In this webinar, Andreia Trigo, RN BSc MSc, multi-awarded nurse consultant, author and TEDx speaker, and Founder of Enhanced Fertility Programme App, talked about emotions and how to understand them. Andreia has also discussed 6 coping strategies that can make a difference and increase your chances of achieving pregnancy.
Andreia Trigo has been diagnosed with infertility at a very young age; she was just 17 years old. Andreia wasn’t trying to conceive at that time, so it was very unexpected for her as well as a loss of a dream that she never had a chance to dream. It was something very difficult for her to cope with, and the diagnosis ended up shaping her life. For this reason, she wants to give back to the community.
Andreia is a nurse consultant and helps patients who are trying to conceive in her private practice. She’s also a senior lecturer and researcher at university, and an NPL coach.
Andreia is the founder of Enhanced Fertility, the program app that is available to everyone; it’s free, and people can download it. This app has a lot of information and emotional support strategies like meditation and mindfulness, and it’s a way of getting not only the support needed when trying to conceive but also a way of making sure you access trustworthy information. Andreia understands that’s very difficult to know what to trust when you just go on Google and try to find all your answers.
This explains Andreia, was her way of bringing together her experience as a patient and as a nurse to give something back to this community. She shares the following: “It means the world to me to be able to be here and to be able to help all of you.”
The strategies shown by Andreia aren’t just out of a book, they’re strategies that have worked for her as a patient because after being diagnosed at the age of 17, she felt completely lost. Only 15 years later, past that stage, Andreia was able to look back and realize that she managed to cope rather well emotionally, so she started looking at everything she had done to be where she managed to be. That’s when she decided to work in this area and to give back to the community all the tools that had come, in a way, naturally for her with some help.
I wanted to make the tools available to everyone because a lot of people are diagnosed in their 20s and 30s, and the reality is that you don’t have 15 years left to cope and try to make sense and meaning of what you’re going through and then decide on your alternative plan.
For this reason, she wanted to share this tool to everyone and hopes it’s useful because they do come from her own experience. She has also studied NLP and started making sense of the things she had done and found a way of teaching them.
Andreia shares that when talking to a lot of people, most of them believe that their emotions just happen and that they have no idea where they come from.
People believe that emotions are often triggered by a situation and cannot be controlled. This is not the reality explained by Andreia. She comments that people may not look back on their life, for instance, when they were just a child. When people are children, they have people in their lives that they value, and it’s usually the parents, family members or teachers.
These adults in our lives are looking after us, educating us, and showing us how the world works. All these people around us have certain values and beliefs, and as children, we look at those we value and trust and suppose that if something works for them, it also works for us. We assume these values and beliefs as our own, and we grow with them.
When something happens in our lives, these values and beliefs are like lenses through which we see the world, and this is the main reason why some people go through similar experiences and might have different views of what’s happening. Therefore, some people might perceive a situation with a certain pair of glasses, and someone else might perceive the same situation with a completely different view. This is because all people have values and beliefs that are different, and when we perceive a situation in a certain way, that makes us feel something.
our actions are always linked to our feelings, and the results that we end up getting in life are all connected to the actions we end up taking. Due to this, we need to start understanding that whatever we’re feeling, we’re feeling it because of the way we’re perceiving the world, the meaning that we’re giving to each particular situation and that we can choose to change that.
According to Andreia, we can choose to change our values and beliefs because those that our parents, grandparents or teachers had, those people who cared for us, maybe didn’t go through the same challenges that we’re going through. So, the values and beliefs that were fine and worked for them aren’t the ones that are working for you. The good thing is that you can change them. This is the first thought, as stated by Andreia, the knowledge that the way you perceive the world isn’t something static but rather something you can adjust and change.
Later on, Andreia shows a sentence she felt summarizes what she’s been trying to explain:
The life that’s happening to us, we don’t experience that life. We experience whatever we believe in, and we experience whatever we’re focusing on. If we believe that something is true, that’s what we’re experiencing. If we’re focusing on something, that’s what we’re experiencing – shares Andreia.
When you go through fertility challenges, whatever you’re believing at that moment, such as believing that whatever is happening to you is taking you where you’re meant to be, that life is happening for you, or that everything is going to happen in the way that it needs to happen, or you’re focusing on the fact that you’ve learned a lot about your body so far or that you’ve gained a lot from all the bad experiences, you’re going to have a very different experience of life. If you, for example, believe that life isn’t working for you, and you’re focusing on all the things you don’t have or all the things you’re missing in your life.
