Infertility is complex; not just the medical side of treating infertility, but the emotional side of treating it. Essentially, infertility, whether it's the inability to conceive, frequent miscarriages or otherwise, is loss.

Many couples are surprised by the intensity of their feelings related to infertility. Perhaps this is because grief related to infertility is disenfranchised grief, or grief that is not acknowledged by society.

For example, the loss of a pet, loss of a home and loss of a family member by suicide are all forms of disenfranchised grief. This type of grief is often unaccompanied by cultural standards for how to provide support.

We know what to do when a loved one passes away, we know what to do when someone is sick, but the loss related to infertility is more obtuse and complex. Most of us don’t know how to support someone experiencing it. This can make friends and family feel helpless or anxious; and rather than attempting to provide support we may avoid the subject.

In my work with couples experiencing infertility, a few themes have risen to the top in helping them cope:

Acknowledge the loss
Just as society as a whole doesn’t acknowledge infertility grief, both women and men struggle individually to acknowledge that their feelings of sadness and loss are legitimate. Infertility takes away one's ability to plan how or when their family is built — a loss of control over one's body. Sometimes it's the loss of a genetic link to our children, or the loss of the experience of pregnancy.

Loss manifests as irritability, sadness, anger, frustration, anxiety and many other emotions. When couples acknowledge that they are experiencing a crisis in their relationship, or a disconnect in how they envisioned their life together, they can begin to understand their feelings and cope with them in healthy ways.

Acknowledge loss, then start again
Unfortunately, infertility is a long cycle of hope and loss — hope in a late period, hope in a medical procedure, hope in an adoption match. Just as there is hope in the events, there is also loss. These events typically follow in lock-step, and often couples don’t have the time or emotional energy to grieve one before another hits.

Although the experience of loss is highly individual, research by Elizabeth Kubler-Ross outlines stages of grief. Many experience denial, anger, bargaining, depression and acceptance. It’s more common for us to experience these emotions in a non-linear way. One day we may feel some acceptance, the next, back to anger and bargaining. Rather than chastising ourselves for feeling angry, accept that at this time, it’s useful to feel the emotion rather than fight it off.

Create space
By creating space, I mean creating emotional space. Give yourself space, time and acceptance to feel your feelings. Grief isn’t a race; there’s no finish line. There isn’t a right way or wrong way to work through it. Rather than placing rules and expectations on how you should feel, or for how long, allow yourself the space to grieve.

This piece can’t be underestimated. Just as you allow for your own grieving, do the same for your partner. Acknowledge that he might not grieve the same way you do. He might not cry or talk about it like you want to. She might not cry, rather preferring to look forward and be optimistic.

Some find it useful to create a ritual or tangible event to mark the loss. Others use their creative side to sculpt, paint or create something that is a visual manifestation of their feelings.

Seek support
Identify the friends and family who understand the intensity of your emotions. If you sense they don’t know how to support you, give them some suggestions. Reach out to others experiencing infertility throughsupport groups or online forums.

Feeling understood and supported is paramount to coping. Infertility can be isolating, being in contact with those who “just get it” cuts down on the need for you to explain your feelings or provide background. Find a group of women or men who understand the loss associated with infertility who can accompany you on the road towards healing.

Welcome! Don't want to take the time and cognitive skill to read Debunking Adoption Myths? (Me neither!) Now you've got the option to put me in your ears! 

I was invited to speak with Kelly Ellison on her podcast, Your adoption Coach, to discuss the myths of adoption. 

Join a small group of women in discussion about the impact of infertility. Open to women on any part of the fertility journey including, fertility treatment or third-party reproduction and those moving towards adoption. Led by Whitney Barrell, LCSW therapist, with both personal and clinical expertise in infertility counseling. 

• Making difficult treatment decisions on a path to parenthood
• Conflict with your partner

• Processing the grief and loss of infertility
• Maintaining relationships with friends and family who may not understand infertility
  
• How to cope in a world where everyone seems to be pregnant

When: Wednesdays March 18th-April 22nd 2015 (6 week group) 8:00-9:00 pm

Where: Whitney Barrell’s Office

1308s. 1700e. #209 SLC, Utah 84108

Why: Because it feels good to be in a group of women who “get” what you are dealing with.

Investment: $120


***Feel free to call with questions about the group, or to see if it would be a good fit for you. 

You are in for a treat.
 Angela Tucker, a blogger, educator and speaker on white privilege, transracial adoption and race relations interviews two young adoptees about their experience with bullies, questions about their "real moms" and why why adoption is happy and sad.  

