Coping with the Stress of Infertility
Contents
1. bilities in all infertility situations to practice stress reduc tion techniques How do You Decrease Stress During Infertility There are currently three psychological methods offered in the U S for individuals and couples experiencing in fertility individual couples therapy support groups and mind body groups To begin you need to think about your own individual needs and preferences You can contact your local RESOLVE chapter for information on therapists support groups and mind body groups in your area For more information visit www resolve org In addition to or in lieu o therapy support groups and mind body groups can offer strength and help to reduce stress using a more social approach Research showed a 55 take home baby rate for participants in mind body groups 54 for support groups and 20 for the con trols It was a randomized study so one third of the women were randomly assigned to mind body one third to a support group and one third received no psy chological intervention the control group All of the women continued to receive cate from their infertility doctor The psychological data showed the greatest im provement for the mind body followed by support and then the control groups Recent research on the type of support groups offered by RESOLVE indicates that par ticipants experienced increased pregnancy rates when compared to women who did not attend a support group Mind body techniques inc2. resolve Coping with the Stress of Infertility INFERTILITY AND STRESS by Alice D Domar PhD One of the many challenges of infertility is hearing the assumptions family and friends make about the relation ship between stress and infertility Wouldn t it be nice if what you heard on a daily basis was I am sorry that you have to go through infertility treatment What can I do to support your or I know it must be painful for you that your best friend is pregnant Should I go buy her a shower gift for you Instead you more often hear comments such as You are obsessed with this baby thing If you would just stop thinking about it all the time it would happen or If you weren t so fat thin if you would only exercise stop exercising if you would only do things differently from what you are doing you would get pregnant And of course the all time favor ite If you just adopt you ll get pregnant There does seem to be a universal assumption that infer tility is caused by stress There is also a universal ten dency to underestimate the stress that is caused by infer tility The goal of this article is to educate you about the stress and infertility connection both for your own knowledge as well as to give you information for your well meaning family and friends How Stressful is Infertility In a word very Research has shown that women with infertility have the same levels of anxiety and depr
3. sex be comes nothing but one more opportunity to fail at pro ducing a baby It becomes baby making not love making Dr Alma Berson a psychologist offers these sugges tions Talk about what it feels like to be focused on baby making rather than lovemaking Sometimes just talking about this can relieve some of the tension An other approach she says is to take a vacation from trying to actually use contraceptives for a month or two so that sex can be focused on pleasure rather than re production Perhaps your response is Never It would be just our luck that the cycle we took as a vacation would be our one and only chance for a successful pregnancy If you feel this way that you couldn t possibly take a vacation says Dr Berson then it s useful to take another look at your priorities A month or two without baby making can restore lovemaking and get the relationship back on track and prepare you to endure the frustration of baby making in the months to come Carol Frost Vercollone another psychotherapist advises couples to distinguish between work sex at fertile times and play sex at non fertile times She says It can be a relief to let go of expectations for passionate creative sex at ovulation accepting that sex at this time can feel more like required work During non fertile times try to let go of the requirements of work sex intercourse doesn t have to be your go
4. you are literally not alone there are millions of people in this country struggling with infertility Second it is completely normal to feel overwhelmed and isolated Third these feelings are not causing your infertility But fourth if you are feeling dis tressed much of the time not only is this clearly decreas ing your quality of life but it may render infertility treat ment less effective There are many things which you can do to feel better ranging from joining a support group to learning some stress management techniques Remember this is a temporary crisis The most impor tant thing to remember is that no matter how your infer tility is resolved you will be okay Alice D Domar PhD is the Director of the Domar Center for Complementary Healthcare in Waltham MA She not only estab lished the first Mind Body Center for Women s Health but also conducts ongoing ground breaking research in the field Her re search focuses on the relationship between stress and different women s health conditions and creating innovative programs to help women decrease physical and psychological symptoms and is the founder of the Mind Body Program for Infertility She is the author of numerous books including Conquering Infertility Viking 2002 COPING WITH THE STRESS OF INFER TILITY by Merle Bombardieri LICSW Although stress management techniques can significantly relieve your stress they can t eliminate it entirely Util