When Andreia was diagnosed at the age of 17, she was really upset. She clarifies that she didn’t have all of this knowledge and still didn’t know who she was as a person and didn’t have her values and beliefs; they weren’t completely formed at that stage because she was just a teenager and didn’t know that to think about the whole situation. Nevertheless, she was very sad and depressed about not being able to have children.
When Andreia started analysing why she was feeling like that about that situation, she realized that infertility is a loss. The reason she was feeling sad and depressed was that she was losing her identity.
I’m much more than my ability to conceive. I always say that, but at the time, I was a student, and I was a sister, and a daughter, I was very active, so I had all these different roles in my life that made me who I was, but part of my identity was also being part of a very big family. Part of my identity was wanting to carry on with the growth of that family, so I lost part of me when I learned that I couldn’t have children.
Andreia goes on by mentioning some examples of what a loss can also be:
Is it normal to feel sad, frustrated, angry? “Absolutely,” says Andreia. After all the loss, it would be completely unrealistic for her to be happy as if nothing happened or be completely happy if something amazing happened. This, according to Andreia, isn’t realistic.
What people may go through is a huge loss, so if you’re feeling sad, frustrated, and angry, it’s normal. It’s a normal response. However, Andreia realized that even though this was a normal response, it shouldn’t last forever. This is a decision she made very early on; even though she didn’t know how she was going to cope, she was going to be happy and okay, living a meaningful and successful life. She didn’t know how she was going to do it, but she remembers one of those moments when she was crying and asking why was it happening to her and feeling an energy inside her. That’s when she took a decision.
I don’t know how I’m going to cope, but I know that if I can cope with this, there’s nothing in life that I’m not able to achieve, and this is going to be a driving force for everything that I want in life, and everything that I want is to be happy. expresses Andreia.
I don’t know how I’m going to cope, but I know that if I can cope with this, there’s nothing in life that I’m not able to achieve, and this is going to be a driving force for everything that I want in life, and everything that I want is to be happy. – expresses Andreia.
Everything that Andreia did from that point onwards was to make herself happy, not because society told her that she should get married or have kids, but because she wanted them. According to Andreia, there’s a decision that all people need to make; the decision that they’re able to cope, that they’re entitled to happiness and fulfilment no matter how bad their situation is and that they have the ability within them. Therefore, it’s okay to feel sad, frustrated, and angry. It’s normal, but it’s also okay to have moments when you feel happy and feel like life is working for you and that you have so much going on for you.
Andreia mentions the roller coaster of emotions in infertility, whose technical name is “the process of grief.” What looks like a linear process of grief is not linear at all. In the beginning, when you first realize that things aren’t happening the way you thought they were going to happen, you find shock and denial, you’re confused and saying that this isn’t happening.
Andreia mentions that she remembers the day of her shocking denial very well because she was very young. She recalls going to the doctor, who told her that she didn’t have a uterus. Her first question was: “Does that mean that I’m not going to have children?” and the doctor confirmed that. She repeated the same question just to get the same answer from the doctor.
I was in complete shock, the world had disappeared beneath my feet, and I couldn’t believe those words.
She explains that the rest of the day is sort of blurry but remembers that there were times she was very angry with the situation and frustrated asking herself why that was happening, and that she didn’t do anything wrong. Andreia talks about being sad, crying and feeling depressed, explaining that in the process of grief, she had seen and felt them in her body.
There was a moment when she made the decision to cope and clarified that not every day from that moment on was happy, but they weren’t the most challenging days. The days when there was a trigger when someone made a pregnancy announcement, or people made comments that they didn’t know were hurtful; “those are the days when that commitment I’ve made to be able to cope helped me the most because I had the intrinsic belief, unbreakable belief, that in the end, everything was going to be okay and I was going to have a meaningful life,” expresses Andreia. If there’s something you can take out of this presentation is that you can choose, and make your choice: What is the belief that you want to believe that it’s going to be with you in good and bad days? And on those bad days, it’s going to take you or carry you up even when you don’t feel you have the strength to carry on.
As part of the last stages of the process of grief, you might notice that there’s an acceptance. This acceptance is not about accepting a life without children, but accepting things as they are and accepting that maybe there’s an alternative plan than can take you where you want to go and give you the happiness you want to have. This, according to Andreia, is when you start returning to a meaningful life.
She then proceeds to give an example by analyzing what she wants, why she wants children in her life and what she thinks this is going to give her. She realized that she wanted the “unconditional love”: She wanted the sense of family, connection, and a loving partner. However, Andreia understood that she didn’t necessarily need to have children the normal way to get everything else that she wanted to get.
