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Sunday, September 23, 2012

Are men the silent sufferers of infertility? What can a wife do to make her husband feel better and well-cared for during the infertility struggle?

We women talk a lot about infertility, express our emotions associated with it, cry a lot and as a result get better emotional protection too! I have seen women complaining about their DH (dear husband)’s attitude to their infertility in many bulletin boards. They get lots of comforting words and support from fellow women. But I have never seen any men venting about their infertility struggles, their view of it or how they cope with it. Even my DH never expresses what is in his mind. I want to hear from him how it feels not to have a baby when everyone around him seems to be fathering a child. What does he think when he hears someone in his friend’s group announce their pregnancy? How does he feel when he sees couples with a cute little child? How does he manage when some of his friends just drop in and ask ‘is there any good news?’ These are all grey areas for me. Sometimes when one our friends say that they are pregnant, I tell my DH ‘does it hurt? Do not worry our turn will come too’, he smiles and replies very naughtily ‘when I am not responsible for that pregnancy why should I worry’ :) Although, he tries to make light of the issue for my sake, I understand that it is of course painful for him too!

The intense desire to have children is not just a women thing. Most men like most women love to have children. When a man is with the company of a young child you can experience the tender side of him. We went to India both the times when my little sister had her baby. I was a bit tensed how my husband will handle the situation. I was worried about his emotional safety. How would he react to the presence of a new-born child especially when we are going through infertility? Will he feel uncomfortable? To my surprise, I was amazed by his fatherly skills. He handled the new born with so much care and affection. Sometimes when the little one cries uncontrollably my sister will give the baby to him. He used to hold the baby in a comfortable position and shake him gently; the little one stops crying and goes to sleep within the warmth of his embrace. At those times, I could see his face soften with a motherly affection. Everyone in my home are proud of him but the only soul which is left weeping on seeing all this is me. I know he loves children. Whenever he sees a naughty, young child his face becomes bright with a smile. His eyes would follow the child as long as the little one is within the viewable distance. When he is eagerly looking at the child my eyes will be concentrating on his face trying to read his mind.  I will be caught in a swirl of emotions. My inability to give him a much desired baby strikes me so hard; my eyes will fill with tears unable to bear those emotions. So if someone says that the longing for a baby is a womanly thing and men are unaffected by infertility I can never ever agree with them.

I would like to share one of my experiences with an infertile couple who lives in my husband’s village. They are very young. They do not have children and I happened to hear from that woman (her name is Manju too!) why they are not able to have a child. She said at the age of 23 or so her uterus was removed because of a tumour! I was shocked! I guessed it may have been a fibroid and might be because of an over-enthusiastic or money-minded physician that this tragedy happened. She is not literate enough to explain her actual problem. Then I started to question her further and asked what she thinks about adopting a child. She said, ‘my health is not that great and we do not have good income too. In this situation, I do not want to take any additional responsibility’. She is not crying her eyes out and that is the best thing about village women. They are emotionally very strong and have enormous resiliency. Actually, city-dwelling, very modern, highly educated women are emotionally very fragile! Although the topic is uncomfortable for her she is able to share her opinion with me very matter-of-factly. I insisted that it will be wise to have a child at home as it would bring new hopes into their life and a sense of responsibility and happiness. She said, ‘my husband always wanted to adopt a child but I am adamant and I refused his wish’. This conversation was hard for me too. I started to think about myself and my infertility. I have seen her husband. He comes home very late after finishing his job. I have never seen him stand and talk to anyone. He seemed to be very silent. The next day Manju came to me. She said, ‘yesterday I told my husband what you suggested’.  I said to him that you wanted us to adopt a child. She told me, ‘you should see the glow in his face; he immediately started to talk about adopting a baby. For a long time afterwards, he talked about the adoption topic non-stop’. She continued, ‘he told me that, ‘see how Manju has understood our problem; what she said is very correct’! When we were returning back to Germany, while taking leave from everyone, Manju’s husband was standing at one corner. I will never forget the look in his eyes; the gratitude in them told me what he is going through!

