SEX THERAPY (Hansard, 6 December 1972)

§ Mrs. Jill Knight (Birmingham, Edgbaston)

I am raising this matter and asking that investigations take place because I was recently handed a full and detailed testimony from a girl who volunteered to act as a sex therapist earlier this year for Dr. Martin Cole of Birmingham. Dr. Cole has already achieved widespread notoriety, and the last thing I want to do is to add to his fame. But the situation revealed by the girl is so full of dangers that investigation is imperative. Other persons may be operating in this way. If so, the dangers are obviously more widespread. An investigation would presumably reveal the extent to which non-medical 1328 persons are setting themselves up as experts in a medical matter. That is the crux of the matter. Dr. Cole is not a doctor of medicine; he is a doctor of philosophy who lectures to young students on plant life and genetics at the University of Aston in Birmingham.

The girl, whose deposition I have here and shall hand to my hon. Friend the Minister after the debate, is not a student, but she accepted an offer by Cole to become a sex therapist after she had read and rather admired an account of his enterprise in providing practical tuition for impotent males. She had formerly had a boy friend of whom she was fond who apparently had difficulties in personal relationships, and without thinking very deeply about the implications and about the kind of services Cole offered, wrote to commend him on them. He wrote back inviting her to see him and to become a sex therapist. She agreed. Her subsequent experiences and the fears and revulsions that arose from them are listed in her testimony.

She had imagined that there would be a clinical and medical connotation to the service she was to offer, and she was surprised not to be given any advice or training. She was handed two books to read, the first by a Dr. Philip Cauthery, an associate of Cole's—I do not know whether he is still an associate, but he was then. The second was by two American doctors who apparently offered sex therapy in a clinic in the United States.

Miss X was told by Cole that she should use her own flat. There was no question of a clinic. Among the reasons he gave was that some clients might want to stay for a weekend.

She was paid £1.50 per session by Cole. She asked about contraception and he advised her on that. She quotes him as saying, "We must not have any of our therapists getting pregnant, although you need not worry—we can always get you an abortion." As Dr. Cole was the prime mover in getting the first abortion clinic set up in Birmingham only days after the 1967 Abortion Act became law, he knew what he was talking about.

Miss X was warned that she might have to deal with some very weird types, and that some might be on drugs. She asked, somewhat fearfully, whether any 1329 might be dangerous, but Coles said that he thought he could recognise any potentially dangerous client and she was not to worry. I do not know whether she was naïve, or altogether too trusting, or what, but, as I have said, Dr. Cole is not a medical doctor. He not only has no knowledge of medicine, but he has no knowledge of psychiatry either, and I should have thought that in dealing with disturbed men even a psychiatrist might have difficulty in always stating that a man would not behave in a dangerous manner when under stress. It seems to me that there was, and still is, a real danger to girls who offer themselves in this way to clients of this type being attacked, possibly even done to death. Anyhow, Miss X was very trusting and she believed Dr. Cole when he said that he could protect her from any dangerous clients because he could recognise them.

A few weeks later, as her testimony shows, she was with a client when a thunderous knocking occurred on the door and the glass panels in the door revealed a blue-clad figure topped by a policeman's helmet. She knew at once that it was her fiance, who happened to be a policeman. He, I may say, had no knowledge whatsoever of the way in which she was offering her services, but there he was banging on the door, thereby considerably startling both her and her client.

It does not need very much imagination to consider what a slightly unbalanced man might have done in those circumstances, with the law hammering at the door and asking to be allowed in. Certainly there is no doubt in my mind that this girl was in considerable danger at that time, and although the situation has overtones even of farce, surely nobody would connive at the danger in which that girl was at the time.

I shall draw a veil over the rest of the saga, but on the last page of her testimony Miss X said: I was panicky and out of my depth. I felt like a common prostitute. I just wanted to go out and leave everything behind me. What kind of system was it where patients knew my name and address and could visit me at any time; where I was told to counsel a patient without being given any training whatsoever; where I had to contend with 1330 ex-inmates of mental hospitals and makers of obscene telephone calls? She was not likely to run short of work, since at one point Dr. Cole informed her that he had about 400 men on his books.

