Couples issues in infertility treatment: some thoughts

Infertility treatment is not easy on a relationship. The logistical challenges and the emotional ups and downs involved are enough to challenge even the happiest couple. Although some couples may be able to navigate the bumpy terrain of infertility treatment without conflict, many others find it to be a tumultuous time in their relationship.

It seems that being in infertility treatment (or any other highly stressful situation for that matter)can aggravate any preexisting areas of conflict a couple might have. But more than that, I have noticed that different coping styles on the part of the members of the couples also produces a great deal of conflict.

To be honest, when people talk about gender differences in regards to expressing emotions, i.e., men are from Mars and women are from Venus, I usually get irritated. It bothers me to think of human beings as so stereotypically defined; are we merely just the product of biology and/or societal conditioning? Can't we choose how we will think and act? That's why I also find what I am about to write irritating--yet nonetheless I have found the following distinction to be useful:

Usually in each couple there is one individual who is more consciously in touch with their feelings, and who thus is more explicitly anxious and upset by the experience of infertility. And there is one individual who tends not to be as conscious of their emotions, not express them as much, and may in fact be in some level of denial about the severity of their situation. More often than not, in a heterosexual couple, the woman is the emotionally aware/anxious one, and the man is the one in the stoic/denial position. Of course this description doesn't fit everyone, but it is accurate enough of the time that despite my prejudices, I cannot deny its validity.

The good news

Although the above pattern has some problematic aspects, which I will discuss below, it can be a very adaptive pattern much of the time. The script I commonly see goes like this: the woman realizes there is a problem, and gets upset. The man feels that she is overreacting and that everything is going to be fine, if only they were more patient. Undaunted, the woman nonetheless springs into action, making appointments, beginning treatments, etc. If the man had his way, nothing might be done, and as infertility treatment is time-sensitive, opportunities might be missed. But by not panicking, and by continually pulling his partner back from the edge of the emotional cliff, he provides a stabilizing force for the couple. On balance, this "division of labor", if you will, allows the couple to move forward.

The not-so-good news

In this system, problems arise most commonly when a disappointment or setback occurs. The woman reacts immediately, becoming distressed and visibly upset. The man, although he may also be upset, tries to ignore these feelings, adopting a more stoic attitude. While the woman wants to discuss recent events and her feelings (sometimes to the exclusion of all else), the man eventually gets frustrated and does not wish to discuss the situation anymore. At this point, conflict arises, as the woman then feels her man is not emotionally "there" for her, and for his part the man feels that she is dwelling too much on her feelings. Further, the man may also feel frustrated that despite all of his efforts, he is unable to do anything to help the woman feel better about the situation--it is out of his control. This may make him feel worse about himself, and in combination with the stress of pushing down his own feelings of loss and frustration, he can then get a bit "crusty around the edges" (a clinical term :)). Eventually the tension erupts, and arguments ensue.

I have also observed a "delayed reaction" phenomenon with men; once the woman starts working through her feelings of loss or frustration and is doing a bit better, the man starts to become visibly upset. Perhaps as she is not as vulnerable, he finally feels like it is safe to process his own feelings. This can also cause conflict, because the woman feels that she is being pulled back into being upset about the situation again when she was just emerging from it. Also, if she felt unsupported in her feelings while she was going through them, she may be less than sympathetic now that he is distressed. Again, this causes a lot of tension in the relationship, which can produce conflict.

Coming back together

I have worked with many couples with the above types of conflict. What has been most helpful to them is to be able to understand each other's different coping styles. Realizing that their partner is not being willfully insensitive on the one hand, or overly emotional on the other, allows them to regain common ground and to feel that they are part of the same team. By acknowledging the emotional validity--and necessity--of both perspectives on their infertility experiences, most couples are able to reconnect and move forward together in their journey of building their family.

A postscript

This evening I came across another excellent article on the different emotional perspectives men and women can have during infertility treatment. It just came out today (I super-swear, I wrote my blog entry yesterday, before the article came out!) from the AFA. It covers a lot of the same ground, but makes some really interesting points. Here is the link:


Differing Perspectives article from AFA

Happy reading!