Emotions and mental health during IVF and infertility treatment
Infertility is like a weed in a garden – it likes to quickly spread itself across every aspect of our lives. As such, it can have a negative impact on our relationships, our careers, and our day-to-day life. For some people, being diagnosed as infertile can be a severe emotional hit, which leads to near-constant stress and self-doubt. How, then, do you keep your mental health? How do you prevent your emotions from stopping you dealing with the infertility?
We invited Andreia Trigo from inFertileLife to talk to us about dealing with our emotions and taking care of our mental health while dealing with major health issues, such as infertility. Andreia is a fertility coach and motivational speaker with years of experience in helping patients help themselves.
Mindfulness and emotional rollercoaster
Andreia understands the emotional rollercoaster that fertility patients go through better than most – she herself was diagnosed as infertile at just seventeen years old. No matter when we are diagnosed, the emotional toll it can take is significant – feelings of anxiety, anger, frustration, disappointment, fear, and others are completely expected under the circumstances. However, just because those feelings are something “normal” for us, it does not mean they should just be left alone, unmanaged. This is where mindfulness comes in.
Mindfulness is a mental state achieved by focusing one’s awareness of the present moment. In this state, we acknowledge and accept our own feelings and circumstances without any judgment. By forcing ourselves to focus on the here and now, we prevent ourselves from thinking about the past (which we cannot change) and the future (which is yet to come). The “noticing without judgment” part is the challenging bit – because we are emotional creatures, we are very good at judging ourselves (and others!) based on our feelings. Through mindfulness practice, however, we can overcome that natural predisposition.
In his 1997 book, “The Power of Now”, spiritual teacher Eckhart Tolle posits that “the quality of your consciousness at this moment is what shapes the future” – a sentiment Andreia fully agrees with. To demonstrate, she explains the process by which our thoughts transform into results in our lives.
From the earliest days of our childhoods, our development process is influenced by our parents, teachers, and friends – our environment. The people in this environment pass on their values and beliefs onto us; as children, we quickly subsume these values and beliefs as our own. This is the foundation of our worldview – quite literally, these aspects of our environment we assimilate as our own become the lenses through which we view and process events in our lives. Because of this mechanism, two people may see the same situation in two different ways.
These “lenses” help us process events in our lives by triggering certain feelings – a certain situation may make you feel sad, another one may make you feel indifferent, and yet another may make you happy. These feelings, in turn, influence the actions we take – and the results we have in our lives. Thus, Andreia says, our mental state influences our future. Knowing this is very empowering, not least because it demonstrates that we have a demonstrable ability to change our lives.
Every person has a tiny voice in their head which constantly spews out negative thoughts. For some people, this voice is louder and actively influences the actions they take through the mechanism we just discussed. Psychology describes this phenomenon with the term, “self-fulfilling prophecy” – it basically means doubting oneself into failure.
People process infertility as a loss, and processing loss involves going through grief. The famous “five stages of grief” map out the emotional journey we go through in these circumstances. During the earlier phases, that is, during the denial, anger, and depression stages, we are especially vulnerable to that negative voice. Mindfulness practice helps us recognize that fact and mitigate the effects it may have on our overall mental state. Once we are aware that the negativity comes from within us, it’s easier to deal with it and move on.
Psychological effects of mindfulness
Mindfulness has been studied scientifically since at least the early 1970s. Its psychological effects are well-documented, and include:
- Reduced stress
- Enhanced performance
- Gaining insight and awareness
- Increased self-compassion
- Experiencing negative inner states in new ways
All these effects are very useful when dealing with infertility. Because infertility is such a complex topic, facing a diagnosis evokes a lot of diverse fears and uncertainties: “will I ever be a parent?” “Will my partner still love me even if we can’t have children” and so on. Each of these fears is rooted in a different place – as such, efficiently processing and dealing with the emotions raised by these issues can be overwhelming. Mindfulness is a tool which helps you break down each of these fears into their basic elements, making them easier to process properly.
Many of us instinctively avoid facing emotional issues as a coping strategy. Mindfulness goes against that and actively forces us to allow ourselves to experience the emotions and understand them on a deeper level. This seems to have actual, tangible results in dealing with fertility patients – Andreia refers to a study in which mindfulness participants were demonstrated to be significantly more likely to become pregnant (45%) than the control group (26%). The practice’s core tenet of experiencing our circumstances and feelings without judgment seems to help fertility patients relate to their condition and treatments in new ways, leading to more successful outcomes.
