Rebounding from Springtime Stress!

Even as bright flowers, longer hours of sunshine and gradual warmth abound in the spring, many of us have encountered emotional potholes in this otherwise cheerful season. Whether you are rebounding from the stress of Spring holidays, winter weight gain or infertility, here are some thoughts on how to set your sights on moving forward!

HOLIDAYS are a time when we are expected to be celebratory. But the gathering of families, complete with familiar roles and lurking conflicts, can contribute to tension of spring holidays like Easter, Passover, Mother’s Day and Father’s Day. Not surprisingly, these spring holidays have a theme of life and reproduction running through them, which can be haunting for families who have lost a loved one or whose infertility prevents them from being celebrated as a mother or a father. If you are rebounding from feelings of disappointment or regrets associated with any of these holidays, you may want to spend some quiet time thinking through what you would like to have done differently this year. Perhaps you might have been involved with more supportive family members? Interspersed a family gathering with some quiet time or a stroll with a loved one? Called a friend who shares your sadness associated with a holiday so you could offer support to one another? It’s a challenge to feel entitled to emotions of regret when others around you are celebrating. But if you have these emotions, try to talk about them with a loved one. And, in addition to considering that you are rebounding from some stress now, also keep in mind for next year what strategies you might plan in advance as spring holidays approach.

HEALTHY WEIGHT is always a goal to strive for, but as spring approaches and our heavy sweaters no longer disguise the pounds we wish we could lose, stress can be one response to that realization. But if you’re trying to rebound from that stress, find a friend who can join with you in some healthy resolutions. Perhaps you can plan a brisk walk on a regular basis. Or join a gym and take some classes. Or sign up for a weight loss program. All of these possibilities give you the support of others, as well as the motivation to “stick with it.” Then there are some more solitary behaviors that may feel more possible to embrace now that spring fruits and vegetables offer opportunities for healthy eating. Brian Wansink, a professor at Cornell University who focuses on food psychology, reminds us that mindless eating causes people to consume far more calories daily than we are aware. He and other food experts encourage people not to include eating as a part of their multitasking but, rather, to focus clearly on being aware of food in all its dimensions: its taste, texture, color, flavor and deliciousness. As someone who researches the size and shape of our serving dishes, Wansink encourages us to use smaller plates and glasses for our food and drink as a way of controlling portions. And, in the spirit of mindful eating, many nutritionists stress the importance of focusing on food as it is being consumed at the meal table, rather than in front of the TV, while multitasking with our mobile devices, and to avoid sampling food while preparing a meal or nibbling a few last bites of leftovers before washing the dishes. For many people, specific medications may contribute to weight gain. This can be a side effect of some antidepressants. Hormone treatments used by women being treated for infertility may also cause weight gain and mood swings. So it is useful for everyone to try to pinpoint the underlying cause of unwelcome pounds before you make a plan to rebound toward a healthier weight in the spring months.

INFERTILITY can feel especially emotion-laden in the spring. Heavy clothing is coming off of both close and casual acquaintances, sometimes to reveal baby bumps. Mothers are pushing strollers everywhere outdoors, so it no longer is enough to avoid the local mall if infants bring envious tears to your eyes. And, then there have been the spring holidays, replete with pregnant and nursing relatives, flowers and eggs as celebratory reminders of fertility, and (we take a deep breath here) Mother’s Day and (yet to come) Father’s Day. So how can you feel you’re rebounding when reminders of your infertility are lurking at every turn? For starters, we can remember that Spring is also a season of “beginnings.” So now is a good time to think about taking new action in addressing your hopes for parenthood. If you’ve been relying on local physicians, now might be a good time to seek the services of an infertility clinic which, among its many advantages, diagnoses and treats both the male and the female as time-efficiently as possible. Another service provided by many infertility clinics is individual, couple and group counseling. You may feel that you’re coping okay, thank you, but keep in mind that counseling can offer new coping strategies that you might not have considered or tried. So even if you’re not a patient at a clinic that offers counseling, think about going to some support group meetings in your locale (consult the RESOLVE website at www.resolve.org) or seeking out a counselor in your community who can help you over the inevitable rough spots, as well as suggest strategies that will strengthen your emotional resilience. And, as readers of my recently-published book know (When You’re Not Expecting), emotional support during infertility can also be offered between the covers of a book – mine captures the words of a sisterhood of several hundred infertility survivors, each of whom shares her own strategies of coping across the entire spectrum of infertility diagnosis, treatment and pregnancy loss. And as I mention pregnancy loss, let me say that many couples who have had this emotion-laden experience and later grief over shattered dreams find that counseling can ease the pain, especially as a counselor will be the first to understand when you confide that loved ones seem to want you to “get back to your old selves,” rather than giving you support as you strive to rebuild your lives. One way many couples use the springtime is to plant a memory garden to honor a lost pregnancy or a stillborn infant. Although you will want to be aware that you may, at some point, move away from your current home with its memory garden, the very designing of it, as well as the process of planting, can feel therapeutic. Should you move, you may decide to preserve the garden in a photograph or painting you hang in your new home or to re-create the garden at your new residence. So spring flowers can be both an emotional tribute and a poignant reminder of dreams deferred. Lastly, in the spirit of rebounding, now is a good time, before Father’s Day arrives, to think about how you have coped with the challenges of your infertility this spring, and what you might try to do differently next spring with its reminders of fertility at every turn.

