Wednesday, September 29, 2010

A cautionary tale of two treatments--the roles of emotion and the scientific perspective in infertility treatment

Being a clinical psychologist, I am naturally drawn to thinking about emotions. They are the currency of my work; it almost always seems to me like it's a good idea to discuss them, understand them, and draw them out. And yet, when it comes to infertility treatment, both my professional and personal experience have taught me that they must be managed differently than we manage most things in our personal life. Too often, our emotional issues can blur our vision of ourselves and our treatment, and we are unable to see what is really happening at the time it is occurring.

These emotional experiences, as I've discussed at length, are difficult to manage, and are likely to color both our medical experiences and our decision making. In particular, those feelings of self-blame or doom, are often present. As discussed in a prior post, these feelings can make the success or failure of treatment seem like some sort of spiritual or karmic comment on your worth as a person or fitness to be a parent.

The science experiment mindset

In addition to being unpleasant, such feelings cloud what I think is the real truth of the matter: instead of being about you as a person, infertility treatment is all about chemical and hormonal reactions and cells in a petri dish. And what those cells and hormones decide to do is, in many ways, out of anyone's control. It's really your own personal science experiment. The doctor has a hypothesis based on past research and clinical experience, and he or she tests it out on you to see what happens. If it works, great--if it doesn't work, then there is more information to be used in the development of the next hypothesis, or treatment plan.

The best way I can think of to illustrate this point is to describe some of my own experiences in infertility treatment, to show you how I came to this point of view--and why I am so convinced of its usefulness.

Please do as I say, not as I did....

I learned the importance of taking a scientific perspective on my infertility treatment the long, hard, and painful way. My first few IVF cycles were emotionally devastating for me, fraught with feelings of failure, frustration, and disappointment. Aspects of my infertility were unexplained, and I filled in the scientific blanks with karmic explanations--perhaps I was somehow a bad person, and that was why this was happening to me. Of course I knew it wasn't logical, but in my experience logic usually never stops anyone from believing the worst about themselves, if they are already so inclined. In addition, my RE was the warm and fuzzy type, and seemed visibly upset whenever things didn't work. During one transfer, he was actually praying out loud to God that it would work this time (no pressure, right?) It didn't. I started to feel that not only was I failing my husband and myself, but I was failing him as well.

Eventually I couldn't take it anymore and I quit treatment. Screwing up all of our last remaining courage, we decided to adopt, and that process, although it had many, many bumps along the way, worked out in our favor. It was only years later, when we wanted a second child,that I began to even consider the possibility of infertility treatment again. The adoption climate had changed, and adoptions in my daughter's birth country had become extremely difficult.

I knew that if I were to reenter infertility treatment, I couldn't do things the same way. So we went to a different RE, who although he was known for his clinical excellence, was often described as cold or lacking in his "bedside manner". During our first meeting, it was clear right away that this guy didn't care one whit about me or my problems. And I had an epiphany--instead of feeling hurt by this, surprisingly I felt incredibly liberated. If my treatment didn't work, he wasn't going to be emotionally hurt by the situation. In addition, the new RE was able to systematically review my prior cycles, and explained all the variables that might have caused them not to work. Amazingly, he none of them included karma. Instead, it was all about the numbers--the clinical techniques used, the statistical success rates of the clinics involved, and the advancements in science since I had left treatment. Again, another epiphany--this was really just all a big, very expensive science experiment. The clinic would try some different protocols on me and see what happened. If they didn't work, it was just more scientific information about what might possibly work in the future. And if it didn't work at all, than it was because science hadn't yet developed the solution to my problem.

I decided that if I could hold on to that viewpoint about treatment--that it was just a science experiment--I could probably survive another go at things. And that treatment experience was much more tolerable, even though it certainly had its ups and downs. I would never say I wasn't emotionally invested in the situation, because of course I was. But I was also able to get a tiny bit of distance from things and think rationally about what was going on at the time. Medications, which may or may not be effective at their purpose. Cells in a dish, with their own agendas. Thankfully this time the a few of the cells' agendas aligned with my own, and I became pregnant with my second child.
But even without that positive outcome, I had learned something profound--by holding on to the idea that it was a big science experiment, it was possible for me to go through a treatment cycle without becoming overwhelmed by my negative feelings.

And believe me, if I can do it, you can too! It is my hope that by sharing this story, you will be able to avoid some of my mistakes, and that you and your course of treatment will benefit.

So try to remember this mantra when treatment gets stressful--in the end it's about the science. About chemical and hormonal reactions. About cells in a dish. And maybe this will give you a little bit of emotional distance, enough to see your options clearly, and to make the decisions that are right for you.

9 comments:

  1. I've never thought of it that way! Thanks for sharing your story!

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  2. That is a very useful way to think about it. There has to be a point where we separate emotionally from all of this and that seems like a good way to do it.

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  3. What a great way to think about this...especially helpful b/c I was just starting to go down the "karmic" path...that I wasn't a good person, not meant to be a parent, or that my husband and I weren't good enough parents, not worthy of having more than one child, not selfless enough to have more than one child, etc.

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  4. I totally agree with you (and strive for some emotional detachment from my cycles myself), but I will say that it's been easier to take this view now that we've already got one daughter. It doesn't make me any less emotionally invested in the cycles, but now instead of giving 100% of my energy to cycling, it only gets 50%. I love your blog - it's really helped give me some perspectives and things to think about while we TTC no. 2.

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