A favorite colleague of mine, Camille Hawkins, LCSW and I wrote this piece for the Utah Infertility Resource Center based on a survey of local individuals who identify themselves as a part of the LDS church. Does this ring true for any of you?


“The reason infertility cut so deep was that I believe with every fiber of my being that I am made to be a mother. I don’t feel that the LDS church is amiss in teaching that. I feel that is the reality I must face as an infertile Mormon. If I didn’t, I wouldn’t spend the time, energy, and money in an effort to become a mother.” This woman isn’t alone in her feelings of experiencing infertility while navigating her faith.

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Mormons facing infertility have a challenging task, one that asks them to balance their faith and commandments as Mormons while being unable to conceive naturally. Mormons are commanded to “multiply and replenish the earth,” but what happens when attempts fail? How does one navigate infertility as a Mormon, which parts of one’s faith help, and which aspects complicate such grief? How does infertility impact a man or woman’s role or identity in the Mormon faith?

Utah Infertility Resource Center, a nonprofit organization providing education and emotional support for those struggling to build their families, performed a needs assessment in 2015 of those struggling with infertility in Utah. 75% of respondents said infertility is the most upsetting event of their lives, compared with the national average of 48% (Domar). Why are Utah residents reporting significantly more distress than the national average? Are cultural factors at play?  

Community Survey
In order to better serve our community, we wanted answers to those questions. We developed a simple, anonymous survey directed to individuals struggling with infertility who self-identified as Mormon, and asked for responses in online infertility groups. We asked one question only: “How has your religion, spirituality, or the LDS Culture impacted your infertility journey?” Over a few days we received 68 responses; we poured over what respondents had to say. It appeared from the responses that simply answering the question was therapeutic: many spent thoughtful time putting their experiences to paper. After reviewing all responses we identified several themes.

Common Themes
Isolation – Many respondents report feeling displaced or left out while attending church. They reported that so much emphasis on family and children makes it hard to feel at peace.  One respondent writes: “It is very hard to figure out where you fit in with your ward family. The entire culture is all about family, and when you can’t have children you feel like you are on the outside looking in.” Respondents reported feeling second-class or left out because others were blessed with children while they were not.

Avoiding Church – Everyone Around me is Pregnant! – Similarly to feeling isolated, many respondents felt their experience of being childless was amplified at church. Experiences such as seeing pregnant women in Relief Society, multiple baby blessings, and the annual Primary children’s singing program left many feeling uncomfortable, conflicted and out of place. “I could not escape infertility and my unmet desire to have a family while I was surrounded by the sounds of tittering children, happy large families, and songs about ‘love at home.’ It was only a matter of time before I had a complex relationship with the Sabbath Day.” Although children are what couples who experience infertility seek, being surrounded by them can be a painful reminder of what is missing in life. Couples struggling with family-building often find church to be unbearable and may take a “sabbatical.”

Intrusive & Insensitive Comments – “You’re 30 with no kids?” or “No kids? Oh, you must be newlyweds.” Many respondents report insensitive comments from their faith community. “It is an environment that should be welcoming, accepting, nonjudgmental, sensitive, etc. but it was actually one of the hardest places for us to be.” Although comments are usually well-meant,  they often leave individuals feeling invalidated and unseen. “One thing we did struggle with is the people…We learned to keep the people and the church separate. I wish people would understand that everyone’s journey is different.”

Questioning One’s Faith – Respondents shared experiences of questioning their faith and having doubts about their God. “I have personally questioned my God, my value as a human, as a woman, and as a wife. I have to deal with continued stress that I am a failure as a ‘Daughter of God’ because I haven’t been ‘blessed with a family.’” Additionally, respondents wondered if God was punishing them because they were not faithful or worthy enough for children. Some respondents felt as if God doesn’t care about them or that God was teaching them a lesson.

Conflict between Divine Role and Infertility – “Getting married and having babies is THE plan!” A majority of respondents wrote about their distress in not fulfilling the “divine role” of motherhood as set out by LDS church doctrine. Women felt purposeless and worthless if they couldn’t fulfill their role as a mother. This caused an identity crisis for many who were unable to achieve what they were taught and believed to be, “the pinnacle of womanhood.” Many wondered, do I fit in the church? If so, how and where?  Women wrote about being offered platitudes such as “you will be with your children in the afterlife,” or that being an aunt or teacher are important roles as well. Although they were well-intentioned, comments left respondents feeling that their experience of infertility wasn’t being acknowledged.

