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Opposite Ends of The Couch

Written by: S. Fenella Das Gupta, PhD

At the Therapist’s office: Jack and Jill enter and sit as far apart from each other as they can.  Jill fiddles with her wedding ring anad Jack looks on nervously, wondering who’s going to start the conversation.  Jill begins, “We are going through infertility issues right now and we argue all the time about it.  I want to do another IUI and he wants to do IVF. It’s really hard on both of us. I never thought we could get like this. We were so strong in the beginning. Bullet proof! But now we don’t sleep that well. It’s worse on me. I make all the appointments; I make sure all the meds are ordered. He leaves it up to me to decide what the next steps are and just doesn’t seem interested!  I mean, I don’t know if he even wants a baby!” Jack retorts, “Well, sometimes I wonder who you are having the baby with: me or the doctor? Sometimes I wonder if I am even a person to you any more … or just a sperm donor? You’re just so focused on this thing!” Jack adds, “And what about sex?!?” “Yeah? What about it!” Jill retorts.

The above scene is common for women who feel that they are in it alone and for men who experience an emotional beating when spending less than 90% of their time focused on how to get pregnant. Understanding how these relationship issues arise is important for prevention.  Clearly, Jack and Jill have built up resentment towards each other, with each carrying high stress. Like this couple, many couples underestimate the psychological stress that comes with infertility. It is an afterthought. Making a baby comes first. But looking at this couple, their bodies and minds are not experiencing stress as an afterthought. As strange as it may seem, the intense feelings Jack and Jill are experiencing are partly normal. The desire to have and raise children is a fundamental aspect of human nature. When this goes wrong a crisis can ensue. The very meaning of life may be thrown into question as life plans go awry. A whole gamut of emotions follow, and like Jack and Jill, many couples experience changes in their relationship.

Let’s take a closer look at how this couple is interacting over the issue. Jill takes on the task of booking appointments and complains about being left alone to do all the work, wondering if Jack even wants to have a baby. Jack expresses feeling redundant and invisible. Their dynamic is circular. In other words, as Jill works harder, Jack feels more redundant; the more redundant Jack is, the more Jill takes on.

But why is this dynamic so commonplace for most couples? One reason has its root in the different ways men and women process the experience. Men, typically take on the role of ‘provider and protector’. This means that typically they are not focused on emotions, but rather the practical details of life. As a result, they often feel overwhelmed by the intensity of their partner’s emotions, which in turn leads to feelings of helplessness. Thus we have the above scene play out; feeling helpless, Jack resolves to make himself feel better with emotionally protective thoughts like Jill is just too sensitive about this whole thing. He focuses harder on his work and distances himself from Jill. Women on the other hand, typically take on the role of the ‘emotional caretaker’  and end up taking much of the responsibility for the couples’ fertility treatment. Trying to keep emotions in check, for fear of “being too sensitive” leads to feelings of overwhelm and resentment. It would behoove couples to accept the following fact: women will typically end up focusing on pregnancy more than their male partners. Women need to track their menstrual cycles, watch for signs of ovulation, get blood drawn, carry the baby and give birth. Men take a more simplistic and rational approach. That does not mean, however, that males are any less invested. They are invested differently and this can be a conversation opener, not an ‘end of story’ situation.

Arguments during the fertility procedure often revolve around wanting different things with no resolution in sight. The following are guidelines to help with finding resolution.

1.         Take a break and agree to return to the topic. Work out what a break looks like for each of you. Do you know when you need to step away? What are your body signals? NOTE: when returning to a topic, research has shown that AT LEAST 30 minutes is required as a cooling off period.

2.         When you are taking your break away, think about the outcome YOU would like to see happen. Ask yourself: What outcome would I like from this discussion? Get clear on what you want and be as clear as you can with your partner. Remember, you want your partner to understand what you want.

3.         The revisit: take turns, as your partner speaks ask ONLY clarifying questions. Swap turns. Use “I” statements to state what you want the outcome to be for the discussion. For example: I Feel —- and I would like to feel —-.

4.         Tell your partner why it is important to you. Explain how it will help you. Talk about what you can do for your partner if s/he is willing to go along with your ideas. Above all, try to RESPOND and not REACT.

If the above steps prove too difficult to do alone, seek out professional help. Be sure to choose a mental health professional that has expertise in fertility issues. The goal is to help you learn how to cope with the physical and emotional changes associated with fertility challenges.

Jack and Jill, even though they described themselves as bullet proof, misjudged the emotional toll that accompanies fertility challenges. Research has shown that couples that set time aside to attend fertility counseling sessions at the initial stages of their treatment fair better in the long run than those who wait until they are emotionally exhausted. Although sometimes daunting, fertility counseling  is worth the emotional support and skills that you will receive. Talking about your emotional issues is tantamount to taking responsibility for yourself, your life, how it affects others and your journey through treatment. Most often, when you make this kind of commitment to treat both your physical and emotional needs, you start to feel better.

About the author:

S. Fenella das Gupta, PhD, marriage and family therapist. dr. das gupta is a licensed marriage and family therapist and infertility Counselor working in the Bay area of northern California. her practice, the inner mirror, includes counseling individuals, couples and running support groups. Her professional memberships include resOlVe, the national infertility association, the american society for reproductive medicine and the California association of marriage and family therapists. Dr. das Gupta also interacts with individuals on her fertility blog at

Dr. Danielle Lane Danielle E Lane, MD, Reproductive Endocrinology and Infertility Specialist

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