I return to her testimony: where, after sessions, I often had to spend three or four days contacting Dr. Coles to tell him of what occurred; where therapists were paid £1.50 a session like factory piece work. I had lost my boy friend and the prospect of our married happiness and lied and deceived to keep my connection with Dr. Cole secret. It is not surprising that she did that. She did not tell her parents or any of her friends, but the fact that she had lied and deceived, which was not usual in her character, clearly upset her. She went on to say: I had cheapened myself in an utterly ill-conceived cause", and her final words were: It is like a really bad dream". I have no wish to debar any person who needs medical treatment from getting it, but surely such treatment can be given safely only within a proper medical context by doctors who know what they are doing, and within the National Health Service. The hazards of such a non-professional set-up as Dr. Cole has are even greater than Miss X lists. What about the dangers of venereal disease? One man about whom Cole briefed the girl had, said Cole, "tried 50 prostitutes". One has only to think about that to considers the dangers the girls are in from VD.

What about the personal lives of the women used by Cole in this way? If they are married, it is difficult to envisage that their employment would not have a disastrous effect on their marriage, for how could a normal marriage relationship possibly endure under such circumstances? If single, their chances of making normal marriage with a normal partner would surely be very much lessened. Men and women are not robots. Emotions do come into this in, I imagine, 90 out of 100 cases.

Miss X had some trouble with a client who became too fond of her. She told Cole about this, and he replied that it was almost inevitable. Her words on that are: He is getting so fond of me he might get funny when he thinks I'm going with other 1331 men. I don't think it's a good idea that he knows my name and where I live. He could arrive at any time. It puts everything on too personal basis. Dr. Cole shrugged off her worries.

This is not a pleasant or savoury subject to raise in Parliament, but I was sent these details by someone to whom Miss X passed them. She is a constituent of mine, she has been through a considerable amount of trouble because of this, and I feel that since the whole dossier was handed to me she clearly has a right to expect me to take action on her behalf and to raise the matter here. This is a case of a woman being coldly and cynically used by a self-styled sex expert with no thought whatsoever of the harm that might come to her, and it is quite clear that other women are being used with similar callous disregard. Here is something that Women's Lib might take up. It seems to me that this is a far more serious instance of women being used than a beauty competition, however large and well publicised it is.

I am offering no suggestions whatsoever about the motives which drive Cole on. He has set up what he calls the Institute of Sex Education and Research in his own home, and goodness alone knows what goes on there, but that is his affair. I make no suggestion that his aims are mercenary. For all I know, he pays the £1.50 out of his own pocket. Certainly there is no evidence in the testimony that I have that any money passed between the client and the therapist.

But whatever Dr. Cole's aims may be, he should not be allowed to use a woman as if she were some sort of human kidney machine. Miss X involved herself quite voluntarily because she had no idea what she was letting herself in for. There is no doubt that the experience has harmed and distressed her, and it is possible that she will never recover from it. But how many other Miss Xs are there, and how does he recruit them? He is constantly in touch with young people, and this fact in itself must give cause for concern.

Are there other Dr. Cole, with a similar zealous fervour for sex and a similar lack of medical qualifications, operating elsewhere? They bring the whole cause of sensible sex education and balanced 1332 views on it into disrepute, and if ever there was a case of abuses I submit that this is it. I am grateful to the House for permitting me to put forward this case on behalf of my constituent, and I beg that investigations be carried out so that other women are not used in the way in which Miss X has been used.

§ The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)

I am grateful to my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight), not only for raising this important subject, but also for being kind enough to give me a little advance notice of the material that she would be presenting to the House.

Although what might be broadly termed sex therapy has been known in one form or another since time immemorial, it is only in the last 100 years or so that sexual problems have been recognised as calling for dispassionate and scientific study and treatment. The problems are varied and cannot always be clearly separated from other forms of behavioural problems. Treatment methods are almost equally diverse. For instance, successes have been claimed for treatment of some forms of fetishism and homosexual tendencies by something akin to aversion therapy—patients have been subjected to sexual stimuli which have been simultaneously accompanied by electric shocks. Other treatment approximates to psychotherapy as it is usually understood, or simply to counselling. Certain sex problems are treated by prescribing hormones and other substances.

