Infertility is often referred to as a “struggle.” But unless you’ve gone through it, you may not understand just how traumatic it can be. There’s the demoralizing diagnosis, the enormous cost, the invasive procedures, the constant fear that it might not work, and, for some, repeated loss. Your hopes are dashed over and over. You and your partner start fighting more, or you just can’t seem to connect. Together, all these factors make up the hidden trauma of infertility.
First, let’s clarify that the trauma is real. In a recent study, researchers found that 41.3% of women going through infertility actually met criteria for post-traumatic stress disorder (PTSD)(Roozitalab et al., 2021).
When you experience a traumatic event, your body becomes more alert and on edge. You may pull away from triggering places or people. It may feel safer to isolate or numb out.
But the best thing you can do is open up to your partner so the two of you can lean on each other through this challenging journey.
The trauma of infertility shakes up your relationship
Infertility is experienced differently for women and men.
In many ways, the burden of infertility is placed on women. Despite the medical cause of infertility being fairly equally split between genders, the first impulse is to assume the woman cannot bear a child (Brigance et al., 2020). Women are also the ones who most often must undergo invasive treatment. This can lead to feeling angry, anxious, depressed, and ashamed.
In contrast, throughout the infertility process, many men feel left out. They feel disconnected, or helpless, and ignored in their pain. And yet, they feel the need to be strong for their wives. They may want to fix the problem and feel angry that they’re unable to do anything.
If the diagnosis is male factor infertility, men too may feel depressed, emasculated, and ashamed.
Very often, though, partners have a mismatched response to trauma. And in it, they lose each other.
In such a poor emotional state, it’s hard to be vulnerable with your partner. It’s hard to come to the relationship feeling positive about yourself, desirable, capable, and able to support your partner.
Instead, fertility treatment becomes the focus of the relationship.
Now your sex life is disrupted, it’s become mechanical. You’ve lost the feeling of bonding through sex since it’s now a responsibility to fulfill, and you don’t feel great about yourself anyway.
Beyond sex, there’s the other big cause of arguments: money. All these treatments and specialist appointments are a huge drain on your wallet. And nothing stresses couples like money.
The trauma of infertility can be sneaky and deceptive. Although it’s the major reason for your change in mental and emotional state, and the change in how you interact (in the bedroom and outside of it), you may not recognize infertility as the cause.
Infertility trauma as the “elephant in the room”
Researchers have described infertility is an “invisible” trauma (Brigance et al., 2020). It swoops in and subtly destroys your self-esteem, your hope, your connection to your partner, and even your joy in everyday things.
This trauma of infertility is felt but perhaps not understood by you and your partner. You’re too caught up in the pain and isolation of it all.
Unfortunately, being emotionally alone in your pain can compound the trauma. That’s why it’s so important to maintain your connection with your partner.
Why your partner is your biggest support through the trauma of infertility
When you’re under a lot of stress, like infertility diagnosis and treatment, you have an even higher need to connect with your partner (Koser, 2020). You need the comfort of their presence and engagement, and you need their support to remind you that you are valuable and lovable, and that there’s hope.
If your partner is emotionally available and responsive, you will feel soothed. On the other hand, if your partner doesn’t respond to your emotional needs, you will feel abandoned.
Research suggests that couples recover better from the trauma of infertility and have higher marital satisfaction when their relationship is secure and they feel well connected (Koser, 2020).
A close, secure bond is the best way to calm jittery nerves. And an intimate and close relationship is the best way to deal with stress and trauma of infertility.
Where struggles arise between couples
Of course, couples struggle to communicate in the face of overwhelming feelings. Infertility leads to intense emotions like anger, shame, hopelessness, and fear which negatively impact communication.
At this point, instead of talking about their underlying fears and hurts, partners blame each other. You end up disconnecting at the time you need each other the most.
Couples get stuck when one partner closes off or pushes away and the other partner pursues them out of fear and anxiety.
