Infertility and Father's Day--typically not a holiday many of us look forward to who are dealing with the difficulty in building a family. KSL recently featured an article I wrote on this very topic. Read on....


SALT LAKE CITY — First, a few caveats: I am not a father, or a male.

Despite this, I am married to a man, and together we survived many a childless Father’s Day. Additionally, I work as a therapist with couples experiencing infertility. Therefore, I will do my best to shed some light on infertility experienced by men via my perspective.

I have found, both personally and working with couples through my practice, that infertility grabs at the very essence of a relationship and tears away your future plans.

Undoubtedly men experience all the same feelings anyone dealing with infertility does — inability to plan one's future, difficult decisions about family building, financial strain, feelings of loss, watching friends/family experience parenthood, anger, and even shame.

But just as women experience infertility layered in our inevitable cultural expectations, men have their own version. They are not limited to: “be confident, be strong, don’t cry, be interested in a family, but don’t show emotion if it doesn’t happen.”

Even for men who don’t ascribe to these values, the undercurrent of these messages in our society is palpable.

Couples are keenly aware of the subtle stigma related to being unable to reproduce. It seems men often feel “less of a man” if the couple experiences male-factor infertility. This feeling is not exclusive to men.

If infertility problems aren’t spread evenly between the couple, one person undoubtedly feels “it’s my fault.” That fault can feel heavy for men who perceive that they are standing in the way of their wife’s dream. Men may feel helpless, their inability to “fix” this problem of infertility somehow chipping away at their confidence. The shame they may feel often translates to “something is wrong with you.”

The factor I see most commonly in men is the desire to support their wives rather than being able to show the very real grief and loss they too are experiencing.
Not to mention the awkwardness of providing a sperm sample, then hearing the results. Men may experience a shift in their sex life with their partner. For example, being intimate “because it’s time.” Men and women are often on different timelines in their family building plans. It seems men sometimes take a slower, conservative approach and may feel pressure from their wife to proceed with testing/treatment/adoption.

But the factor I see most commonly in men is the desire to support their wives rather than being able to show the very real grief and loss they are too experiencing. This is a shame, because although there are certainly some feelings inherent to experiencing infertility as a man, many of the core beliefs and experiences are shared between couples. Because who doesn’t need a companion (or two) while riding the roller coaster of infertility?



Whitney Barrell, MSW, LCSW, holds a master's degree in social work from the University of Utah. She is an "infertility survivor" and enjoys working with couples experiencing infertility. Find out more: www.whitneybarrellcounseling.com.

Emotional Aspects of Infertility

A subject near and dear to my heart, infertility. Some of the most important work I do is with women and couples around infertility. The following article is from Resolve, the National Infertility Association. If you aren't familiar with their work , skip over to their website here. They are an excellent resource for information on treatment, testing, support group (on-line and in person), books on family building. They also have an active advocacy group who work with congress to extend the adoption tax credit and work towards infertility treatment being cover by insurance. 



One of the most challenging aspects of the infertility experience is dealing with the emotional ups and downs relating to medical treatment, the uncertainty about outcomes, and the challenge of having to make important decisions such as when 'enough is enough.' It is important to learn how to take care of yourself, make sure you that get the support you need, and to manage your emotions so that your self-esteem and outlook on life remains as positive as possible.

Loss 
What does a couple who has just been diagnosed with a fertility problem have in common with a couple who just had their fourth miscarriage? The level of anguish may not be the same, but these two couples do have a lot in common: a sense of loss and disappointment, and the feeling of emotions and events being out of control. For both couples a basic assumption-that by being decent people who try hard in life, your wishes will be fulfilled-has been shattered.

Symptoms 
Even if your mind isn't consciously thinking about loss, your unconscious mind and your body may be responding to feelings of grief. Do you recognize any of the following symptoms that either appeared or worsened during your infertility experience:

• lack of energy (especially when you have an unsuccessful cycle on medical appointment days or when you will see a pregnant friend);
• headaches;
• irritability (snapping at people or making mountains out of molehills);
• insomnia.
• extreme sadness.
• inability to concentrate.

The best way to get back to "business as usual" is to take care of the emotional business at hand. And there's nothing wimpy about healthy grief work - it calls on all of your courage and resourcefulness. A Zen proverb says, "The way to control a bull is to give it a big pasture." Paying attention to grief ends its power over you. Give grief its due and you'll find the energy and concentration to get on with your life. See a mental health professional if you feel that infertility is making it hard to cope day in and day out.

Denial, Shock and Numbness 
After several months of unsuccessful attempts to get pregnant or stay pregnant, feelings of shock or numbness may result. Feelings of "this can't be happening to us" or "I know next month we will be successful" begin to change over to anger and guilt.

Anger 
Anger usually results from feeling vulnerable or helpless or both. Helpless feelings result from the lack of control that you may feel over your life plan, your body, and your future. This may be a new experience; previously, when you worked hard at something, you probably achieved your goal. Now you are working hard and doing everything you can to conceive, but without reaching your desired goal. A sense of vulnerability evolves from feeling "jinxed," or feeling that life isn't fair. You may feel as if you can no longer count on anything good happening in your life.

Anger can consume you, coloring your everyday thoughts and experiences. You may feel emotionally guarded, pulled between tears and sadness or anger and rage. The next time you feel angry, irritable, or frustrated, take an inventory of your body and identify how different parts of your body respond to the angry feelings. Do your legs feel weak? Does your heart beat faster? Do you feel flushed or shaky? Does your breathing change? Become familiar with how you react physically to these intense emotions.

Remember that anger is a normal response to infertility. You may find it helpful to try some of these techniques to manage angry feelings. There is no "right" way to do this; don't force it, and don't expect a specific response. Tears and feelings of sadness often mingle with anger.

