Source: Used by permission: JM Darling for SarahWhiteLife.com

Sarah White is the pseudonym of a woman who operates an online service called “The Naked Therapist.”

Via web camera, Sarah provides one-on-one interaction with men around the world, talking with them about their problems and issues. But, distinct from any other therapist or coach I know of, Sarah disrobes during the session, and allows her clients to also disrobe, and even masturbate.

Sarah’s business has gotten a lot of media , due to the salacious nature of her services. But, most of the attention has focused overwhelmingly on the skin and the sex, often dismissing and even ridiculing her claim that she is providing a therapeutic service.

Sarah’s comments in these articles intrigued me, as a psychologist. I’m not planning on getting naked with my patients, but her strategy of accepting sexualization in order to help men to express their needs and desires is compelling. Sarah agreed to an interview with me, exploring her business and the behind it. (We were both clothed during the interview, for those of you who might wonder, though fair disclosure, I wrote some of this while in my pajamas.)

Sarah turned out to be far more than the “dumb naked chick” portrayed in the media, but was a thoughtful, poised individual, with a great head on top of her admittedly attractive shoulders.

Source: Used by permission, Abdul Smith for SarahWhiteLife.com

Sarah’s "Naked Therapy" business started, first, with the idea of offering “naked” coding and programming assistance. At the time, Sarah was working as a waitress, model and doing web design, and realized that people might pay her to discuss web design while naked. Lots of customers turned out to want to talk to her while naked, though they didn’t care about web design. Sarah has been around therapy, in her personal and family life, and she realized that just talking to people, while naked, could be a powerful therapeutic phenomenon.

Since 2010, Sarah has worked with over 1000 men and feels that her practice has improved as she has gained more and experience in developing insights into her clients. She has increased her fee, now charging $250/hr, compared to the $150 she started at, but her increased rate has not hurt demand. She tried having some other people work for her and replicate the approach, but found that it wasn’t a good match, and continues to provide the service herself.

Sarah has been criticized as being merely a “webcam girl with a clever hook,” so I asked her how what she does is distinct from the naked women readily available for free via webcam, and what distinguishes her service from mere :

A webcam girl is there to fully serve and please the visitor within her personal limits in whatever way he deems desirable. I'm a therapist, so my goal is to help my client achieve therapeutic progress. I do not simply "do whatever the client asks" (even within my limits). Rather, I do what I consider most valuable toward achieving that ultimate goal: therapeutic progress for the client. There is a world of difference between pornography and Naked Therapy. One is a mere sexual indulgence (and is perfectly acceptable) and the other is a therapeutic practice that involves the component of arousal.

Sarah believes that by getting naked online, she can connect with men in ways which shortcut around men’s barriers and their fears of . What she is doing is tapping into powerful issues of acceptance, which, in men, is intrinsically connected to .

Naked Therapy has several features that make it an exciting alternative to normal therapy. First, because nakedness is allowed, there is an immediate sense of intimacy, , and trust between the therapist and client, which many of my clients have said has made a huge difference in terms of what they're willing to talk about with me vs. a normal therapist. Surprisingly, I have found that many men won't talk to normal therapists about a variety of issues because they're too embarrassed, but they feel comfortable talking to me about them because they find my willingness to undress for them a sign that I trust them and that I won't judge them (which is true).

Distinct from other forms of therapy (excepting perhaps the very limited service of sexual surrogacy), Sarah’s approach actually embraces (virtually at least) a client’s sexual expression. In traditional therapy, a client’s sexual desires should be addressed and discussed, in the abstract. A client’s arousal towards their therapist would never, ever result in actual in-session sexual activity, without potential charges of misconduct. But for Sarah, that’s where the real work actually starts:

Naked Therapy engages sexual arousal as a vital part of thinking. Rather than pushing it aside, or claiming that it is simply an expression of a deeper longing, Naked Therapy says "sexual arousal is important in and of itself" and it utilizes the sexual arousal of the client to arrive at unique, powerful, relevant insights. Asking a man to share his feelings in an environment in which sexual arousal is forbidden is like teaching him to swim on land. I just firmly believe that sexual arousal is so central to men's that it must be openly embraced and accepted in the therapeutic context if men want to truly get to the bottom of their feelings.”