Must Mask Feelings – Respondents felt pressure by the LDS community to put on a happy face. When individuals chose to share their experience of infertility, they were often subtly encouraged to revel in “the good news of the gospel” instead of feeling sad. One respondent writes, “I felt constant pressure to get over my infertility.” Individuals felt like they could not express their feelings about infertility, and when they did they were misunderstood. “I feel a lot of people in the LDS church have a hard time dealing with negative feelings because we tend to think that we don’t have to be sad because we know it’s all part of God’s plan.” Individuals walk a tightrope of wanting to share their internal experience of infertility in the hope of receiving support and acknowledgment, but also fearing judgement, or being encouraged to “get over it.”  

LDS Church Stance on 3rd Party Reproduction – “Confusing handbook policies are an aspect of being an infertile Mormon that can be distressing. I have heard varying accounts of bishops advice toward the handbooks’ stance on third party reproduction. I feel this is an area that needs to be cleared up.” The LDS Church Handbook Policies on Moral Issues states, “The Church strongly discourages [infertility treatments] using semen from anyone but the husband, or an egg from anyone but the wife. However this is a personal matter that must ultimately be left to the husband and wife. Responsibility for the decision rests solely upon them.”
When traditional treatments are not recommended or fail, 3rd party reproduction is often suggested. Egg donation, sperm donation, gestational surrogacy, or embryo donation (sometimes referred to as embryo adoption) are all 3rd party methods. LDS couples look to their leaders and church handbooks for policies on these family building methods. Couples are left wondering how to proceed when they receive mixed messages and confusing guidance. Women reported an internal conflict between building one’s family and following the Church’s recommendations.  

Comfort in God and Religion – Finally, respondents reported that despite or in addition to their experiences with faith as outlined above, many also felt heard by God and strengthened by the gospel of the LDS church. One respondent states, “I have felt my Savior’s love for me so strongly in my darkest moments and he has carried me throughout this trial. I don’t know that I could make it through infertility without the gospel.” Many felt comfort in the idea of having or seeing their children in the next life while others felt grateful for their relationship with the Savior and felt that God was aware of their struggles and sorrow. Respondents found comfort in scripture, prayer, the prophets, and temple attendance.

Grief and loss are hallmark symptoms of infertility, and these feelings can undoubtedly be complicated by one’s faith and relationship to her or his religious community. As with any experience, individuals will assign meaning to it which may be derived from their faith traditions or personal journeys. If you are invited to discuss one’s experience of infertility, let him or her define the crossroads of spirituality, meaning, and the struggles to build a family. Many respondents commented that validation and empathy from others went further than silver linings. One respondent said it best when she remarked: “What I craved was someone to say, ‘Even if you know that God has a plan for you, it must be so devastating to struggle to build a family.’”

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I am very, very excited to announce a collaboration a colleague and I have been working feverishly on. Shannon Hickman is a fellow clinical therapist who specilizes in sex therapy. In her private practice she treats couples dealing with a myriad of issues related to sex, intimacy and their implications. 


Shannon and I are both new mothers. We starting talking about how important it is to us that our girls feel comfortable in their bodies, think about and experience sex without shame and get their information from us (rather than rumors and school yard pals). So, we started digging into the research about how to ensure this happens. Lucky for you, we've distilled all of this down into a parenting series that we're offering to parents who feel as passionate about this issue as we do. 

We plan to discuss how our own thoughts about sexuality have the tendency to bias our discussion with our kids, we will talk about age- appropriate sexual development, break down the nitty gritty on just how to share information about sex and cover any other questions you can conjure up. It's going to be a great time, join us. 

If you're interested in a little taste, check out the KSL article we wrote to give you an idea of where were headed. 

Beyond the Birds and the Bees: Discussing Healthy sexuality with your child. 
By Shannon Hickman, LCSW and Whitney Barrell, LCSW
First published by KSL July 29, 2015

Most parents tend to dread, or at least feel intimidated by, having “the talk” with their child. There are a myriad of resources discussing what topics to introduce at which age, and what is characterized as normal sexual development. The National Child Traumatic Stress Network offers a comprehensive outline of healthy sexual development.


