importance, she realized, and not a secondary consideration in a relationship with someone she knew to be a “good man.”
“Sexual energy is primal energy,” she says, “and with the pelvic healing, I realized I had trauma in my pelvis and was disconnected from that part of myself. I realized I was starving for wholeness.”
To connect with that primal energy — and to live “more honestly” with her sexual desire — she began an exploration of somatic techniques, which may include an array of massage styles, as well as movement and breath practices such as yoga or tai chi.
In the process, she found her calling. These days, Kai Wu is a love, sex, and relationship coach — and she is also a “sexological bodyworker,” providing healing for sexual trauma and dysfunction via a form of touch similar to the one that healed her.
A member of the Embodiment Arts Collective, a group of holistic wellness practitioners in the Mission, Wu is part of San Francisco's long tradition of seekers and healers. A former entrepreneur who worked in her family's restaurant for six years and then in corporate finance for 12 years, she describes herself as “non-woo.” Yet her own experience with pelvic healing led her to realize how powerful body-based therapeutic work can be.
Exploring somatic therapies, which encourage clients to use sense experience to strengthen their understanding of themselves and their lives, she became interested in “sexological bodywork,” a somatic practice that may involve touching a client's genitals, but does not include actual intercourse.
Though the term “sexological bodyworker” may lead people to assume otherwise, this type of therapy centers around “one-way touch.”
Wu's sexological bodywork clients receive her touch, but they generally don't touch her. (In some instances, Wu serves as a relationship coach rather than as a sexological bodyworker. Then, the touch can be two-way, as Wu's clients do a kind of “dress rehearsal” of erotic play.) Whatever approach she takes, Wu remains fully clothed, even in intimate positions.
“Recently, I entwined with a client — a woman in her late 60s — who said that she had seen others do it, but had no experience of this herself,” Wu explains. “She asked me to teach her how, so we wrapped our arms and legs around each other and had a really sweet session, where we talked and practiced different kinds of touch on our arms and legs.”
Though intercourse with clients is a boundary Wu does not cross, she believes wholeheartedly that sex can be part of a successful therapeutic approach to healing traumas, big and small.
Sexual trauma isn't necessarily rooted in one particular extreme experience, but often arises in response to the accumulated pressures of modern life, she explains. As we deal with work, family, and other difficulties, our ability to express ourselves sensually and to connect with others pleasurably can suffer. And our relationship to intimacy reflects our relationship with ourselves.
Wu bases her practice on a laying-on of hands that allows her clients to relax, breathe, and be present with their bodies, free of shame. Her training is based in part on what she calls Neo or California tantra — a Western interpretation of a Tibetan tradition of working with the breath and the physical body to connect to that primal creative energy. Primal energy is often difficult to tap into, particularly because desire and shame run hand-in-hand. Many Americans still suffer from the Puritanical repression of sexual feelings — and no doubt even the most confident and liberated lover among us has fumbled somewhere along the line in her sexual life.
Yet experts say many people operate under the assumption that everyone else is having great sex, and believe they alone are missing out on fulfillment. Such assumptions can have physical as well as emotional repercussions.
And sometimes, it takes a hands-on guide to correct those assumptions.
“Surrogate Partner Therapy,” or SPT, is perhaps the most radical form of somatic therapy focused on intimacy and sexual expression. Surrogate partners engage in “two-way touch,” receiving as well as giving. They provide a truly unique space: an opportunity to explore intimacy without the additional concerns that arise in romantic partnerships.
This can include intercourse with their clients — but you should look elsewhere if you're looking for a fast ride to a happy ending.
“I get a lot of inquiries from reality TV show producers seeking titillation, but [they find that] SPT is like watching grass grow,” explains Mark, a surrogate partner who works with the International Professional Surrogates Association. (SF Weekly is withholding his last name to protect his privacy.)
Reality TV producers and the public alike might imagine SPT as a legal — or at least not illegal — way to exchange money for an orgasm. But surrogate partners aren't prostitutes, and what they offer their clients is more than simply relief from unbearable urges.
