Therapy, Intimacy Coaching,
Sexual Surrogacy and Sexological Bodywork:

What’s the Difference, and which is right for you?

Sexual support services

If you’ve found your way to my website because you’re struggling with something around sex, intimacy, touch or your relationship with your body, you may be wondering what kind of support you actually need. Do you need a therapist? A sex therapist? An intimacy coach? Sexological Bodywork? And what about sexual surrogacy – is that basically the same thing?

It’s a question worth answering because, although there can be considerable overlap in the subjects we work with, these are actually quite different professional relationships.

Sexological Bodywork is one of several modalities focused specifically on supporting people with sexuality, arousal, pleasure and intimacy. It sits within a growing field of somatic sex education, alongside intimacy and sexuality coaching, sex therapy and other forms of sexual support. The field is becoming more widely accepted and understood thanks to the pioneering hard work of many practitioners, advocates and teachers, as well as forward thinking and sex-positive shows like ‘Sex, Love and Goop‘ which recently aired on Netflix. There are now several hundred qualified practitioners around the world, whom you can find through the directories of their respective membership bodies: The Association of Somatic and Integrative Sexologists (ASIS) and the Association of Certified Sexological Bodyworkers (ACSB).

Most importantly, I am not a therapist or psychotherapist. My work as an Intimacy Coach and Sexological Bodyworker can certainly have therapeutic effects, but it isn’t a replacement for therapy – and understanding that distinction helps us create a clear, safe and useful container for the work we do together.

What does sex therapy do?

Sex therapy is essentially psychotherapy with specialist knowledge and training around sexuality.

You might seek a sex therapist because of difficulties within a relationship, sexual trauma, anxiety, shame, compulsive behaviours, problems with desire or arousal, or longstanding patterns that are significantly affecting your emotional or sexual wellbeing.

As with other forms of therapy, the work usually happens through conversation. Depending on their approach, a therapist might explore your history, relationships, attachment patterns, beliefs, behaviours and emotional responses, as well as what is happening in your life now. They may suggest exercises to practise at home and discuss afterwards, and many therapists now work somatically – encouraging clients to notice physical sensations and responses in the body – but there is no sexual or intimate touch between therapist and client.

Therapy is therefore an appropriate place to investigate and process deeper psychological and emotional material.

This is important territory – but it isn’t my professional role.

Our bodies don’t exist separately from our histories, so emotional material can naturally arise when we’re exploring touch, nudity, sexuality, pleasure and relationships. But there is a difference between something emotional arising during bodywork and undertaking psychotherapy to treat it.

If it becomes apparent that what you’re struggling with is rooted in trauma, significant psychological distress or deeper emotional issues that require therapeutic processing, I may suggest working with an appropriately qualified therapist alongside our sessions – or sometimes before continuing with bodywork.

So what is Intimacy Coaching and Sexological Bodywork?

One of the simplest distinctions is to think of education and coaching rather than therapy.

My work is generally much more experiential, practical and present-focused. We’re interested in where you are now, where you would like to be, and what skills, awareness and experiences might help you get there.

Rather than spending most of our time analysing why something happens, we’re often interested in questions such as:

What do you actually notice in your body?

What happens when you’re touched?

Can you recognise what you want – or don’t want?

Can you communicate that to another person?

What happens when you slow things down?

Can you receive touch without feeling that you need to perform, reciprocate or reach a particular outcome?

We might work with conversation and coaching, practical exercises, breath, movement, awareness or hands-on bodywork.

For example, somebody experiencing difficulty with arousal might have already spent a lot of time thinking and talking about why it happens. In bodywork, we have an opportunity to become curious about what is actually happening in their body. Where do they feel sensation? What kinds of touch allow them to relax? What happens when there’s no expectation to become aroused? What changes when we remove the pressure to perform?

Similarly, somebody who struggles to communicate boundaries might intellectually understand that they’re ‘allowed to say no’. Practising noticing a yes, a no, an uncertainty or a desire for something different while actually receiving touchcan be a very different kind of learning.

That’s one of the things I find so valuable about this work. We aren’t only talking about the body – the body gets to be part of the conversation.

And after more than a decade working hands-on with people, I’ve seen again and again that understanding something intellectually and experiencing it physically can be two very different things.

But isn't Sexological Bodywork therapeutic?

It certainly can be.

A session might leave you feeling more comfortable in your body, more confident communicating your needs, less anxious about receiving touch or more connected to your sexuality. Bodywork can support people in moving through sexual concerns, and sometimes clients find that embodied exploration unlocks something that talking about the issue hasn’t.

Those can be very meaningful changes.

But something having a therapeutic effect doesn’t make it psychotherapy.

I don’t diagnose or treat mental health conditions, and I don’t position myself as someone who can process complex trauma simply because it manifests itself through the body.

We can notice what arises. We can slow down. We can talk about it. We can change or stop what we’re doing. And we can use what happens as useful information.

But sometimes the most responsible thing I can say is: this feels like something that deserves support outside the scope of what I offer.

For some clients, therapy and Sexological Bodywork therefore work beautifully alongside one another. Therapy provides a space to understand and process deeper psychological material, while coaching and bodywork provide an opportunity to explore what happens when those insights meet the body, touch and real-life experience.

What about sexual surrogacy?

Surrogacy is different again, and it’s probably the modality most frequently confused with Sexological Bodywork.

In surrogate partner therapy, a surrogate works as part of a therapeutic process to help a client develop skills and confidence around physical and emotional intimacy. The work is usually coordinated with a therapist, with practices designed around the client’s wider psychotherapeutic goals.

Unlike Sexological Bodywork, the surrogate may take on aspects of the role of an intimate or sexual partner. The work can therefore involve mutual touch and sexual interaction between the surrogate and client.

That isn’t the role I take.

Although my bodywork can involve intimate touch within clearly agreed professional boundaries, I am not acting as your partner and we aren’t creating a simulated romantic or sexual relationship.

You are there to receive, notice, explore and learn.

Which kind of sexual support do I need?

There isn’t always a perfectly neat dividing line, and sometimes people benefit from more than one kind of support. I find this a useful way of understanding the difference:

Therapy asks: What is happening psychologically or emotionally, why might it be happening, and how can I understand, process or heal the deeper material involved?

Intimacy Coaching and Sexological Bodywork ask: What am I experiencing now, where would I like to get to, and what can I learn through conversation, awareness, practice, touch and embodied experience?

Surrogacy asks: How can I practise intimate or sexual relating with another person within a structured therapeutic relationship?

For me, the distinction between therapy and education is particularly important. My role isn’t to analyse you, diagnose you or dig deeply into your psychological history. It’s to provide a professional space in which you can become more curious about your own body and sexuality, learn practical skills, experience conscious touch without pressure to perform, practise communicating boundaries and desires, and discover more about what actually works for you.

Often an initial conversation is enough for us to work out whether that’s the kind of support you’re looking for.

If you’re considering working with me and aren’t sure, you’re very welcome to get in touch by completing an intake form to tell me a little about what you’re experiencing and what you’d like to change. From there, we can decide whether Intimacy Coaching or Sexological Bodywork feels like an appropriate place to begin – or whether another kind of support might serve you better.

Recent Posts