Here’s when life started unravelling for her. She started feeling that there was meaning in her life, she found her husband, and they found many different ways of feeling fulfilled and empowered and that they’re giving back to this community. Andreia emphasizes that even though it’s normal to feel sad, depressed and angry, when something bad happens and, sometimes lots of bad things happen, there’s also a way out of it and it’s okay for you to allow yourself to return to a meaningful life.
The fact that you’re feeling happy does not invalidate all the pain, all the sadness or anything that happened. All your feelings are valid, no matter where they are in this process of grief.
If all these feelings are considered in the process of growth, which everyone goes through when trying to conceive and not being able to, as well as the time of the pandemic, those feelings are exacerbated because people who were trying to conceive had their clinics closed and weren’t able to go through treatment as they planned and felt the clock ticking. They didn’t just have all the anxiety and stress that’s natural for the process but also had a lot of reproductive uncertainty. There was a lot of uncertainty about their own health, if they were going to be fine or if they were going to get the virus.
There was also a lot of financial uncertainty because people were losing their jobs, and a lot of family and friends were uncertain with regard to their health. Andreia also talks about global uncertainty.
When thinking about the feelings that a lot of people were already going through and, on top of it, having a pandemic, it’s normal to feel a bit worse than you were the year before. It’s important to recognize that your feelings are valid and it’s normal.
According to Andreia, people tend to get anxious every time they go through something new, ambiguous or unpredictable.
When people initially find out about their infertility, it’s something new and ambiguous, they don’t know what it might mean, it might indicate that they may or not be able to get pregnant, and it’s unpredictable because they don’t know how it’s going to turn out when they have a fertility treatment.
Just know that whatever you’re feeling, acknowledge it because it’s in response to your environment, it’s something that’s happening to you. But you’re not your emotions, so you don’t need to stay in that emotion, acknowledge it and then we can release it.
Andreia goes on by showing a phrase which she has reflected for a long time and kept using it over and over again. We may not choose the situations that are happening to us, for instance, Andreia didn’t choose to be born without a uterus and you didn’t choose your fertility problems, but we can choose how we respond.
Andreia states that she could have made a choice very early on to have a very sad and frustrated life, angry at her body, but it would’ve been a miserable life, wasting 50 or 70 years being angry. She could’ve also chosen to respond in a way that would bring her happiness and realise that she can choose, that she has the ultimate power in her life; the only thing no one can take away from her is the power to choose to be happy and live a meaningful life, no matter what. She also reinforces the idea that what is happening to her is going to give her the force and drive to achieve everything else that she wants to.
Going deeper into the coping strategies, Andreia Trigo found a really interesting study that was done during the pandemic.
This study looked at 92 women from the US and Canada who had their treatments cancelled. 52% had depression, and a lot of them said there had been a decline in their quality of life and mental health. They were also looking at the impact of cancelled treatment on their mental health, and it can be seen in the graphic shown by Andreia.
It can be seen in the pink circle that most of the people had a negative mental impact when treatments were suspended. This study also looked into more detail how people cope with it. The strategies used more often, and you may relate to some of them, were the following:
These often-used strategies, which you may have used yourself in the past, aren’t that helpful. They don’t change your outcome nor make you feel better. They don’t allow you to process what’s happening.
The study looked at coping strategies that had the biggest impact on mental health. The strategies they noticed that had the biggest impact were:
People who were engaging in this kind of coping strategies were able to have more mental health improvements compared to those who were using the other coping strategies.
What I take out of this study is that if we change the way that we perceive the world, the world around us will change. – states Andreia.
If people get the support they need from their partners or social circumstances, if they try to find something good no matter how bad the situation is, if they have a more optimistic approach, their perception of the world is going to change.
Andreia Trigo shares some strategies that worked for her and made a huge difference.
Andreia clarified that she asked this question to herself more times than she could count. Something she remembers from her 17-18 years of age, which should be the happiest times in her life because she was just starting university, is being in her bedroom crying and asking why this was happening to her, every night. Her dad said it wasn’t up to them to ask why and that one day she’d understand.
She believed in her father that one day, all of that would make sense, and looking back, she now understands that it makes sense.
It might be that you have something in your life, maybe not related to fertility, but to work or relationships, and where you are right now, maybe you never thought you’d be there. Maybe you’re in a relationship and you’ve suffered, maybe many times before every time you had a breakup, and now it makes sense why that breakup had to happen for you to find the person you’re with right now.
This is something that happens all the time in life, so recognize that even though you don’t see a reason for something that’s happening to you, there is a reason, and one day you will understand. So, asking “Why me?” just consumes you completely. The biggest advice Andreia gives for this is to just keep reminding yourself that one day you’ll understand and, if you believe it, one day you will indeed understand.