Surrogate partners and other hands-on practitioners provide their clients with a safe space to investigate the dark realm of desire, offering a rare therapeutic bridge between talk and touch. Through them, clients can experience sensual pleasure as potent medicine, and connect directly to its innate healing potential.
Surrogate partners remind their clients that sexual expression doesn't happen in a vacuum. Nor does it require a body that is free of blemishes or the marks of age and experience. Clients learn to be at ease with sexual desire, to approach potential partners with confidence, and to be free of damaging assumptions about themselves and their lives.
Our sexual expression is deeply entangled with the marketplace — with sports-like talk of achievement, business prowess, and large portfolios — and with religious, social, familial, and other norms (whether we cloak ourselves in them or angrily throw them off). Surrogate partners and other somatic practitioners help their clients navigate that complexity and strengthen the connection between body and mind.
For them, this work is more a calling than a profession. As they pursue it, they come face to face with the judgmental, juvenile, and puritanical ideas about sex that remain deeply entrenched in our society.
Even in San Francisco.
Surrogate partner therapy follows a “triadic” model: Partners always work with a talk therapist with whom they communicate before and after sessions with clients. In other words, if you want surrogate partner therapy, a therapist will have to agree it's necessary beforehand. Therapists and psychologists who recommend SPT for their clients recognize it as an effective complement to the more analytical processing that can happen with words alone.
They suggest SPT for clients suffering from an array of difficulties — from obvious sexual problems such as premature ejaculation in a man, or vaginismus (vaginal closing) or the inability to orgasm in a woman — to the subtler difficulties of shyness and awkwardness that can lead to decades of unwanted celibacy. SPT might also benefit individuals suffering in other ways, by teaching breathing and relaxation, and encouraging people to land in their own bodies before attempting to connect with others.
For clients working through difficulties arising from sexual expression — whether they are simply awkward in their approach to potential partners, or have difficulty on a physical level — giving and receiving erotic touch with someone can be revolutionary.
“SPT is an excellent clinical tool for men and women who come to sex therapy without a partner,” says Dr. Martin McCombs, a psychologist specializing in clinical sexology. “Sex therapy is at once insight-oriented and behaviorally driven. There are real clinical limitation challenges for single people addressing sexuality or intimacy dysfunctions. Professionally supervised, appropriately trained surrogate partners who are members of IPSA and bound by its code of ethics are a gift in the field. “The three surrogate partners I interviewed spoke highly of the training that they receive through IPSA, which has provided resources, certification, and ethical guidelines in the United States and internationally since 1973. IPSA has certified surrogate partners working in England, Switzerland, and Israel (which is currently the only country with health insurance that covers SPT).
Currently, there are about 50 certified surrogates, most of whom are based in the United States. The IPSA training is not for everyone, however.
The application process is rigorous. There is a lot of writing about why the applicant would like to do this work, including his or her own sexual history, a letter of intent, and three letters of recommendation from either therapists or educators. They'll also need a rundown on how much study the applicant has done in the field of sexuality (in or out of school) and a list of books regarding sexuality the applicant has read.
After passing the screening process, the applicant is required to participate in two-and-a-half weeks of daily, 10-hour workshops, a period of work with a supervising talk therapist, and a one- to two-year apprenticeship with an established surrogate. Finally, in order to work on one's own as a surrogate partner, one would have to earn the stamp of approval from a committee of established surrogate partners (hence the varying length of the apprenticeship).
Mark credits famed sexuality researchers William Masters and Virginia Johnson, whose studies from the 1950s to the 1990s make up the bedrock of received wisdom on human sexuality, as the originators of modern surrogate therapy. Masters and Johnson began their studies at Washington University in St. Louis, and went on to establish their own research institute. Their work with nearly 700 volunteers was described in what are considered the classic texts about sexuality: Human Sexual Response and Human Sexual Inadequacy, and their lives are the subject of the Showtime TV series Masters of Sex.
“Our work is based on Masters and Johnson's 'sensate focus' model,” Mark explains. “We take our clients through a slow progression from talk to touch. We meet the client where they are. We don't just get right on the plane to cure the fear of flying.”