So, as we think of rebounding in the spring, whether it is from the stress of spring holidays, unwelcome weight, or infertility, the real issue is how to think about the stress as an ongoing learning experience. Stress is with us in all seasons, for lots of different reasons. What matters more than the existence of stress is how we use those experiences to move forward rather than to get emotionally bogged down with anger, regrets and self-blame. So, whatever issue in this blog resonates most strongly for you, take the rebound perspective (start with small steps) and see whether you can feel empowered to use the spring as a season of positive change. Good luck!

Am I A Mothers' Day Grinch?

Am I a Mothers’ Day Grinch? Not exactly, but today I’d like to present a perspective that is different from that depicted on Hallmark cards: the perspective of families who need some extra compassion on this holiday.

With Mothers’ Day falling this year on Sunday, May 8, now is a good time to think through how the meaning of this holiday for you may differ from the meaning it holds for some friends and family members.

Families without mothers. Even as I write this title, I feel some personal sadness. My own mother died over 30 years ago, after many years of my celebrating this holiday to honor her. Not only would I send flowers and, if distance prevented our spending the day together, we’d have a long phone conversation in which I’d tell her how much she meant to me, and I’d also remind my younger brothers to be sure to connect with Mom. In those days, Mothers’ Day was about MY mother. Following her death it became a holiday with mixed emotions, as I cherish her memory while, at the same time, wishing that her life could still be a part of my life.

In my early 30’s I was diagnosed with infertility. All of a sudden Mothers’ Day was “in my face” for at least a month before the actual day occurred. Every time I opened a newspaper or a magazine I would find stories of mothers. Every time I turned on the TV or radio, there would be some attention to the approaching Mothers’ Day and the opportunities families had for celebrating it. And in all the media would be reminders to make reservations at a favorite restaurant for a Mothers' Day meal. And there I was, wishing like anything I could be a mother. Not so that I could celebrate this holiday so much but, rather, to satisfy my craving for cuddling an infant in my arms. My husband and I did find ways of escaping the holiday hoop-la, but even with our efforts to plant a garden or play some golf or take a leisurely walk in a nearby state park, I still knew that others were celebrating a holiday I could not call my own. It wasn’t fun in those days.

As many of you know from my recent book When You’re Not Expecting, I have counseled hundreds of individuals and couples with infertility. Each year as Mothers’ Day approached I would ask my clients to anticipate this holiday, think through its meaning for them, and try to find creative ways of deciding how to spend it. Some celebrated the holiday with their mothers or their mothers-in-law. Others used the day to connect with nature in some way, to indulge in a short trip, or to have a potluck dinner with other infertile friends who, like them, dreaded this particular holiday. So, while I won’t go so far as to think of myself as a Mothers’ Day Grinch, I do own up to my role in helping my clients to figure out how this holiday could be less painful for them.

Another group for whom Mothers’ Day is poignantly painful includes those individuals and couples who have experienced a pregnancy loss or an infant death. Since, with regard to pregnancy losses, there are no rituals to memorialize the pregnancy loss (and often no mementoes to save, except perhaps a sonogram photo), the mourning parents may feel especially emotionally vulnerable on a day that honors mothers. If an infant has died, there may have been a service, sympathetic loved ones, and a gravestone in a cemetery, but in American society there often is the assumption that emotional recovery equates with putting the loss “to rest.” So loved ones may not be at all aware of the emptiness of a Mothers’ Day for parents who, even years later, are grieving the death of their infant.

In my life more recently, I’ve needed to extend comfort on Mothers’ Day to my two nieces, ages 12 and 14, whose mother died unexpectedly just 16 months ago. It was especially difficult to comfort them last year, their first Mothers’ Day without her, but this year as well they remind me that Mothers’ Day will never be the same for them. And they’re right. So I talk with them and their dad (my brother) about how they can embrace Mothers’ Day in a different way than their friends’ families are doing. This year they have decided to lay flowers on her tombstone, and then to go hiking outdoors, away from the visible celebrations in restaurants. If the weather is too inclement, they have a backup plan – a movie followed by takeout food they can enjoy at home. For them, as for other families without mothers, having a plan for the family to enjoy themselves gives them an emotional cushion when faced with families in their community who are celebrating the holiday that will never be what it once was in their family.