Mindfulness and fertility treatments – practical tools
So, how do you incorporate mindfulness into your fertility treatments? Andreia presents us with five simple strategies that you can get started on straight away.
Introduce short pauses into your everyday life
The number one strategy, and the most fundamental one, is introducing short pauses into your everyday life. This means exactly what it says on the tin – start introducing short periods of time in your daily life during which you allow yourself to appreciate everything that’s going on around you and in your head, without any judgment. This is as simple as mentally identifying one thing you can notice with each of your senses – one thing you see, one thing you hear, one thing you feel, et cetera. Whenever your mind wanders off and you start worrying about the past or the future, use this technique to return to the present.
Activity number two is self-affirmations. Affirmations are short phrases you repeat every day; with time, these phrases become actual, internalised beliefs. This works using the self-fulfilling prophecy mechanism described earlier, only in this case, we make it work for us instead of against us. Repeating an affirmation such as “I’m committed to being in a state of peace, love, joy, and gratitude” every day may seem silly, but once it becomes an internalised belief, you will notice it affecting your reactions to negative events for the better; you will unconsciously stop yourself from overthinking bad things, which in turn stops them from spreading and affecting other areas of your life. Remember how we talked about our beliefs becoming lenses through which we view and process the world around us? This is exactly the mechanism we are leveraging here.
Option number three is called mindful activities, which may sound very broad and unspecific. It refers to taking a new approach to activities we have got so used to, we are doing them “on auto-pilot”, without thinking about them. During this activity, we force ourselves to be mindful while performing these actions – which could range from mundane things such as brushing our teeth or tying our shoelaces to even sex.
Let us take brushing your teeth as an example. Start by noticing everything you can about your toothbrush: it’s colour, how heavy (or light) it feels in your hand, if the bristles are all straight or if they are beginning to bend. Then, the toothpaste – its smell, the taste it leaves in your mouth. Then start counting how many strokes you do on each side of your mouth. You can apply this principle to any other activity you do not usually focus on. This activity helps establish a new habit – of staying focused on the here and now. Have you ever heard the Latin expression carpe diem? The Romans evidently knew how to be mindful – and now, so do you.
Activity number four is called the mind-body connection. This ties in with the previous activities by grounding us in the present; this time, however, we do it by examining our entire body. This activity turns our focus inwards, on our own bodies – simply relax and start noticing things about your body: how you can feel the support of your chair, how your feet touch the floor. Become aware of the joints in your ankles, knees. Work your way around the entire body – notice how your stomach and torso expands and contracts as your breath, how your shoulders start to slump as you relax, et cetera. This exercise should take you around three minutes, making it very easy to introduce into your daily life.
If you are having trouble with this activity, you can look for recording of coaches and trainers doing body scans – simply put one on, relax and follow the voice of the instructor. Andreia prepared one such recording for us, which you can find below:
The fifth and final activity is the gratitude diary. This activity may seem simple, but it has tremendous effects on your mental state and well-being. Start a diary – or simply say everything out loud to your partner – and each day, find three different things you were grateful for. It may be hard at first, especially if you have never done anything like this before. After a couple of days, however, you will see how it becomes easier and easier. The things you are grateful for may be big or small, it doesn’t matter – it may be simple things, such as having a seat on the bus, or something more involved, like spending time with your partner. Andreia posits that the more things you are grateful for, the more gratitude will enter your life.
We need to beg forgiveness, dear reader – we misled you. We have six mindfulness activities for you, and this one is specifically for fertility patients. Andreia calls it the Fertility Priming Routine, and it is a morning routine that takes about eight minutes. It is a recording which helps you stay focused and find the strength needed to achieve your desired results. You can find the recording below:
Questions and Answers from the event
I would like to stop my IVF treatments, but I can’t – they’re like drugs. What do I do?
The prospect of stopping treatments may seem daunting to patients who spent a lot of time trying their best – they’ve been at it for so long, it almost becomes their entire identity. I remember myself before I embarked on this journey: I used to be a daughter, a partner. Once I realised there was a fertility issue, however, that was my entire new identity, that was all I was thinking about 24/7.