This is a strategy that helped Andreia a lot and it happened almost around the same time she learned she didn’t have to ask “why me?” As she was born into a very large family and thought she would grow and continue that family, knowing she wasn’t able to have children triggered a lot of emotions such as: “Maybe I wasn’t good enough”, “my life had no meaning”.
She learned that she needed to challenge those beliefs because the beliefs she had were from all the parents and teachers that were useful to them but didn’t in fertility, they didn’t know what she was going through. So, she challenged her thoughts.
Andreia mentions that everyone has a tiny voice in their heads and that it’s good to challenge it. She then shows that around 80% of people who are trying to conceive have these voices in their heads, this negative thinking daily. Moreover, she put an image with some of those thoughts that were sent on Instagram.
Some of them say:
“I’m never going to be a mom.”
“My body is useless.”
“What if I miscarry again?”
You might relate to some of these thoughts and when there’s 80% of people have these thoughts daily, they need to take control because they can choose which thought they’re going to listen to.
Another strategy given by Andreia is to get a table, as shown in her presentation, and write on the top:
She then shares some of the thoughts she as well as her patients experienced and explained how it works.
The brain, according to Andreia, does these three first columns very easily and quickly. People do it all the time, however, they have a hard time with the evidence that refutes that thought.
So, it would be something like “Even though I don’t have children, my partner, my friends, my job brings meaning to my life.”
When reaching this conclusion, you can notice the emotion that you had initially has softened down a little bit. So, in the case Andreia showed, the hopelessness reduced from a nine to a six.
You can play with this table as much as you want. Andreia usually prints it, writes it down and keeps it in a place where she can see it.
You can write whatever thought you have: that your body isn’t doing what it’s meant to be doing or that this cycle isn’t going to work. Whatever thought you have, write it down and write the evidence that is going to refute it. – explains Andreia.
How many of you have judged yourselves for feeling sad, angry, frustrated, happy, anxious? – asks Andreia.
Everyone has felt this way at some point, but this journey is hard enough as it is. Therefore, you must release judgment of whatever you’re feeling as well as of whatever is happening to you because every situation is just that, it’s one situation which is not necessarily good or bad, it’s just the judgement you’re giving it, and that’s why nothing has meaning except the meaning you give it with the judgement that you’re making.
Andreia explains the different ways to remove those judgments.
Step 1: You can try recognizing that you’re judging yourself or the situation.
Step 2: You can try to reduce the judging by doing positive judging.
Step 3: When something that you don’t expect is happening and you’re judging it and giving it a negative meaning, you can try to think what else the situation could mean, what you can learn from the situation.
Avoid avoidance.
Andreia recognizes she did it a lot in the beginning and probably knows that most people have done it at some point. For example, avoiding pregnancy announcements, baby showers, family reunions or reunions with friends where there’s going to be talks about babies.
If this is looked at, taking into account the research presented before, avoidance is more likely to give you the resilience that you need to feel that you can cope with what’s happening to you than avoiding.
Let’s be honest, we cannot avoid these situations because they’re completely outside our control, I cannot avoid pregnancy announcements for the rest of my life. So, I need to be able to find a way of coping with them – declares Andreia.
It may work short term, and it might be that, in the beginning, it’s something that you need to do, but it’s not something you want to use long-term. It’s recommended by Andreia to just recognize that the situations that are triggering are completely outside of your control, and you need to find the tools inside yourself, the coping mechanisms, that allow you to manage those situations in a way you feel okay and not afraid, resentful, fearful or frustrated.
A thought Andreia usually has is one where she starts questioning herself:
“We don’t,” says Andreia. It’s good for the short term but it’s not a good long-term strategy. There’s a lot of work that you have to do to feel stronger and to stop avoiding these difficult situations.
It’s important to think about who you are and know that you’re more than your ability to have children and your ability to have your genes passed on from generation to generation.
You are a human being, you have things you enjoy, you have a job, you have a family, you have friends. – emphasizes Andreia.
She realized very early on that all the years after her diagnosis had taken her identity away from her, in the split second, she realized she couldn’t have children. However, the years past that stage were the years of choosing who she wanted to be as a human being. She sees it as an amazing opportunity because if it hadn’t happened to her, she would’ve probably just been whoever the world wanted her to be. Therefore, Andreia recommends reclaiming who you are as well as your identity.
Moreover, Andreia shows some questions to think about:
According to Andreia, this is the moment when you’re reclaiming your identity that you start trading your expectations and you’re expecting life to give you ‘x, y and z’: the job, the partner, the child. You trade those expectations for appreciation of what you already have because your life is already blessed.