But, what we’d like to offer is a broader view of this “talk,” and some factors to consider. Parents typically think of the “talk” as discussing sexual intercourse in a framework of how children are conceived. Rather than just focusing on the mechanics of how babies are born, consider broadening the discussion based on the child’s age and ability to understand concepts. No one knows your child better than you do, and as parents, your deep love and connection to your child makes you the best person to talk with them about sex. Before talking with your child about sex, think through your own values about the role of sex in a relationship, healthy sexuality, what you want your child to understand about their body, and how you want them to feel about their body and their sexuality. Think back to your own experience when learning about sex and intimate relationships and how your parents or others discussed this topic with you. Are there important values or standards that you want to impress upon your child? Consider the biological, emotional, social, relational and spiritual aspects of sex and how your beliefs and values fit into these areas. Was the way your parents shared this information with you successful? Is there something you’d like to do differently?


-Healthy Sexuality
Often children grow up viewing sex as a physical gratification rather than equating it to love and fulfillment. It is important to remember this is not a one time conversation. It is an ongoing topic of discussion and the more open the child can be, the more support a parent can provide in helping to positively shape their child’s sexuality. With our children being bombarded daily in the media with sex and sexual images, it is more important than ever to help them to develop healthy attitudes about their bodies and sexuality.


-Attitudes
Identifying your own beliefs and attitudes about sex ahead of time will allow you to work through some of your own anxieties prior to having the discussion with your child. We as adults have often developed unhealthy attitudes about our bodies and sex that may affect the way we communicate with our child during discussions about these topics.


-Practice
Most parents feel a degree of anxiety in discussing sex with their children. Examine what makes you anxious: is it talking about a private topic; is it that you don’t feel prepared? Keep in mind that the tone or level of anxiety will convey more about how you feel about the topic than the actual content you share. If you want to exude acceptance and openness, make sure your face, and body positioning also conveys this. Plan out what you’d like to tell your child and choose words that feel comfortable for you.


-Conversation starters
Using everyday life to bring up topics of sex and sexuality are typically the best way to proceed. If you see something on TV with your child that feels like a “teachable moment,” take it. You might ask, “what do you think about all of that?” Focus on what questions they are asking. If your child asks “where did I come from?” He may just be asking which hospital he was born in? Clarify the specific question, then answer it as succinctly as possible. Follow up with “did I answer your question?” Follow their lead. Also consider the importance of strengthening your relationship through special times and activities that promote heartfelt sharing and connection.


-Avoid metaphors. 
Young children are concrete thinkers. Metaphors tend to complicate things. If you are talking about specific body parts or functions of body parts, be as direct as you can, while also keeping in mind the child's developmental stage. It is helpful to use the appropriate names for body parts. This helps the child to begin to understand they do not have to be ashamed or embarrassed about any part of their body. This approach will begin to set the foundation for positive body image and healthy sexuality.

-It’s not one talk, it’s many.

Rather than sitting down with your child once they reach puberty to talk with them about sex, consider starting early and building on the depth and complexity of this topic. Identify an end goal. Parents may want their child to grow into an adult who is capable of an intimate relationship without feeling ashamed. If this is your goal, work backwards, expounding on experiences and discussions to support your goal. Consider the use of tools such as age appropriate books to help guide you in your discussions.

Shannon Hickman, LCSW is a trained sex therapist. Whitney Barrell, LCSW specializes in child therapy. Together they are leading a parenting series on how to talk with your child about healthy sexuality.

Beyond the Birds and the Bees
Parent Education Series

Sex. Wondering how to discuss it with your children? Wondering how your own experiences are shaping the conversations with your child? Want to know what is normal, healthy sexual development and when to be concerned? Want to ensure that sex doesn't become shameful or embarrassing? Do you want your child to talk to you first? No one knows your child better than you do, and as parents, your deep love and connection to your child makes you the best person for the job. 

 Join us! Shannon Hickman, LCSW a trained sex therapist, will be sharing her expertise on healthy sexuality. Whitney Barrell, LCSW who specializes in child therapy, will focus on child development and the use of parent-child relationship to foster healthy development. 