A subject near and dear to my heart, and largely misunderstood. First featured on KSL, read on to have your myths debunked--or if you are an adoptive parent, read on to feel some validation about the experience you know so well. 


Adoption is mysterious to many of us; we’ve relied on Lifetime movies and anecdotes of the most rare situations in adoption to define it. As a result, there are many myths that swirl around adoption and, as always, the truth is somewhere in the middle. The information that follows is applicable to domestic and foster care adoptions, rather than international adoption.

The birth mother/father can show up at any time and take the child. 
False. Once the adoption is finalized, the child’s adoptive parents are recognized by law. Post-adoption revocation is very rare, but these cases do gain publicity, which further perpetuates the myth. According to Utah law, the birthfather can sign relinquishment papers at any time, including before the birth of the child. The birthmother may sign relinquishments 24 hours after the birth of the child. Most ethical adoptions are agreed on by birth parents who have made a very sacred decision that they feel is in the best interest of their child.

Birth parents are troubled teens and not to be trusted. 
False, false, false. On average, birth parents are in their 20s. Typically, birth parents choose adoption because they don’t have the means — financially, emotionally or otherwise — to parent the child. This factor doesn’t make a person dangerous or untrustworthy. Consider the amount of trust a birth parent gives an adoptive couple in order to choose them to raise their child.

Open adoption (where the adoptee has identifying information about their birth family, and the birth parents choose adoptive parents) is emotionally harmful to the child. 
False. Open adoption takes away the mystery. When adoptive parents are able to share information about the child’s birth parents and their history, the children understand their beginnings and they understand why a placement decision was made. According to a study completed by the Minnesota/Texas Research Project, birthmothers involved in open adoptions had lower levels of adoption-related grief and loss than compared with those involved in a closed adoption. The study points out "adopted adolescents was no different in levels of adjustment from the national norms. Level of openness by itself was not a major predictor of adjustment outcomes at Wave 2. However, relationship qualities, such as collaboration in relationships and perceived compatibility, were predictive of adjustment across openness levels."

Open adoption is like co-parenting. False. Birth and adoptive parents do not share custody. Adoption outlines distinct roles. Open adoption allows for the child to have an ongoing relationship (of some level) with birth parents. Some birth parents report having an aunt/uncle-like relationship with the child.

Same-sex parents are not capable of providing a healthy environment for a child. False. Years of research by the Donaldson Adoption Institute has proven that children parented by same-sex or heterosexual couples have the same outcomes, happy and healthy.

The racial background of most children in foster care is that of a minority. 
False. According to the most recentKids Count data, 46 percent of foster children are white, 26 percent are black, 21 percent are Hispanic and the remaining 9 percent are multiracial.

Adoption is born of loss. True. Adoption is sometimes the best-case scenario for the birth parents, who aren’t ready to parent; the adoptive parents, who have sometimes been waiting many years to parent; and the child, who is provided a safe, stable home. Despite this, adoption occurs because of a loss — a child's loss of biological parents and the loss of connection to their history. As an adoption community we don’t do anyone any favors by glossing over this fact.

Adoption is expensive. 
True and False. Adoption from foster care can cost little to nothing. Information from the Child Welfare Information Gateway cites domestic adoptions can range from $5,000 to $30,000, and international adoption can cost $15,000 to $30,000. These fees are paid to social workers, attorneys and a small amount (as determined by each state) can be used for birth parent expenses such as rent, maternity clothes, etc. Birthparents are not paid for the adoption.

Adoptive parents must be “perfect” to pass the home study. 
False. Adoptive parents must prove that they can provide financially and emotionally for the child. They are asked about their relationships with family and spouse, employment, plans for when the child arrives and understanding of adoption. Most adoptive parents pass the home study process.

Waiting to tell my child he or she was adopted until they can understand is better for them. 
False. History has been a guide for us in this domain. Historically, adoptions were closed. Because of this, it was easier (and expected) for adoptive parents not share information about their child's origins at all — or if so, later in life. Due to the research on open adoption, we now know that children who are provided information about their birth family early on fare better in the long run emotionally.

Same-sex parents are not capable of providing a healthy environment for a child. False. Years of research by the Donaldson Adoption Institute has proven that children parented by same-sex or heterosexual couples have the same outcomes, happy and healthy.

If I don’t talk to my child about their racial identity (if it's different from my own) then it won’t be an issue.
False. Children adopted transracially need special attention in order to achieve positive formation of their racial identity. Again, the Donaldson Adoption Institute has found “positive racial/ethnic identity development is most effectively facilitated by 'lived' experiences such as travel to native country, attending racially diverse schools, and having role models of their own race/ethnicity.”