Just because a man is not expressive doesn’t mean he is devoid of all the feelings women claim to possess. Many women tell me, ‘Manju we are women and our heart always yearns for a baby but my husband doesn’t feel like this!’ Can this be true? The problem with us is; the first thing we do when talking about infertility (or for that matter any sensitive topic!) is to cry. It is very uncomfortable for a man to see his wife cry and break down emotionally. A man thinks it is his responsibility to keep his wife happy and when he sees that his wife is not as happy as he would like her to be, he feels very frustrated and his ego gets hurt too. They really do not know how to react to such situations and their silence makes us think that they are cold, unfeeling and uncaring. From an evolutionary point of view, there is one more interesting reason why men can’t tolerate crying spells and high pitched voices. I happened to listen to a psychologist on TV and she was telling ‘if you want a man to listen to what you say, talk to him softly without becoming too emotional’. She also gave a beautiful explanation why it is so! When humans lived in caves, it was the man’s job is to hunt and gather food. Women took care of the children. When a man goes hunting, he has to be aware of all the danger signals around him. He used to listen keenly to the sounds made by wild animals so that he could avoid places which were perilous. He also has to be emotionally strong when he has to hunt animals. His sole intention should be to provide food for his wife and children and he should not get carried away by the pathetic sounds made by animals and their young ones when he kills them. A woman, on the other hand, has to be very sensitive to the cries of her children, so that she can feed them and take care of them well. These differences in their activities can explain why men’s brains and women’s brain respond to the same cues in such a different manner. A man is unable to tolerate high pitch voices as it is like a danger signal for him. The psychologist said, ‘please keep two things in mind if you want a man to listen to what you say-do not raise your voice, and talk slowly so that his brain can imbibe what you are saying. Never cry because it will make him uncomfortable and he will try to move away from that place’. I found that explanation to be very interesting.

When a couple deals with infertility, obviously a man gets hurt too. Fathering a child gives him gratification as it is considered as a proof of his manliness. When infertility strikes a couple and the man realises that he is not able to father a child, he starts to feel inferior. His emotional burden becomes worse if the problem is with his own fertility. He feels that he is less masculine, a total failure and his self-esteem goes down. When his wife does not understand what he is going through, and if she is always crying and complaining, then that just adds to his mental torture. I know women who break down in front of their infertile husband and cry thinking about a baby. Is it wise to do so? Have you ever imagined what kind of mental pressure you are subjecting your husband to? When your husband is the one who is having an infertility problem, as his wife, it is your greatest responsibility to make him feel comfortable. But many women fail to give the much needed intellectual and emotional support. When his wife is crying because she cannot have a baby and when a man senses that it is his inability which has caused such suffering to his wife, he naturally goes to pieces. Women have many ways to relieve their infertility related stresses. The best support a woman gets during infertile times is from her mother. She vents out whatever she is undergoing (physically and emotionally) with her mom. When I talk to my mom I have no inhibitions. I have no fear that I will be judged wrongly. All my mental stress clears quickly if I talk to her. But for a man it is impossible to get such emotional support. As a man grows older, he no longer feels comfortable sharing his emotions with his parents like a woman does. Since men are looked upon as being the stronger sex, crying or expressing emotions like a woman is considered to be a sign of his weakness. Hence he maintains his silence and suffers within himself. When a couple faces infertility, the man’s parents also tend to react differently to their daughter-in-law. As a result the connection between the man’s parent and his wife becomes strained. This makes a man’s condition even worse. He is caught in the emotional drama between his parents and wife. This makes him retract from his parents too. Infertility somehow pushes a man’s parents and siblings away from him. This is why coping with infertility can be so much more difficult for a man than for a woman! He is forced to bury himself in his work and pretend that all is well, even though he may be bleeding inside.

Many infertile women behave in ways which can make the life of their husbands a living hell. The first mistake women make is to submerge themselves within their sorrow. They tend to obsess about a baby all the time and they forget all their day to day duties and happiness. It’s very hard for a man to deal with his wife’s crying spells – especially if he loves her. While he can handle his personal pain stoically, seeing his wife suffer leaves vulnerable and heart-broken. Infertility also kills the sex life of couples. It turns a pleasurable act into a ritual which is done only for the sake of a baby. For a woman, the best sex stimulation centre is her brain. When her brain is too occupied with infertility and making babies, the act of making sex becomes very difficult. Women have high libido, but they desire sex only when all the conditions are just right! For a man on the other hand, sex can be like soothing medicine for all his troubles and frustration. This difference in the mental make-up between men and women also adds to the problem. When physical intimacy is denied, a man feels that the emotional bonding with his wife is lost. This further adds to the problem. His only solace during infertility, his wife, seems to move away from him both physically and emotionally. He stops sharing his pain with his wife because he is scared she may break down emotionally. After all, isn’t he meant to provide her a shoulder to cry on? If he starts crying as well, how will she cope?  This makes the situation much more complicated. The other mistake most women tend to do is to talk about her husband’s infertility to her parents. I have seen this happen in many families. The woman’s parents are very happy to tell everyone that their daughter is super fertile and the lack of a baby is due to the problem with their son-in-law (it is actually the fear of social stigma that makes them behave this way!) Sometimes I wonder how ignorant and self-centred people are! How could they even talk about such things without any guilt? Isn’t it the duty of the wife to safeguard her husband’s self-esteem? If a couple faces infertility, is it necessary to reveal whose problem it is? Is it really anyone else’s business? As a couple, doesn’t infertility affect both of them equally? Playing the blame game is emotionally destructive!

