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What can we all learn about sex from The Sessions?

What can we all learn about sex from The Sessions?

I urge you to go and see the movie, The Sessions, which is currently out in cinemas. Not only is this a quietly beautiful and uplifting film about life and love, alienation and connection, in the same vein as another favourite of mine, The Station Agent, it also has a lot to offer on the topic of sex.

The Sessions

The film, based on an autobiographical essay On Seeing a Sex Surrogate, follows Mark O’Brien (played by John Hawkes) as he attempts to find a sexual relationship. At 38, Mark has had to spend most of his life in an iron lung since having polio as a child and is only able to be outside of the machine for two or three hours at a stretch, still lying on a gurney and reliant on his mouth for typing or making phonecalls, and on paid carers to move him around.

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After being opened up to the possibilities of love, but subsequently rejected, by a potential partner, Mark decides that he wants to experience sex. A therapist refers him to a sexual surrogate: an expert practitioner who engages in sexual therapy and education through both conversation and sexual intimacy with their clients (unlike sex therapists whose professional boundaries forbid physical contact). Cheryl Cohen-Green (played by a rightly Oscar-nominated Helen Hunt) sees the highly anxious Mark for a number of sessions and helps him to explore his fears and hopes around sex, as well as experiencing various sexual practices, with the aim that he will then have sexual knowledge and skills to take into future relationships. The film takes us through both the physical and emotional aspects of the sessions and reveals the impact of these on both main characters as well as on a number of beautifully drawn additional people in Mark’s life including friends, carers and his priest (William H. Macy on cracking form).

What can we all learn from The Sessions?

The film was moving without ever straying into sentimentality, and funny whist retaining a deep commitment to the humanity of all of the characters. It contained, for me, many important messages, particularly about the value of being open to connections with others (wherever those happen) and of being able to express one’s vulnerability and uncertainty. I loved that, whilst the main character did want to have a romantic and sexual relationship, we also saw that romantic relationships are not necessarily sexual, sexual relationships are not necessarily romantic, and the other relationships in life (such as those with the priest, friend and carer) are equally valuable in their own ways.

Just as Hope Springs (which I wrote about here) does for ageing and sex, The Sessions directly challenges the common, and deeply problematic, misperception that disabled people cannot and/or should not be sexual. Clearly Mark is just as needing, and capable, of both sex and love as anybody else, and those who are able to relate with him in any kind of mutual way (rather than being unable to see past his body) are the richer for it.

The movie relays this message in a far more subtle and sophisticated manner than I could possibly do justice to so I will leave that point there. Instead, in the rest of this post, I want to ask what all of us might learn about sex from the sessions depicted in the movie. If we haven’t experienced disability it would be too easy to come out of this film assuming that what happens is only relevant to ‘other people’, or possibly to ourselves at some future time of injury, older age, or illness, but not now. Actually I think that we could gain a lot from considering the ideas around sex in this film as relevant to all kinds of people and bodies.

Sex in The Sessions

It is striking to me that the thing which makes sex with Cheryl most difficult for Mark has little to do with what his body is and is not capable of. Rather, as for so many of us, it has much more to do with his own anxieties about sex. These come from the messages which he has received about what kinds of sex are and are not okay, about what sex means, and about what it should involve.

It is extremely common for people to report sexual difficulties (more than half of people according to most surveys, as I mention in the sex chapter of my book). And even those who don’t report such problems have all kinds of ideas which get in the way of them having a pleasurable or fulfilling experience. This is a truly psychosocial issue because our psychological experience of anxiety, discomfort and self-doubt is intrinsically related to the social understandings of sex that surround us. That social stuff operates through us in the form of self-monitoring. It is like there is somebody inside observing and commenting that we might look ugly in this position; or that our partner is probably expecting us to do this now; that we’ve taken too long over something, or not long enough; or that it isn’t okay to do that because it is too dirty or weird or not ‘proper sex’. All of those kinds of internal commentaries relate to social messages about who should be having sex and in what ways.

So not only does Mark need help to believe that it is okay for somebody with his body to pursue sex at all, he also struggles with messages that sex is only acceptable in a certain kind of relationship (definitely not one with a sexual surrogate), and with ideas about what counts as sex. He has many ‘shoulds and oughts’ about sex which we will recognise from the social world that we share with him.