All of her 1000 clients are men. Originally, Sarah saw some women, but over time, she’s gravitated towards working only with men, and feels that her style and approach is most effective and helpful in dealing with issues of masculinity.

Indeed, Sarah has become a defender of men and argues that masculinity is too often reduced to simplistic, stereotyping concepts that paint men as simple beings controlled by their sexual desires.e

Naked Therapy is man-positive. One just hears too many therapists these days — male and female - talking about how men have a hard time expressing their feelings (they even have a word for it — alexithymia), how men don't want to be in therapy, how men are resistant and aggressive and often overly sexual toward female therapists, etc. I'm probably the only...therapist in the world who can say she has an all male patient list and not one of them is there because a judge or a wife made him go. The men I see are also deeply capable of recognizing and expressing their feelings. I have never found them aggressive or resistant, and in embracing their sexual feelings toward me, rather than shaming them for having them, I have had countless intimate dialogues with men in which they've talked to me about things they've never told anyone in their lives. Talking about these things has allowed them to better understand, come to peace with, and/or put behind experiences.

What kinds of men come to Sarah’s virtual office? She presents four types of men who are willing to pay for her services, talking out their issues while she, and they, take off their clothes:

Curious/frightened: has "reached a point where he wants to try something new in his life, usually of a sexual nature, but he's confused about how to pursue it, so we work together on understanding his desires, becoming brave and figuring out a way to realize his urges."

Unconfident/ : "feels like he can't talk to women, can't sexually perform with them, or doesn't understand how to be a "good man," so we work on helping him gain confidence and we talk a lot about the reasons he feels uncomfortable around women and how he can start to feel stronger and more knowledgeable around them.

Unmotivated/ : "we do a lot of work on optimizing arousal and finding things that can help him feel excited to live and pursue ."

Sexually obsessed/frustrated: "has a sexual ' ' of some type that he's concerned with, which is most often pornography, so we work on coming to terms with his desire for porn and figuring out a way he can either stop or look at porn in a way that makes him feel powerful and in control.

The latter category hits an interesting issue, as male sexuality is frequently synonymous with the modern issue of porn or . So-called sex addicts are overwhelmingly male. Some have argued that Sarah's Naked Therapy is either treating, or even encouraging, through her work. Sarah says that she doesn’t use or adopt the sex addict label, but it does come up quite a bit in her work:

I meet with a lot of clients who state openly that they have an "addiction to porn"...in general I try to steer my clients away from thinking they have an addiction and toward a more thorough analysis of the hole in their life they're trying to fill with that activity, the positive things that activity does or can bring into their lives, a larger understanding of how that activity might fit into a healthy, positive, self-acceptable way of behaving, how it might bring them power, how they might lose the , etc. What I treat are men looking to make a change, and I help them understand and achieve that change in whatever way we together come to believe it is best. I received an email from a man who lives in Saudi Arabia who said "My wife will not have oral or anal sex with me, so I am addicted to pornography that contains these. Can you help me please?" This man is not addicted to pornography. He has a fully understandable desire to take part in certain types of sex, and his wife, because of (I imagine) her religious or family beliefs, will not take part in those types of sex. So then HE is an addict? No, SHE is an addict to traditional values that restrict her from exploring certain sexual activities that are perfectly fine to partake in. When a man says he is addicted to pornography, what I do first is to talk with him about his life situation, and beneath every "addiction" I generally find a wife who is not interested in sex, a man who is afraid to talk to women, or a man who has been told that sex and/or are shameful and wrong. But, of course, we are very sexual by nature, so we WILL have sex one way or another, and often that's through watching pornography, which there is absolutely nothing wrong with. What I do is help men come to understand how they can solve whatever is causing them to watch pornography (if they want to stop watching it) or I help them understand how watching pornography can actually be a perfectly acceptable part of a sexual existence. Naked Therapy helps men achieve better lives.

