ConceiveOnline.com: One of your studies, published in 2011, looked at something called Acceptance and Commitment Therapy (ACT) and how it might help treat stress from dealing with infertility. Specifically, ACT can help couples accept and come to terms with difficult emotions about infertility, like disappointment and feelings of failure. Can you share a couple of techniques our readers could try that they might find useful to ease stress related to TTC?
Dr. Brennan Peterson: One of the most basic techniques I use with clients is “cognitive defusion.” This basically means that people learn to observe thoughts as thoughts without getting tied up with the negative implications they carry. For individuals TTC, cognitive defusion techniques can play a major role in decreasing the power of unwanted thoughts and thereby reduce their negative impact. It sounds simple, but one easy way to do this is to insert the phrase, “I am having the thought that . . .” in front of any negative thought. One of my clients said that this was the most helpful idea she learned during all of therapy.
Cognitive defusion is a simplified aspect of the larger practice of mindful acceptance – or being present with your thoughts, feelings, and physiological sensations in a compassionate, non-judgmental way. Mindfulness is becoming more integrated into therapy and counseling, and research supports its effectiveness in reducing stress and helping people cope with difficult life situations. Women TTC who struggle with disappointment or feelings of failure can learn to mindfully accept these difficult emotions and accompanying thoughts and feelings rather than avoiding them. This can seem like a crazy idea at first, but avoiding infertility-related thoughts and feelings is similar to getting your fingers stuck in a Chinese fingertrap – the harder you try to get out, the more you get stuck. To get relief, you need to do something counterintuitive, and with those TTC, it is accepting the painful thoughts and feelings and letting go of control.
ConceiveOnline.com: You've also written on infertility counseling -- finding a counselor who specializes in issues surrounding TTC to help women and couples navigate this difficult emotional territory. What's your advice for finding a therapist or counselor to work with?
Dr. Peterson: The most important thing in finding a counselor is finding someone who you are comfortable with. If you don’t have a good fit with that person, you aren’t going to feel much better about your situation. You can go ask your OBGYN or infertility specialist for a referral to a mental health professional they trust. You can also contact RESOLVE or browse therapy websites such as Psychology Today. Call them up and talking with them about their approach. Schedule an appointment. If you don’t feel 100% comfortable at the end of the first session, seek out a new counselor.
ConceiveOnline.com: How do you know if you need to talk to a mental health professional? Are the signs different for men and women to look for? When might seeing a counselor be useful?
Dr. Peterson: When infertility stress leads to depression, anxiety, or relationship distress, it is time to seek counseling. In my experience, the first few sessions are heartbreakingly sad, but they are also so cathartic for the client. It is almost as if all the stress and pressure has been building forever, and they finally have a place to release all of those emotions.
With regards to gender differences, women are more likely to experience depression and social isolation, and talking to a counselor about her many losses would be valuable. For men, distancing from infertility-related conversations and acting like the infertility doesn’t matter that much to them is a good indicator they could benefit from counseling. A lot of my research has looked at these gender differences and has examined how one partner’s coping strategies impacts the mental health of the other. A man’s distancing from the stress of infertility can raise depression levels in his partner, while for women, her inability to talk about how difficult the infertility is with others increases his marital stress. Counseling can help normalize these reactions and provide a space where couples can discuss their differences, pains, losses, as well as their plans for the future.
ConceiveOnline.com: What would you want all couples dealing with infertility to know, that they might not?
Dr. Peterson: First of all, I would want them to know that they are not alone and that there are many good people who want to help them. There are therapists, medical professionals, and others who can help. If they can find the right people who understand their struggle, it will make it easier to deal with. Second, they should know that it gets better over time. Our research has shown that even couples who are undergo years of unsuccessful treatments find a reduction in their personal stress over time. The strong feelings of discouragement, depression, and frustration will not last forever, and ultimately, they will be able to get their lives back. Finally, they should know that the experience of infertility may change them in positive ways. One recent study I read interviewed people many years after failed infertility treatments. Of the 65 participants who were interviewed, all but one said that if they had to do it all over again, they would! This is astounding given how difficult this experience can be. I think that this speaks to the nature of enduring unexpected challenges. Many people comment that they wouldn’t trade the infertility experience for anything because it made them a kinder, more compassionate person in the end.
Dr. Peterson has kindly offered to send copies of his research or answer inquiries about infertilty counseling; you can email him at email@example.com
Brennan Peterson, Ph.D., is an Associate Professor of Psychology in the Crean School of Health & Life Sciences at Chapman University. He is also the Director of the Marriage and Family Therapy Program. Dr. Peterson researchers the mental health implications of infertility and is a member of several international research teams. He has collaborated with researchers at the University of Copenhagen in Denmark, Uppsala University in Sweden, and with the Special Interest Group in Psychology and Counseling of the European Society for Human Reproduction and Embryology (ESHRE). He has delivered numerous national and international presentations on his infertility research and has published articles in Human Reproduction, Fertility & Sterility, Family Relations, Cognitive and Behavioral Practice, Family Process, the Journal of Marital and Family Therapy, Contemporary Family Therapy, and The Family Journal. Dr. Peterson is a practicing Marriage and Family Therapist (MFT) in California.