The fertility therapist: Managing thoughts, emotions and waiting time during breaks
There can be a considerable amount of waiting and many involuntary breaks when you're undergoing fertility treatment - and it can be difficult. How can you use the breaks constructively and turn the wait into something positive?
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27. oktober - 2022
Midwife with maternity ward experience and in general practice, fertility clinic and gynaecology specialist clinic. She is also a trained psychotherapist MPF with a particular focus on the psychosocial aspects of infertility and pregnancy loss. She has a practice as a fertility counsellor, therapist, and grief counsellor: board member and advisor of the National Association for the Involuntarily Childless.
There is so much waiting time - and many involuntary breaks when pregnancy is not a certainty and undergoing fertility treatment.
Sadly, scenarios such as too thin or unstretched mucus, missed periods, illness, strikes, holiday closures, pregnancy loss, and waiting for tests or test results are very common. It can be challenging. Really hard. It can be difficult to understand if you haven't experienced it yourself, but the waiting and breaks are a strain for most people undergoing fertility treatment.
It's stressful not knowing how many treatments you have to undergo. When to do what, and whether all the steps taken will even lead to a child. A feeling of powerlessness and loss of control are feelings most people can relate to. Not being able to plan your life and feeling like your life has been put on hold. The life you want to live. It takes a lot out of you physically and mentally. You often feel drained of energy when you don't get pregnant.
It is often the body that, in one way or another, causes some of the waiting time that occurs during fertility treatment. During the treatment, the body senses relatively quickly that it is exposed to stress. Therefore, attention is typically focused on the physical body. However, fertility treatment also has a psychological impact, which does not have quite as obvious signs as the body. Many people first notice that their mental health has been affected when they find it difficult to recognise themselves because, for example, they are no longer happy, find it easier to cry, find it difficult to concentrate at work, get angry more quickly, cannot cope with social events, cannot cope with everyday life, etc. Often, we don't feel that something is too much until it has been too much for too long.
Time for calm and reflection
You are in a constant state of alert, physically and mentally, while undergoing fertility treatment. You stay alert - all the time. You take time off work and miss social events at short notice, coming up with quick explanations and excuses when someone asks or comments about why you are not having a baby soon. You have to remember appointments - and book new ones. Inject yourself and live with the hormonal impact the medical treatment is causing. You're constantly aware of the signals your body is giving. You worry. All the time: are there any eggs? Are there enough eggs? Are they fertilising? Is the egg attaching? Is it growing? Are there heartbeats? Will I be myself again? Will I ever be a mother? There aren't many moments when the body, thoughts and emotions are peaceful.
This is precisely why breaks can be a positive thing. They can be good for both your body and your mind. You need rest, calm and recovery - and perhaps prepare for the next step in your fertility treatment.
Not being able to have the child you want is life-defining. Existential. It results in thoughts and questions about life. Your life. What has been? What is? What is to come? Or not to come. Dreams. Hopes. Big emotions come to the fore. You may feel changes - physically and mentally - constantly, and it can all be hard to keep up.
Having a break with no clinic appointments, no medications, and no "rules" about how you should live your life can provide much-needed rest and time for reflection. Peace and time to work on the thoughts and feelings that can dictate and define day-to-day life, dominated by the baby that is taking its time in coming.
The wait time can also give you the calm to take in life, the reason why you want to grow your family.
The break can be an opportunity to speak with someone about everything you're going through. Everything is heavy and difficult. You can speak to your doctor, a psychologist, a therapist, or someone who is not emotionally involved. It can allow you to let go completely. You don’t have to consider other people's emotions. You can say it how it is and what you are feeling.
There are about 40,000 fertility treatments carried out every year in Denmark. If you like, join a network meeting for women or couples undergoing fertility treatment. Also, use the break to speak with other people undergoing fertility treatment. Everything feels a bit better knowing you are not alone or not feeling lonely. You're not alone. There are other people in the same situation, and it can make a difference to talk to someone who can recognise the thoughts and feelings you're going through.
Also, see the break for what it is. A break from tests, scans, medication, sex on a schedule, cancelling social events, feeling guilty. The break allows your body to recover and your mind time to recover too.
The break can make room for the life outside of treatment - your job, hobbies, friends, family, your partner. You can refocus on the part of your life that gives you energy and strength for the subsequent treatment.
Whether planning something you want to do - or not having any plans, maybe you need to be a little spontaneous. Do things that make you feel good and give you energy. Take a breath and enjoy the fact that it's possible. Perhaps you can even let go of your worries for a while.