Topics include:

• Understanding healthy sexual development.
• Instruction on how to share age-appropriate sex-ed. 
• Discussing sexuality without shame. 
• Equipping kids with accurate information and an understanding of their bodies. 
• Encouraging kids to make decisions based on their values. 
• How to discuss sex in terms of a relationship, and in terms of conception. 
• Exploring your own view of sex and conception and how it impacts this discussion with your child. 

Who: Parents of children ages 3-17
When: Monday July 13th AND Monday July 20th 7:00pm-8:30 pm. 
Cost: $200 per couple/individual
Where: South Valley Therapy
8537 S. Redwood Road, Suite A, West Jordan, UT 84088

Click HERE to sign up. 

Shannon Hickman, LCSW holds a Master's Degree of Social Work from Rutger's University and has a private practice in Taylorsville, Utah where she specializes in couples counseling and sex therapy.  As a trained sex therapist she is able to help with a variety of concerns related to sexuality and intimacy. 

Whitney Barrell, LCSW holds a Masters of Social Work degree from the University of Utah and maintains a private practice in the Salt Lake City, Utah. She works mainly with young children and their families on mental health issues and is focused on and improving family relationships.

Parenting is the most demanding job we’ve got.

Most parents aren’t making deliberate decisions about what skills they need to possess to be the best parent; rather they are ensuring teeth are brushed, homework is done, and talking with children about their ideas and goals — which turn out to be important parenting skills.

Parenting absorbs us; it’s hard to get an objective look around.

We don’t often rely on science to guide our parenting decisions. It’s more likely that we consider the type of parents our parents were, and either duplicate the parts we felt were effective, or turn the other direction entirely.

Women talk with their girlfriends about discipline or choosing a good school. Men trade stories about their children and their relationship with them. We ask the pediatrician, and we notice the skills other parents utilize at the park and we integrate them into our routine. We Google. We read parenting books. And when we’ve done all of that, we realize how much contradiction exists.

Dr. Robert Epstein has done the legwork for us. He’s compiled a list of 10 parenting competencies that are predictive of good outcomes. In this case, good outcomes for children are defined as a child's success, health and happiness, as well as the quality of the relationship between parent and child.

Eleven parenting experts evaluated the 10 competencies identified, and data was collected from over 2,000 parents who identified both the outcomes of their children (health, happiness, success) and how closely they parented related to the 10 competencies.

Using this data, Epstein ranked what competencies had the most impact down to which had the least:

1. Love and affection: Time spent one on one, exhibiting physical affection.
2. Stress management: Parents' ability to manage their stress.
3. Relationship skills: Parents' ability to maintain a healthy relationship with their partner.
4. Autonomy and independence: Treating your child with respect and encouraging independence.
5. Education and learning: Providing opportunity for your child in education.
6. Life skills: Having a steady income and stable home.
7. Behavior management: Discipline techniques, both positive and negative.
8. Health: Access to healthy foods and exercise.
9. Religion: Supporting "spiritual or religious development."
10. Safety: Keeping your child safe from harm and harmful relationships

Love and affection
Love and affection tops the list. The one-on-one time we spend supporting our child has a direct impact on his or her degree of happiness, health and success. Parents are powerful.

Stress management and relationship skills
Interestingly, competencies ranked No. 2 (stress management) and No. 3 (relationship skills) are factors that don't involve our child directly. How a parent manages stress and the skill he or she possess in relating to other adults aren't typically considered parenting skills. But, as we see from where they rank, are factors of high importance.

Mothers and fathers in healthy and satisfying marriages are more engaged in their roles as parents and have more positive attitudes toward their children. Frequent and intense conflict, on the other hand, is associated with unresponsive and insensitive parenting.–Urban Institute
Stress management is a measure of how well a parent manages his or her stress. If a parent can rely on healthy ways to minimize stress, he or she is more accessible to the children and has more time for love and affection.

This finding dovetails with what we know about maternal depression and its impact on children. When mothers are depressed when their children are young, they may be fighting to manage basic care-giving tasks (food, hygiene, etc) and don't have the energy for important bonding that takes place early on. Regardless of a child's age acting as a role model by caring for yourself, will pay off for the entire family.

Relationship skills reference a parent's ability to communicate and compromise, whether he or she is parenting in the same household or co-parenting due to divorce or separation. Children show improved outcomes when parents are able to speak kindly to one another and model healthy relationship skills. Prolonged exposure to high conflict between parents has an impact on children's psychosocial development.

