Thursday, June 30, 2011

When Hopes for a Happy Pregnancy are Disrupted

It happens. The early joy of a much-wanted pregnancy is suddenly shattered by something unexpected. Whether your partner (imagine former US Congressman Anthony Weiner) reveals some giant stupidity that makes you question whether you want this person in your life anymore; whether your physician delivers some troubling news (imagine a Down Syndrome diagnosis) from a prenatal test; or whether a family catastrophe (imagine being laid off from your job and losing your health insurance) takes over your life, stifling the joy that had nourished your spirit, you feel as if you are in the midst of an emotional balancing act with no acrobatic training.

So how do you cope when a joyful pregnancy is no longer in the center of your life because your partner has demonstrated an emotional betrayal, an act of extreme stupidity or some other unexpected dimension of behavior that you never would have thought possible? As you are re-grouping, you could be weighing whether to remain in the relationship, whether to continue the pregnancy or whether to consider placing the baby for adoption. Each one of these issues feels life changing and overwhelming. And, given the betrayal exhibited by your partner, you may feel reluctant to confide in close friends and family, since you don’t want to face yet more pressure from them about what actions you “should” take. You also need desperately to vent, but hopefully are careful about saying too much too soon. So here is where an excellent option is to seek counseling from a professional who practices marriage and family therapy. This could be a psychologist, a social worker, or a marriage and family therapist. Some pastoral counselors will have this training as well. As I have said in earlier blogs, as well as in chapter 7 of my book When You’re Not Expecting, there are several ways to locate a therapist: recommendations from friends or clergy, names provided by your county mental health clinic, suggestions from a hospital social worker, or contacting your local family service agency. Plan to present yourself as someone who is experiencing a crisis, which will minimize the likelihood of being placed on a wait list. And be persistent in asking for services – if you are concerned that you cannot afford them, ask whether the agency or the therapist has a sliding fee scale. But the bottom line here is that it is important to receive emotional support and guidance in this difficult time from someone who appreciates the complexity of your dilemma AND who has the professional perspective to guide you through the decisions you will face in the months ahead.

Troubling medical news from prenatal tests can be immensely disruptive emotionally. Although the opportunity to learn early about genetic or other developmental disorders is important to expectant parents, the flip side of this opportunity is that often tests cannot predict the extent to which a particular abnormality will affect the developing fetus. This places many parents in an immensely difficult position. Clearly the first goal is to learn as much as possible; medically this may involve more specific tests or a consultations with specialists; emotionally you may very well want to meet parents of children born with the disability (being sure to include children both severely affected as well as minimally affected); and you will want to learn about community support services for children with the special needs that your child may have. All of this information presents a particular challenge to prospective parents who may be considering terminating the pregnancy or placing the baby for adoption. And, of course, your view of your pregnancy is forever changed; you now are apprehensive, anxious and fearful at the same time you also may be feeling protective and hopeful. Prospective parents who make the decision to terminate the pregnancy often choose to present the loss as a miscarriage, in large part to protect themselves from the judgmental reactions of others. Some will be forthright with close friends and family about the careful thought they gave to this wrenching decision. And all will be very careful in subsequent pregnancies to receive early genetic counseling and prenatal testing, as a way of being informed about any risk factors.

In addition to partner woes or worries about the health of a developing fetus, other life catastrophes can take a huge toll on the happiness initially associated with a pregnancy. These days financial issues, unemployment, home foreclosure, family illnesses and other unanticipated crises can be a significant source of worry and uncertainty. Sometimes we have some control or influence over these situations, and other times there is little we can do. Given that anxiety is usually associated with loss of control, perhaps the one antidote is to remain as calm as possible in the figurative “eye” of the situational storm. Since it is known that the cortisol associated with stress can enter the fetus’s bloodstream via the placenta, remaining calm is for the health of the fetus as well as your own. In addition to considering counseling as one path to take in addressing sources of stress, relaxation efforts and mindful behavior also can help you to feel more centered as your pregnancy progresses. The kind of counseling that is most appropriate in dealing with situational stress is cognitive behavioral therapy, where a therapist will help you to re-frame your tensions differently and more manageably. After helping you to think about constructive ways to address the stress, the therapist will offer support and encouragement each step of the way. Not only are you learning about problem management, but you also are learning skills that will be excellent for future difficulties that initially seem overwhelming. Deep breathing exercises, yoga, and mindful relaxation are additional skills you can learn to help you calm your body and your mind when tension intrudes. It can be empowering to learn that even when you cannot change a particular situation, you can exert some control over how you respond to it and the extent to which you allow its stress to affect you.

