Part Two: Medically Unexplained Infertility: What’s There To Talk About?
This is the Part 2 of our blog piece on medically unexplained infertility. In the first Part we reflected on when women and couples seek help and why. In this Part we share a typical therapy journey - describing the sorts of issues we might work with a couple or woman about.
Our key task as psychotherapists is to be emotionally engaged and attuned to the rollercoaster of feelings our clients have been on. This is not the time for neutrality! At RSF Therapy, Sarah Hanchet is passionate about this work because of her own experiences.
What is our psychotherapy treatment plan?
We usually begin with a 3-session assessment for each individual. This is partly to understand the complexities of each person’s fertility journey. It also serves to enable a shift in mind-set from talking about the process measures of ART to a consideration of how the process has felt.
If a couple presents, we will see each person individually, and then have couples sessions as we go along. We would begin by working weekly and then seeing what is required.
The therapy goal is to help people we look after who have struggled for so long with medically unexplained infertility to feel understood. We work to validate people’s feelings and responses, individually and to each other.
Most importantly we create an environment and therapy relationship in which our clients can begin to feel psychologically cared for. Medical interventions over long periods often leave people feeling powerless and therefore defended.
What are Some Key Outcomes?
When we work with individuals and couples with medically unexplained infertility, our key goal is to help the individual return to the place of personal equilibrium that they were in before treatment. With a couple, we also work to help them reconnect with what it was like being a couple before they embarked on treatment. Working with people individually and as a couple, we work on the following:
Helping people to tell their fertility narrative. The aim is to enable people to re-connect with the person they were before this ‘episode’ of intense treatment. It is to begin to integrate the person they feel to be now, with their old sense of themselves, by reflecting on how this experience has changed them.
The act of piecing together their fertility narrative also helps people to see where they have made choices (and still can), rather than feeling pushed around by medical processes or feeling at the mercy of fate.
This process also helps people to talk about the impact of their family / community on their sense of themselves. We work in therapy on whether people have given space in their heads to an unhealthy voice from their family / culture about ‘people who are infertile.’
Accepting Limitations. This needs to be helped to happen in order that people may begin to grieve their losses and changes in their sense of who they are. A significant loss to work through may be the need to let go of the possibility of making childhood hurts and wounds better by being a better parent than their own parents had been.
Growing Up. The process of having and raising a child enables the process of moving apart from one’s parents and re-connecting in a new way. Therapy is a useful space in which to reflect on being conscious of this rite of passage that needs to be navigated even without a biological child.
Enabling Improved Self-Esteem. This happens as the individual and couple begins to de-prioritise the centrality of reproduction and replace it with other values and goals. Slowly, becoming a parent in this way becomes a less defining part of the self.
Channelling Energies and Aspirations. The desire to procreate is a strong drive, and therapy is a place in which to think about repurposing these energies.
Revitalising intimacy. Years of ‘baby-making sex’ can take its toll on a person’s sense of being a sexual person, as well as on a couple’s sex life. Psychotherapy is a safe space in which individuals and couples can explore what pleasure might mean for them again.
Considering Options and Making Practical Decisions. Alongside the psychological and inter-relational work above, we also help couples and individuals think through their options in order to feel once again a sense of agency.
Has This Article Touched You?
We hope that you have enjoyed this blog piece.
As well as seeing patients individually and as a couple, we are in the process of setting up a therapy group for individuals and/or couples needing support with this diagnosis.
If you would like to know more about our work with individuals and couples with medically unexplained infertility, then do get in touch with us.
You can find out more about our work on our website and social media: