BRIA spoke to Deanna Kiley, MSW, an experienced therapist who sees individuals and couples who are trying to conceive. She sheds light on the importance of opening up the conversation on what it means to struggle with fertility, and how to support someone facing fertility challenges.
BRIA: What’s the most important thing you want your clients to understand about the therapy you provide?
Deanna: I find it’s very important to provide a safe space for people to be listened to, validated, heard, and to help them recognize that what they’re experiencing is normal and expected in an infertility world. The hardest part of clinical practice is wanting to give them what they need to solve their problem because that is what they are searching for, the thing they are longing for. But what I help them to understand is that there’s no quick fix; what is important is that they give themselves time and give themselves the opportunity to talk about their experience. One session with a counsellor may not solve all their problems, but it will get them started on learning to better manage the overwhelming grief they’re experiencing. Time, and a lot of patience, are often the key factors to successful therapy.
BRIA: What role does anxiety play when people are struggling to conceive?
Deanna: Infertility can overtake the sense of self, the sense of achievement, and the ability to concentrate on anything but trying to conceive or have a successful pregnancy. We all like to believe we can control what’s happening in our lives, and there’s a huge sense of loss of control through the infertility journey, and a lot of unknowns and uncertainty that can cause anxiety responses. Similar to other anxiety-provoking experiences, people have triggers that increase the anxiety or put them into moments of arousal, and they start to feel that they can’t function at work, in social environments, and even in their relationship with their partner. That’s usually when they seek help because they recognize that the overwhelming anxiety spills over into every area of their life. They stop focusing on the things they enjoyed and instead focus on fertility and how they can create an environment of perfection to make the pregnancy happen. Therapy can help them get back to recognizing who they are as a person, by helping them to try to separate the infertility challenges and learn to live again, and to partake in activities that are good for their mental and physical health. This improved sense of wellbeing may inevitably have a positive influence on their fertility treatments and path.
BRIA: What are some other mental health issues you see in this population?
Deanna: I would say that infertility can lead to a significant grief reaction, and it can be complicated because it’s a unique and invisible experience. When people experience fertility challenges, their grief is real; they need time and space to work through their frustrations, envy, fear, shame, and feelings of uncertainty. You can imagine a person or couple who finds out they’re pregnant at four weeks, and then they have a loss at six weeks. To them, in those two weeks of pregnancy, they have imagined a whole life with this child, a new start, and the growth of their family. Whether they want to acknowledge it or not, even when trying to be cautious, they have invested feeling, emotion, and energy into this achievement. The grief of this loss can be devastating, especially after trying so hard. Infertility diagnoses, disappointing diagnostic tests, failed cycles, negative pregnancy tests, and every single loss along the way can be a significant or cumulative loss.
BRIA: What’s the best advice you can give to a support person- family, friend or therapist- who is trying to help someone through their fertility struggles?
Deanna: Respect for the person’s individual experience, time, patience, and empathy are important. That’s probably the easiest piece of advice for people supporting those dealing with infertility.
As a support person, it’s important not to minimize or invalidate this experience. Every person’s experience is unique and individualized, and if they are not “moving on” or “getting over it,” there is a reason for that, and they need support in working through what they’re feeling. Sometimes simply saying, “I’m sorry you’re going through this,” is enough to validate their feelings, or “let me know if I can help”. Remember that people struggling to conceive often experience avoidance, feelings of being left behind, restrictions in diet, exercise and what they feel they can do with their own body. A helpful gesture would be to encourage them to go for a walk, plan a one-on-one visit, or bring them their favourite meal. Sometimes it’s better to just take supportive action and limit the decision-making process; there are so many decisions to be made along the fertility journey, sometimes it’s nice to have someone just do something for you without asking!