Families whose mothers are at a physical or an emotional distance. These families could include grandparents raising grandchildren, children in foster care, children whose fathers have custody of them, children who perceive their mothers as abusive and adolescents who have left home because of family conflict. Mothers’ Day is likely to touch these family members in different ways, often with considerable ambivalence and wishes for greater closeness with this parent who does not live with them.

Another family where mothers may be physically separated from their children could include immigrant families, either because the children have not yet come to the United States to join their parent(s) or because, in the case of some undocumented Chinese immigrants, their infants are sent back to China to be raised by the grandparents until the immigrant parents in the US have enough economic security to provide a home for their young child being raised in China. Another immigrant group where parents and children may be separated for periods of time includes agricultural workers who travel entire geographical regions sowing or harvesting seasonal crops. Living circumstances can be very chaotic for these families, with low wages added to the uncertainty of living quarters.

Childfree families: In couples who have decided not to have children because they are infertile and unable for various reasons to bring a child into their family, Mothers’ Day can be bittersweet. Many couples have ultimately made their peace with being childfree, whereas others still carry feelings of sadness and regret for the door to parenthood that has closed in their lives. Other couples have a firm commitment to remain childfree, a decision they reached after careful thought and, perhaps, after bucking their parents, in-laws and loved ones who urged them to consider the joys of having children in their lives. Indeed, many childfree couples do have children in their lives, but not as offspring; they are likely to look at Mothers’ Day as an observance they can share with friends and relatives who invite them to their holiday meal.

Where do we go from here? So now I’ve elaborated on those families where Mothers’ Day evokes feelings of sadness and regret rather than the glow of happiness most people anticipate from women of childbearing age. And, as you may have gathered, my hope is to encourage readers to think about how we can be sensitive to those women who are not mothers.

I think a great deal of grief could be avoided by not wishing every female in sight a “Happy Mothers’ Day!” It doesn’t pay to assume they are mothers and, if they are, chances are they have figured out how to enjoy this day.

Be on the lookout for well-meaning folks who are possessed with the Mothers’ Day spirit. I am thinking particularly of religious leaders who, with the best intentions in the world, decide to honor the mothers in their congregations on Mothers’ Day, either by giving them corsages, having them stand for recognition, or by having a special reception after the service. I cannot tell you how many of my clients and friends have been blindsided by a religious service in which they felt invisible, not honored and generally discounted. If your place of worship is one with the tradition of honoring mothers on Mothers’ Day, perhaps you could encourage your religious leaders to revise their message by reminding their congregations that families come in many shapes and sizes, that not all families include living mothers, and that families who have experienced the loss of a mother, the loss of a pregnancy, the death of an infant or infertility deserve to feel emotionally safe when they come to worship, including on Mothers’ Day.

So, as May 8 approaches, and as you and your family think of how, or whether, you will celebrate this day, please also take some time to be thoughtful about your interactions with others. Don’t make assumptions, offer comfort when it would be appreciated and, when in doubt, ask what you can do to make May 8 a positive experience for a friend or a loved one.

How to Adapt Stress-busting Strategies for Really Tough Problems

When life is filled with too much pressure, we either cave or we decide to deal with it. If you’re on the “deal with it” team, you may feel apprehensive about how to identify strategies that will work. In today’s blog I’ll suggest some ways you can gather strength and resources to reduce the stress that threatens to become a way of life.

In my most recent blog (Life Happens – But what about the stress it generates?), I offer some strategies for identifying and dealing with the small-time irritants in your life. These strategies are good practice for the time when you need to take on larger sources of stress, our focus for today. These larger sources of stress could have to do with health (cancer), life dreams (infertility), finances (debt), work (too much of it), or any number of other issues that have you in a stranglehold. The common thread these diverse issues share is that they have claimed more of your time and energy than you want to give – AND that they seem too tough to tackle successfully.

So here is where we need to get clear about a few things: How do we define the issue we want to change? What kind of change do we want? What do we call “success?” What resources are available to help with the issue?

Defining the issue. This is actually very important, since it’s easy when we’re overwhelmed to lump together a whole variety of issues. Sometimes defining the issue clearly places it in manageable proportions – but not always, for sure! So, using the issue of infertility, let’s define the issue as “I want to have a baby.”

What kind of change do you want? First you’ll need to consider how you have already tried to address the issue that is causing you stress. You don’t want to keep banging your head against an unyielding wall. So deciding on the kind of change you want amounts to looking for a previously invisible gate in that wall. In that effort, you’ll need to look more carefully at whether your definition of the issue could be broadened, allowing for more flexibility in the changes you are willing to consider. It also is a time when you should open your mind up to possibilities you may not have been willing to consider before. So, using the infertility example, you might re-visit your definition in #1 and reframe it as “I want to be a parent.” By doing that, you move beyond your initial issue of becoming a birth parent and broaden the kind of change you want to “parenthood,” which could come about through your willingness to consider donated eggs, donated sperm, donated embryos, surrogacy, adoption and, maybe, foster parenthood.

