Dealing With Infertility Problems Part 2

This article is taken from an AMCAP convention in October 1984.(AMCAP is the Association of Mormon Counselors and Psychotherapists.)
This is the second part of the article. The first part is written by Robert Taylor; it was featured two weeks ago. Sorry I didn't get it posted last week.

The second part is by his wife, Jayne E. Taylor.
Here is part two.

Jayne E. Taylor:

A large portion of our lives as Latter-day Saints centers on reproduction, parenthood, and raising children.

When couples become aware that reproduction is delayed or unattainable, they enter a stage of emotional crisis--the crisis of infertility. The emotions include feelings of surprise, denial, frustration, anger, guilt, and typically isolation. Another initial reaction is the sense of helplessness and anger at losing control over one's life plan and body. This reaction is particularly true of people who are goal-oriented and people who need to have control over their lives. The feelings of one or both partners may negatively interfere with many areas of their marriage such as communication, sexual adjustment, and the whole quality of their life. A common fear for an infertile couple is that the fertile partner might abandon the infertile one, or worse, stay in the relationship resentfully. Some even make offers of divorce or say such provoking things as, "Well, if you had married someone else, you would have a family by now." The fertile partner may hide his or her disappointment and anger instead of dealing honestly with his or her feelings. Often we find that single people who know they are infertile will retreat from relationships or keep them superficial because they don't want this dreadful secret to be out. Married people may do the same.

Infertility can also reactivate unresolved past feelings of danger or loss. Sexuality can become extremely threatened. One Relief Society sister told an infertile woman, "You are not really a woman until you have borne a child."

The next phase following the initial shock centers on body image and self-worth. Feelings of worthlessness, defectiveness, and shame are common. People become preoccupied with the infertility workup, formulate theories about why this has happened to them, why they are defective, and why they are denied something that the rest of the world can take for granted. Barbara Manning, the past National Resolve president, said,

There's a sense of loneliness and isolation in infertility that defies description. The couple frequently feel they have no one to turn to, but each other. Family and friends are often reluctant to discuss such a personal and inherently sexual problem. If they do listen, they seem to answer with platitudes and misinformation born of generations of mythology and superstition. Somehow worthiness and pregnancy get conflated.

Because of these feelings of failure and inadequacy, it is hard for a couple to discuss this with anybody. Defense mechanisms are often set up to deal with family and friends. A man and a woman often feel damaged and defective. I have heard women describe themselves as feeling hollow or empty. One woman described herself as looking like Hiroshima after the bomb. Men describe themselves as castrated or talk about intercourse as shooting blanks.

These feelings of defectiveness go further. Many people comment that they cannot do anything right. One woman was unable to work on her doctoral dissertation; she said that her mind was sterile also. I had a very hard time going back for my master's degree until I had resolved some of my feelings about infertility. Somehow it affected my whole inner self. The monthly menstrual cycle is a terrible reminder and an enormous tension builds up towards the end of each cycle. Many women feel a deep depression verging on despair when menstruation begins. The intensity lessens over time, yet it is still always there as a reminder.

The next phase involves mourning the loss of the children a couple will never biologically have. This is a very difficult task because the loss is so vague. It is hard to define a potential. There are no funerals, no rituals to help the bereaved. It is an invisible process. I work in an intensive care unit with parents who lose children. For the most part, they have a lot of support systems--family actually present, support from family members not physically present, people who work with them, support groups, and a funeral helps them through the grief process. But people who are infertile may have no one to talk to.

The final step is that of resolution. The couple must now redefine their sexuality so that procreation is not a central point and work at regaining a healthy self-image.
Conclusive knowledge can help people who know there is absolutely no chance of ever becoming pregnant. They can close the chapter, go through the grief process, and continue with their lives. One woman I talked to recently had had a hysterectomy after years of trying to become pregnant. She was surprised at the relief she felt knowing that she couldn't become pregnant. There are many cases of infertile women who have had tubal legations just so they can't get pregnant.

The couple must assess their inner resources and decide what they are going to do in the absence of biological children. Sometimes this has to become a joint decision on which they can both agree, or the relationship will not last--or if it does, it will be unhappy. If you continue to have faith, does that mean you continue to go to the doctors?

The nonresolution of infertility can be a leading cause of failure in adoptive placements. Adoption may symbolize one's inadequacy in reproduction, and the presence of the child will actually be seen as a narcissistic injury for a couple who has not worked through that infertility. The point is, adoption does not cure infertility. Anecdotal evidence to the contrary, the statistics simply do not show that adoption cures infertility. Adoption and infertility are two different issues.

Failure to grieve is the most common block to resolution and the easiest to help. Every person has losses. We all have losses. It is very useful to give people permission to grieve. They must realize and acknowledge that a loss of great magnitude has taken place and that to grieve is normal. Also, grief runs a predictable course, and the pain does lessen as time goes on. A social support system to help is really important. I'd recommend the National Organization of Resolve (now RESOLVE: The National Infertility Association) which is very active in Utah. Also, the LDS Social Services (now LDS Family Services) here in Salt Lake can be a support system for people going through the adoption process.

In summary, the challenges to most infertile individuals/couples, and particularly those in the LDS culture, are very significant and far-reaching, in part due to many contributory cultural factors. Most people in the resolution of those challenges go through the steps of emotional crisis, mourning, and resolution. A social support system is very helpful in the successful resolution. As we remain mindful of these points, we can make a significant contribution to those suffering with infertility.

References
- Mazor, M (1979). Barren couples. Psychology Today, p. 101.
- Menning, B. (1975). The infertile couple: A plea for advocacy. Child Welfare, 54, pp. 454-459.
- Packer, Boyd K. (1973). Why stay morally clean. Salt Lake City, UT: The Church of Jesus Christ of Latter-day Saints.
- Tanner, N. Eldon (1973, January). ENSIGN, pp.7-8.