Research by the Urban Institute goes further, reporting, "Mothers and fathers in healthy and satisfying marriages are more engaged in their roles as parents and have more positive attitudes toward their children. Frequent and intense conflict, on the other hand, is associated with unresponsive and insensitive parenting."

Life skills
Life skills are another domain where parents have a degree of control. Epstein defines life skills as one's "ability to provide for your child, have a steady income and a plan for the future." As we can see, many of these competencies are intertwined. Those who are financially stable have one less thing to worry about and one less stress to manage.

Behavior management
Behavior management is likely the competency most fuzzy for parents. There are myriad opinions on the best way to diffuse conflict with our child, or ensure that he or she complies with our requests. Recently, advances in neurosciencehave shed some light on this topic. We know that when a child is hyper- or hypo-aroused, he or she is unable to participate in problem-solving or skill-building.

The good news is, despite all the contradiction in how to best discipline our child the approach we use isn't as important as it may feel. Besides, this competency falls in the lower third of the list.

Religion
Religion makes a surprising appearance on the parenting skills list. One theory is parents who support or encourage spiritual development may be a part of a broader religious community that provides support for the family spiritually and informally, and that leads to improved outcomes.

Figuring it all out
Parenting often feels sandwiched between guilt and shame. Being a parent seems to be a very public display of one's skills and abilities when this isn't the case. All parents, regardless of outside circumstances, desire for their children to be happy and healthy. How we progress toward that goal is determined by our history, values, experiences and opportunity.

Among this list of 10, there is undoubtedly a place where we "have it down." If one is interested in testing where he or she falls among the 10 competencies, Epstein's website has a skills test that will assesses a person's strengths and provide feedback.


First published by KSL on May 24, 2015. 
https://www.ksl.com/?sid=34582765&nid=1009&title=parenting-skills-the-top-10-suggestions-for-raising-happy-children&s_cid=queue-5

The Finding Peace Infertility group has just wrapped up it's first rotation. It was incredible. A group of five women who didn't know one another at the beginning of the 6 weeks formed honest, genuine, vulnerable relationships with one another. The group members shared their intimate thoughts, feelings of intense loss and were met with support and open arms. 

Throughout the group participants journaled, used art therapy to create a visual representation of how infertility feels, their goals and accomplishments, and most importantly,  found a space where they didn't feel alone.  (Current group info here.)

One of the journaling assignments was related to how infertility affects the relationship with ones spouse. I requested that the group write a letter to their spouse about how infertility has impacted them.  And, one participant blew us away, a wicked smart women full of love and compassion shared her letter, and there wasn't a dry eye in the room. So, in honor of Infertility Awareness Week, and with her permission, I'd love to share her letter with you. Maybe you can relate. 

A letter to my husband, 
Infertility has beat me up. It has drawn blood and left me battered and bruised. 

When I was younger I had a plan that I was going to be married and starting a family by 23. It was always something that I wanted but never happened, and you know I'd never settle. 

When I married you at 30 I thought it was finally my turn. You know I wanted kids right away, but I had to wait- we needed to finish law school, then we needed to move, take the bar, get jobs, get better jobs. By the time we said "fuck it" and gave up trying to be ready, I thought again, this is finally it. Month after month, year after year, disappointment set in. After the miscarriage in December, it happened. I lost hope. I am defeated, broken, sad. 

I know you must feel something too, but when you try to comfort me by agreeing that infertility sucks or that you know how I feel- I am surprised. I feel as if I am telling a friend my woes and I expect sympathy, but not understanding. I often times forget you are on this journey with me. I don't know if that is because you don't often share your feelings on the subject because I am so consumed with mine, or that I don't listen. 

I want to though, I want to listen to you and be excited about the future with you. I want us to be the "Spokane us." We were broke, unemployed, childless, and without a clue to what we would do next, but we were happy, and in love, and excited about possibilities. 

I think more than anything I want, I need, action. I am so sick of saying everything and doing nothing. Let's do our frozen transfer, let's adopt, let's move, let's change careers or take the bar again. I don't want to wait anymore. I want to live the very precious lives we've been given. Life is so short and I don't want to spend it waiting. I want to LIVE IT with you. I want to TRY with you. I love you. 

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