What do you call “success?” With a clearer and more flexible idea of changes that would be acceptable, you may want to identify more than one measure of success that would bring you relief or satisfaction. Ideally, “success” specifies something over which YOU have some control. Success can be in mini-steps, with you feeling satisfaction each time you move forward even a bit. So, let’s say that, using our infertility example, you define success as completing the paperwork for an international adoption. The mini-steps could include reading books on adoption; sharing your hopes with close family and friends; becoming acquainted with some adoptive families in your community; deciding the country from which you hope to adopt; identifying an reputable adoption agency; increasing the funds in your adoption savings account; meeting with the agency staff to learn their expectations for prospective adoptive parents and, finally, completing the necessary paperwork to move the adoption forward. Taking these small mini-steps has made it possible for you to feel small successes and increasing confidence in your decision to pursue adoption as the previously invisible gate in the wall leading toward parenthood. When setbacks occur, as they inevitably will, it is important to have a foundation of some mini-successes to bolster you as you regroup and take a new route.

The resources you identify will be very important as you encounter the inevitable setbacks that may be associated with your issue. In my earlier blog, I mention partners, loved ones, religious leaders, physicians and counselors as possible resources. Here is where you need to look at the issue as you have defined it and decide what network of helpful people you need to consult as you move forward. Ask trusted and experienced people for names of the professionals they would recommend.

And don’t try to do too much! It is better to move slowly and carefully than to get tangled up in frustrating details associated with your issue. Remember that your goal is to make progress in moving through that once-invisible gate in the wall. Take your resourceful colleagues along with you so you and they can feel like partners-in-success. There’s nothing as joyous as being able to celebrate mini-successes together! So, with infertility as our issue, possible resources could include family members, local adoptive families, a financial advisor, adoption agency professionals, travel agents, pediatricians, attorneys and language tutors.
There’s no question that feeling stressed and pressured is emotionally exhausting. And it is worse when you have been working for months or years on trying to grapple successfully with an issue that just won’t yield to your persistent efforts to bring about change. So today’s blog shifts the emphasis from “try harder” to “look for the invisible gate in the impenetrable wall.” And remember to recruit friends and experts, since their partnership in opening that gate can be invaluable!

Life Happens -- But what about the stress it generates?

Feeling overwhelmed happens to all of us. For some of us it’s occasional, for others it seems like a way of life. The causes can range from relationship problems to chronic health concerns like infertility or cancer, with hectic lifestyles usually weighing in with their share of stress. So what to do when life is filled with just too much pressure?

As I’ve counseled people over the years, the one thing I’ve learned is that troubles arise from a whole variety of complex situations. Being able to be as clear as possible about the source of stress can go a long way toward getting it under control. And, if you’re feeling overwhelmed, it’s likely that there’s more than one source of stress to contend with. Many people find it’s helpful to make a list of what is stressing them out, and then putting that list in some order, with the most stressful situations as the top, working down to the least stressful ones at the bottom. As you review your list, very likely you’re saying “No wonder I feel overwhelmed!” And just that admission can go a long way toward helping you feel less crazy and, hopefully, more ready to take the proverbial bull by the horns and work on the issues like a skillful matador.

So, once you’ve named your troubles, another step is to think through the resources you have available to grapple with them. Are loved ones available to help in any way? If they’re part of your stress, are they feeling troubled enough that they’d cooperate in seeking some relief? Could you brainstorm with a good friend who has your best interests at heart? Is your religious leader someone who might help you sort through some of the challenges you’re facing? Would it be a good idea to see your family doctor, either for relief from physical symptoms or for a referral to a specialist? Could a counselor be helpful? In my recent book When You're Not Expecting, as well as in earlier blogs, I provide information on how to find an appropriate therapist, including ways of doing this without a significant outlay of money.

So, now that you have your list of stressors, as well as a list of resources, what’s next? I’m a great believer that success breeds success, so unless you are feeling completely unglued by the issues at the top of your list, my first suggestion would be to tackle two items toward the bottom of your list. These should be items that are troublesome and irritating but, at the same time, capable of showing some improvement. Do one at a time, involve friends, loved ones, or others if they’re willing, and hopefully in a week or two you’ve been able to calm down some troubling issues and feel some mastery over them. Notice, I didn’t say you’d removed them, because some sources of stress aren’t removable so much as they are improvable. Now, keep an eye on these lesser troubles (or ask someone’s help in monitoring them so they stay stable), and go to the middle of your list. Choose one issue there, figure out what resources are available to call on for help, emotional strength, financial assistance or whatever, and make a plan to address this problem.

• What does it mean to make a plan? The most important thing will be to identify what your goal is. (What changes do you want to see? Who needs to make these changes? What changes will you need to make? When will you know you have reached your goal?) You also need to ask yourself if your goal is realistic; if it isn’t, then you’re setting yourself up for feelings of failure and frustration. A goal isn’t necessarily a full solution to the problem if that’s not realistic; it can be a change in the problem that makes it more bearable. Just remember that every change you are able to make lightens your load emotionally and gives you more energy to give to other problems on your list.