Eileen Chao, a 35-year-old surrogate partner and kink coach who is currently pursuing a master's degree in psychology — and who currently has four surrogate clients — expresses tremendous respect for IPSA. “I would caution anyone seeking this type of therapy to be sure that their surrogate partner is IPSA-certified,” she says, noting that many people who advertise sexual healing services online or elsewhere have not been IPSA-trained.
IPSA-certified surrogate partners may have websites, but they connect with clients through referrals from therapists, not through advertising. Chao credits IPSA with maintaining high ethical standards and providing critical resources for surrogate partners — not only insisting on regular testing for sexually transmitted infections, but also offering counseling and support for the surrogate partners themselves.
Because their work can be intense and emotionally draining, the surrogate partners, like other therapists, seek counseling to help them remain psychologically healthy. The training helps people who are living well in their own skins develop the skills to help others relax and enjoy having a body, rather than seeing it as a burden to be overcome.
“I have always been comfortable with my body and my sexuality, though my family was very conservative,” says Chao. “I found I was attracted to awkward people, and that I was able to put them more at ease.”
For a surrogate partner, putting the client at ease is the first step toward helping them overcome their fear of flying.
There are many reasons why the stimulation of our erogenous zones can inflame fear and shame.
Fear of sex is more widespread than many of us will ever admit — even to ourselves. For most of us, being sexual means being vulnerable. Sex usually involves taking off our clothes, and being naked is something many have nightmares about.
“Men have so much cock shame,” says Wu, who notes many sexually frustrated men respond — negatively — to the pressure to perform. “What's called erectile dysfunction is often just a perfectly reasonable emotional response [to discomfort]. And women — particularly cisgender, heterosexual women — are often disconnected from their own pleasure, and seek help from bodyworkers and surrogate partners only when their relationships are in jeopardy.”
Surrogate therapy is not a quick fix to sexual and social anxiety. You can't order it online. If your talk therapist feels surrogate therapy is warranted, you're going to have to show up for it and take your time.
Stephanie Wadell, who has been practicing SPT since the mid-1980s, says many of her clients are men who, for one reason or another, have been unable to “get from the couch to bed.”
Some of her clients are not having sex, Wadell says, because they don't know how.
She described the progression of sessions.
“The first session is a two-hour sexual history,” she explains. “Often, talk therapists don't ask as many questions in this area. We teach breathing, focusing, and how to touch in a non-demanding way.”
Wadell identifies three kinds of touch: therapeutic, sensuous, and erotic. Therapeutic touch is generally firm and focused on addressing a physical complaint — a pulled muscle, say, or working out a knot — and is more about applying pressure than about a lingering gentleness. Sensuous touch could be defined as a caress. (Think of the touch a parent might give a child — gentle, soft, open-palmed.) Erotic touch may be more focused on the erogenous zones and is intended to stimulate rather than soothe. Over the course of a dozen or so sessions, she teaches clients how to move through these different modes, practicing on them, and allowing them to practice on her.
Wadell makes a distinction between the work that she does and the offerings of “tantricas” and intimacy coaches who advertise online, pointing out that people seeking someone “safer” than a prostitute may answer such ads — and that “self-described tantricas” are often not trained, and certainly don't work in consultation with a talk therapist. I asked Wadell, who noted that many of her clients are 50 or older, what made them decide, at this late stage, that something was missing. She said that often it was a major upheaval, such as the death of a parent or other family member or friend, but that the question could use further exploration.
“I recently had the privilege of working with [two different and unrelated] 60-year-old virgins,” Wadell says. “To all outward appearances, they were completely normal. Had jobs and so forth. One of them had been living with his mother, and finally sought me out when she died.”
For the rest of us, what is the tipping point that leads the realization that sexual help us needed? And what keeps sufferers from seeking help with a sexual dysfunction? Denial may seem easier, until it doesn't.
“I've had people meet with me, then decide they can't afford the sessions,” Wadell says, explaining that surrogate partners usually charge between $150 and $200 an hour. “They might wait a year, but they end up finding the money, because they realize how important this is.”
