Relationships and Infertility. BACP Private Practice Conference September 2016 Gerry McCluskey FCSni

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Nathaniel Joseph
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1 Relationships and Infertility BACP Private Practice Conference September 2016 Gerry McCluskey FCSni

2 Setting the Scene 1:7 couples have difficulty conceiving the failure to conceive after regular, unprotected sexual intercourse over 1-2yrs world s first IVF baby born 3m IVF babies born worldwide ,000 IVF babies born in UK each year HFE Act 1990 requires that counselling be offered HFEA

3 Fertility Problems Unexplained Infertility 25% Ovulatory Disorders 25% Tubal Damage 20% Male Factor 30% Uterine or Peritoneal Disorders 10% Both male and female factor 40% (NICE) 56% seek medical help (Boivin et al)

4 Fertility Treatments Intra Uterine Insemination (IUI) In Vitro Fertilisation (IVF) IVF Donor Sperm Intra Cytoplasmic Sperm Injection (ICSI) Donor Insemination Egg/Embryo Donation Sperm/Embryo Freezing Surrogacy

5 Journeys to Treatment Couple meet later in life, one has children Male partner has had a vasectomy Previous treatment for cancer Genetic disorder e.g. Turner s or Klinefelter s syndrome Children have died due to genetic condition Single person Same sex couple Early menopause Primary Secondary Infertility

6 Loss in Infertility A child.opportunity to parent Hopes and dreams..anticipated future Each cycle, failed treatment, ectopic, miscarriage Child with chosen partner genetic continuity Experience of pregnancy and delivery Sense of self of control The natural order..core purpose of life

7 Infertility as a Loss Unrecognised Tangible/Intangible Repeated Cumulative - Enduring Simultaneously holding two conflicting positions Loss and Hope Resurrect past losses..anticipate future loss Insights and Wounds can live on

8 In the Counselling Room 1 IDENTITY - Changed by infertility Angry, anxious, depressed, joyless See self as the problem See body as dysfunctional Consumed by infertility Different to others Loss of confidence/self esteem Left behind isolated missing out on life stages

9 In the Counselling Room 2 DISRUPTION functioning at a lower level Natural activity becomes medicalised Loss of control, surprise, ability to plan Socialised into more invasive treatment Treatment at the expense of other activities To the cultural ideal To the lifecycle To the sense of security

10 In the Counselling Room 3 Relationships with parents with friends - greater bond with their children - heightens sense of difference - feelings of envy/betrayal - need to protect self/avoid pain - insensitivity of others

11 My infertility is a blow to my self-esteem, a violation of my privacy, an assault on my sexuality, a final exam on my ability to cope, an affront to my sense of justice, a painful reminder that nothing can be taken for granted. My infertility is a break in the continuity of life. It is, above all a wound to my body, to my psyche, to my soul. Jorgenson 1981

12 FROM ONE TO TWO

13 Factors Affecting Grief Response unique meaning of the loss; personal characteristics - coping behaviour, personality, mental health, maturity, stage of development, cultural, ethnic, religious background, belief system, gender, gender role conditioning, concurrent stresses, lifestyle, previous loss history, sense of fulfilment; characteristics of current loss journey; social factors family s expectations, reaction, understanding and support; physiological factors physical health, rest, sleep, nutrition, exercise, addictions

14 Gender Differences Infertility is distressing for both partners but can be more so for women than men Men can be more confident that treatment will work Men can envisage life without being a father Men less likely to talk about their feelings re. infertility experience and treatment Women can assume more personal responsibility and feel a sense of failure Men can worry more about the impact of infertility on their partner

15 Couple Coping Strategies Research indicates that there can be gender difference in preferred coping strategies Congruence/fit of coping styles influence relationship (dis)stress Nature of coping strategy may reduce individual stress but increase relationship stress Escape/avoidance and accepting responsibility associated with increased stress Seeking social support and planful problem solving - lower levels of social and relationship stress

16 Back in the Counselling Room Couples attend support/therapeutic counselling less often than individuals Impact on one partner Impact on relationship Emotional and physical stress of treatment Prepare/educate for treatment experience

17 Still in the Counselling Room Telling their story Communication Conversations about difference in experience, coping, pacing Identify what works for each re. support Individual and couple sessions Fertility time.relationship time Celebrate..memorialize

18 The Future Wounds can live on Triggered at grandparent stage Quality of Life can be high for childless couples and post-mar parents Separation/divorce rates lower than general population Infertility can forge closer relationships, improve communication and conflict resolution skills, increase insight

19 THANKYOU FOR LISTENING

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