5. House Love P amp Robinson J 1998 Hot monogamy How to achieve a more intimate relationship with your partner London Piatkus Religious Perspectives on Stress and Growth Kushner H S 2004 When bad things happen to good people New York Anchor Schacter Shalomi Z 2003 First steps to a new jewish spirit Reb Zalman s guide to recapturing the intimacy and ecstasy in your relationship with god Vermont Jewish Lights Publishing Stephenson L R 1992 Give us a child coping with the personal crisis of infertility San Prancisco Michigan Zon dervan Grieving Sterns A K 1988 Living through personal crisis New York Ballantine Tatelbaum J 1993 The courage to grieve London Wil liam Heinemann RESOLVE Fact Sheet Series The information contained in this fact sheet is offered as part of RE SOLVE s educational efforts and is in no way intended to substitute for individual medical advice Discuss your medical situation with a qualified medical professional Copyright RESOLVE All Rights Reserved Originally published March 1988 Last update June 2007 The mission of RESOLVE is to provide timely com passionate support and information to people who are experiencing infertility and to increase awareness of infertility issues through public education and advo cacy Visit www resolve org today to find information and resources on all aspects of infertility and family build ing as well as e Your
6. dis traught despite your efforts to cope Expect these times and try to accept them as best you can If nothing seems to help a good step would be to see a counselor Most couples going through infertility find it helpful to have a few sessions with a counselor knowledgeable about in fertility It just might help you to get unstuck if you feel lost or in a blue period If you are eager to learn more about coping techniques sign up for a stress man agement course If there s a silver lining in the cloud of infertility it s that coping techniques that you learn can be used for the rest of your life in a number of situations They even make good preparation for parenthood We hope this publica tion will help make this time in your life a little more bearable and increase those moments when you can feel peaceful and positive The 20 Minute Rule First Aid for Couples in Dis tress The Problem Many infertile couples find themselves in this rut she s miserable about not having a baby and keeps on talking about it in hopes that he ll finally understand why she s so upset She also tries to find the magic words which will make him more supportive because even though he tries hard he somehow never seems supportive enough He s miserable because he can t stand listening to her night after night powerless to take away her pain After a while he only half listens in order to dull his frustra tion She escalates in i
7. e Allow time in your life for rest and recreation e Get plenty of exercise Not only does it relieve physical tension but if it s aerobic exercise like running or swimming you will actually metabo lize norepinephrine and serotonin the sub stances your body produces when youre under stress You will truly get rid of stress e Consider taking a yoga exercise or dance class at yout local YMCA health club or adult educa tion center Learn to breathe deeply When you re under stress your breathing tends to be too fast and shallow Practice sitting comfortably with your eyes closed and con sciously breathing long slow deep breaths You can either breathe in and out through your nose or in through your nose and out through your mouth Can you hear your breath Try to feel the pleasure of filling yourself slowly and calmly then releasing the air Fill not only your chest but also your diaphragm This is a won derful method for calming yourself when you feel pan icky Try doing this for five minutes You may want to try the following breathing technique Breathe in to the count of one out to the count of two in to the count of three out at four and so on up to 10 Then start with one again If you find yourself at 11 or above that shows that you re obsessing or your mind is wandering and you re having a hard time concentrating Simply return to one and try to stay more focused this time All Rights Reserved These breat
8. may think that the only reason she is willing to make love is to extract sperm from his body Infertility can have an impact on one s relationships with family and friends In all likelihood siblings and friends are getting pregnant Many of my patients don t want to go home for holidays because the sight of pregnant sib lings is so difficult They may have difficulty receiving support from their parents who may not understand enough about infertility may not agree about treatment choices or may be distracted by their own life issues If your friends are successfully building their families you may begin to avoid them thus losing social support dur ing your life crisis Infertility can also impact one s job You may be hesitant or unable to travel for work due to your treatments you may be late for work due to early morning appointments and you may need more flexibility for last minute treat ments such as intrauterine inseminations IUI s etc In addition many of my patients have found that while they can avoid pregnant friends relatives and neighbors they are unable to avoid pregnant co workers which can make the work environment intolerable Infertility can also cause a great deal of financial stress This can trans late to the need to work causing all of the stresses just mentioned to be more magnified Finally infertility can lead to a religious or spiritual crisis Many patients tell me that this is the fi