Despite her grounding and theoretical understanding of some aspects of , Sarah isn’t a licensed therapist or even a self-described life coach. She has a disclaimer on her website that her services are not intended to be therapeutic, but informational only. But, her work seems more than titillation or mere entertainment. Sarah looked into going to graduate school and pursuing a degree and license in therapy, but was told that to do so, she’d have to stop doing Naked Therapy. She believes strongly that what she does is therapeutic, and helps people, but thinks it is best for people to know upfront that she is not offering a licensed service.

I had to choose: Stop practicing Naked Therapy and get my license, or keep practicing Naked Therapy unlicensed, and I chose the latter.

Sarah’s not worried about professional licensing boards coming after her for use of the term “therapy/therapist,” but she is cautious to avoid using words such as counselor or psychologist, which could result in sanctions.

Unfortunately, as Sarah’s work crosses state lines via teleconferencing, she could find potentially find herself subject to licensing boards in other states. This seems somewhat unlikely, but as many licensed clinicians have learned, professional boards can be mercurial, vindictive, and unpredictable at times. Some have recently taken action against coaches and other advice-givers who cross state lines, using teleconferencing, though such actions have typically emerged from complaints by clients. Given the sexual nature of Sarah’s work, I can imagine that in such a case, being seen as merely a “webcam girl” could actually be protective, as clinical licensing boards might not feel her services are credible enough to restrict.

Regardless, Sarah knows her limits. She refers clients to licensed and specialty therapists when she feels they need more than she can offer, such as dealing with clearly organic issues such as and brain injury, or where she feels they may benefit from “more advanced help,” and specialty services such as .

Sarah believes that she is being ethical and careful, by being upfront and honest, about her limitations and abilities, and about the nature of her service, saying:“I am a firm believer in patients knowing what they're getting into…” She clearly distinguishes her approach from therapists who cross ethical boundaries and become sexual with their patients. She argues that such patients aren’t treated properly or ethically when they enter treatment thinking that rules and expectations such as ethical boundaries around sex, will be enforced. “It's all about acting in accordance with what is laid out in the beginning so that no one feels taken advantage of and treated unfairly,” she says. Though she might not describe herself thus, Sarah is supporting her clients’ rights to determine for themselves what they need and is enacting a unique form of client-directed therapy.

Kate Franks, PhD., is a researcher and former exotic dancer, who argues that men go to topless clubs for much more than the nude women. In such environments, Franks has suggested that men can behave naturally, not suppress their sexuality, and are seeking acceptance by women in such clubs, even as they indulge their desires to sexualize and leer at women. Sarah appears to have hit on the same phenomenon and has found a unique way to respond to it.

Sarah’s business reminds me of another entrepreneur and "therapist" who provides “cuddling” for hire, and the current controversy over the "cuddling app." They are all recognizing and responding to an unmet need for people to connect, and be accepted. In the 1970s, some mental health therapists did practice “naked therapy,” during the heyday of Free Love and the hippie movement.

Some of my older colleagues have told me stories of conducting naked group therapy sessions. Modern therapists have suggested to me that in some cases, such as disorders, they believe that naked therapy might actually be therapeutic and beneficial. But in today’s American business and liability environment, it is essentially impossible for a licensed clinician to include such activity in their work, regardless of its potential therapeutic benefit.

Entrepreneurs and creative thinkers like Sarah White are recognizing the effects of these limitations that have been imposed on how traditional therapy can work, and are using the power of modern communications technology to circumvent these limits. Men, particularly heterosexual men, traditionally access psychotherapy far less than other groups. The high rate of in men is often attributed to this, at least in part, and if Sarah's work is getting men to engage with help and support, it's hard to argue with.

Source: Used by permission: JM Darling for SarahWhiteLife.com

I’m not professionally inclined to take my clothes off in front of a patient, even on-line, and would certainly discourage any of my own employees or interns from doing so. But, I would certainly accept a referral from Sarah, and I can imagine times when I might refer a man to her. Like Cindy Gallop’s “Make Love Not Porn” initiative, Naked Therapy is trying to change the world and the way we view sex in our lives and society. I’ve got to say, I’m cheering them on. Psychologists, and our industries of mental health and sexuality , need to be taking these people and their ideas and questions more seriously. Believe it or not, they have things to teach us.

You can follow Dr. Ley's musings on therapy, sex, and the business of mental health on Twitter @DrDavidLey.