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Infertility: Interventions for Shame, Mourning, and Feelings of Inferiority
On the last track, we discussed belief systems regarding infertility. This included uncovering beliefs about infertility and fertility and locating the origins of these beliefs.
On this track, we will discuss two more beliefs about infertility. These will include maleness and femaleness and children and parenting.
#1 Maleness and Femaleness
In order to avoid getting caught up in a debate about what is nature and what is nurture, we take the position that each perspective offers a way of understanding the differences that arise between men and women.
Have you found, as I have, that although men may appear to experience less distress, their actual distress may be closer to that of their partners’? When content, rather than the extent of the distress is analyzed, men and women seem to have similar responses to the infertility in the areas of role failure, loss and reduced self-esteem, helplessness, guilt, inadequacy, and a focus on having a child and a willingness to go to great lengths to do so. Over time, as men and women continue to struggle with infertility, differences between them tend to decrease.
I have found that discussion regarding gender-linked differences with couples can help them to understand each other. I have also found that discussion can minimize conflicts that arise when one partner tries to impose his or her feelings and attitudes on the other.
Rigid Gender Stereotyping
Ben and Cheryl had just learned that Cheryl would be unable to carry a pregnancy to term. I asked, "Which one of you will feel saddest about not having the opportunity to experience a pregnancy?" Ben stated, "I think I will…I’ve always wanted to see and feel our baby grow inside Cheryl…I’ve been fascinated with our friends’ pregnancies. I think it’s such a miraculous process."
Cheryl stated, "I hate to say this, even though I want a child more than anything else in the world. If we have to have a baby without my experiencing pregnancy and childbirth, I’d feel just fine about it…I’ve always hated any kind of physical inconvenience and pain, and blood terrifies me. I could easily do without it…Ben’s the one who’s always been excited about pregnancy and being there to see the baby born."
Toward the end of the session, Ben and Cheryl told me that asking questions not directed to one or the other partner in a gender-role played an important part in helping them to process their feelings about infertility. These questions had an important effect on each of them and on their relationship. Ben stated, "This allowed me to feel comfortable with my atypical attitude, and furthermore, I feel it’s helped Cheryl and I to accept the other’s ideas and feelings without assuming we were in any way abnormal."
#2 Children and Parenting
When I asked Chase, age 40, what his thoughts were regarding being a father, Chase stated, "I want to leave my mark on the future…I can’t imagine doing that without a genetically related child." When Chase and his wife, Margo, age 38, learned that she could neither produce viable eggs, nor carry a baby to term, Chase believed he could never be a father, and became extremely depressed.
Margo, on the other hand, came from a family in which there were several relatives diagnosed with several mood disorders. Margo stated, "My mom and my brother are chronically depressed and my family often refers to my mother and brother as their ‘morose and suicidal’ forebears. When I was little, I loved visiting other peoples’ families and anybody else’s home was always cheerful compared to mine!"
Margo had few reservations about adoption, and actually preferred not passing along her family’s genes, thereby placing a child at risk for depression. However, because Chase was so depressed about not having a genetically related child, Margo had undergone several cycles of infertility treatments fearing that if she did not, Chase’s depression would worsen and become long-term like the depression in her family.
My discussions with Chase and Margo about of the value and meaning of children and parenting included beliefs in regard to genetic relationship, adoption, and life without children. Because Chase and Margo’s chances of having a genetic relationship to a child would decline over time, we revisited the options of adoption and no children.
11 Questions for Revisiting the Options
Four Additional Questions
I asked Chase to think about whether there were other ways to "leave his mark on the future," and I asked Margo to think about whether Chase’s sadness could be viewed as anything other than a psychiatric problem. Margo was able to distinguish between pathological depression and sadness as an expression of grief. Margo was then able to acknowledge Chase’s feelings and comfort him. Chase, for his part, began to see the value of passing on his life experiences and not necessarily his genetic make-up.
On this track, we have discussed two more beliefs about infertility. These have included maleness and femaleness and children and parenting.
On the next track, we will discuss facilitating mourning. This will include the "mourning ritual" technique, mourning and attachment, support systems and who knows what.
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