Sexual dysfunction could be a pandemic. A large swath of the population would likely benefit from a sexual surrogate, or sensuality coaching of some sort.
Many of Wu's clients refer to themselves as “broken.” Several of them, particularly those with outside-the-norm body types in terms of size, ability, or scarring from injury, describe an experience of looking in the mirror and not really being able to see certain parts of their own bodies — only their heads.
That brokenness or disconnection can lead to a desperate and vulnerable psychological state. Although a positive sensual experience is not a cure-all, it is a wonderful step toward helping a struggling person feel more whole.
Surrogate partners talk about “non-demanding” touch, meaning the kind that requires nothing in return, such as a parent's caress that soothes a baby. Such touch can also calm an adult, in a way that no words can. (We are social animals, after all.)
Though it's hard to know exactly how many people are working with surrogate partners — just as it would be difficult to guess how many people are in therapy — Mark is able provide a broad overview of the demographics.
Twenty years ago, he says, 90 percent or more of SPT clients were male, but in the last 10 years, many more women have sought treatment, so that about 30 percent are female.
“I think as people realize it's a valid form of therapy, some women realize they'd like take control of their sexuality,” explains Mark. “Some women have put their careers first and now they're in their 50s or 60s and realize they've missed out on an important aspect of life, sex, but don't know how to date. Maybe they've been virgins too long. Maybe they've never been able to orgasm and want someone to help them figure that out. Of course, men can't 'give' a woman an orgasm, but we can be there to coach.”
One hopes this means more women are investigating their own potential for pleasure. The surrogates themselves also fit a pattern that suggests something about the way gender and power are expressed in our society.
Mark estimates that “80 to 90 percent” of surrogate partners are women.
“Most are heterosexual and work with male clients, although some do work with women as well,” he says. “Many surrogates, both men and women, work with men, women, and transgender [populations], or the disabled. Some work just with men. Some work just with women. I'm bisexual and work with all four populations. There are a few gay male surrogates, and a few bisexual male surrogates, but many more female surrogates work with both men and women.”
Chao and Wadell made similar estimates regarding the gender and identity breakdown of surrogate partners and clients. Their findings seem in line with Wu's statement — which she recognized as a generalization that is most appropriately applied to cisgender heterosexual people — that women are often moved by concern for others, while men struggle more with the need to perform, or to be the aggressor.
Learning to deal with that performance anxiety might lead a single man toward SPT, while being socialized toward empathy might lead women to take on the role of surrogate partner, and to being open to working with a larger segment of the population. SPT sessions cost about as much as talk therapy sessions, but unlike other types of therapy, insurance in the U.S. doesn't cover it. So access to this important resource is constrained by the almighty dollar. What may be more troubling than the cost barrier is the potent combination of a lack of sex education and the proliferation of sexual images online.
Today, many young people learn about sex through watching porn or Hollywood movies, and they have few other outlets for investigating and understanding their sexual urges.
“Sometimes, people know very little — sex education is terrible in this country,” surrogate partner Chao says. “Only 10 or 12 states actually offer any at all, and generally it's a rudimentary discussion of pregnancy and disease. I'm blown away by the shaming of this desire. Have you heard the abstinence-only people talking? Saying that 'no one will love you if you allow yourself to be touched in this way.'”
We can find out a lot about a society by looking how it deals with sexuality. Whether inherited from the religious zealotry of the Pilgrims or the mores of Victorian-era WASPS, America's puritanical streak is alive and well.
Abstinence-only programs block people from learning the truth about their physical nature — that we are animals, and that our bodies can be sources of joy. These approaches to sexuality often serve, consciously or unconsciously, other systems of social control.
As Williams S. Burroughs once said, “Is Control controlled by its need to control? Yes.”
As children, we learn by modeling our behaviors on what we see around us, Wadell observes. Young people who learn about sex through Hollywood and porn often neglect the slow unfolding of sensual pleasure — foreplay absent from films both dirty and artistic — surrogate partners attempt to teach.
None of the practitioners argue that porn should not exist, but they make the point that it follows a “drive-thru orgasm” model, which suggests that sex is all in the genitals.