Men and women have different coping styles in response to stressors. This may add to what is an already stressful time. Even though men desire to have children , they are usually not afflicted by the “babylust ” which strikes women. They tend to analyse the situation rationally and might have a clearer dispassionate view of the problem .  On the other hand, a woman’s intuition is stronger. Instead of being adamant about your own viewpoint, it is much wiser to work as a team. A baby is not the only solution to the problem of infertility ! You might one day find yourself in a situation where you have to decide when to give up all the draining infertility treatments, stop trying to conceive , and get on with your life. This kind of end to your infertility journey can be very hard for both of you , especially if you do not have alternate plans. So it is always wise to keep other options like child-free living and adoption open. When your husband talks about these topics , try to listen to him patiently and give your views about it. Do not react to such talks with an emotional outburst. If you do so then that will be the end of a rational discussion and this will in turn leave your husband in ambiguity and uncertainty. He will be totally confused how to deal with your emotions. Achieving an emotional closure and moving on with your life is very necessary if the infertility treatment does not work. As his wife it is your duty to provide him the opportunity and space to do so. Chronic grieving can lead to significant psychological damage to you and your partner. Your relationship will get adversely affected as a result of this. If you want your marriage to withstand the tests of time you should learn to weather the storm of storm by climbing the peaks and valleys together. I have seen many infertile couples do this successfully. Caring enough to bring out the best in each other, and wanting his happiness even above yours seems to be the key! Many men when faced with infertility tend to divert their attention to their career and try to excel in it. Support your man during such times and see his self-esteem grow. This will also give you immense happiness. Many infertile women tend to think that their happiness is solely dependent on a baby and as a result tend to suffer and make their man suffer too. Remember “The foolish man seeks happiness in the distance, the wise grows it under his feet”.

When you are tackling infertility, provide emotional support for your husband. Having a rational discussion about your infertility will provide your husband with confidence and strength because he is reassured that you have a mature sensible outlook; can cope well; and have realistic expectations. Crying might give you relief, but, when you make it a habit to cry and get depressed every time the topic of infertility springs up, you will end up making your husband miserable as well. It is not wise to complain about his parents all the time. Just like you need your parents when you are in distress, he needs his parents too (whether they are good to you or not doesn’t matter!). Even though he doesn’t express himself to his parents as you do, he will feel emotionally comfortable if you maintain a good relationship with your in-laws. Taking care of his physical needs will make him feel more secure and cared for. Sex helps to provide emotional catharsis and improves bonding. This helps you as well. Remember that a man’s ego is fragile and it is in your best interests to make him feel strong and comfortable! If your husband is suffering from infertility never discuss it with anyone else - especially not with your parents (if they will go around spreading the news to everyone!). Remember, just like you are his better half, he is your better half as well, and hence infertility cannot be an individual’s problem! Tackle the situation wisely so that your relationship becomes stronger during the crisis of infertility!

Monday, September 10, 2012

How to acquire emotional resiliency in order to cope with the IVF roller coaster ride?- Part II

You can read the first part here.

9)      Stay connected

Many people tend to do this mistake – they start shrinking within their shell because of infertility. They tend to avoid social gatherings. They even avoid meeting their close friends and relatives. This kind of social isolation can only do you more harm than good. While you believe that you are protecting yourself from emotional assaults, long term social isolation can cause chronic depression, increased stress levels and impaired decision making. Being isolated can give rise to a variety of negative emotions. All these can cause significant harm to your mental strength when undergoing IVF journey.

10)   Be kind to yourself!

Be empathetic, kind and compassionate to yourself! Infertility can make you feel worthless, defective, and unloved. There are women who lose all the interest in life’s day-to-day activities and brood on their misfortune. Actually, the common misconception is infertility medicines will make you to gain weight. But the truth is that the stress and depression you are going through causes you to eat more and exercise less and it is this which causes you to put on weight. Infertility is not your fault. An IVF failure is not your fault. Stop blaming yourself and start living! Cultivate healthy food habits. Turn to good books. Take care of your mind and body. Learn something new. Engage in something which will make you feel worthy and important. Only when you love yourself will you respect and nurture your mind and body, so that it is prepared for the struggles you may have to go through. When you are kind to yourself, you will feel physically and mentally strong. This will make you resilient enough to face the IVF journey.