For example, when a woman is scared, her emotional heat rises. She goes after her partner, wanting reassurance. If she can’t find him, if he is not emotionally responsive to her, she becomes louder, perhaps even accusatory. Her partner avoids the emotional heat by shutting down. He thinks he is avoiding conflict by not talking to her, but the more he shuts down, the louder she becomes. And on and on it goes.
What drives these behaviors is something psychologists call “attachment needs.” If you feel securely “attached” or connected in your relationship, you will find your partner when you need them. You won’t feel the need to turn away to avoid your partner or get angry and loud when you can’t find them. And together you’ll be able to meet the crisis head on.
If your attachments are insecure, that’s where this vicious cycle of pursuit and withdraw becomes a problem.
One fertility counseling specialist explained, “couples run the risk of turning away from their partner…and further escalating the heightened experience of loss and disconnection they are already feeling from each other, those around them, and their body”(Koser, 2020).
Couples dealing with the trauma of infertility together
Couples therapy can help you and your partner find and maintain connection (“secure attachment”) and deal with the trauma of infertility together.
Particularly, couples therapy for trauma can be an important way to recognize how infertility has affected your lives and bodies. It can help you create a safe space together to reveal how vulnerable or afraid it has made you feel. And it offers you and your partner the guidance you might need to express yourselves and reconnect after feeling so overwhelmed by big emotions.
A strong relationship with your partner has been proven to reduce feelings of pain and hopelessness(Coan et al., 2006; Greenman & Johnson, 2012). Even after a trauma like infertility or miscarriage, that relationship can be your biggest source of strength.
Researchers have studied a particular style of therapy called Emotionally Focused Therapy (EFT) for couples experiencing infertility. They’ve found that EFT helps reduce the rate of depression, anxiety, and stress for the partners, as well as increases marital satisfaction (Najafi et al., 2015; Soltani et al., 2014). Through EFT, couples begin to process their experience together, express empathy for each other, and become more securely attached (Brigance et al., 2020).
About Dr. Irena
Dr. Irena is a licensed psychologist and certified Emotionally Focused therapist with over 20 years of experience. She uses EFT to help couples support each other through the trauma of infertility. She offers online therapy for women and couples in Houston, the Woodlands, and New York City.
If you would like to schedule a session, email Dr. Irena for a free 10-minute video consultation: firstname.lastname@example.org or call (281)-267-1742.
Brigance, C. A., Brown, E. C., & Cottone, R. R. (2020). Therapeutic Intervention for Couples Experiencing Infertility: An Emotionally Focused Couples Therapy Approach. The Family Journal: Counseling and Therapy for Couples and Families.
Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: social regulation of the neural response to threat. Psychological Science, 17(12), 1032-1039. https://doi.org/10.1111/j.1467-9280.2006.01832.x
Greenman, P. S., & Johnson, S. M. (2012). United We Stand: Emotionally Focused Therapy for Couples in the Treatment of Posttraumatic Stress Disorder. J. Clin. Psychology: In Session, 68, 561-569.
Koser, K. (2020). Fertility Counseling With Couples: A Theoretical Approach. The Family Journal: Counseling and Therapy for Couples and Families, 28(I).
Najafi, M., Soleimani, A. A., Ahmadi, K., Javidi, N., & Kamkar, E. H. (2015). The Effectiveness of Emotionally Focused Therapy on Enhancing Marital Adjustment and Quality of Life among Infertile Couples with Marital Conflicts. International Journal of Fertility and Sterility, 9(2), 238-246. https://doi.org/10.22074/ijfs.2015.4245
Roozitalab, S., Rahimzadeh, M., Roghieh Mirmajidi, S., Ataee, M., & Esmaelzadeh Saeieh, S. (2021). The Relationship Between Infertility, Stress, and Quality of Life with Posttraumatic Stress Disorder in Infertile Women. Journal of Reproduction & Infertiity, 22(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669410/pdf/JRI-22-282.pdf
Soltani, M., Shairi, M. R., Roshan, R., & Rahimi, C. R. (2014). The impact of emotionally focused therapy on emotional distress in infertile couples. International Journal of Fertility and Sterility, 7(4), 337-344.