• Another important component of a plan is a timeline. Don’t ask too much of yourself or others too soon. Remember, this issue took some time to develop, and it’s going to take some time to unravel it. So try to set a realistic timeline, and be prepared to revise it to a faster or a slower pace depending on how your change efforts are working.

• Pause from time to time and pat yourself (and others) on the back for the progress being made. Even little changes deserve attention, encouragement, and ongoing support.

• It’s a good idea to revisit your goal and to reassess whether it remains as realistic as you initially hoped. By now you’ve had a chance to try out various strategies, engage the cooperation of others, and see how committed others are to change. If you decide your original goal needs to be redefined, fine. You’ll base your new goal on new information and behavior, so hopefully you’ll have a better chance of reaching that goal.

• When you believe you have moved as far as possible toward achieving your (perhaps revised) goal, it’s time to decide what needs to happen so that there’s no (or as little as possible) backsliding away from the changes that have occurred. Maintaining these changes may take some energy, but hopefully some of this energy can be supplied by others who have cooperated in making the changes.

• And now it’s time to move higher on your list…

Why didn’t we start here in the first place? For one thing, now you’ve had some practice in problem solving AND you’ve had some successes AND you have fewer problems on your list AND perhaps you already are feeling less overwhelmed. In short, you’ve reached some goals, involved some resources, begun to feel as if change is possible, and hopefully have the energy to take on a tougher problem. So what will be different as you tackle a #1 or a #2 problem on your list? Probably its difficulty.

Simply by virtue of having risen to the top of your list, this is a compelling problem. It seems to you as if it interferes with your capacity to get on with your life. It probably is something that involves other people in some way. And, very possibly, it has resisted earlier efforts to bring about change. So here is where you’ll want to give yourself some “subgoals” rather than just the one big goal of erasing the problem or reducing it considerably.

So, watch out for next week’s blog, when I’ll take on the challenge of problems at the top of your list. In the mean time, how about trying out this blog’s strategies on a stressor or two at the bottom of your list? That way, you’ll already be polishing your problem solving skills and hopefully reducing those feelings of being overwhelmed. Sure, life happens. But you can play a role in steering clear of the worst potholes by strengthening your resilience! Tune in next week….

Craving Parenthood: A New Trend on Grey's Anatomy?