9. al you don t have to end up in the ideal position to deposit sperm near the cervix you can avoid worrying if sex this time will lead to pregnancy You may find you both want to make a special effort to create the setting for fun sex a resort motel room sexy lingerie your choice of erotic reading a candle lit meal or a playful bubble bath for two whatever feels right for you Another side effect of infertility related sex problems is feeling incapable of giving your partner any pleasure You can turn the tide somewhat by providing each other some pleasure in non sexual ways e Making him her a special meal or drink e Buying a present e Putting on favorite music e Surprising him her with tickets to a concert play or athletic event and e Hugs and hand holding or backrubs All Rights Reserved Some couples enjoy sexual sensual contact with each other that doesn t lead to baby making therefore is safe and unthreatening These things are done with the explicit rule There will be no intercourse Some examples e Taking a shower together e Giving your partner a bath e Massaging each other and e Oral or manual stimulation of genitals which can lead to orgasm if desired What if you ve tried a number of the suggestions in this publication and nothing seems to help First expect that using these suggestions will not work all the time There will be times when you can feel drained and
10. e will be But at least we re going to a specialist and doing our best Negative Thought T could never adopt Talking Back Adoption has no appeal right now I want a biological child But I can t be sure Pil always feel so negative about it It is a way that some of our RESOLVE friends have become happy parents Negative Thought Our sex life is ruined forever Talking Back We know from reading and from attend ing our support group that it s normal for sex during infertil ity to become a miserable chore We can still enjoy some of our non fertile times and also hugs and massages We have every reason to expect our sexual relationship to be restored when the crisis is over The goal is not to fool yourself with false reassurance It s to counter your distorted statement with a more ac curate one that focuses on hopefulness and problem solving Pay attention to the unnecessary Should s you re dumping on yourself Talk back to them too Here are some examples I should never fail at anything My body should always function perfectly I should keep a stiff upper lip and not burden my bus band so much I should have tried to get pregnant five years ago I should be able to cheer up my wife I ve really let her down Can you think of some humane compassionate replies to the statements above the sort of replies you might hear from a kind and person w
11. ession as do women with cancer heart disease and HIV status While this may surprise some it actually makes sense Procreation is the strongest instinct in the animal kingdom You are facing genetic and social pressure to have a baby You are likely surrounded by friends fam ily neighbors co workers and a society who conceive easily Infertility can be very lonely Infertility can have an impact on literally every area of your life It can and usually does affect the relationship RESOLVE The National Infertility Association www resolve org Fact Sheet Series Fact Sheet 15 between you and your partner I have never seen part ners respond to infertility in the same way In most cir cumstances the female expresses more distress regarding their infertility wants to talk about it more often and is ready to move on mote quickly see a doctor consider high tech treatment move onto adoption etc than her male partner In addition women tend to become jeal ous when another person conceives and may want to avoid pregnant women and babies more than her male partner does This is completely normal but it may put pressure on a couple He may want to go to a party re gardless of how many pregnant women will be there and she might rather stay at home Infertility may also have an adverse effect on one s sex life the woman may be gin to associate sex with failure and might only be inter ested mid cycle while the male partner
12. hen they get pushed the better you ll know how to prevent or get rid of future stress So learn to monitor signs of stress in your mind and your body One way to note physical stress is to ob serve tension in your shoulders A way to monitor mental tension is to realize for exam ple that you have a negative inner voice that constantly tells you that you shouldn t be so up set about your infertility that a really strong mature person wouldn t be so upset about not getting to have a baby Coping Techniques Learn about the normal responses to infertility The first step in reducing the stress of infertility is to stop feeling panicky about feeling rotten Something terrible is happening to you and you re supposed to feel rotten Stressful experiences will contribute to these feelings personal conflicting emotions you may have pressures from your partner and family societal pressures sex doctors and technicians tests and procedures drugs and unpleasant side effects and difficult decisions you may face I am not talking about self pity but simply the normal mentally healthy person s responses to the strug gle to have a baby and the resulting stresses Talk to other people going through infertility You can do so via a RESOLVE chapter infertility support group or local RESOLVE chapter or affiliate For more information visit www resolve org Such contacts reas All Rights Reserved sure you that you re okay because yo
