Yes to both, however those are the mechanical aspects of the interaction. What is much more important is the human connection between the client and therapist.
It's about the human to human connection that counts. To me, it is all about limbic resonance.
"It refers to the energetic exchange that happens between two people who are interacting in a caring and safe relationship. Their interaction stimulates the release of certain neurochemicals in the limbic region of the brain. These chemicals are necessary for full emotional and physical well-being. Without enough limbic resonance in our lives, over time, we function and feel less and less well. This is why isolation is bad for us."
"We are social animals; we need one another. As adults, we become depressed and anxious without enough limbic resonance in our lives. As newborns, we may die; if we don't die, we are going to be damaged by this lack. We are not self-contained, self-regulating units. We are regulated through our healthy interactions with those to whom we feel safe and close."
The providers (therapists, escorts, etc.) who understand this are the ones that know their craft and the need for human interaction in a safe, close, compassionate environment.
Sessions are rejuvenating and an affirmation of our humanity.