An initially happy pregnancy can be threatened with worry or misery for a wide variety of reasons. Often our initial reaction at such a time is to turn to friends and family for help and support. After all, haven’t they been there for you in other times of stress? Perhaps. But the examples in this blog go beyond the skills and knowledge that our informal networks typically possess. So, in addition to dealing with the current disruption to the joy in your pregnancy, you also will need to stretch yourself to consider how to access necessary support and skills. Use the web, use the yellow pages, use your spiritual leader or health care professionals, and do it in the spirit of moving forward to learn the acrobatic training for this uninvited interruption in the joy you deserve to nourish.

Monday, June 13, 2011

Fathers' Day: A holiday of gratitude or yearning?

Fathers’ Day is a holiday that is so visible you can’t miss it! Advertisements, greeting cards, gift ideas, restaurant (or home grilling) choices… everywhere is filled with the importance of this holiday. But fatherhood is complex. Some of us can genuinely express gratitude to our father on this holiday. Others may have several fathers or father figures, with each representing a unique relationship. And then there are the men who yearn to be fathers but, because of personal or partner infertility, lack of a female partner or singlehood, cannot easily attain that coveted role.

So for those readers who have a positive relationship with a father, this holiday is just one day to express your love and caring to this special man in your life. It’s easy to focus these feelings on a holiday, but it’s important to know that spontaneous expressions of gratitude or sharing special memories can occur whenever the spirit moves you. Count yourself very fortunate to have this father in your life.

For many readers, Fathers’ Day is a time to weigh the differing relationships you have had with fathers and father figures. Complexity can be a challenge when a highly visible holiday suggests one father, positive feelings, and a life of shared experiences. If you have had various father figures in your life, this holiday is a time to decide how (or, perhaps, whether) to connect with them. Whatever you decide, aim to be genuine in your expression of what each relationship has meant to you over the years. This may include references to your differences, disappointments and difficulties, but even with the challenges, you may have emerged at a place where your gratitude is genuine. Relationships with fathers are an evolving experience, so hopefully you can capture some recollections to share even if the relationship may have become distant over time.

Likewise, fathers themselves may use this holiday to renew ties with birth children, adopted children, foster children, adult children and other folks of a younger generation with whom you have had a special relationship. If these relationships are ones that are valued, then think about shared meals, shared time together, or shared plans for getting together in the future that both of you can look forward to. There’s nothing magical about the holiday itself, but if it serves as a reminder that you would like to be more connected, then go for it!

But it is the men who yearn to be fathers for whom I have a special empathy on Fathers’ Day. They are the forgotten guys in the shadows of elusive parenthood. They are the ones who don’t yearn for cards or gifts but, rather, for a son or a daughter to cherish. And they feel invisible, except to their partners, on this day when their incapacity to father a child reminds them sharply of this missing role in their lives. So how to turn Fathers’ Day into something other than a day of yearning? That question will depend somewhat on your circumstances.

If infertility is the barrier between becoming a father or not, hopefully you and your partner are being diagnosed and treated at an infertility clinic, where each couple is assessed carefully by a team of health care professionals. That team should be sharing with you a timeline and a game plan for treatment, so that you don’t linger unnecessarily in the same treatment and can move to another level as medically appropriate. However, be careful with your finances, since infertility treatment can be enormously expensive and, for some couples, reduces their savings so that other choices, like adoption or surrogacy, are not an easy option economically.

Lack of a female partner is another barrier to fatherhood. For gay men wanting to become fathers, adoption and surrogacy are the major options to pursue. The “Resources” section of my recent book When You’re Not Expecting has listings of agencies that gay men will find supportive and informative in their quest for parenthood. The challenges posed by surrogacy are finding a reputable agency, handling the expenses, and deciding whose sperm will be used to conceive the baby. Some men request that their surrogate to use sperm from both of them to fertilize her eggs, while others will be more specific about which man’s sperm will be used during the insemination procedure(s). Men who choose surrogacy as an option usually identify genetic connections as important, prefer to adopt an infant, and may wish to use the same surrogate for future pregnancies, so the siblings would have a genetic connection. Adoption, which is likely to be a less expensive option than surrogacy, also should be pursued using a reputable agency. Many gay partners say that healthy infants are more likely to be matched with heterosexual couples, whereas older children, children with special needs and sibling groups are likely to be available for adoption by single parents and same sex partners. International adoption may widen the availability of adoptable infants and children, although some countries are very strict about such issues as marital status and heterosexual couples when releasing children for adoption. It is good to inquire about the average waiting time from application to adoption, learn whether travelling to the country is expected by the agency, and to understand fully any hidden costs or requirements associated with an international adoption.

Many of the same issues will pertain to single men wishing to adopt that I have indicated in discussing the challenges and rewards of gay couples adopting. However, there is one caveat I will offer. If you are a single gay male wishing to adopt, do not present yourself as heterosexual in the hopes it will enhance your chances of being matched with a child. Complete truthfulness is essential in the adoption process, in order not to risk voiding the adoption if later there is proof that deception occurred. This sounds harsh, I know, but any lawyer would tell you the same information. As with any single parent planning to adopt, you will want to assess your financial security, as well as your emotional support network who will join with you in loving your child and providing experiences and a sense of “chosen kin” that will be so important to both of you.