13. hing techniques and other relaxation tech niques can be done with your spouse They might be a good transition point between an infertility conversation following the Twenty Minute Rule and an enjoyable evening Or you might want to try a relaxation tech nique before you start talking about infertility It might make the conversation more relaxed and more focused Practice progressive relaxation Progressive relaxa tion also known as Deep Muscle Relaxation consists of relaxing muscle groups one at a time until you ve pro gressed through your whole body eliminating or reduc ing muscular tension Instant relaxation Here s a relaxation quickie you can do anywhere even when you don t have a lot of time to spare Close your eyes or focus them comfortably on a point such as a flower on the wallpaper or a vase on your desk Breathe slowly and deeply Tell yourself to relax and monitor your body for signs of tension If you no tice a tense area such as your hands tense it up even tighter then let go telling yourself to relax Make sure your shoulders are dropped not rigid and raised Open your mouth slightly to make sure your jaw isn t tight Sit this way for five minutes Then open your eyes and just sit for a minute or two before going back to your normal activities Learn to meditate Meditation is easy to do and very helpful not only in relaxing you and emptying your mind of worries but also in bringing forth solu
14. ho loves you just as you are imperfections and all What sort of compassionate responses might you make to a friend who made Should statements Develop your spirituality Many people have found community support and peace of mind through religious involvements Some attend church or synagogue on a regular basis Others prefer to pray or meditate on their own You don t have to have an old fashioned belief in God to benefit from spiritual experiences such as feeling connected to the rest of the universe oceanic feelings feelings of peacefulness and renewal RESOLVE Fact Sheet Series Take care of your health How long has it been since you ve had a physical examination Precisely because you spend so much time energy and money in gyne cologist s or urologist s offices it s easy to neglect your general health Don t assume your stress and malaise are 100 due to infertility if other health problems haven t been ruled out Diet is an important aspect of stress management It s best to cut down on or eliminate sugar salt saturated fats white flour chemical additives alcohol and caffeine Caffeine is a particularly strong offender and you may be amazed how much more peaceful you ll feel when you give up or at least cut down on colas and coffee And don t forget that a soothing cup of tea or cocoa also has caffeine Other Important Health Tips e Get plenty of sleep many people need eight hours
15. iz ing the following suggestions will prepare you for clearer communication and better problem solving Before you begin keep the following in mind e Set realistic goals Don t say to yourself I must become an immediate genius at stress management or I must get rid of all these aw RESOLVE Fact Sheet Series ful feelings and feel like my old self today Your ability to get rid of stress will increase with practice like any other ability you would work at developing such as playing the piano or learning French A realistic goal would be I hope to feel a little better after reading this Pm going to spend 20 minutes a day on some stress management technique and see if I feel better In the same vein don t assume a technique is useless if it doesn t provide immediate relief The mote skilled you become at stress reduction techniques the more relief you ll get from them But if you don t start now and give it your very best you ll never have a chance to know the greater peace of mind and body available to you even during this rough time e Develop an awareness of stressors and stress This may sound like obsessing or wal lowing but it isn t It s troubleshooting A busi ness consultant can t advise his client until he s had a chance to find out the specifics of the problem Similarly the better you know what specific things push your stress buttons and the better you know exactly how you behave w
16. local RESOLVE e Support groups e Educational events e RESOLVE publications e Member to Member Contact System where available e Telephone HelpLines e Online communities e Advocacy e Insurance coverage for infertility treatment e Questions to ask your doctor e Volunteer opportunities and more RESOLVE is a non profit 510c 3 organization Our mission is supported by individual donations All Rights Reserved
17. lude both physical and psy chological skills Physical skills include relaxation tech niques mini relaxation techniques and information on lifestyle habits which can impact fertility Psychological techniques include cognitive restructuring social sup port coping with negative emotions such as anger and guilt and self nurturance At the Domar Center for Complementary Healthcare www domarcenter com for example we teach mini relaxations which involve slow and deep breathing that individuals and couples can use during blood tests ultrasounds IUI s phone calls to the doctor etc We also teach cognitive restructuring which involves identifying and reframing recurrent negative thought patterns so that a comment such as T will All Rights Reserved never have a baby may end up as I am doing every thing I can to try to get pregnant Self nurturing skills are also included in the curriculum These range from 101 excuses to avoid baby showers to ways to restruc ture your daily life to add as much joy as you can The main purpose of mind body techniques is to teach you tools and skills that you can use to help yourself feel better to help you get your life back and be like your old self again Summary Many individuals experiencing infertility report that it is the most stressful period of their lives If you feel this way you are not alone However there are several things to remember First of all