• Take a blank sheet of paper and list all of the things in your life that you are angry with
• Get active physically
• Express your anger but use "I feel" statements rather than attacking a family member of friend.
• Talk about your anger with a counselor or therapist who can help you process and deal with your emotions.

Guilt and Shame 
Shame is a searing, painful feeling associated with faltering self-esteem, and a sense of inadequacy, defectiveness and helplessness. As repeated attempts to get pregnant come to naught, there is a realization that this intensely strived-for goal has not been, and may never be, attained. As this failure becomes more and more evident, one's self-image is assaulted. It is easy to move from procedures that have failed to the feeling that "I am a failure." Anguish, self-doubt, and chronic sadness converge as couples come to think of themselves as failing, not only in realizing their own dream to reproduce and nurture, but failing their spouse, parents, and siblings as well. Because shame embodies the painful sense of self-defect, it is often hidden and disguised, even from oneself. The tragic story of chronic infertility is that, over a period of time, the sense of failure gradually and imperceptibly spreads like a shadow over a person's experience, while simultaneously the sense of other competencies gradually become obscured.

Ultimately what heals is the acceptance of the self with all of its weaknesses and failures. The goal, then, is to reach a point where you can accept what you see as failure and no longer have to conceal these feelings of shame. The process of coming to terms with infertility is long and gradual, but it is possible to transform the sense of failure into an empathy with yourself, an affirmation of your strength, an acceptance of your limits, a pride in your endurance, and maybe most of all, an empathy with others who, as partners in the human condition, also face defeats. In time, the shadow cast upon your life can fade and the light can shine through again.

Hello, 
I'd like to share a short video on one of my favorite topics. The intersection between neuroscience, therapy and parenting. It features two highly regarded researchers and professionals in this field, Dr. Bruce Perry and Dr. Daniel Siegel. These findings help guide my treatment planning with children who have experienced trauma. Enjoy!

Good Day, Welcome KSL readers! Today KSL has published an article in which I outline the common reasons that parents bring their children to therapy. I also attempt to decrease some of the stigma related to child mental health.  Head here to read it! Or, I've also provided it below. 

Could my child benefit from therapy?

For the majority of children, the answer is no, but if you are wondering, read on.

As parents, our primary goal is to nurture and protect our children. When we consider that our child may benefit from mental health intervention many of us feel overwhelmed, guilty or ashamed. But this need not be the case. Life happens, and it happens to children too.

Therapy is a safe place to explore difficult events from the past or learn new life skills. Play therapy has some similarities and some differences from traditional talk therapy.

For example, we know that children make sense of the world through play. Additionally, their cognitive mechanisms are not fully developed yet and therefore focusing interventions purely based on talking and the use of language is less effective. We use play to bridge this gap.

When we consider that our child may benefit from mental health intervention many of us feel overwhelmed, guilty or ashamed. But this need not be the case. Life happens, and it happens to children too.
Play therapy relies on parents' input and cooperation. You know your child better than anyone else. You have the relationship and opportunity to best assist your child. Consider the therapist as a coach who provides instruction on things to do at home.

Many parents wonder if their child may benefit from therapy. There are several common reasons parents bring their children to be seen.

1. History of trauma or abuse
   
   If a child has been a victim of abuse it is to his or her benefit to process this information sooner rather than later. There are many evidence-based interventions that have proven effective in decreasing the impact on children. Their brains are still developing and learning ways to make sense of violent or abusive events and therapy helps them to re-organize and regulate better, both now and as an adult.
   
   Additionally, we often consider trauma something significant — for example, surviving a natural disaster — but more commonplace events such as car accidents or even dog bites have undoubtedly traumatized children. Often times if this is the case, you may see children re-enacting the event in their play. For example, making toy cars crash over and over again. This is a sign that they could benefit from intervention.
2. Difficulty in peer relationships
   
   Social and emotional health is a very important skill that children are learning during school years. School can also be a place of anxiety or loneliness for children who lack these skills. Conversely, children who are aggressive toward others often feel alienated. Successful peer relationships are a predictor of quality of life into adulthood. Individual and group therapy can provide a practicing ground for relating to peers in a healthy way
3. Emotional regulation difficulties
   
   Often when teachers or daycare providers give feedback to parents such as “he is aggressive toward the other kids," or "it’s her way or the highway” they are ultimately referring to the ability for children to regulate their emotions. This is a learned skill. In fact, the parts of our brains responsible for reasoning and problem solving are not fully developed until we are into our 20’s. Despite this, children can learn tools and exercises to help identify and express feelings appropriately.
   


4. Divorce or stepfamily building
   
   When families separate or new families develop, children may feel powerless because those decisions are not their own. Additionally, it’s very common for children to have a loyalty to both parents. Children benefit when parents are able to co-parent in a healthy way. This is, of course, easier said than done when any relationship ends there is inevitably pain, grief and sometimes anger. Play therapy with children focused on divorce or family building often aids in navigating this road.
   
5. Something else that just doesn’t feel right
6. We have intuition — sometimes we notice subtle changes in our child that we can’t articulate. Maybe his or her mood has shifted, perhaps there is an underlying anger brewing. At times, exploring this with a play therapist can ensure that we aren’t missing something.
   

Lastly, children are resilient. Early identification and treatment will prevent the loss of critical developmental years. Researcher Emmy Werner has identified children that are “active, affectionate and good-natured” are better able to cope with stressful life situations. Providing your child with the tools needed to work through this sometimes unpredictable world will benefit them for years to come.

Whitney Barrell, LCSW, has a master's of social work from the University of Utah. In her private practice she enjoys working with children and families on myriad mental health issues. She can be reached atwww.whitneybarrellcounseling.com.