Going through infertility as well as fertility treatments can be an incredible challenging endeavor, one that can certainly test one’s physical, emotional and mental health and wellbeing. Individuals or couples who experience this are also often juggling everything in their lives that were present before infertility presented itself, i.e., careers, marriages, family and friend relationships, caretaker responsibilities, children (yes, secondary infertility is a thing), etc. Infertility, like most ongoing health issues, does not care about all of the other things you’ve got to attend to. Infertility just is.
The CDC estimates that 1/4 to 1/5 individuals experience infertility (CDC). Another estimate is that 1 in 8 couples will experience infertility (Domar & Rooney, 2018) Unfortunately, despite it being a very common experience, many individuals go through this struggle feeling very alone. It is often not until one goes through it that they begin to see how prevalent a condition this is in our society. Several factors – a lack of support, developing emotional reactions to the infertility such as anxiety or avoidance, having to attend to the million other things that we tend to – can lead one to neglect a proper processing and acknowledgement of what they are experiencing. Self-care can also go by the wayside. Oftentimes, individuals also can feel that once they begin fertility treatment, mental health concerns also begin (i.e., anxiety surrounding fertility treatments) and that it can become easy to ruminate, or overly focus on this one aspect of their lives (tunnel vision on the thing that we become anxious about). Ongoing medical treatment, sometimes with no known or determinative stop date, can lead one to over-identify as “a patient”, and to develop negative cognitions related to themselves and their body, (i.e., "I'm tired of being poked and prodded"; “my body is failing me”; “my body is not working”). How does one maintain a balanced sense of self through it all?
Taking a Life Inventory
It is important when going through something like infertility, or ongoing medical treatment, to reflect on our self-concept – the multi-dimensional view that we have of ourselves that comes from our experiences, our underlying beliefs about ourselves and our place in the world. How does one view oneself throughout the phases of this journey, from trying to conceive naturally, to potentially seeking fertility treatment to coming to an endpoint of that treatment, whatever that may be? How did one view oneself before infertility came to be?
Carl Rogers, the founder of Person-Centered Therapy identified three components comprising this idea of self-concept: self-image (the way we see ourselves), self-esteem (the value we place on ourselves), and the ideal self (the self that we strive to be). I also think of self-concept as encompassing the different views we have of ourself: our relation to others (mother, father, daughter, son, sister, friend), our utility (our usefulness and productivity, i.e., our careers), our belief systems (this could include religion, but can also encompass other belief systems), our self-image (our internalized evaluations of ourselves), and self-esteem (how we ultimately feel about ourselves overall). Self-concept starts in childhood but it is not set in stone. It is an ever-evolving phenomenon – as we experience more life we collect more data to sift through that can cause slight shifts here and there in our self-concept. When one experiences a medical diagnosis like infertility, it can certainly make an impact on their self-concept - the ways we view and perceive ourselves, the ways we measure our own value, and the way we conceptualize the self we want to be in the future - post treatment.
It is important to get back to viewing oneself not as just “a patient”, but as all of the ways that you show up in the world, for yourself and for others. Exploring our self-concept can naturally lead us to examine the ways that we take care of ourselves. The need for a well-rounded self-care plan is paramount when going through ongoing medical treatment. With all of the hats that we wear in our lives, we need to take care of ourselves in each way, particularly during a trying time.
What are the different dimensions of your self-concept? One might conceptualize it in a similar way to the above graphic - all of the different ways that you engage with your life: your relationships, career endeavors, engagement in your community, your interests and your belief systems/intellect/emotions. Revisiting the very real fact that you ARE NOT only a patient receiving ongoing care, but that you have all these different facets to your life, how can we begin to implement self-care that honors all that makes you YOU. And how can we get specific in remaining mindful of the richness of your life and in addressing your needs in each of the different areas of your life?
Putting a Self-Care Plan into Action
During a challenging time in life, it is a wise idea to put intentional thought and action into your self-care plan. For some, this could mean actually putting pen to paper to write out that plan; if you're not a lists person, I do recommend that you to find some way of tracking this. One easy way to conceptualize this is to think of the different aspects of self-care: physical, emotional, mental and spiritual self-care. Another aspect of self-care that could be included is social self-care. Individuals that experience infertility often express feeling alone in their experiences; perhaps on such a journey, social self-care would be an incredible thing to put some effort into. (If you feel a sense of disconnection from others, a lacking of real support during fertility treatment, there are many organizations and groups out there that bring people together, i.e., the National Infertility Infertility Association, Resolve.org, that has many resources as well as groups nationwide). What are the things in each dimension of self-care that you know you can do to take care of yourself, whether or not you are doing those things right now? Emotional tasks might include journaling, attending therapy, or expressing and processing emotions you have with your partner; mental health tasks might include remaining engaged in your interests, listening to podcasts that ramp up your motivation or optimism, or alternatively, get you thinking about a different topic altogether; physical health tasks could include daily walks, prioritizing whole foods or getting a bit of sunshine each morning. You can also think of rounding out your self-care based on the dimensions of self-concept discussed above. In what new or improved ways can you take care of yourself in relation to your relationships? Your career or interests, or your community? If you have been feeling more disconnected from an important relationship as you navigate a new stressor, in what ways can you take care of yourself by tending to that relationship?
Once we've explored the things we know we can be doing to improve our self-care and our mindset, we can put a plan together to make sure we remain mindful and intentional of those tasks, i.e., writing out a weekly plan of exactly when and how we are going to get the specific tasks throughout our week. Throughout fertility treatments, there can be a lot of waiting due to medical procedures that need to be done before moving forward, waiting to take a step at the right time in your cycle, waiting for anticipated test results, self-imposed waiting or pausing when needing to process the journey that's been had to prepare for the journey ahead. Your life does not have to stop in the pursuit of your fertility goals, and any seasons of pause that come up within it. You are a full person, one that shows up in many different ways and areas of your life. You don't have to lose sight of who you are throughout your treatment.
If you would like to explore how to implement your personalized and intentional approach to whole-person self-care as you navigate your fertility journey, please feel free to reach out to me to see if working together in therapy might fit nicely into that plan.
References:
CDC.gov. 2023. https://www.cdc.gov/reproductivehealth/infertility/index.htm. Accessed October 2, 2023.
Domar, A., Rooney, K., 2018. The Relationship Between Stress and Infertility. Dialogues in Clinical Neuroscience, 20(1); 41-47.
Fast Facts About Infertility. Available at: http://www.resolve.org/about/fast-facts-about-fertility.html. Resolve: The National Fertility Association. Accessed July 26, 2017; [Google Scholar]
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