There are so many things you have in your life, something that’s good within your heart is beating inside you without you having to work for it, your lungs are breathing for you, they’re keeping every cell of your body alive. Appreciate everything good in your life, and your life will change in that moment. – states Andreia.
It was shown in the research that part of it was all about getting the right support and Andreia states that she usually says that; however, for example, when you go to the dentist because your tooth is hurting, that’s probably not the best strategy.
You need to have a preventive plan, start creating your support plan when you’re good because when you feel bad it’s really hard to pick yourself up if you don’t have a plan. Therefore, Andreia shows a table and explains that’s the strategy she usually gives to her patients: to create your emotional support team and create a table.
These are people you value and trust, people with whom you can talk, people who understand what you’re going through, someone who can be your shoulder to listen when you’re on a really bad day. It may also be healthcare professionals, counsellors, friends, an online forum, social media or an app.
You have to write down their name and how to contact them because those are the people who are going to be there for you when you have a bad result when you do a pregnancy test, and it’s negative. Those are the people who are going to be there for you.
The second part of this support plan is to create your unique support plan. When you start understanding how your body and mind respond to the situations that are happening to you, and you write the situation down and the strategies that have worked, some of you might even think ahead.
So, you might write a situation where you’re having the two-week wait and it’s a very anxious time during treatment. You might write down strategies which you think are going to be really helpful such as calling a friend or watching a movie.
If you write down the situation, for example, when you’ve done the pregnancy tests, and it was negative, you can also write the strategies that have worked. Maybe you might stay in contact with this person or write down a list of all the things that are going on for you. Therefore, writing down your own life can be extremely helpful.
Furthermore, Andreia Trigo emphasizes the following:
Know that life is working for you, life is not working at you, things are not just happening around you, everything in life happens for you, and one day you will understand why everything is going to have a meaning. – concludes Andreia.
She then proceeds to mention that her app is a bit all over the world and you have a lot of the strategies mentioned in the presentation and more. They have support groups that happen twice a month and lots of tools available which are free.
Number one: you’re not alone because I hear it all the time. The biggest challenge is that both of you never thought that you’d be in the situation that you are now, and a lot of people, they never had to cope with anything this challenging in their lives before. So, it can be quite difficult, and you’re both independent people trying to cope with it as individuals but also trying to cope with it as a couple. As a couple, it’s good to understand that everyone copes differently, and I don’t know how your partner is, but usually, men tend to be a bit quieter, and they don’t like talking as much or sharing as much. Women usually like to analyse things and talk them over and, sometimes, that gives the impression that people are not as caring as we are, but that is not the truth. That just means that they’re coping with things in the way they know how to cope with things. It would be really useful to have time for both of you to talk about your journey and the things that you want to do, but it’s also good to have times when that talk is off-limits.
You should have protected time when you’re not trying to conceive, you’re not talking about trying to conceive, and you’re just enjoying each other’s company. And you’re going to see that, for example, if you schedule half an hour on a Monday at 7:00 p.m., we’re going to talk about it, we’re not going to resolve all our issues, but we’re going to resolve what we can. But before that time and after that time, we’re going to enjoy ourselves as a couple and that tends to help because otherwise it can almost feel like you’re talking about it 24/7.
Another cool tip I have is to have separate areas in the house where you don’t talk about it because otherwise you can contaminate everywhere you are, so having a dedicated space in time to talk about these problems and then allowing yourselves, as a couple, to enjoy each other’s company can also be very helpful. And, of course, when you’re talking to each other, just being honest, and it might be that when you’re honest, when you’re sharing and when he’s sharing, you realize that there’s a lot that is actually bringing you together instead of pulling you apart.
I think you should seek expert help if you feel that you’re not able to have a conversation with each other without being angry, and you’re not being able to find a consensus. So, if you’re not able to communicate effectively with each other, I think it can be quite useful to seek expert help and to have that third person as a mediator to teach you some of those communication strategies and to nail down exactly what is happening because sometimes when we’re talking, and we’re very emotional, and all of these topics are very emotional, we tend to say things that we don’t mean. I think when things start escalating like that, bringing in a third person, an expert, can help.
There are support groups for men, I know that a lot of men don’t like Facebook, but Fertility Network UK does have one on Facebook and, recently, there was also something by the caveman. He is also on Facebook and Instagram. I think he’s done a webinar as well here for my IVF answers. He’s been through it, he’s very vocal about his story, and he’s trying to create that network from men to men who are trying to conceive, so that could also be a good resource.
