A report in the Jerusalem Post - Oct. 1997
Gloria Deutsch
Dr. Mark Roitman, a psychiatrist specializing in sex problems, was horrified when it was suggested to him that women who work as sexual surrogates were considered akin to prostitutes.
"Nothing could be farther from the truth," he maintains. "These women are all educated and come from the caring professions - teaching, nursing, and social work. Yes they do have sexual intercourse with the patient, but only in the final stage of treatment. And surrogate is a very effective treatment in the majority of cases of sexual dysfunction.
Surrogacy - when specially trained women teach men with sex problems to function correctly - was pioneered in the fifties by sexologists like Masters and Johnson and Hellen Kaplan in the United States, is by any standards a fairly revolutionary concept even today, and especially in a basically conservative society like our own. Sexual surrogate is nevertheless regarded as an essential part of behavioral treatment for problems like impotence and premature ejaculation.
Dr. Roitman, who has a private clinic in Kfar-Saba, has been a psychiatrist for twenty years and sees many patients suffering from anxieties and depression, but fully one third of his practice is devoted to sex problems.
Any woman wanting to become a surrogate has to go through vigorous psychological testing and extensive interviews to ensure that she is suitable.
"We prefer mature women, between the ages of twenty five and fifty, from a stable background", explains Dr. Roitman. "They have to be single to avoid family conflicts. We're not looking for great beauties, just the sort of woman the patient would be likely to meet in everyday life. If you saw them outside the clinic, you wouldn't look twice".
Candidates who want to be surrogates have to go through a special course as well as be tested psychologically to ensure they have the right motivation. Patients to be treated by surrogates also have to meet stringent criteria.
"Men of all ages come to me with their problems" says Dr. Roitman, "and if I feel they would benefit from a surrogate relationship, I recommend it to them. Besides men suffering from impotence and premature ejaculation, there are many disabled army veterans whose treatment is carried out in conjunction with the Ministry of Defense. All these patients suffer from low self-esteem and social awkwardness and have problems in finding partners if single. Another group are those suffering from recurrent depression and personality problems of all kinds, and even schizophrenia. In conventional settings they were never considered candidates for sexual therapy and rehabilitation but in the surrogate clinic the results with these men are good".
This raises the question of the surrogate having to be alone in intimate - very intimate - situations, with a man whose mental stability is, to put it mildly, questionable.
"All patients who enter surrogate programs get a thorough psychological evaluation to decide if they are suitable", says Dr. Roitman, reassuringly, "No drug users or HIV sufferers are accepted, and condoms are always used.
Sessions take place at the clinic in a small room with a double bed and a shower and last 90 minutes. The procedure used is one developed by Masters and Johnson called Sensate Focus Exercises. The patient learns at each session, to touch and be touched, progressively in different parts of the body.
Explains Dr, Roitman, "For the first time in his life, he learns to feel comfortable with the opposite sex and becomes acquainted with his own and his partner's body".
Every meeting of a patient with his surrogate, is preceded by a meeting of the patient with his therapist, but perhaps more importantly, the surrogate also meets with the therapist to plan the session thoroughly. The patient always knows what assignments are going to take place and the surrogate will work in the session strictly according to the plan she has received from the therapist.
The number of meetings depend on the particular problem and the pace of progress varies for each patient. Anything between twelve to fifteen meetings take place on average. The cost to the patient, other than those subsidized by the Ministry of Defense, is $ 220 for the surrogate, and around $ 100 for the preliminary meeting with the therapist. It is certainly not a cheap form of treatment but Dr. Roitman emphasizes that when the treatment is completed the patient has not only solved his sexual hang-ups but is functioning better on all fronts.
"Patients who were out of work have gone back to their jobs. They no longer need drugs to counter depression and socially they are rehabilitated. So although it is very expensive, it has a wide-ranging beneficial effect," he says.
In his private clinic, Dr. Roitman uses sex therapy videos to reinforce the lessons learned from the surrogacy sessions. These films, made by s husband and wife team of therapists form the United States, leave little to the imagination and it was mildly disconcerting to be given a demonstration, as though watching what, in any other context, would be considered pornography were a normal part of a serious interview about a fascinating subject.
Surrogacy may strike people as anything from 'not quite nice' to outrageous', but Dr. Roitman points out, it has a higher then 90% success.
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