Treatment for sexual problems is of course available under the National Health Service both from general practitioners and from the hospital and specialist services, but I do not think that it would be wise to attempt to prohibit treatment by persons practising outside the National Health Service. This would be contrary to the principles we have followed, whatever the political complexion of the Government, since the inception of the National Health Service. It has always been accepted that people should be free to decide for themselves whether to avail themselves of National Health Service treatment or to choose to be treated privately.

1333 I would regard that freedom of choice as particularly important in the field we are now considering. Just as, in the field of family planning, there must be many people who find it less embarrassing to consult complete strangers rather than go to the family doctor they have known perhaps for years, so people with sex problems may shrink from talking to their general practitioner and prefer to arrange private treatment or consultation.

It would be possible, in theory at least, to regulate the provision of sex therapy services outside the NHS rather than prohibiting them; but when this possibility is considered in detail it becomes apparent that we should encounter very serious problems and might well do more harm than good, by driving things underground.

The first difficulty would be to define what we wished to control. I have already indicated something of the diversity of treatments which are being practised, and in a field where there is still so much to be learned it would clearly be wrong to forbid or even seriously to hamper legitimate and responsible inquiry and experiment.

This is not to say that we should permit or condone any excesses or misdemeanours merely because they were committed in the name of research, or masqueraded under the title of science. The Sexual Offences Act, 1956, already proscribes various practices; I assume that my hon. Friend has already considered whether the particular acts to which she has drawn attention constitute a breach of that law, which is detailed and specific. It is open to her or to any other hon. Member who considers that Act to need revision under modern conditions to initiate the appropriate action.

Another possibility which might be considered is the prohibition of the provision of sex therapy services by anyone who is not medically qualified. My hon. Friend mentioned this as one of the points that she particularly wanted to pursue. However, this again would be contrary to the tradition of freedom and tolerance to which we are accustomed. We recognise that not all the advances and discoveries in medicine have been achieved by doctors and that the unorthodox practices of one generation may conceivably become the accepted treatment of the 1334 next. Sigmund Freud, the great pioneer in the treatment of sexual problems by psychological methods, had to face bitter hostility from his medical colleagues before his theories began to gain acceptance.

There are only two categories of disease in respect of which there are restrictions on treatment or offers to treat—namely, venereal diseases, under the 1917 Act, and cancer, under the 1939 Cancer Act. In each case, there are obvious reasons of public interest for the restrictions. I do not at present think that it could be maintained that sex therapy could be regarded as coming into this category.

Having said all that, I am sure that every other hon. Member who has heard my hon. Friend would fully agree with her in deploring any attempt to exploit the needs or the weaknesses of ordinary, perhaps gullible, citizens for private gain. Particularly would we deplore any such attempt which involved the use of agents who may not be fully aware of the dangers to which they are exposed, of which my hon. Friend has given a striking example, and who may themselves be subject to exploitation and misled as to the true implications of what they are doing.

As I have suggested, certain practices are prohibited by the Sexual Offences Act, 1956. It is also possible that some of the more irresponsible and ridiculous claims which might be made would come within the scope of the Trades Descriptions Act, 1968 or the Fair Trading Bill, which is now before Parliament—[Laughter.] This is a serious point, and I hope that my hon. Friend will weigh it carefully.

In this field, the difficulty is to control the objectionable elements in advertisements or actual practices, without unreasonably hampering responsible treatment or experiment, whether or not it is within the National Health Service and whether or not the practitioner is medically qualified. I am sure that this debate has been useful in alerting the House and public opinion to the dangers inherent in the practices to which my hon. Friend has drawn attention. It may well be that public opinion will prove a more flexible and potent weapon in combating them than direct Government action.

1335 Nevertheless, I propose to consult my colleagues and to seek any expert advice which may be necessary on whether, and if so what, limits should be set by Government action on sex therapy services outside the National Health Service which are organised and offered to the public.