Infertility is ranked by psychologists as high on the stress scale as that of a life-threatening disease. Emotional reactions to infertility occur on a Grief Continuum©, range from basic grief about the difficulty or inability to have a biological child to a post-traumatic stress reaction that often lasts for a period of time even after the medical treatment is ended. The diagnostic manual that psychotherapists use describes Post Traumatic Stress Reaction (PTSR) as caused by extreme stressors which infertility fits the definition of and the diagnostic criteria even include fears of the future such as the fear of never having a child. The PTSR includes physical, cognitive and emotional reactions to anything that reminds the person of the original trauma. In the case of infertility, the underlying anxiety is frequently the new and acute awareness that “bad things can happen to me” or as people attempt other family building options “something will go wrong and I will never have a child”.
While these anxieties and the related physical symptoms are challenging, PTSR often responds extremely well to professionally-led support groups where the reactions to the infertility experience are normalized and worked through, and resilience skills can be built to cope with either the infertility process itself or if they chose specialized groups dealing with other family building options such as donor options or adoption. Sometimes people need or prefer individual counseling. And others like Mind-Body groups where they focus directly on building coping skills. With counseling many infertility patients dealing with reactions all along what I call the Grief Continuum© can do exceptionally well over time. Successful living during infertility treatment isn’t easy. I have outlined a basic plan for protecting your mental health during infertility treatment or during the exploration of your
other family building options.
Nurture your relationship
You start with infertility treatment because you love each other and want to have a baby together. Remember that the process can help to connect you to each other but can also hurt, because it is so stressful and stirs up so many feelings. So be mindful of each other’s feelings. Accept that it is unlikely that you will deal with infertility issues the same way. Accept that the relationship must come first. Love and marriage came first. Remind yourself that individuals’ feel or see things differently when responding to the same crisis. You each had different backgrounds and influences. You may have even chosen each other because your differences complement each other. Yet infertility often occurs early in a marriage before these differences have been balanced. Try to be willing to talk about differences.
Men and women can react differently. It helps to understand how your partner processes problems and issues. Women often need to process verbally and express the nuances and intensities of their emotions. Men traditionally like to solve problems and may respond with answers when all their wives need is listening. Women may feel agitated when their husbands are so focused on solutions because being listened to feels more emotionally validating to them.
It helps if men listen more or if women seek an infertility support system in person or even online. It helps if women understand that their emoting may make their husbands feel helpless and that even when their husbands do understand the emotions, they have that urge to do something. Be patient with each other.
Infertility is stressful. Stress makes communication harder. You may want to learn some communication and decision making skills. You have so many stresses to deal with and a number of decisions to make. Making decisions together can be very complicated. What may relieve one of you may be too anxiety producing for your partner to deal with yet. Accept that it is unlikely that the two of you will resolve infertility issues at the same rate. Give your partner some time and space to work his or her issues. Try to talk to each other. And always remember that talking is not doing.
Keep in mind that you need to stay on the same page and find a solution together. Anger can to be directed at the situation or the process, not each other Help each other with the stresses. You don’t have to go to every family or baby involved event during this time if it’s too much for you. If you do go, limit the time. Make signals to let your partner know you are in distress. Assign a supportive family member to change the topic when a topic is too upsetting for you.
Enjoy each other again. Do whatever the two of you always enjoyed. Get theater tickets, go on a vacation, or enjoy a hobby together. Try something new, like yoga that is relaxing, or that is nurturing. Renew your sense of joy in your relationship. Recommit to each other.
The purpose of a family is to nurture the development of its members over the course of a lifetime. If you can remember that and begin with that position now you will be creating not only a healthy environment for yourselves but good role models and a healthy environment for your child to enter into.
Take care of your physical health
Don’t forget your regular medical check ups. Often the idea of another doctor is hard to bear during medical treatment. Women need to remember that with all the doctors they are seeing, they still need a standard gynecological exam, and both partners need to stay on top of any health issues they have.
Use a “No Regrets” System
Between or after medical treatments and monthly cycles, take time to explore both your emotions and the practical aspects of your family building journey. You may be distressed, depressed or resentful that you have to deal with doctors and other professionals to do what most people can do with ease. Yet you will want to think about your personal resources in terms of time, money, and emotions. Exploring your feelings and your options can help you to make good plans together. Informed decision making can lead to “no regrets” as time and other resources get used up. For some people it is hard to see beyond the immediate cycle. While that is fine at the beginning of medical treatment, take a pause after each cycle to reconnect with your feelings, your questions and your partner. Talk to professionals or peers so your next steps are mindful of both immediate and long term considerations.
Knowledge is power
Don’t reinvent the wheel, resources are plentiful. Use short cuts; tap others who have done this before! Ask your doctor questions. Learn about medical procedures. You don’t need a medical education but you don’t need to be surprised every step of the way during an IVF cycle. Learn what to expect so that you feel more prepared. If you can’t concentrate at the group training at your IVF clinic, ask one of the nurses to review the steps of a cycle with you before you start. Try to meet some peers (RESOLVE ) or (American Fertility Association ), or at a local professionally led support group (EG, IAC Center ). Learn how other people are dealing with the procedures, their emotions and their choices. Use books. See Tapestry Books Learning about infertility can give you a sense of empowerment and help you with the process.
Get support when you need it
Join a support group – group sessions aren’t necessarily gloomy. In fact many of the sessions are full of laughter and could even be considered upbeat. People feel good because they are in a room where all of the other people are in the same boat at the same time, and they can let off steam about the process, get tips, and enjoy shared infertility related humor. Sometimes women really enjoy groups because it gives them a chance to talk and to get emotional validation. When you meet adult friends during stressful times sometimes you make a friendship that lasts.
Or just meet a friend or another couples experiencing infertility to see how they are dealing with their concerns & questions, or to enjoy a night out together where all subjects feel safe. Some people prefer individual or couples counseling with a counselor familiar with infertility and family building options issues. Look for short-term, focused counseling not long-term therapy at this point in your family building journey. Reactions to infertility should not be seen as indicative of deep-seated psychological issues. Infertility stirs deep emotions and real problems that need to be addressed.
At the IAC Center, we have seen a range of reactions along our Grief Continuum. The range includes the basic grief reaction, anxiety reactions, a state of grievance in which a person is stuck between denial and anger in the grief process, and the Post Traumatic Stress Reaction. While all of these emotions are treatable, you can help your selves by nurturing your relationship, taking care of your physical health, gaining knowledge, using a “no regrets” system and getting any kind of support that works for you.
I wish for you successful living during infertility. The tools you develop to cope with this can only add to your tools for life. Surviving infertility can make you stronger.
Joni Mantell, LCSW, Director IAC Center