The way to get through this is to understand and acknowledge that everything we’ve been through is a part of ourselves, but it doesn’t define us 100%. Introduce new things into your mindfulness, identify things that you are grateful for that are not related too fertility. It’s all about engaging with those things more and more – it’s an ongoing process. Allow it to take however long it needs to take.
What to do when my partner is skeptical about mindfulness?
Mindfulness suffers from a rather misleading media image. As a result, when people hear the term, they immediately picture a hermit meditating atop a mountain. That makes it rather difficult for people to relate to the practice – the immediate assumption is that it takes a lot of effort and commitment, when really, the whole point of the practice is integrating it with your life.
If your partner doesn’t believe in mindfulness, obviously they’re not going to be mindful on their own. You can try to convince them – let’s say you’re having a meal. You could say things like “isn’t this plate colourful?” This makes your partner immediately think of the plate just because you’re talking about it. Obviously, this doesn’t just work on physical things – try telling your partner that you’re grateful for their presence during your treatment or that you enjoy spending time together to make them mindful of your feelings.
I know my only option is egg donation, but I can’t bring myself to commit; instead, I keep trying and trying with my own eggs and failing. The worst part is that my partner is pushing me towards it, but would not accept donor sperm if there was a problem with him. How do I get help?
The first step is accepting the reality of the situation while not putting any guilt or blame on yourself. It’s completely acceptable to wait a couple months or give yourself that one last try; definitely don’t jump into something you aren’t ready for.
One common concern that is a major dealbreaker for a lot of patients in that situation is the supposed “lack of genetic connection” between you and the child. Research shows that the mother’s mRNA – the carrying mother’s, that is, yours – has an influence on how the genes express themselves. While you may not be 100% genetically related, some degree of relation will exist. You will also be carrying that child for nine months – the connection you will share because of those nine months will more than make up for the “genetic relation”.
As for your partner, solving a problem as a couple is a notoriously tricky thing – ostensibly, you’re both after the same thing, but the level of commitment may be different between the two of you. Trying to reach a satisfactory compromise is especially tricky when we’re dealing with sensitive topics like infertility. This is where fertility coaching and counselling comes in: it allows couples to get on the same page and talk out their uncertainties and differences.
Is it worth it to speak to other people about fertility problems? Sometimes they just don’t get it.
From my experience, sharing is always better than not sharing. The simple act of talking about your problem relieves the “weight” of the issue and makes you feel like you’re not dealing with it alone. Of course there’s the risk that people aren’t going to be willing to offer any support, but in my experience, that is very rarely the case. The people you share with don’t even need to be your family or friends – plenty of communities online can offer you support, and you can talk about your issues while maintaining anonymity.
What are the key steps to maintain a positive mindset and attitude?
Mindfulness is all about noticing your feelings and environment at this very moment. When you notice negative feelings, it’s important to acknowledge these feelings and deal with them accordingly. If you’re in a situation, where the only feelings you notice are negative, and this state starts spreading out into other areas of your life, that’s when you seek professional help.
The trick to staying positive is to accept our feelings and allow ourselves to experience them while at the same time containing them and not allowing them to affect other aspects of my life. Let’s say you had a negative result on your latest embryo transfer – feeling anger and sadness in these circumstances is normal, but they shouldn’t influence other events in your life; let’s say you’re meeting with friends soon – during that meeting, focus and be mindful of the positive feelings.
How long do you recommend to wait after five failed attempts?
I would need more information to give you good advice – visit my website and e-mail me. I give one free consultation to everyone, either over the phone or Skype.
How long did you need to accept your infertility diagnosis?
I was diagnosed at 17 years old and I became a nurse at 21. For a good while, I simply avoided everything related to pregnancy. I purposefully looked for partners who didn’t want children simply because I didn’t want to face that reality. Eventually, I started a journey of self-discovery and self-acceptance; I realised that I was perfect just the way I was and that everyone is different.
The way that society at large believes parenthood and fertility should be is not actually real – families come in all shapes and sizes. Realising this took me fifteen years. This is why I do what I do – if I was diagnosed when I was 30 or 40, I would not have fifteen years to figure out what my next step would be.
How to cope with the wait after the embryo transfer? It can be very nerve wracking…
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