The negatives of positive thinking--denial, optimism, and pragmatism in infertility treatment

One question I am frequently asked by clients in the process of infertility treatment is what sort of attitudes and expectations they should maintain about the outcome of their treatment. In my experience, it can be common for some infertility patients to maintain a very optimistic outlook regarding their chances for success, even in light of indications to the contrary. Frequently, people with this outlook are seemingly afraid to explicitly acknowledge the possibility of problems or failure. In this post, I am going discuss some of the pitfalls of this type of thinking as it relates to infertility treatment.

Why thinking positively may not always be the best thing to do

You may be wondering what on earth could be wrong with maintaining a positive attitude in even in the face of a challenging situation. I realize that my argument does fly in the face of much conventional wisdom, but I think that having an unqualified positive attitude may give rise to two problems. The first is that it can make it difficult to acknowledge and respond to important medical and situational information. The second is that it can make it difficult to acknowledge, process, and respond to negative emotions, such as fear, anger, despair, and hopelessness, that are an all too common part of the experience of infertility.

In our culture, there has been a great deal of recent emphasis on thinking positively, as epitomized in books such as "The Secret". The fundamental gist of these beliefs is that to get a positive outcome, you must only think positive thoughts about your situation. Thinking negative thoughts is not good as it will somehow bring negative energy, and negative outcomes, your way. You have no idea how much I wish that it was really that simple, because life would be a much, much better place. But the fact is that although you can think as positively as is possible, the power of your thoughts cannot change the physical reality of the situation. I remember in my second IVF cycle, I decided to use a lot of positive imagery and visualizations as a way of improving my ovarian response. During the early part of the cycle, when we could still travel, my husband and I serendipitously came across $300 round trip tickets to Hawaii. What better place to have a positive attitude? One day as I snorkeled among the beautiful fish through the sunbeams, I imagined the warmth of the sun healing my underachieving ovaries. Then unbelievably, I was suddenly joined by a pod of spinner dolphins, who surrounded me, leaping in the air. The pod was filled with several pairs of mother and baby dolphins--what could be a better omen than that, right? Flash forward to my first big ultrasound for that cycle, and--you guessed it--there was no dolphin magic for me. Although it was an amazing experience, it didn't change the reality that my ovaries were not up to par. If I didn't accept that information and respond to it, both practically and emotionally, I would not be able to make decisions to maximize my success given my situation.

In my opinion, not accepting the possibility of a negative outcome, or believing that positive thinking can trump physical realities, really isn't positive thinking at all. Rather, it is denial. It is much more common in infertility treatment among people who tend to use denial as their main psychological defense in other areas of their life. And I've seen it have some very negative long-term effects in people's lives. So trust me, you don't want this to be you.

Secondly, I have found that some people are afraid that if they consciously acknowledge their negative feelings about their prospects, they will somehow "cause" their treatment to fail. The idea that negative thoughts or feelings by themselves can produce some sort of negative outcome is quite common and in fact is a normal part of our childhood emotional development. If we don't get the proper responses to our negative emotions as children, this belief can sometimes persist, albeit unconsciously.

However, if we deny ourselves the opportunity to acknowledge and express negative feelings as they come up (and in infertility treatment, believe me, they are going to come up sometimes) we unwittingly create more problems. In order to avoid awareness of our negative feelings, we must use up a lot of psychological energy. This can be exhausting and draining, but may lead to a more serious problem--it can chronically raise our cortisol levels, which has been linked to several negative health outcomes and may even impair our fertility--although the jury is really still out on that one. Plus, we don't get the benefit of the information about ourselves and our situation that our negative feelings are giving us. Just as thinking positively cannot transcend our medical reality, acknowledging negative feelings and working through them in a measured way can't make our medical reality worse.

The power of practical thinking

Now I am by no means suggesting that one should adopt a doom and gloom attitude when it comes to infertility treatment. I believe that positivity has its place, and that optimism is a very useful outlook. But it must be tempered with an awareness of the problems that we currently face, as well as the negative outcomes which potentially occur. As much as I've witnessed bad things happen to people in their infertility treatment, I've also witnessed true miracles. But these miracles usually happened to people who acknowledged the problems in their situation, and adapted their treatment strategy to them--often with great daring and personal sacrifice. It has taught me that true optimism and hopefulness isn't really what you think or feel--in the end, it's what you do that counts. Pushing ahead as best and as wisely as you can, being fully aware of the emotions involved and the risk of failure--to me that's optimism and bravery at its best.