18. m you re having trouble having a baby without giving them any medical details When asked for details you can say Sorry but we don t care to discuss details Our relationship with you is important to us That s why we wanted to tell you about our infer tility so you wouldn t be insulted by or misinterpret any unusual behavior But we prefer not to talk about the details By making an effort to communicate better with family you can alleviate some of your stress Give yourself permission to cry and be angry Don t try to shut off your feelings If you need to cry about the unfairness of another pregnancy announcement go ahead If you need to pound a pillow or pummel a punching bag do it When you try to snap out of it you waste all your energy Consider planning a certain time of day when you spend 30 40 minutes focusing on your feelings about infertility When you let the feelings come you will feel relief and have a little energy left over for coping Give your partner permission to feel and cope dif ferently than you Don t waste energy trying to get your partner to feel as devastated as you do RESOLVE Fact Sheet Series Improve your communication about infertility Is there any way that you and your partner can prevent in fertility from taking over your lives You might try what I call The Twenty Minute Rule see page 8 of this fact sheet which forces you to limit the amount of time you talk abo
19. many months perhaps years of uncertainty about bringing a pregnancy to term You can t get a crystal ball but you can reduce some of your uncertainty by collecting information Finding out about your medical conditions and family building options available to you can make you a mote informed assertive consumer Paths to knowledge include e Read current books and articles on infertility treatment and other family building options e Read RESOLVE fact sheets and newsletters to keep current on medical options and the emo tional aspects of the infertility experience e Visit the RESOLVE website at www resolve org e Find out about adoption and childfree living so you will have some idea of how you would cope with these options Then you will no longer feel so completely overwhelmed by the possibil ity that treatment might not work Keep in mind that information can add to your stress if you don t keep a check on your emotional agenda Here are three possible problems with information collecting e Overdoing it Are you giving up your social life and lunch hours in order to pour over every journal article and medical textbook that covers your problem Perhaps you ve already learned what you truly need Are you telling yourself If I only work hard enough at getting pregnant it s bound to happen All those women who don t get pregnant haven t tried hard enough PI be different because of my A effort The u
20. n a support group Perhaps you can channel some of your nervous energy into an invigorating and tension releasing walk Other possible uses of pent up energy filling out an adoption or IVF application or taking on a hobby or household task you have neglected Identify new interests unrelated to infertility to which you can devote energy Allow yourself to grieve Many stress management ex perts point to the value of grieving Unresolved grieving can be a major source of anxiety Perhaps some of what you ve interpreted as the inescapable pain of infertility is really the relievable pain of unfinished grief work Even though you hope to have a successful pregnancy whether you know it or not your unconscious mind has already begun the task of grieving for the biological child you may never get to have together In order for you to feel better again you will have to go through a period of All Rights Reserved mourning Mourning you ask How can I mourn someone I never saw Someone who could be growing inside me or my partner this very moment Or maybe next month Yes it is hard to mourn someone so in tangible Nevertheless it has been the experience of RESOLVE members and of infertility counselors that this difficult process is a necessary prerequisite to life s becoming normal again Get more information One of the worst facets of stress is uncertainty about the future Infertility by its very nature can involve
21. nfor tunate truth is that babies don t always come in proportion to how hard couples try for them Some infertile couples who get no medical in formation at all will get pregnant and there is still the possibility that you won t So don t ex pect too much from medical information It can relieve uncertainty but it can t guarantee a successful pregnancy e Allowing yourself to get carried away As you read about endometriosis resulting in hys RESOLVE Fact Sheet Series terectomy or couples turned down for an adop tion home study don t panic The worst case studies are just that studies of one or two peo ple who aren t you You may benefit from dis cussing your fears with your physician or a counselor e Overstuffing yourself with medical knowl edge while neglecting the psychological knowledge Reading literature on emotional aspects of infertility may stir up some feelings but it will also help you feel more peaceful and teach you some good coping techniques Use old coping mechanisms One of the best sources of coping strategies is your own past Try to think of other crises you ve been through starting college losing a parent or being unemployed How did you cope then Can you recall ways you calmed your panic and lifted your spirits Maybe some of those techniques will help now Here are some common ones e Reaching out to family and friends e Collecting information e Forcing yourself to concen