As I have been watching the medical series Grey’s Anatomy over recent months, I have been struck by how the themes of fertility, unplanned pregnancy and pregnancy loss are interwoven through so many of the episodes. And then after the episode that aired March 31st, I vowed to devote a blog to this thought-provoking series and the way it has humanized so many fertility issues. So, for those readers who may need a quick introduction to the relevant characters, we have these residents and physicians at Seattle Grace Hospital: • Meredith Gray, the protagonist of the show who has been trying for many months to become (and to stay) pregnant. • Derek Shepherd, Meredith’s husband, who was told a number of episodes ago that Meredith had suffered a miscarriage at the same time he had been shot by a gunman in the hospital. She waited some months to confide this to him, hoping that she would become pregnant in the meantime. • Christina Wang, Meredith’s best friend, childless by choice, and a doctor whose life is devoted to perfecting her surgical skills. • Callie Torres, a bisexual physician who has been in an off again-on again sexual relationship with Dr. Mark Sloan, and who has recently renewed her relationship with her estranged lesbian partner, Arizona Robbins. • Arizona Robbins, who has learned in recent months that Callie is pregnant by Mark Sloan. Callie is ecstatic at the pregnancy, but Arizona had said throughout their relationship that she did not want them to become parents. • Mark Sloan, who is also ecstatic at Callie’s pregnancy, since he missed out on raising an adolescent daughter from an earlier relationship, missed out on becoming a grandfather when that daughter decided to place her infant for adoption, and now sees Callie’s baby as an opportunity to become a bona fide dad. So there you have the characters; now for the plot and its infertility dimensions. See how many of these issues resonate with you or your loved ones who are grappling with infertility. • Meredith kept her miscarriage a secret, in part because it paled in contrast with Derek’s life-threatening wounds from the gunman, and in part because denial is one of Meredith’s coping mechanisms. Any reader familiar with pregnancy losses will appreciate that these losses often are not shared (for any number of reasons), and that there are no rituals in North American society to memorialize the loss of a pregnancy and the hopes and dreams attached to that pregnancy. • Meredith, once she didn’t conceive, underwent a diagnostic workup, which she said revealed that she had a “hostile uterus.” Not exactly a medical term, but the message to viewers has been that it will be difficult for Meredith to become pregnant. And, sure enough, over the course of many episodes we can see her and Derek finding private places in the hospital for intimacy, for hormone shots, and for furtive tears. Meredith remains quiet about her infertility, although Christina is aware of her friend’s sadness. However, the hospital provides plenty of opportunity for Meredith to devote herself to her medical practice, perfecting new skills, and participating in research. As most women with infertility are aware, it isn’t unusual to compartmentalize infertility – attending to it when your period arrives or there are medical procedures to submit to, but also trying to keep alive some distractions in your life: career, relationships, being kind to others. • When Callie conceives a baby, certainly without intending to, she realizes she is thrilled at the prospect of becoming a mother, and Mark is equally ecstatic at being the father of this baby. Arizona, recently returned from a medical sojourn in Africa, tries to re-engage Callie in their relationship and, once she learns of the pregnancy, makes her peace with it. Callie, Mark and Arizona ultimately become a threesome emotionally, with all the complications that go with meeting their needs. • When Callie asks Christina Yang to be the godmother of her baby, Meredith quickly moves to action, asking Christina to re-consider her plan to accept the invitation. Ultimately Meredith confides to Christina that she had always hoped Christina would be the godmother to Meredith’s baby, and she wanted Christina to be a special person in that baby’s life. How many times have couples with infertility watched their lives passing by as others live out their dreams: naming their babies the names we dreamed for our baby, inviting a godparent to accept when we had envisioned that person as our baby’s godparent, giving a baby gift that we would have loved to save for our own baby? • And, of course, when the hospital staff celebrated Callie’s pregnancy with a lavish baby shower, we could see the dimensions of feelings playing out: Meredith was on the sidelines; Arizona, ever ambivalent about this baby, was perplexed about why there was such a fuss being made; father-to-be Mark was actively participating in all the shower activities, and the mood was convivial and celebratory, with Callie’s joy being over the top. Seeing this shower was all the reminder infertile viewers needed to know why avoiding showers becomes a high priority the longer it takes to become pregnant. It also was a reminder that no one celebrating at a baby shower has any appreciation for the mixed emotions and depression that some participants will feel, especially if they are being private about their own infertility. • Immediately after the baby shower, Callie and Arizona decide to take a weekend away from the pressures of the hospital (and, for Arizona, from the smothering presence of Mark Sloan). While driving the car, Arizona proposes marriage to Callie, and the resulting discussion causes Arizona, who is driving, to take her eyes off the road. A serious accident results in Callie’s having life threatening injuries, in Arizona (not seriously injured) and Mark arguing about whether Callie’s life or the life of her baby should be given priority, and ends with Mark telling Arizona that, legally, she has no say in that decision. As father of Callie’s baby, he positions himself to be in charge of deciding what Callie would have wanted. All right, so this episode is unbelievably complicated (and made moreso because much of the dialogue is in song, a bit distracting to say the least!). But the take away message comes through loud and clear – that babies are precious, that high emotions cause huge friction, even with everyone professing to have Callie’s best interests at heart, and that the threat of a pregnancy loss is not something one ever anticipates in the glow of a joyful pregnancy. As is typical in TVland, peace is made (Arizona, a gifted pediatrician, cares skillfully for the one pound, one ounce baby; Mark apologizes to Arizona for his cutting words), and we are left waiting for the next episode to see how Callie and baby survive. • The last scene is of Meredith collapsing tearfully in Derek’s arms, protesting the unfairness of it all: Callie’s serious injuries, the baby’s prematurity, and the worry about brain damage for both, balanced against Meredith’s long infertility history of basal body thermometers, ovulation kits, post coital positions, hormone shots and the despair that she will never be a mother. In spite of Derek’s comforting her that they will find a way to become parents, any woman or man experiencing infertility knows this despair, which is highlighted whenever a joyful pregnancy is celebrated on behalf of friends and relatives. So, stay tuned to Grey’s Anatomy if any of these issues resonate with you. And keep an eye on the TV show that follows on ABC, Private Practice, where one of the female characters is deciding that she wants to try for a pregnancy, but her male partner does not share her hopeful enthusiasm. That, too, is all too familiar a dimension of many relationships when the biological clock begins to tick all-too-loudly…

Infertility: Do You Wear A Scarlet Letter?

We may remember Hester Prynne whose scarlet “A,” sewn to the front of her dress, branded her as an adulteress. But, for those of us with infertility, the letter “I” can be a prominent symbol in our lives, sometime public sometimes not. And we have some choices about how to “wear” that symbol.

When it’s public, here’s what you find. The first sentence out of a friend’s mouth is an expectant “Any news?” The next sentence could be about anything from a friend’s just-announced pregnancy to an invitation to go shopping at the mall, which you’ve been avoiding like the plague, given the number of pregnant women and new mothers pushing strollers who seem to fill every mall in your life. And then, there are inquiries from mothers and mothers-in-law, too embarrassed to speak to your partner directly, but eager for you to know it’s not such a good thing if he’s still wearing jockey underwear or taking long bicycle rides or balancing his warm laptop on his lap. And, then there’s always the awkward pause as you enter a room of chatting friends or co-workers when, out of sensitivity, everyone pauses and hastily changes the subject from babies to something more neutral. And, still more awkwardly, may be your reaction as less sensitive friends or co-workers circulate photos of their sonograms, their newborns or their thriving infants. And, of course, the supreme indignity comes when you receive an invitation to a baby shower and you have to figure out how to respond, convinced that you’re probably the only one reading this invitation with anguish rather than anticipation. Of course you wonder whether it even was worth it to go public with news (limited as it may be) of your infertility. Some friends are super-sensitive, whereas others seem clueless.