Cheryl challenges these perceptions well in her work with Mark. Instead of reinforcing his idea that penis-in-vagina sex is ‘proper’ sex, she introduces him to a wide range of sexual practices including those that do and do not involve the genitals, as well as the idea that certain roles or places (like motels) might be experienced sexually by people as well as certain acts. She jokes about taken-for-granted rules about sex like the idea that after fondling one breast it is ‘kindof a rule’ that you have to fondle the other one.

Whilst Mark does feel good when he meets his aim of orgasming inside a woman and her orgasming too, he later comments that it wasn’t any better than many of the other practices they engaged in, and not even as good as some. Mark also orgasms quickly on any kind of genital contact or even visual stimulation. At first he regards this as a failure but Cheryl helpfully challenges the common assumption that a (male) orgasm means the end of sex. They enjoy both sex without orgasm and sex after orgasm, and the concept that simultaneous orgasm is the epitome of good sex is challenged when it is clear that Mark can enjoy Cheryl’s orgasm more from having already had his and being able to focus on her.

What the film helpfully points out – if we are able to see it – is that we all have different kinds of bodies that work in different ways. Instead of this being a cause for shame and distress as we all try (or pretend) to meet up to some narrow, limiting standard of sex (or avoid sex entirely if we don’t), we could embrace this diversity and make it the starting point for each new sexual conversation. Rather than going in with assumptions about how our body, and our partner’s, ought to work, we could go in assuming that this will be a new and different body and being open to the inevitably new and different experience it will bring.

Our concerns could be not ‘will I get an erection?’, ‘will it last long enough?’, ‘will I be able to be penetrated?’, ‘will I come at the right time?’ but rather ‘how does this person’s body work?’, ‘what do they like having touched?’, ‘what other kinds of stimulation do they enjoy?’, ‘how do I respond to what they do?’, ‘what can I tell them about how I work with my words and with my body?’, ‘what new ways will I discover with them that I haven’t with other people?’. With such questions it ceases to matter whether or not we orgasm from penetration, or at all, or whether we get erections or can be penetrated. We can put down those anxieties and just open up to the conversation as it unfolds.

I will leave the details of how this might work in practice to future posts on sex communication and consent (and several suggestions are also already made in my book). However some ideas – many of which are touched upon in the movie – which can be helpful include:

  • Exploring the whole of a partner’s body rather than focusing on assumed ‘erogenous zones’ and asking a partner to feed back to us on how each touch is for them (avoiding what they dislike in future), and doing the same thing the other way around.
  • Practising mindfulness, or being in the moment. at other times in life (washing the dishes, sitting still, walking) to cultivate that capacity and bringing it to sex.
  • Reflecting on our assumptions about sex, whether they are helpful, and how they can get in the way of our pleasure and ability to be in the moment.
  • Communicating about what we enjoy sexually with partners outside of explicitly sexual situations (e.g. in conversation, on the phone, or online), perhaps sharing fantasies or considering all the possible sexual practices that we are aware of together.

Find out more

The issue of sexual surrogacy, and working physically with people around sex, is one that will be discussed by sex therapists, sex coaches, surrogates, body workers and others at the College of Sexual and Relationship Therapists conference this Summer which I co-organised. See the COSRT website for booking form and forthcoming programme if you are interested.


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  1. Mike Lousada

    28 January

    Meg – thank you for writing this. I think this movie is very significant in its portrayal not only of sex and disability but also regarding the valuable role of sexual surrogates for those with sex and intimacy issues. As someone who works in that field myself, I am glad of anything which helps people understand that what surrogates do is to provide a valuable therapeutic holding and education which clients find deeply healing. Well done, The Sessions, a very courageous film.

    • megbarkerpsych

      28 January

      Hi Mike. I was just about to email you a link but you’re way ahead of me! I’m so glad you like the post. I’m very pleased indeed that this film has come out prior to our conference because it will be so helpful for unfamiliar people to help them understand the value of sexual surrogacy and related professions.

  2. Thanks for writing about this film; I hadn’t even heard of it and now I’m really interested in seeing it!

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