Infertility is Trauma

The statistics vary, but there are approximately 7 million women living in the United States with impaired fecundity, meaning they have difficulty getting pregnant or carrying a child to term.  About 6% of women in the US have been diagnosed as infertile.* In addition, as would be expected given the nature of the issue, folks dealing with infertility are much more likely (than those without infertility issues) to suffer from mental illness, most prevalently depression and/or anxiety.

What’s interesting about those statistics is that, despite infertility being relatively common, the mental health surrounding infertility is still relatively un-talked about.  The shame and stigma surrounding it is still high.

But here’s what we mental health professionals who work with infertility know- it is traumatizing.  And I don’t mean that in a casual way- I mean that, in many of the clients that I work with, both men and women, many of the symptoms mirror that of post-traumatic stress disorder (PTSD).  While they may not fully meet criteria for a diagnosis of PTSD, I often end up treating many of the same symptoms.

Think about it.  When someone is dealing with infertility, they often become very anxious, especially in certain situations, feeling triggered by something like the baby clothes section at Target, or seeing a pregnant woman.  A pregnancy announcement on Facebook or in the mail can feel devastating.

Because of these triggers, people struggling with fertility issues often become hypervigilant, a hallmark of PTSD.  Suddenly, that support system that used to be safe becomes a “minefield”.  Since many who are dealing with infertility have friends also in the reproductive health age range, it suddenly seems that everyone is getting pregnant.  The hypervigilance comes into play in so many social or family situations.  For example, people with infertility suddenly are very aware of who isn’t having a drink at a party, or whose clothing looks a little bit tighter than normal.  In addition, well meaning family members or friends at the annual holiday party may ask when they’re going to have a baby, or even make unintentionally unkind remarks that they “shouldn’t wait too long to start a family”.

Many times avoidance, another trauma symptom, comes into play.  At Target, the person suffering from infertility may walk all the way around the store just to avoid the baby section.  That person might stop going to parties or gatherings with friends who might be pregnant, or where there will be a friend who is known to be pregnant and is showing.  They will almost definitely have a difficult time going to something like a baby shower, and may decide to stay home instead.  Often that person is left feeling a range of unpleasant emotions, including sadness, resentment, and even guilt that they are missing out on friends’ events, because attending is simply too painful.

People with infertility often have nightmares about their struggle, another symptom of trauma.

As with other types of trauma, those struggling with infertility often become laser focused on their infertility, until they feel that they are infertility, rather than that they are dealing with infertility as a medical condition.  This “laser beam” can be incredibly isolating and cause a sense of hopelessness or despair.

And, if/when a person who is dealing with infertility does get pregnant, they are automatically at a higher risk for perinatal mood and anxiety disorders, as is someone with a history of trauma.  If there is a loss, such as a miscarriage, those risk factors are multiplied.

So how do we treat the trauma of infertility?  As a therapist who specializes in infertility, I see my role as someone who helps hold that grief and trauma, who can help normalize the range of emotions that someone may be struggling with, even those emotions they are ashamed of (such as jealousy, or anger towards their pregnant and parenting friends).  I help clients walk through the often painful, confusing, and complex world of assisted reproductive treatment, or ART.  I see my job as someone to help reframe the experience, and shift them away from feeling that they are infertility, but rather that infertility is one (very stressful) challenge they are experiencing.  Often we will work on techniques to help manage stress and anxiety during this process, and to focus on other positive aspects of their lives.

But, like with other forms of trauma, we know that infertility has a very physical, somatic component to it.  Trauma is held in the body, in so many ways, and with infertility that could not be more true.  Not only is the trauma of infertility experienced in the body in the way that other forms of trauma are, there are countless and ongoing physical reminders of the distressing experience.  People dealing with infertility are all too aware of every step of their cycle, what day they ovulate on for example, or when their period will start.  If they’re going through ART, they may have to do painful injections, or take medications that cause a range of unpleasant physical symptoms, not to mention emotional ones.

In my next post, guest blogger Marisol Tomás Colette will discuss her specialized form of body-based, mindfulness therapy, called Organic Intelligence®.  Marisol and I are excited to have formed a collaboration to treat that trauma that is associated with infertility in a holistic, comprehensive way, which addresses not just the cognitive and emotional aspects, but the biology, physiology and spirituality as well.

Look for the next post to learn more about the beautiful healing work Marisol does, and how that can be a great adjunct to the work I do!

*What’s frustrating to me about most of the listed statistics on infertility is that they still only take into account women, when we know that about 50% of the problem is men… they often don’t differentiate same sex couples or pull out certain groups that are more at risk for infertility, such as African American women, but that’s another blog…

Ariel M. Shumaker-Hammond, MPH, MSW, LCSW is a therapist specializing in infertility and perinatal mood and anxiety disorders.