And if the scarlet “I” is well hidden, what does this mean for you? Well, like Hester Prynne, knowing that you are different in some symbolic reproductive way may make you feel very alone. It also can raise issues of shame, since you may believe your friends/relatives/acquaintances/co-workers will think less of you if you are not successful in reaching your goal of parenthood. Or you may want to share your situation with others, but your partner isn’t ready for either of you to go public, probably out of those very feelings of shame that can lurk so deceivingly in the background. The hidden “I” forces you to put on a good face when your heart is breaking, especially in the presence of babies and pregnant or nursing women. It may make you question what is wrong with you, now that you are having such awful feelings about these women who are, after all, just doing their best at what you can’t yet experience. Hiding your infertility from others puts you and your partner in the unique roles of being each other’s sole emotional support. In short, staying private with your infertility can feel lonely and solitary, even as it enables you to have some control in figuring out your own issues without unwelcome intrusions by others in your life.

But let’s imagine that your public or private “I” is causing you some distress. If so, there are some things to think about in the way you offer information (or not) about the impact your infertility is having on your life. Let’s first consider how you might want to re-focus a loved one’s well-meaning inquiries about your infertility. In fact, these constant inquiries may make you feel as if the only thing others perceive when they see you is your infertile self. Granted, you spend a good part of each day preoccupied with your infertility, but chances are you’d welcome an escape from this. So, one approach is to give a very brief “infertility response,” followed by a change of subject and an effort to inquire about your friend’s or loved one’s life. Or you could be more direct, by saying something like, “You know, I really appreciate your concern with my infertility treatment, and I’ll be glad to let you know whenever there’s any news. But I also really enjoy it when our time together can be a distraction from my infertility. So I’d love it if we could talk about things that have nothing to do with my reproductive health: current events, girl gossip, work challenges, new movies……That would help me stay in touch with stuff that was important in my life before it got hijacked by not being able to get pregnant.”

There’s another issue in the lives of those of us who have loved ones who constantly express their concern about us. We begin to feel somehow less capable, more vulnerable and, perhaps, less balanced in our relationship with others. After all, they are constantly extending their emotional support in our direction, but we don’t feel as if there is much of an opportunity to reciprocate. How can we, if the major focus of conversation is on us and how we’re coping? So, again, it’s up to us to shift the conversation. Perhaps beginning with “Gee, thanks for asking, but nothing much has changed. How about you? We’ve been so focused on me recently that I really miss feeling caught up on your life. What’s going on?” Or, if you want to be more direct, you could say something like “Susan, you have been such a dear all these months to care about my efforts to get pregnant. But, as I think about it, what I really treasure about our friendship has always been the give-and-take, and the support we both can offer to each other. I feel like I’ve been more on the receiving end lately, which doesn’t give me an opportunity to feel as connected as usual with what’s happening in your life. Can you help me by trusting that I’ll let you know when I need your support, and in the mean time we’ll try to get back to a different balance in our friendship? “ Those strategies can convey your appreciation to others, as well as a wish to refocus your energies back to a more reciprocal relationship. And, while you’re at it, another thing to consider might be to indulge in a new hobby, join a class or a book club, try out some new recipes to share, find some new hiking spots, or in other ways broaden yourself so that you can initiate conversations about things in your life, beyond your infertility, that friends can find interesting.

Now, for those of you who have been guarding your privacy so you can avoid the one-sidedness in relationships I’ve just addressed, does it really seem so difficult to redirect friends away from your infertility when you don’t want the conversation to go there? I have a healthy respect for the need for privacy but, as I say in my new book When You’re Not Expecting, it is a heavy burden for a couple to bear when the two of you have decided to keep your infertility to yourselves.

Other readers who may be reluctant to share news of their efforts to become pregnant include same sex couples and single women, who may anticipate disapproval of their decision to bring a child into this world. However, here, too, there are choices you can make about which friends and loved ones to tell. Keeping silent about your hopes for a pregnancy can sometimes simply reinforce your feelings of being unconventional or different in a society that expects heterosexual married couples to have children and excludes others who cherish the hopes of parenthood.

So, cast off whatever remnants of the scarlet “I” that may have clung to your identity! There are many ways to live with your infertility that need not include being out of balance in your relationships. And, actually, it is those relationships that may be the foundation of strength that help support you emotionally through the especially tough times when you welcome a shoulder to lean on.