22. ntensity to try to rouse him out of his protective fog After she turns the volume up he tunes her out even more The Cure I call it the Twenty Minute Rule Its goal is to stop infertility from eating up your entire life as a couple It RESOLVE Fact Sheet Series forces you to limit the amount of time you talk about infertility in a given evening It goes like this agree on a time limit which may be as short as 10 minutes or as long as 30 You may have to experiment to find the length that s best for you Many find that 20 is best Set a timer or alarm clock and stop as soon as possible after the timer goes off This makes stopping your mutual responsibility rather than something the bad guy male imposes on the poor thing female The Results When this technique is applied she talks less about infer tility She crystallizes her message because it has to be quick or she ll miss her chance He listens intently be cause he knows he doesn t have to listen all night She feels better because she s no longer driving him crazy and because finally she feels listened to He feels better because he doesn t have to listen so long and because he can tell that now she really feels listened to And best of all they have the rest of the evening to talk about or do something else Less is more in this instance A remarkable fringe benefit for many couples when she talks less about infertility he talks more It
23. ormal production of luteinizing hormone which is necessary for reproduc tion A European study found that anxious women took longer to conceive and were more likely to miscarry than women with lower levels of anxiety The best and most thorough research to date has been on the relationship between female distress and in vitro fertilization IVF success rates There have been 14 published studies that have looked at distress levels in women prior or at the beginning of an IVF cycle These studies have been conducted worldwide Ten of the studies showed that distress levels are indeed associ ated with decreased pregnancy rates The more anxiety or depression the women expressed before undergoing IVF the less likely they were to get pregnant In several of the studies the results were dramatic for example in one study the most depressed women experienced half the pregnancy rates as compared to the least depressed RESOLVE Fact Sheet Series women Two of the 14 studies had small sample sizes and the results showed trends i e there was a tendency for the distressed women to have lower pregnancy rates but the results fell just short of statistical significance Two of the studies found no relationship between dis tress and pregnancy rates On a whole however the ma jority of the research does support the theory that dis tress is associated with diminished IVF success rates It is logical then for IVF success and the increased possi
24. rst time that God hasn t answered their prayers They wonder if they are being punished for previous behaviors or if God thinks they will not be a good parent In addition certain relig ions forbid or discourage some forms of infertility treat ment Thus when you add up all the previously mentioned factors it does make sense that infertility can cause a huge amount of stress To top it off it is one of the few diseases where the patient is blamed for her condition e g If you would just relax you would get pregnant Can you imagine the response if you said something similar to a cancer patient You would be considered cold unfeeling and certainly uneducated But what zs the truth about the stress infertility connection Does Stress Cause Infertility The answer is we don t know It certainly isn t a consis tent relationship For example rape and concentration camp victims conceive This defeats the theory that sttess causes infertility and supports the likelihood that some women are more reproductively sensitive to stress than others In general it is highly unlikely that stress independently causes infertility There has been some research on whether or not anxiety or depression contributes to infertility This research has shown that women with a history of depression are twice as likely to subsequently experience infertility as women who do not have such a history Another study showed that depressed women have abn
25. tions to prob lems It subdues your verbal analytical left brain and gives your playful intuitive right brain a chance to solve problems that have had you stumped Contrary to belief you do ot have to make your mind go blank in order to meditate To learn how to meditate see the suggested readings Try techniques for coping with sexual stress Sexual stress is an unavoidable outcome of infertility If you were to ask a sex therapist how a happily married couple with a good sex life could deliberately ruin their sexual relationship the answer would be something like Tell them to ignore their internal signals such as whether or not they re feeling loving or angry toward each other whether or not they re sick or tired Tell them to pay attention only to external signals telling them when to have sex and when not to This is of course just what happens when a couple undergoes infertility treatment Of course a woman s ovulation time is an internal phe nomenon But evidence of ovulation is examined con tinually by the couple via the basal body temperature chart This externalizing of sex because of infertility is frustrating and difficult for the couple and makes sex RESOLVE Fact Sheet Series routine neither fun nor exciting It s hard for either partner to feel sexy when they re depressed about infer tility giving and receiving injections or angry at each other s reactions to the crisis To top it all off
