• stress reduction controversy

Stress Reduction Controversy

There is an understandable trend in modern medicine to base treatment on evidence.  Without disparaging the wisdom of this belief, I’d like to add a caveat:

Human experience is complex with many variables that are difficult if not impossible to control for in scientific experiments.

At the same time that evidence-based treatment is held up as the gold standard, much of psychoanalytic research is distained as soft science.  Mind/body research falls in this category.

One thing is for sure: Descartes was wrong.  The mind and the body are not separate entities.  It would be impossible for them not to influence one another.  Add to that, much of what goes on in our minds is out of conscious awareness and the attempt to nail down evidence becomes even more complicated.

Evidence-based research is both useful and not helpful when it comes to infertility.  It is inspirational when you realize that if, as the research has shown, you can rid yourself of migraines with biofeedback by using your mind to control your temperature, it is only a short distance from there to realizing that you may not be helpless when it comes to influencing your fertility.  (Of course this would only have merit if there weren’t structural abnormalities.)  Feeling helpless will certainly contribute to stress.

What’s lurking below the surface, however, are myriad known and unknown components that complicate research’s attempt to establish evidence that stress relief enhances fertility.  The Hawthorne Effect, a known component, is one fly in the research ointment.  This term refers to the tendency of some people to work harder and perform better when they are participants in an experiment.  It also comes into play when individuals change their behavior due to the attention they are receiving from researchers rather than because of any manipulation of independent variables.  An unknown “fly” could be the personal underlying psychological issues which a study would not unravel.  Another hindrance might be the Placebo Effect.

There have been studies that have looked at the role of stress as implicated in a person’s infertility, studies that support the effectiveness of mind/body practices in facilitating pregnancy, and studies that cast doubt that stress reduction can matter.  A commentary appearing in the June 30, 2011 issue of Fertility and Sterility* reports that evidence is inconclusive regarding the questions: “Does stress cause infertility?” or “Does stress relief augment fertility?”

To me, here’s what matters:

  1. If stress plays a role in the etiology of infertility (which has yet to be proven), the important thing is to uncover the source of the stress.  I’ve seen the power of psychotherapy make a difference here.
  2. Having a diagnosis of infertility in and of itself is stressful; infertility treatment increases stress exponentially.
  3. Mind/Body strategies do reduce stress if there is sufficient dedication to practicing them.
  4. Mind/Body strategies can be learned.
  5. There is no down side to managing stress.

I can only say that of the myriad people in more than three decades whom I’ve taught mind/body stress reduction skills, most feel empowered.  I have watched the relief that patients experienced when they realized that infertility can not only be managed, but can also be a crucible that leaves one feeling stronger.  Stress will lessen if you no longer feel out of control.  While the controversy goes on, you can judge for yourself if learning to reduce stress makes a difference.

A full array of mind/body strategies are taught in my book, On Fertile Ground: Healing Infertility. They are easy to learn but sometimes not easy to commit to, especially if you have lived your life as a “type A” personality.  Slowing down might be a problem for you.  Yet, the motivation to have a child can be just the impetus you need to make the changes that can make all the difference.

*William H. Catherino, M.D., Ph.D., Stress Relief to Augment Fertility: The Pressure Mounts, Fertility & Sterility, Vol. 95, No. 8, June 30, 2011, pp. 2462 – 2463.

About the Author:

Helen Adrienne, LCSW general psychotherapist, clinical hypnotherapist, and practitioner of mind/body therapy with a specialty in infertility. New York City