The inability to become pregnant is often associated to one of the most distressing life crises for women and couples. Struggling with infertility can cause tremendous pain and if you are feeling sad, anxious, depressed or isolated, you are not alone.
We talked to Hong Kong psychotherapist Allison Heiliczer about the emotional weight of infertility and some of the coping strategies she recommends.
Why do fertility problems cause so much pain?
Fertility problems are often a huge source of emotional pain as they reflect feelings of not only personal failure but also communal. Infertility, even the very word, often connotes an inability to create, produce, and nurture and therefore places a heavy psychological load onto an individual or couple.
As much as we might not be aware of social forces at play while trying to procreate, there are still assumptions in many cultures and religions that in order for one to be fulfilled, he/she must have a baby, and by having that baby, those babies, that a couple fulfils a societal obligation. This often gets socially reinforced as people watch other people have babies and assume that they had no challenges doing so and wonder why they cannot. Their mind then often jumps to thinking they have failed or will miss out on experiences others have. This is often connected to emotional pain as the mind starts to wonder whether having a baby will ever be possible and if not, then could they be fulfilled? Some people also do not have the financial and/or emotional reserves to invest in fertility treatments or adoption and therefore feel that that if they cannot get pregnant “naturally”, they are doomed.
What are the normal emotional reactions to infertility? What are the differences between women and men?
I often see strong emotional reactions to infertility, and the feelings for some are so strong they feel consumed by them. Others, while not necessarily consumed, sense a radiating feeling in the background. While some people dominantly feelsad, depressed,angry, disappointed, depleted, and/or disoriented, most often, people have a mixture of emotions that can feel unbearable to carry at once because of their heaviness and/or conflicting nature.
I have also seen another, more taboo emotional reaction – relief. I have worked with people who do not truly want to have a baby and have tried to conceive because of external and/or internal pressure and feel relieved when they are having trouble conceiving.
Even though many people still believe women are the ones who render a couple infertile, only in about 1/3 of the cases is it often linked with the woman, another 1/3 due to the man, and the last third due to either to the couple or unknown. Even though the blame is often placed on the women, I have seen men equally as devastated and sometimes with less societal space to express this. While women are physically carrying a baby, if a couple is healthy and strong, then they are both psychically carrying it and therefore can equally feel strong emotions about infertility.
What are some of the coping strategies that you recommend for infertility?
Having support is hugely important. While I am a therapist, and therefore see the value in therapy for many, I don’t believe it’s the only source of support needs. Some people do well with speaking with family, friends, and/or seeking pastoral/spiritual guidance. Also, as remarkable is modern technology in assisting couples who face infertility, it’s important that couples unhook from the prescribed narrative that “they will have a baby if they only do X”. Many practitioners provide false hope, and so in order to really cope through the process, there has to be a healthy balance between hope and acceptance.
Couples’ counselling can also often be an important part of coping. Although each person in the couple has his/her own emotional experiences, it’s important to come together and process how the couple is being shaped by the experiences. People often assume that if couples are struggling with infertility, both people must really want a baby. While this is often true, I find there is often a discrepancy in how much emotional investment there is in the experience – in terms of time feeling/thinking and desire to invest emotionally, financially, and/or spiritually in trying to have a baby.
When should I seek psychological support for fertility problems?
- Pre-existing mental health issues
- Impacting partnership/marriage
- Impacting other areas of functioning – i.e. work, friendships
- Feelings of loneliness – that one actually lacks a support system or has one but still feels alone in his/her experiences
- General feeling or instinct that a supportive, objective ear, eyes, and mouth would be helpful
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