"Hey, Remember Me?" Getting Your Partner's Attention

Whether it is our hectic lives, a conflict in schedules, diverging interests or more serious disruptions in our lives, it can be distressing to feel disconnected with our partner. We began our relationship hoping for a partner who would be “there” for us, who would anticipate our needs, and who would be responsive to our efforts to connect. We are especially sensitive to those feelings of emotional disconnect during unanticipated personal crises, such as infertility or cancer, which may render us unable to cope and reluctant to confide in others. What do we make of it when those connections with our partner feel frayed?

Perhaps the first thing is to see whether the two of you can have a conversation about your perception, to see whether your partner feels at all as you do. If so, then ask whether you can both find a time to talk more about what changes you would like to see in your relationship. If not, you should still propose that you find some time to talk, but be prepared to be the one taking the lead. And in either case, there are a few areas to acknowledge as potentially sensitive:
You do not want to convey to your partner a sense of blame for the distance that you perceive has been growing between you. Instead, you want to enlist creativity and cooperation to draw you closer together.
You do not want to come across as being a nag. “You never…” or “You always…” or “Why don’t you ever…” are key phrases to avoid.
It is possible that the two of you actually have different needs for emotional closeness. So at the very time you are feeling left out, your partner may be feeling as if the closeness/distance balance is just right.

So, starting at the beginning, you already are moving in the right direction if you and your partner agree on making some time to talk about the emotional disconnect that at least one of you is feeling. A caution here: it’s best to have this discussion in a private, neutral space (not the bedroom, not the table/countertop where you eat your meals, not in a place with distractions like riding in the car, and not a place that is physically uncomfortable or where you cannot easily make eye contact). Turn off all ringing, buzzing objects/alarms, so the message you give to each other is that each of you is the other’s priority.

Once the time and place have been set aside, since you’ve taken the initiative, you’ll want to explain why. How about finding an upbeat way to begin? “I’ve begun to realize that I miss the times when we had more chances just to relax and talk/ problem-solve/snuggle/hike/have a candlelight dinner/ be intimate together” would be one way to open the conversation, followed by something like “Do you ever feel this way?”

If your partner agrees, then you both can begin to explore what you would like to do to create more time together. And you’ll also need to figure out what are the factors that have contributed to the emotional disconnect you’ve been feeling. Those factors may be real life issues, like high maintenance family members/friends/co-workers/bosses/or even pets! Other factors may be physical exhaustion, illness, emotional distractions, job or school obligations, work-related travel, or any number of things that have crept unnoticed into your lives. So the combination of a mutual wish to recapture calm time together, paired with a recognition of the factors you think get in your way, should set the stage for a productive discussion on what both of you can do to set the stage for more attention to each other.

But what if your partner doesn’t perceive the emotional disconnect that has been worrying you? You still are entitled to your feelings, but understanding where your partner is coming from becomes especially important. Is it that your partner may be worried that there will be an expectation that some favorite activities will be sacrificed? Perhaps that you may want some changes that would be unwelcome? Maybe that your partner has a real commitment to some of the high maintenance people in your lives and is apprehensive you may demand equal time? As you can imagine, it’s really important to ask your partner’s help in understanding why only one of you is feeling this emotional distance. Here your partner may actually be relieved if you offer your perspective first, which may turn out to be not nearly as difficult to address as your partner initially anticipated.
So if you begin by offering that you find yourself missing the times when you had more time to spend together, and that you want to nurture that closeness and not take your relationship for granted, your partner will hopefully take that as a positive message and not a competitive one. Then, in the spirit of enlisting your partner’s participation, you might ask “I wonder what we could do to recapture some of the special times together that we used to enjoy so much?” Hopefully both of you could begin to explore together your ideas, acknowledging the inevitable demands that have interrupted efforts to spend time together. Trying to figure out how you both can shuffle/reschedule/ re-prioritize those demands will be important. You may need to call on others to help create the space you need for yourselves: parents, siblings, best friends, a religious leader or a counselor all could be resources to consider.

Realistically, we also must consider the possibility that your efforts to re-engage emotionally with your partner may be met with denial, side-steps, avoidance or disregard for your feelings. If you genuinely have avoided blaming or nagging, then your partner’s lack of responsiveness is a serious signal that you are not going to be met half way. This would be a time to encourage your partner to come with you to a marriage counselor to sort out your different perspectives on your relationship. And if your partner is unwilling, then you should seek counseling for yourself (see some of my earlier blogs or my book When You’re Not Expecting for how to find a therapist).

Relationships are sensitive territory, often changing and often needing ongoing attention. And, since the need for attention to the relationship may coincide with life changes, personal crises, family losses or other emotion laden events, you and your partner can potentially benefit if you develop a style of connecting that is open and responsive even in trying times. So if you begin by using your current perception of wanting to nourish your relationship, hopefully both of you will develop and nurture ways of staying emotionally resilient and connected for many years to come.