Psychological support during fertility treatment

Struggling to conceive affects the emotional wellbeing of individuals and couples.

We spoke to Tamaryn Spandiel, a clinical psychologist affiliated to Hope Fertility Clinic at Mediclinic Sandton, about the role of infertility counselling.

Apart from being a medical condition, would you agree that infertility is also a social and emotional condition?

Absolutely. Men and woman with infertility difficulties have deep internal [emotional] struggles. Many people socially isolate themselves while going through this journey as they’re often judged for being unable to have children. One patient was told: “A woman’s most basic function is to bear children. So how can you be a woman if you can’t bear any?”. Infertility is unique to each person and can be immensely lonely. People often hide their IVF journey until their pregnancy is “safe”. If you’re facing infertility, it’s important to find the right psychological support.

What are common emotions for people struggling with infertility?

Each person’s process is unique. From my experience some of the most common emotions are anger, rage, hopelessness, sadness, isolation, inadequacy, guilt, and frustration. This is why a therapeutic process is so important for everyone faced with infertility.

How can a therapist help?

It’s vital to listen and be present with the patient in a non-judgmental way. Patients need a space to explore what feels best for them even it goes against religious or societal norms and expectations. A therapist should never impose their personal beliefs or rush the process. Working too fast, or too slowly, can cause distress. I listen to and respect the patient’s boundaries, working at a pace that is comfortable for them.

What process does infertility counselling follow?

The method I use is to work from an analytic framework in which the patient needs to grieve their loss and find their own process of healing. I’m there to facilitate this process, which takes as long it takes. Other therapists use a cognitive behavioural (CBT) framework, which entails working with the patient to set concrete goals and time frames to meet those goals. These are very different processes. It’s vital for a patient to find a therapist who best suits their needs and with whom they are comfortable.

Do you work in tandem with the fertility specialist?

Psychotherapy is a very personal experience so although I’m affiliated with a fertility clinic it’s important to keep the patient’s psychological journey separate from their medical treatment. They must be assured that their therapeutic journey is as confidential as their medical treatment at the fertility clinic. During the fertility process so much is out of your control; your body at times feels like it’s no longer your own. This is why it’s important for the patient to feel in control during their psychotherapy process. It’s also why my rooms are situated outside of the fertility clinic. If anything significant comes up during the therapy, I encourage the patient to share it with their treating doctor. Of course, there are exceptions where the treating specialist needs to be consulted. But this is usually if risk of any kind is involved.

Is there a difference between a couple struggling with infertility versus a single person struggling?

I can’t compare processes because everyone has unique challenges. As infertility affects men and women differently, it’s helpful for each partner to engage in their own therapeutic process. Once they’ve worked through their personal difficulties, it’s easier to then work through their process together as a couple. I always encourage my single patients to build a support network of non-judgmental people. Both couples and single patients often seek contact with others who’ve been through a similar experience of infertility.

How are you affiliated with Hope Fertility Clinic?

I carry out the psychological screening of potential egg donors and provide psychotherapy for various therapeutic needs. For example, when a couple or individual has suffered a bereavement after miscarriage, it helps them to acknowledge and grieve the loss before they try again. I also work on exploring which medical treatment meets the spiritual, emotional, and physical needs of individuals and couples. I chose to affiliate with Hope Fertility Clinic because it provides an intimate experience where patients are more than a number.