Helen Hunt sits in a hotel room, her back to sunshine flooding through the window, so it’s hard to see her face properly. “How would you feel if I knit while we talk?” she asks, taking needles and wool from her lap. “I might seem like a crazy lady, but it’s a present for my daughter.” (Eight-year-old Makena’lei, which means “many flowers of heaven” in Hawaiian.)

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It seems incongruous to watch her knitting away while we discuss how she feels, aged 49, about spending most of her latest film stark naked, as a sexologist altruistically bringing a paralysed polio sufferer to sexual fulfilment. A last taboo – sex and disability? “I guess so,” she says. “Stupidly.”

The Sessions, which has garnered Hunt both Bafta and Oscar nominations as supporting actress, is based on a 1990 article On Seeing a Sex Surrogate by the late poet and journalist Mark O’Brien (played in the film by John Hawkes). O’Brien was paralysed from the neck down after contracting polio when he was six. He hired a certified sex surrogate, Cheryl Cohen Greene, a married mum and now grandmother who is still working, to relieve him of his virginity at the age of 38. The sex scenes are leavened by a surprising amount of humour, particularly when O’Brien discusses his predicament with a Roman Catholic priest (William H Macy).

Hunt was nervous, “but not so much that I didn’t show up. It’s a special movie and the shock [of her being naked] is part of it. I never thought, ‘My God, I can’t do this.’ I was so moved by the script. My partner [producer/director Matthew Carnahan, father of Makena’lei] read it and wept because he thought it was so beautiful. One obstacle was my self-consciousness but I had lunch with Cheryl, and she was very extrovert, so that’s how I play her.

“I’d never heard of surrogates so I had no pre-judgement but I realised it’s serious work, which was a foot on the gas to get me through any nerves. Sex makes us nervous. We joke about it, have shame. They give this film an R-rating yet provide violent movies for 13-year-olds. I’d heard Americans are weird about sex, and you really see it when you offer up a piece of work like this. You’d really have to work to make it into something perverted. It’s so pure.”

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She says she’d like 16-year-olds to watch it as a sex education tool – except her own. “I have a stepson and it would be bizarre for him to see me naked.” It would be churlish to doubt her good intentions and the film is too matter-of-fact to ever be accused of voyeurism. There are other films that depict sex with disability (Rust and Bone) or without commitment (Friends with Benefits) but The Sessions is the most vivid and, I suggest, the most sexist. Cheryl takes a full-length mirror into one session to let O’Brien see his own aroused body – but nothing is shown on screen. Hunt admits, “That’s a good point. But I’m naked five minutes after the opening scene, and the mirror comes at the end. It wouldn’t have worked.”

Hunt has had a diverse career, starting at ten, encouraged by her father, Gordon, a film director and acting coach. “I feel I was designed to go into the theatre, but then a left-turn happened – I was in an acting class with my aunt and an agent came along.” She’s quoted as saying movies are great in your twenties – “You go places, have affairs” – and that sometimes she felt too grown up for it. She bristles. “None of that’s true. In my twenties I was a journeyman actor who took the parts I was given. Now it’s different. To say ‘yes’ means not picking up my daughter from school, and that matters to me.”

Indeed, she’s been out of the limelight since What Women Want in 2000. “I slowed down in terms of mainstream, but did plays, made a movie and had a baby which is fantastic, like winning the lottery. I have a lot of interests.”

She directed, co-wrote and starred in Then She Found Me in 2007, with Colin Firth, Bette Midler and author Salman Rushdie as her (miscast) gynaecologist. It took ten years to complete. “When financing fell apart for the fourth time, I wondered who gets any movie made, and was told, ‘The one who doesn’t give up.’ There’s no other secret. You have to be tough, and I’m not. Eventually it was bought by a wonderful company – and they went bankrupt just before it opened worldwide. Crushing. I enjoy writing – except for the days when it’s horrible: you know something is missing and aren’t smart enough to work out what it is. You write until they give you money.

“I’ve acted in films where I only used five per cent of myself. I tend to turn them down – unless I’m being paid, which is a rare pleasure.” But she’s an Oscar winner, for As Good as It Gets in 1997 with Jack Nicholson. “I’ve made very few big-budget movies. The Sessions [out on Friday 18 January] was tiny and we were paid next to nothing. The whole thing cost less than the salary of many actors.”

That must be upsetting. “I don’t spend time being upset about what I can’t control. I’m not in it for the money. If I was, I’d go crazy. I love movies. I pay to see them, with popcorn. OK, my looks could go, but I don’t focus on it. I try to keep despair for real problems. I’m lucky to live in a time when people get to forge their own paths.” And she’ll continue to do that, whatever the hurdles.

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The Sessions is released in UK cinemas nationwide on Friday 18 January

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