Adoption has always been a way to build families, although in the past two decades, our understanding of best practices for all members of the triad has increased. As this understanding shifts, so does public misunderstanding. Adoption stories and experiences are as diverse as they come, because an adoption experience is a human experience. 

We use social skills in a broad sense every day. In a work environment sometimes referred to as soft skills, they enable us to work as a team, practice empathy and relate to others. Social skills are learned. We are born seeking relationships, seeking interaction, but it’s through practice and watching others that we learn how to implement social skills.

Elementary school age children are the perfect example that these skills are learned, we see them practicing them every day. We see children bullying others or learning to compromise. The playground is a great big mixing bowl where kids can learn which skills will serve them and which won’t. Social skills are needed not only on the playground, but at soccer practice, in school, visiting grandparents and at the park. There are four skills sets that, if mastered, tend to promote healthy relationships in the long term.

Research gathered by the Center for Parent Information and Resources found that when addressing social skills, successful interventions have some things in common. For example, the interventions focus on reflection and self awareness. Secondly, when children are walked through each step in the new skills, they are better able to retain and generalize it. When role-playing is used or specific skills are practiced in a group environment, children are able to master the skills. You will see these principles built into the suggestions to use for your child.

Making and keeping friends

It’s adorable to see young children walk up to one another at the park and confidently say, “Hi, my name’s Jack, do you want to play?” This is an example of a child who has been taught the social script for making an introduction. From here children learn to build by asking others questions, or inviting others to join in play with them. The ability to make and keep friends relies on a child’s ability to empathize, see things from another’s perspective and compromise.

Young children are naturally egocentric, this is a normal developmental stage. Around age 4, children develop what is referred to as theory of mind, the understanding that others may have a belief, intention or knowledge that is different than their own. This is a developmental leap that allows them the capacity to engage in more meaningful friendships.

If your child is struggling with this skill, you may put on your detective hat and do some observation while your child is at play. Is he isolating himself, hesitant to join others? Once he begins engaging with others, does he tend to become bossy and set the rules of the game?

When you see one of these things happening, pull your child aside and say something like, “I noticed when you told Abby that she wasn’t playing the game right, she frowned and walked away. What do you think she might be feeling?” Continue to process this event with your child and help your child problem solve a way that will lead to the interaction the child wants. Encourage your child's ability to take the perspective of the other child and find a solution that works for everyone.

Emotional regulation

Emotional regulation is an umbrella for important skills such as impulse control and identifying and expressing feelings appropriately. If a child is consistently losing control and acting aggressively toward peers, that child is often ostracized and avoided. Impulse control plays a role in friendships. A child who is able to wait his turn or stay calm enough to be in a conversation with peers is more socially adept.

Gaining emotional regulation begins with identifying emotions. You can encourage your child to notice changes in his body, for example, fists tightening when he is feeling anger. In order to regulate these strong emotions, the child first needs the ability to identify them. Once a child is able to pause between noticing a strong emotion and reacting to it, he can make a more calculated decision. Modeling this behavior for your child is often the best teaching tool.

If you begin to become frustrated, you might say out loud, “I’m starting to get upset, I am going to sit down and take a few deep breaths.” This will show your child that each of us is responsible for managing how we feel and that even adults need a break sometimes.

Sportsmanship

Team sports are an excellent setting to practice social skills. Children are required to work together, handle disappointment and take turns. If your child is struggling with social skills it’s a good idea to encourage a team sport, that way she will have a consistent chance to practice improving her skills. Sometimes poor sportsmanship is rooted in a child's anxiety about her performance. Perhaps if she misses a shot she feels embarrassed or she is sensing underlying pressure from family members to succeed. Before she can improve her social skills in this area, she needs to be free of such barriers.

Visualization and self-talk are good skills to practice if your child struggles with poor sportsmanship. Identify the triggers. For example, does your child lose control when the team loses? If so, review what self-talk might be occurring. Is she telling herself something like “you are the worst, you’ll never win.” Suggest an alternative, such as, “We didn’t win this time, but I played my best.” Refuting self talk takes practice. Use visualization by walking your child through what thoughts and feelings she may feel when the team loses, prompt her to use positive self-talk and visualize herself maintaining control.

Conflict resolution

Conflict resolution is another skill that is impacted by maturity. Our ability to use higher-level thinking such as planning and problem-solving doesn’t develop in our brains until we are well into our 20s. Despite this, elementary school age children can practice skills that will aid them in relationships.

It is very common for children to struggle with ways to address conflict. Some children lack the confidence and skills needed to advocate for themselves, and as a result are stepped on by other children more willing to assert their wishes.

