In The Sessions, (originally titled The Surrogate) based on the article “On Seeing a Sex Surrogate” by Mark O’Brien, a poet paralyzed from the neck down due to polio, who hired a sex surrogate to lose his virginity. (A documentary about Mark O’ Brien can be found here: Breathing Lessons: The Life and Work of Mark O’Brien) The research and interviewing he did as preparation for writing an article about sexuality and disability led to the opportunity for him to do so with the help of a sex therapist and sessions with a sexual surrogate. Having been raised Catholic and remaining a practicing Catholic in adult life, O’Brien regularly sees a priest for confession, even though he spends his nights in an iron lung and limited hours during the day with a portable respirator on a gurney, seriously limiting his opportunities for most sinning of any kind, in deed, if not in thought and word. Thus, in many of the scenes where he is delivered to the church for confession, he uses this time to ask questions and advice of the priest, rather than to confess sins, per se, at least during the time period portrayed in the movie. He uses an initial encounter with a new priest for confession to elaborate on feelings connected with negative thoughts about one of his attendants.
However, knowing that an overactive guilty conscience is at work, the priest suggests that O’ Brien talk to a therapist (as perhaps an alternative to going to confession without it being a confession per se). O’Brien is in fit condition to be left without an attendant for a limited time, so though his mobility and life-support equipment can’t fit in a standard confessional, he can (depending on whether the church building is otherwise empty) have the privacy he is entitled to for the sacrament of reconciliation. (In situations where there are other people in the church building while someone with physical issues like this is making his confession, it is to be remembered that the Seal of Confession applies to anyone else’s confession they should chance to overhear).
O’Brien meets a new priest at his church this way, and having first encountered each other for confession, he ends up developing a more informal relationship with this priest (later in the movie, the priest ends up visiting O’Brien while wearing civilian clothes and bearing a six-pack). It is to this new priest that O’ Brien turns for advice about the potential sinfulness and the church’s thoughts about his therapist-enabled and sanctioned sexual surrogate therapy.
O’ Brien informs the priest: “This is not exactly a confession, I haven’t yet done the deed. I was sort of hoping to get a quote in advance”.
The priest makes it clear that while the letter of the law with regard to the church’s stance on this would be to condemn fornication in all its forms, but, directing a silent prayer heavenward, and looking at a statue of Jesus mounted upon a wall slightly above him, assures him that divine compassion with regards to O’ Brien’s moral predicament is such that “I have a feeling that God is going to give you a free pass on this one. Go for it.”
According to The Sessions Production Notes on, “Father Brendan” is a fictional character for the purposes of portraying the story on-screen. The relationship between O’Brien and Father Brendan is supposed to be reflective of the fact that religion was important to the real Mark O’Brien, who consulted several priests about the morality of the sexual surrogate therapy which he planned to undertake, and had several close relationships with priests.
O’Brien goes through with the sexual surrogate sessions. His initial attempts at sexual intercourse have him shaking with fear, fraught with guilt, and clearly suffering from his Catholic baggage against sex outside of marriage, and fear of divine punishment. He also expresses shame about times when he has accidentally ejaculated in the presence of his attendants, some of whom are female, and some of whom were attractive enough to inspire a “compliment” from the male body.

Attendent does personal care services for paralyzed man in iron lung

Clearly, hiring an attendant for her attractiveness (out of lust) can backfire. All goes well for a while, until Mark oversteps their relationship boundaries by proposing marriage to her…

When he and the sexual surrogate end up doing some serious talking, she reveals that she had grown up Catholic as well, but the church, naturally, disapproved of her more liberal attitude toward sexuality. Because of her husband’s family, another religion has come onto her horizon, the Jewish religion. She tells O’Brien that her husband’s family members want her to convert, based on the theory that if they are happy, she will be happy. As she puts it, “the fact that I’m already happy”, without the formal practice of an organized religion, “is irrelevant to them”.
Later in the film, she does go through with the formal ritual requirements of converting to Judaism, including a bath in the mikvah. The older female attendant there is surprised at how “comfortable” she is with her body when naked. She might have been less surprised if she hadn’t lied and said she was a housewife when asked her occupation. Though in her capacity as a sex therapist she had made extensive notes about O’ Brien’s attitude instilled by his religious denomination and his Catholic family life while growing up, and used counseling to help O’ Brien relieve his anxiety, so that he could approach sex without fear and Catholic guilt, the larger mainstream culture of shame surrounding sexuality has even made an impact on her, when she claimed to have long ago rejected the attitudes and beliefs of the religion with which she grew up. She is later one of the four women to attend O’ Brien’s funeral, though, while the priest gives a eulogy, euphemistically referring to O’ Brien’s having “lived his life”.

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