“We're substitute teachers,” says Wadell, acknowledging that the lack of access to information about sex can plant the seed for a lifetime of anxiety and suffering. “Intercourse is the least of what we do.”
Surrogate partners don't solicit clients or work the streets, and though some of their friends or relatives might not understand what they do, law enforcement has never brought criminal charges against a surrogate partner.
“I've heard that some years ago, an undercover cop in Los Angeles tried to bust some surrogate partners for prostitution,” Mark says, estimating that only about 2 percent of the time surrogate partners spend with their clients involves intercourse. “Finally, he gave up, saying, 'I've spent $1,000, and I haven't even taken my clothes off.'”
In the absence of a legislative ban, surrogate therapy is not technically illegal — and it doesn't seem as though California is predisposed to outlaw it.
In 1997, Kamala Harris, now the state Attorney General, told the San Jose Mercury News, “If it's between consensual adults and referred by licensed therapists and doesn't involve minors, then it's not illegal.”
In spite of that, Chao says that she has known some therapists who are hesitant to use SPT because they fear that their license could be imperiled. They also express concerns that their clients will become overly attached to the surrogate partners.
Yet it is difficult to find any therapists who have actually used SPT and who say it has a negative impact.
Run-ins with the law are not the only risk. I asked the practitioners if their clients have ever fell in love with them, or misunderstood the boundaries. None had encountered that problem, and of the three I spoke with, none had found a lover or partner through serving as a surrogate partner, either.
“No one's ever fallen in love,” says Chao. “I've had clients feel weird within the constraints of this structure imposed on this sensual thing, but we acknowledge and work through that. And if they've never been in love or had those feelings, it's a safe space to explore that.”
Grace Paley wrote that “sex is common, like bread.” Like bread, it nourishes, it sustains, and it is a big part of our lives. And like bread it could be stale or dry or poorly held together, and it requires the right conditions to be what it can be: delicious and life-giving and — sometimes — sublime.
It was certainly so for Brian, who found in SPT a way to address a lifelong problem of premature ejaculation.
When Brian — whose last name I'm withholding to protect his privacy — finished his sessions, he felt he had become a new person.
“It was a life-changing experience, and I don't say that lightly,” he says. “I had always been a caregiver, a provider. I was in the military, and I'm a doer. I had never before been a lover. Relationships ended because of this problem. I feared that someone I asked on a date would say yes. After one woman left me, I was celibate for five years. At age 40, I said, 'I have to do something about this.'”
Brian had his doubts. He had tried books and breathing exercises. At first he didn't believe that someone else could change what he could not change on his own. But the surrogate partner and his talk therapist cared about his progress, and they helped him to commit fully to the work.
“You can't dabble in this,” Brian says. “You think you're going into this to talk about this one problem, but you end up talking about your whole life. You want to guard yourself against the emotions that come up. But I realized I had to lay myself bare, to give everything to this process. Sometimes you just have to pull over while driving and cry.”
He was afraid at the beginning of his SPT sessions, and then again at the end. At first he feared that SPT wouldn't work, and when he made progress with his surrogate partner, he feared that after the sessions were over, his old problem would return. But the techniques he learned have stayed with him.
For three years now, he has had complete control over his ejaculation. He credits SPT with enhancing all of his relationships: with friends, family, and with business associates.
“This was an incredible process, you learn how to touch everything,” he says. “You begin with simple objects, learning to notice textures, things like that. Slowly, you learn to be intimate in a completely safe environment. You experience a sense of self-realization. You are in it and at the same time, you are watching the process from the outside.”
Surrogate partners and other bodywork practitioners provide a space for people to learn how to live with themselves as physical beings who need one another for pleasure, as well as for health and sanity — because those things are related.
For Wu, Mark, Chao, and Wadell, the experience of helping people connect with their bodies is one of shared liberation. Wu's own healing led her to explore new possibilities in her own life, and to bring it into harmony. She says that her goal is to help people's heads, hearts, and genitals all vibrate together, in tune with one another. Sounds like a worthy endeavor for all of us human animals.