Nothing Like Phone Sex

Mixed Feelings Among Sexologists About Online Therapy Sessions

Graphic Sophie Morro

In our digital age, nothing seems to be very far beyond the grasp of our technological means.

As technology advances, some developments are dehumanizing, like drones or the more quotidian self-checkout machines at grocery stores that replace cashiers. On the other end of the scale, some developments serve to bring us closer together, allowing us to share our photos, thoughts and sometimes even our deepest, darkest secrets.

Or at least that could be the case with a trend that sees therapists and psychologists increasingly offering their services over Skype and FaceTime.
Wondering if it was a legitimate practice or just a particularly modern fad, I called sexologist François Renaud because he advertises the possibility of such electronic therapy sessions.

There is an added layer of interest to this digital approach as sexology usually deals with the physical—specifically with issues of a sexual nature—such as loss of desire or premature ejaculation.

“People assume that it’s fucked up people,” Renaud said. “They assume that I have juicy information, but it’s just regular people.”

Renaud has a master’s degree in sexology from the Université du Québec à Montréal, the only university in Canada to offer such a program. He has been practicing for three years.

He began offering electronic sessions when one of his clients moved away and didn’t want to lose him as a therapist. After that, other people started requesting the same method.

“I always wanted to avoid it,” he admitted. “I thought it would lose the personal contact, depersonalize the therapy.”

As of last month, Renaud’s clients can access services online without ever having to come to his office, even paying online.

“It’s for people who are out of range,” he said. “I have a Nunavut client.”

France Cassistat, another sexologist who graduated from UQAM and has been practicing in Montreal for seven years, does things differently.

She also gets requests for telephone or video-chat sessions. While she agrees it makes sense for people without access, difficulty getting around or a social phobia, she is not keen on the idea. Based on her experience working mostly with couples, she said people often get in arguments over text messages where there is, of course, no tone of voice or visual cues.

“For clinical and ethical reasons, I choose not to do it,” she said. “When you’re in a closed office, it’s a lot easier to protect the client’s confidentiality. When you’re not in person, the client doesn’t know where you are, whether there are other people around.”

The ethical code of the Association of Sexologists of Quebec does not explicitly forbid tele-therapy or videoconferencing, nor does that of the Order of Psychologists of Quebec. Cassistat sees the ethical code as left mostly up to interpretation.

“There is no perfect system, so it’s debatable,” she said.

Stéphane Beaulieu, secretary-general of the OPQ, said some research shows tele-therapy can produce equal results to in-person therapy for specific pathologies and it depends on the individuals. While psychologists are allowed to practice through electronic means, Beaulieu said it could present risks to the treatment.
“They should probably be careful because the person is not in front of [them]. You could miss some important information,” he said.

He highlighted the contract that exists between client and professional, the need for trust and close contact.

Even though it means missing out on the advantages of sharing physical space, phone and video services can mean a lot to people who wouldn’t otherwise have access to certain therapies. In Canada, few sex therapists offer their services outside of the urban centres.

The tele-therapy trend has also found a supporter in Vivianne Bentley, an integrative therapist, trauma specialist and transformative life coach who graduated with a PhD in psychology from Concordia in 2001. For some of her clients, about 80 per cent of which are female, issues revolving around sexuality are prominent.

“When I work with women, I’m looking more at their relationships with themselves, who they think they are compared to, who they think they should be,” she said. “I don’t see sexuality as just something you do with a partner, I think it’s who you are.”

“I work mostly from a holistic perspective,” she added.

She approaches helping people from a humanistic and spiritual point of view, focusing on growth rather than “what is wrong.” The Harmony Health Centre where Bentley works combines naturopathy and massage among other things, a departure from her clinical training.

When asked what she thought of tele-therapy, Bentley said it’s “the way of the future, definitely.”

“Telephone [therapy] is interesting because people are quicker to reveal themselves,” she told me. “I think it can be mutually beneficial. Can you hold on a second?”
The line went silent.

“Hello?” she said, her voice returning with a hint of amusement. “That was one of my phone clients actually.”

Bentley offers phone sessions to clients, some as far as the Middle East, according to their wishes.

“I have some clients who say that, ‘I really want to see your face.’”

She noted that there is visual connectivity when practitioners use Skype or similar programs, but that’s lost over the phone.

Like Renaud, Bentley wasn’t always receptive to the idea of phone therapy. Her own positive experiences in life coaching and reaching out to mentors internationally opened her up to the idea.

“It just kind of naturally evolved,” she said. “I started to work a lot online myself. It was a lot easier for me. I could just get right to the heart of it.”
Now she enjoys working on the phone.

“I think people can hear through your voice who you are and you can do equally good work on the phone as in person.”

Cassistat, meanwhile, believes it’s to clients’ advantage to confront any fears or misgivings by actually going to a physical space when possible. She said it shows motivation and commitment crucial to goal setting in long-term treatment.

“Think about it like online dating: you won’t really know how you feel about them until you meet them in person,” she said.

Plus, she pointed out that the biggest indicator of therapeutic success is therapeutic alliance.

“It’s based on the relationship you develop with that person,” she said. “It’s two human beings.”