For further reading on the challenges of Fathers’ Day faced by men who are trying to become parents, I encourage readers to view the website of RESOLVE, the national infertility association ( This week there is a focus on Fathers’ Day that is both sensitive and encouraging for men who are yearning to become fathers.

Thursday, June 2, 2011

Can We Learn Anything From Tornadoes About Resilience?

As coverage of tornadoes across the US has filled pages of newspapers and hours of newscasters’ time, I find myself speculating about the larger lessons that may lie beneath the shattered landscape left in a tornado’s wake. Issues of coping with loss, recovering from devastation and seeking support are universal in many tragedies we face over the course of our lives.

None of us invites tragedy. Sometimes it comes upon our lives slowly; other times it strikes like a bolt out of the blue. Yet when tragedy touches us or our loved ones, it may be helpful to have thought about how people salvage their lives and move forward with resilience. In reading about the recent tornadoes in the US, a few of which have caused me to retreat to a cramped crawl space in my own basement as sirens screamed in the distance, I have felt relief at being spared from the damage that people in nearby communities have experienced. Sometimes I have felt survivor’s guilt. And other times I have felt like a ghoul as I find myself riveted by news reports in the aftermath of the wreckage. So I’ve tried in my own mind to think about how I might sort out my life if it were upended by a tornado – by which I could mean a violent act of weather, but I also could mean any event that rips me from my psychological moorings.

Coping with loss: I have lived enough years by now, and counseled enough grief-stricken clients, to have more than a passing familiarity with the emotional devastation that loss can bring. Although each person handles loss differently, I have found that North American culture often communicates the expectation that people should get on with their lives after a loss. And yet, for most people, it takes time to absorb the meaning of any loss. A year after a loss, when anniversaries have passed without the loved one, most survivors will say that it has been the comfort of family and friends that has enabled them to face each day. Some also will say that a ritual following the loss or a memorial to a loved one has helped to sustain them during their time of grief. But, most of all, grieving people will say that they have needed a shoulder to lean on, someone to talk to and a chance to review the circumstances leading to the loss to try to make some sense of the tragedy. And they will feel relief if their support systems are willing to be good listeners, neither judging nor hastening them to get on with their lives. Sometimes, as in the case of chronic health problems, terminal illnesses or infertility, the impact of loss grows heavier over time; conversely, when someone dies unexpectedly or there is a pregnancy loss, it is the suddenness of this event that leaves us emotionally adrift. So, whether for ourselves or loved ones, it is important to respect the unique pace each person needs in the process of healing, as well as the importance of support during the months and years that follow.

Recovering from devastation: At the memorial service of a friend a few years ago, one eulogy mentioned the decreased person’s frequent proclamation that “It’s just ‘stuff’”! As this friend had coped with his terminal illness, he was reminding others around him about what mattered, and it wasn’t the material possessions they were fussing over. We hear of tornado survivors who celebrate that they are alive and that their friends are alive, while proclaiming that life is what matters most as they contemplate rebuilding their lives. In watching coverage of families who have lost their homes, their scrapbooks, and their treasures of a lifetime, only to reclaim shreds of their possessions, I find myself wondering about what I value in my life and how I would tolerate the loss of a valued object. With this tornado mindset, I have donated many bags of clothing to charity, tried to simplify my life so I am able to spend time doing what brings me joy, and remained thankful daily that life in the moment is worth celebrating. I would hope that if/when devastation strikes, I could separate “stuff” from substance, lean on loved ones, and fortify whatever resilience I could muster in the wake of any personal storm.

Seeking support: In both of the earlier paragraphs I have emphasized the importance of leaning on others, even in a society that expects we should be able to bounce back quickly from catastrophes. And, since these catastrophes may very well have touched the lives of loved ones, I have found that it is wise to maintain relationships with a diverse network of caring people. Whether professionals (clergy, therapists, health care professionals), friends, mentors, neighbors, co-workers or distant folks who care about you, it is important to stay in touch or to extend emotional support when needed, in part because you may need to ask for such support in return some day. Not all folks will be available or emotionally able to connect with us on every issue, so it pays to think over the months and years about which people we feel most ready to confide in on which issues. As life changes, we change. But remembering to stay in touch with caring people of all ages is one way of being able to be responsive to their requests for help, as well as to call on them when your own life’s storms are just too much.

In writing today’s blog, I hope I am striking a responsive chord in some readers who, like me, are aware that, actually or figuratively, tornadoes can appear without warning on the horizon. If they strike, hopefully we can feel empowered to honor our emotions, to rebuild our lives and to seek support of various dimensions from the caring and concerned people in our lives.