11)   Be Philosophical

Being philosophical helps you to find positive meaning in life, even when faced with difficult or traumatic events. When you start to analyze and interpret the happenings in your life rationally, you will start to view things differently. You will develop resilience when you start thinking better. Remember, it’s not what happens to you, but how you react to it that matters. The way you think determines how you react to a situation!  This IVF journey has helped me to understand certain philosophies of life which I wouldn’t have learned in such a short time period, and at such a young age!

  •                I have learned that creating a life which is perfect in every way is not easy. I myself am a miracle and I should learn to appreciate and respect the life I was given and be grateful for my blessings!

  •                I have learned that being good doesn’t guarantee a struggle free life but good people learn to handle their struggles in a better way without becoming bitter!

  •              I have understood that even the most difficult times cannot take away the happiness from you unless you yourself decide to let it go!

  •                 I have learned that struggle is what makes you and keeps you human!

  •             I have learned that infertility doesn’t kill you; it only serves to make you stronger, if you don’t allow it to weaken you.

  •              I have learned that it is only the everyday small happinesses in life which matter - nothing else does!

  •            I have learned that a failure teaches you many more valuable lessons in life than success does.

  •  .            I have learned that if you enjoy the best times of your life, you are also bound to accept the hard times too!

Developing these positive philosophies in your mind despite your difficult situation will help you to be cool-headed. This in turn will help you to tackle the other hard times you are sure to encounter in your life! Treat your IVF journey as a learning experience, which will teach you to become a better human being!

12)   Turn to spirituality

Being spiritual helps us to accept life as it is. When you have faith in a higher power, you tend to let things happen, rather than strive futilely to make things happen. This removes the stress from your mind and you become more philosophical in your thoughts. You will realise that a lot of what happens in your life is not in your hands; and you learn to wait patiently, so that it will happen in its own time. When you stress yourself by assuming that the only acceptable outcome of an IVF cycle should be a baby, then you are prone to suffer if the cycle fails. Instead, if you believe that God will give you a baby when the time is ripe, you are much more likely to bounce back from the depression of a failed IVF cycle. Spirituality also keeps you connected with other people, because you go to religious places, meet people, and exchange your beliefs, happiness and struggle. This in turn increases your coping skills. When you are spiritual, you aim to live a life filled with love, compassion, forgiveness, hope and inner-peace. Spirituality is usually connected to God or religion but you can lead a spiritual life without depending on these concepts, because spiritualist has to be internal! However, do remember that while spirituality can greatly enhance your emotional resilience , there are certain religious practices which end up instilling guilt, self-pity and unnatural expectations! This can destroy your peace of mind and self-confidence. So beware of the dangers in your religious practises as well!

13)   Help others

Helping others is the best way to help yourself, and is also the best way to build your emotional resilience! Extending a helping hand to people going through infertility has helped me a lot with my personal infertility struggle. Through this blog, I frequently hear from people who are kind enough to say that my writings give them hope and strength. When I talk to them, hear their struggles and heartbreaks, hopes and aspiration I get a lot of strength, because I realise that I am not alone. When I use the knowledge I have gained during my IVF journey to guide them through the infertility maze, I get a lot of personal satisfaction. This gives me a high which provides me with a boost to help me cope better with my daily tribulations. When I was confronted with infertility soon after our marriage, I was ignorant about everything. There was no one to give me sorely needed information and hope. I was afraid to talk about it to anyone. There were days I felt gloomy and fearful. There were times when I used to think, ‘How nice it would be, if there is someone who could sit and talk with me, and guide me through this’. Because of all the suffering I went through, I know that people experiencing the crisis of infertility need emotional and intellectual support. When I provide it to people who are in a similar situation like mine, I feel I am helping myself! I have learned to help, not because I know a lot but because I know exactly how it feels to have no knowledge about infertility! When I guide others I feel I am doing something worthwhile and it increases my self-esteem several fold. It also shifts my mind from thinking and obsessing about my own infertility. I feel more confident and my ability to cope with infertility related stresses have increased because of this. Everyone can help someone else! Share what you have (money, knowledge, and kindness) with people who need them the most. The best help you can do to someone is to spend some of your valuable time and to lend an ear to their sufferings. When you help others your own miseries take a back seat in your mind and your self-esteem increases. A high self-esteem is necessary for a good mental health and a healthy mind can cope with the adversities of an IVF cycle much better!