The break can also get items off your "to-do list". Practical tasks and chores might be nice to get out of the way, as you know there won't be time or energy you recommence treatment. Organise your calendar, so there is time and an overview. This can give you a little more mental edge when you start treatment again. On a physical level, you can also use the break to exercise and keep your body healthy and strong to withstand the challenges ahead.
How do you manage your thoughts and emotions during this time?
Undergoing fertility treatment is psychologically and physically stressful. Many people are surprised by how tough it is. Especially the psychological strain comes as a surprise to most people. Being infertile can be a lonely, despairing and frustrating experience. There is an increased risk that involuntary childlessness can lead to an existential life crisis with anxiety, stress and depression as side effects. Therefore, working through your thoughts and feelings during the process is essential.
How best to do this varies from woman to woman, man to man - person to person. But for many people, it makes sense to put into words the thoughts and feelings that weigh on us and affect our quality of life. Just as it makes sense to understand the thoughts and feelings that reoccur. Where do they come from? What do they want? What can we do with them?
So put it into words - even if it can be difficult. Get the thoughts and feelings out of your head. What are you thinking? What do you feel? How do you feel? What's going on inside you - and with you? What do you do when it happens? Stop and feel. Be aware of changes and reactions. Write it down if it's too hard to share out loud. It's often helpful to have your thoughts and feelings written down. Get support and help if it's too difficult.
Remember that feelings are feelings. Thoughts are thoughts. None of it is dangerous. But it can be draining. On a normal day, we have thousands of thoughts. An average of 60,000 thoughts a day. That's a lot of thoughts to deal with daily- many of them are harmful. If you're undergoing fertility treatment, where there are typically a lot of unanswered questions, it's no wonder you feel tired.
Unfortunately, our thought processes are unhelpful. Often negative thoughts take up too much space and become truths. This can make us even more sad, angry, frustrated and unhappy. You can therefore benefit from working on understanding your thoughts. Negative as well as positive thoughts. Because no matter how hard you work to avoid negative thoughts, you won't get rid of them completely. They are part of being human.
Thoughts often trigger emotions. They come and go and are hard to control. You may spend a lot of energy trying to control your emotions - energy you don't have in ample supply. But instead of trying to control what you think and feel, it may be more beneficial to learn how to relate to and work with your thoughts and understand and accept your feelings. It sounds strange, but by giving your thoughts and feelings space in this way, they will change shape and character and perhaps become a little easier to live with.
By becoming aware of what thoughts you have, when they are triggered and what they do to you, you will be able to feel which thoughts are valuable and helpful - and which are not. The useful and practical thoughts do you the most good, so they should be allowed to take up the most space. The thoughts that are not useful and helpful, you need to practice listening to less. They're usually about something you can't influence - or control - anyway. So why spend energy on them? Instead, spend your energy on something you can impact.
Of course, that's easier said than done. But it can be done. Some days you may excel at it. On other days it may feel impossible. Allow yourself to admit it's hard sometimes. Find a focus that can help you when the nagging thoughts take over. It can help you distance yourself from your thoughts; maybe you'll find that thoughts are just thoughts. That they're not the truth. That you are not your thoughts. That your life is not your thoughts. That your life is so much more. Because it is!
For example, try changing the focus of your thoughts by focusing on what's present in the here and now. Think about the "now". What are you doing right now? What are you about to do? And stay there. You may be able to help your thoughts improve by describing a positive action in your mind while you are doing the activity. For example, "I'm hugging my girlfriend", "I'm playing my favourite music", "I'm going for a walk in the beautiful countryside", and "I'm sitting in my garden and feeling the warmth of the sun's rays".
If you want help, support and connection with others during this time - how can you involve them?
Is there someone you want by your side more than anyone else to be there for you? It can be difficult, but you must dare to ask for help, support and closeness. These are the people to speak with. Feel what you need and tell them how you feel - and what they can do to help you. Most people want to help if they can but may fear doing the wrong thing and making it worse. So they often need a little help along the way.
You may not even know what you need, which makes asking for help and support extra challenging. But then you can try to be open about it. Few people can fix the situation anyway (only having a child likely will) - but most will be able to be there for you. Just be. Right next to you. Often that can make a difference. Feeling alone in your grief, frustration, loss of identity, and control can change shape if you have someone by your side. Just being. With you.