Husbands are certainly affected when unexpected fertility challenges arise. Here’s one husband’s story…
David* pulled on his designer tie, loosening it two inches as he settled into my couch. In the five sessions since he began psychotherapy, I came to recognize this cue as a signal he was ready to emotionally open up. Outside of the treatment room, he was a finance guy who relies on numbers to make sense of the world. Unfortunately, no mathematical formula could help him process his feelings around his unexpected fertility challenges.
How he arrived in therapy
The therapy began at the insistence of Ariel, David’s wife of five years. They had been trying to conceive for over two years. She appreciated his warmness and support, but she was concerned he was not dealing with his own emotions around their increasingly invasive fertility treatments. After countless unsuccessful procedures with assisted reproductive technology (ART), they were about to begin their third round of IVF. This time, the doctor recommended a more rigorous protocol with ICSI with genetic screening. He felt confident in moving full steam ahead in the medical milieu, but he expressed ambivalence around engaging in psychotherapy treatment. He presented compelling evidence to rationalize he was too busy to focus on his mental health. After unpacking his resistance he agreed to fully commit himself to at least 10 sessions.
Unfortunately, no mathematical formula could help him process his feelings around his unexpected fertility challenges.
A treatment goal
Each time David loosened his tie to signal his emotional readiness, it confirmed my hypothesis that he had awareness of his feelings but trouble verbalizing them. He presented a condition commonly seen in male patients known as alexithymia, a difficulty in identifying and communicating feelings. The primary treatment goal became helping him build an emotional vocabulary that would help his ability to express his psychological states. By strengthening his emotional attunement, he could more successfully identify his genuine needs and find more effective coping mechanisms.
We processed his wish to be able to relieve Ariel’s fertility frustrations and suffering, and recognized how this unrealistic expectation left him feeling powerless and impotent. He grieved the loss around not getting her pregnant in the traditional way. He struggled with his guilt around feeling upset that the embryos were not implanting in her body, even though intellectually he knew it was not her fault. We focused the work on improving his self-compassion and dialing back his self-criticism and judgment.
We recognized how this unrealistic expectation left him feeling powerless and impotent.
A weight lifted
During one session David revealed that his close friends knew he wanted children, but they never directly asked him how he was emotionally. He decided it was safer to repress his feelings than expose his vulnerability. Below the surface, he realized he craved more support from his buddies. Davis was feeling resentful and unconsciously pushing them away. As he worked through this inner conflict, he accepted that not all of his friends could fulfill his needs right now. Instead, he identified one close friend to whom he could reach out. In the next session after making the disclosure, he described feeling like a weight was lifted from shoulders. He felt liberated that no longer needed to hide this part of his life.
Ariel & David, together
The role of communication continued to play a valuable part in our work. As a psychotherapist, I believe all people are part of an interconnected system. After several weeks, Ariel joined us for a collateral session. The purpose of her visit was to help David offer insight into her feelings around their struggles. During this powerful session, they shared in each other’s distress and sat with their sadness and pain. Together they reflected on the importance of validating their feelings, even if they did not personally feel justified. I confirmed that sometimes emotions are not logical.
David’s treatment has now exceeded 30 sessions and the therapy evolves as their fertility treatment intensifies. He is still working to carve out space for his stressors and is trying to integrate them into his daily life. By deepening his insight into his authentic feelings, he is becoming better at making emotional choices that reflect his genuine needs. David tries to be more present in his relationship, but when he is unable to fulfill this goal, he reacts with patience and compassion. He accepts that even though they are experiencing the same stressor, they are entitled to their unique emotional responses. Finally, he tries to balance his sadness with resilience. He knows life will never be free from challenges, but through therapy, he is better equipped to deal with them.
*David represents a composite of patients, however, name and personal details have been changed to protect confidentiality.