26. trate on one thing at a time and to get through one day at a time e Trying to remove any unnecessary duties or pressures e Lowering your expectations of how much work you d be able to accomplish in the next few weeks e Seeing a therapist or joining a support or ther apy group e Looking for ways to turn the negative into something positive e g responding to being fired by working on the career change you d been thinking about but hadn t acted on yet e Meditating or praying e Relaxing tense muscles through exercise deep muscle relaxation yoga e Plan to use at least two of these coping methods every day And don t stop the first day you wake up feeling normal relaxed and confident Re sponses to infertility as to any crisis tend to be up and down What seems like an equilibrium can be totally upset by the onset of a menstrual period or the arrival of a baby announcement Experts advise the use of stress management techniques on an ongoing basis to prevent stress from getting out of hand Start talking back to yourself Try paying more atten tion to the negative thoughts that go through your head You ve probably been trying to tune them out with All Rights Reserved poor results Try really listening to the specific words countering them with accurate more positive messages Here are some examples Negative Thought TY never get pregnant Talking Back I can t really know yet what the outcom
27. turns out that women are often grieving for two expressing their partner s feelings as well as their own When he starts speaking up she can step down from the podium Fi nally the couple can talk face to face Of course you wouldn t use this on a day you got a dis couraging diagnosis or other disappointing medical news ot the day you found out that your sister sister in law and best friend are all pregnant In a crisis of course you will need to talk more But for the day in day out infertility grind this rule can bring some relief Suggested Reading Stress Management Borysenko J 1988 Mending the body mending the mind Reading MA Bantam Burns D 1999 Feeling good The new mood therapy New York Avon Goldstein J amp Kornfield J 2001 Seeking the heart of wis dom The path of insight meditation Boston Shambhala The Stress of Infertility Barbieri R Domar A Loughlin K 2000 6 steps to in creased fertility New York Free Press Domar D amp Kelly A L 2004 Conquering infertility Dr Alice Domar s mind body guide to enhancing fertility and coping with infertility New York Penguin All Rights Reserved Couple Intimacy and Sexuality Barbach L 2001 For each other Sharing sexual intimacy New York Signet Comfort A 2002 The joy of sex Fully updated and com pletely revised for the 21 century New York Crown Downing G 1998 The massage book New York Ran dom
28. u see that other infertile couples are intelligent attractive appropriately masculine or feminine yet unable to have a baby and just as miserable about it These contacts may become new friends to socialize with while it s too hard to be around pregnancies and babies your families and friends are producing It s wonderful that RESOLVE s history shows that friendships formed through RESOLVE ac tivities or support groups endure years past the infertility crisis Overcome isolation by building a bridge back to your family All but the least sensitive can be educated about infertility and can be taught by you how to be helpful and supportive Ask them to do some reading on infertility Also be sure to let them know how you want to be treated Half the infertile couples I know are mad at their families for not asking how things are going Don t they know we re going through hell Don t they care The other half are mad at their families for ask ing Busybodies Don t they know if we had any good news or developments we d tell them Most infertile women ate saddened by invitations to baby showers and gleeful pregnancy announcements But some are infuri ated by not getting the invitation or by hearing that the gleeful announcement was carefully made when they weren t around So you really have to let people know what you would like from them Remember when communicating with family and friends that you can tell the
29. ut infertility in a given evening Tell your partner how you want to be helped We expect the impossible from our partners If he really loved me he d comfort me without my having to ask If she understood me she wouldn t keep dwelling on infertility when it s all I can do to forget it But partners are mere humans incapable of mind reading If you need to pass up family gatherings that feature nieces and nephews under two then say so If you want to be hugged or massaged or left alone for a few minutes or just listened to without any response you ll be more likely to get what you want if you ask If you re not in the habit it s hard to ask for help What if the other person doesn t give you what you asked for Maybe he or she will laugh or get mad or somehow hurt you Asking for help means taking a risk being vulnerable It means sometimes vot getting what you want but it also in creases the likelihood of getting what you want some of the time Keep a journal A journal can be a comfortable friend who s never too angty or upset or too busy to listen And it s available at 3 00AM when you wouldn t dream of calling up a friend As you record your thoughts you may uncover insights you didn t know you had Writing is a great crystallizer Try to change your anxiety into excitement and en ergy Maybe you can get excited about a new medical treatment your doctor suggested or about meeting new friends i
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