14)   Ask for help! 

Along with helping others, getting help from others will also help in building your emotional strength when going through an IVF cycle. When you are in fear and pain, every small problem you face appears to be big and unsolvable. Talking to someone who has gone through what you are going through helps a lot. When starting an IVF cycle, everything appears like a puzzle. You will be scared about all the injections you take and the medical procedures you go through. You will be scared of your doctor and all the medical jargon he uses when talking to you. You will be petrified that your IVF cycle may fail. You will also have several questions in your mind-what to eat, what not to eat, how long should I rest after embryo transfer, will not taking rest affect my chances of success, will stress cause my embryos not to implant  and so many more. The best way to feel better and stronger emotionally is to talk to someone who knows the procedure well. This will put your mind at peace. Your doctor may well be the best person to talk to, but unfortunately doctors do not have time to answer all your questions. Infertility bulletin boards are full of knowledgeable ladies who will help you with all the questions and fears you have. If you write to me, I will be happy to help you as much as I can.When going through an IVF cycle do not hesitate to ask for help. Remember, when you take help from someone else, you are helping that person too!

15)   Start with a clean slate

Have a clear mind and clear thinking - this is the most important requisite to keep you strong and sane when doing IVF. By the time you start IVF, you would have been tormented enough with your infertility struggles. This might have turned you into a very different person (bitter and suspicious). You might have lost faith in almost all the medical procedures used to treat infertility - and may not trust doctors either. When you start an IVF procedure, you should have faith in that medical procedure, you should have faith in your doctor, and you should have faith in yourself! But most people start the procedure with many uncertainties in their mind, and the scientific complexity combined with the enormous cost of the IVF procedure magnifies their doubts. Instead of thinking - I am going through a procedure which will give me the best chance of having my deeply longed for baby, many start thinking – is this doctor doing his job right? Will he steal my eggs or embryos and sell them? What if this doctor causes my cycle to fail because he is careless? Is he crooked? What if he doesn’t transfer the embryos, because he wants to make me come again and again for money? I have failed so many times in my attempt to conceive a baby, will this IVF cycle ever work? etc. If you are a person who is prone to think like this, the entire IVF procedure will be like a torture for you. When you carry an aura of negative energy around you, you tend to repel all the people who are important for your mental and physical well-being. To add to the insult, if your IVF cycle fails, you tend to blame everyone and everything for your failure. You will not be able to accept the failure with a strong and calm mind. The end result will be depression, disbelief, anger, and self-pity. When going through an IVF cycle, forget your past bitter experiences with infertility. Do your homework sincerely, so you can select a competent clinic. Select a good doctor. Once you do so start your IVF procedure with a clean slate and happy mindset, do not allow your mind to play games with you.  It is OK to doubt, but do so only when you have solid proof.  It is wise to believe than to live in disbelief!

16)   ABC model of Rational Emotive Behaviour Therapy

Recently I was introduced to a book called ‘A Guide to Rational Living’ by Dr.Malpani. It teaches readers to recognise the impact of their thought processes and beliefs on their emotional well-being. The fundamental concept of the book is that our emotions are the result of how we respond to an adverse event, and not the event itself. If we can change our beliefs, we can change the way we feel about the event too! Albert Ellis, a trained clinical psychologist and the author, proposed the ABC model of REBT. This model helps us to make sense of our problem and deal with it effectively. For example, what kind of beliefs do we accumulate when an IVF cycle fails and how does this affect us? And how can we change the way we think, so that we feel better?

Adverse eventIVF failure

Beliefs I am a total failure. I will never have a baby. While everyone around me gets pregnant easily, I am cursed to suffer like this.

Consequence Depression, poor self-esteem, lack of self-confidence

But if you train your mind to think in the following way after an IVF failure, you will feel much better and will gain the ability to bounce back quicker and stronger.

Adverse eventIVF failure

BeliefsA failed IVF cycle is painful but it is not my personal failure. I have done my level best and I should be proud of myself for going through this difficult procedure. The success rate per IVF cycle is only 40%. If this cycle doesn’t work it doesn’t mean I will never be able to conceive using IVF. There are many women who have succeeded after many IVF failures. I still have bright chances to get pregnant in my next cycle. It is true that many women around me get pregnant easily, but everyone has their own suffering to go through. Is there anyone in this world without suffering?  My challenge in my life now is to conceive a baby. I will go through this struggle and try my level best to succeed in my quest.

ConsequenceEmotional resilience, renewed hope, confidence and increased self-esteem.

So, try changing the way you think about an IVF failure. This will help you to gain immense emotional strength!
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