Conversely, some children may bully others or use aggression to get their needs met. Keep in mind all of these skills are learned. Our expectation that children should always be seeking the most fair solution for everyone isn’t realistic. Compromising is a skill that is important if you live in a society that values cooperation. It isn’t in our DNA to solve problems peacefully, but it is “nurtured” into us.

Improving conflict resolution relies on a child’s ability to hone the previously noted skills, of empathy, emotional regulation and good sportsmanship. This skill is most effectively addressed right when the conflict is occurring.

This is the aim of social skill groups facilitated by play therapists. But you can also practice this skill with your own child. When conflict occurs between siblings or friends, consider asking the child to take a break for a few minutes to calm down if the conflict has risen to an aggressive level.

Afterwards, practice talking through the thoughts and feelings the child had during the event and challenge the child to identify thoughts and feelings the other child may have felt as well. Prompt the child to consider an alternative, for example, rather than hitting and taking a toy, suggesting asking an adult for help, or finding another toy to play with.

The barrier to conflict resolution without aggression is often impulsivity. If you can stop the child from acting out and walk through her choices, (and practice this over and over again), she will have a much better chance of doing it on her own.

I often consider these social skills as life skills. They are the foundation of all relationships. Each interaction you have with your child has the potential to teach the child pro-social ways of interacting. We know that the playground can sometimes be the Wild West of childhood. But children who are able to navigate it effectively will be ready for the workforce — the Wild West of adulthood. 

Last year you were sitting in the same spot in your home, looking at your tree and thinking to yourself, maybe next year I’ll be sitting here holding a baby. But, then the year goes by and it’s Christmas again and your arms are heavy with the sadness that only infertility can bring.

The holidays are child-centric. Thanksgiving, Hanukkah and Christmas engender images of rosy-cheeked children with their families. Because of this, it can be a difficult time for those of us trying to conceive. It can feel lonely. It can feel sad and isolating, in particular when there is an unsaid expectation that this is “the most wonderful time of the year.”

The questions you know they’ll ask
Holidays can be tricky with family members. Infertility is rarely understood by those who don’t experience it. Everyone has a version of great-aunt Sue who always asks “when are you going to give your parents some grandchildren?”

If you haven’t discussed your infertility with family members you are bound to get some of these questions. This doesn’t mean that you are required to let your family know the details of every last test you’ve undergone. But, it is useful to have a response ready such as “that’s something were looking forward to in the future” or “it’s not as easy for everyone to get pregnant as you may think. We are working on building our family with the help of a reproductive endocrinologist.”

Likewise, you aren’t required to share information with family members if you aren’t comfortable, discussing with your partner what you’d like to share and with whom may be helpful.

New traditions, and opting out of old ones
You may consider getting out of town or doing something alone with just your partner. If it’s painful to go to your sister's house and watch your nieces and nephews open presents, don’t do it. You could suggest just arriving for brunch or dinner. Before the event occurs picture yourself at the family party and feel it out: Does it feel forced? Are you holding back tears? Give yourself the gift of permission and self-acceptance this year. If it’s painful to try to carry on like nothing is wrong, don’t do it.

Gratitude and service
Remember the reason for the season. Although cliche, it does change our perspectives when we are able to provide service or time to someone who needs it.

Infertility is all-encompassing and it’s easy to feel enveloped in grief. Consider spending some time with an aged relative or volunteering in your community. Not only will it help others, but it will also provide you with the realization that although you are struggling to build your family, you have a house over your head, food and access to health care.

If you are passionate about infertility and have an interest in advocacy, Resolve, a national infertility organization, is often seeking volunteers.

Give yourself a break, you are grieving
This one is most important. All of the clients I see need to be reminded that perhaps they don’t feel as happy as they used to or don’t have that sparkle in their eyes because they are grieving.

Infertility isn’t seen, you can’t point to a broken arm and say “this is why I’m upset,” but it’s there. You are grieving the loss of a dream. You are grieving the idea that your life would be a certain way.

Many of my clients say that they always imaged themselves a parents and with infertility it’s out of your control. No matter how hard you work at it, how much you want it, those things don’t calculate like they might when you’ve worked toward other goals. This is frustrating and makes us feel helpless and beaten down.

Now is the time to practice good self-care, to be aware that you might not have the emotional strength to hold it together like you normally can. That’s OK, that’s honest. Be kind to yourself.

Lastly, the holidays will eventually come to an end. The best thing you can do is be prepared, know what your limits are and set a calendar in place that honors where you are emotionally this year. And somehow, hold onto hope for next.