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Archive for: self-awareness

Nature Loves the Truth

Would an orchid keep its bloom in a closet without water, fertilizer, or exposure to the light of day?  Would a palm tree last very long in Siberia?  Could a herd of elephants sustain itself in a concrete jungle?  Doesn’t Mother Nature demand that each form of life live according to a certain set of built-in truths or risk death?

What are the truths which control our human species?  Of course, there is the basic need for water, food and shelter.  Given the unity of body and mind, our physical needs slide over to a psychological realm where we aim to thrive, not only survive.  There is a vast array of emotional responses which reflect the experience of living in a human body, running the gamut from ecstasy to despair.  It is my belief that our nature is most at equilibrium if what we feel and what we show – to ourselves – are in sync.

Some emotions are easier to experience than others.  Our capacity for denial and suppression allow us to manage our emotions to a certain degree.  Sometimes we use denial to the hilt.  Sometimes this capacity for denial saves our lives.

But when we are stressed to the max, as is the case with infertility, if denial is not helping you, could it be hurting you?  I am not talking about denial of the infertility.  I am talking about denial of the feelings which cannot help but be evoked when something as profound as procreation is at stake.

How does one square denial as a bona fide coping mechanism against a “nature loves the truth” postulate?  This story is illustrative:

I was working with a woman who became a convert to the power of emotional truth.  Let’s call her Jane.  Jane was relatively sophisticated and understood that emotions land in the body in the form of symptoms, and that symptoms are the body’s wisdom trying to grab our attention.  She had a pain on the left side of her neck which was unresponsive to Advil, heat packs, ice packs or yoga stretches.  Deep tissue massage had given her relief, but shortly after getting off of the table, her neck went back into spasm.

She came in for a session totally frustrated.  I gave her a paper and pen and asked her to “journal,” stream of consciousness style, while I remained quiet.  I wanted her to be in touch with herself – in touch with her truth.  She wrote and wrote and suddenly looked up at me as if she had seen a ghost.  I asked her what had just happened.  She said that she had found herself writing about Mary who was a real “pain in her neck.”  She had not thought of her friend in this way, but when she wrote this, her pain went away.  Nature loves the truth.

Of course, the problem with denial is that it can be out of conscious awareness.  This notwithstanding, nature has a way of poking at our body, hoping that we’ll respond to the invitation to “get it.”  Jane was not going to get relief from her discomfort until she allowed her body to teach her how she was feeling.

Infertility is “treated” by the medical community on the basis of what scientific evidence is revealed by blood tests, sperm tests, post-coital tests and surgery.  That is fine and dandy.  Many grateful moms and dads are pushing strollers around because of the sophistication of modern medicine that seems sometimes to border on science fiction.

But for you, the patient, it’s only half of the story.  Stress levels can interfere with a logical conclusion to this approach.  It opens up a “treatment” approach to unexplained infertility, doesn’t it?  It also allows those with a clear diagnosis to “participate” in their medical care.  In both cases, self-awareness can make the difference between conception and disappointment.  I’ve seen it!

If in Jane’s case, the pain in her neck resolved when she identified the “truth,” imagine your power to contribute to the resolution of your fertility challenge.  This does NOT mean that your infertility is your fault!  It does mean that you can suspend the horrible feeling of being out of control and participate in discovering the truth of what you are feeling that, as they say, can set you free.

Excerpt from, “On Fertile Ground: Healing Infertility”

The following excerpt from my book speaks directly to those in an infertility struggle, but keep in mind that the tenets apply no matter what adversity you might be dealing with.

by Helen Adrienne, LCSW, BCD
Chapter 10
Gain from the Pain:
Would You Believe There’s an Upside?

So what do you stand to gain by suffering through the delay in getting your baby?  Your cheerleaders, who are on the other side of the infertility battleground, are eager for you to know what the experience meant to them so you can hang in there.  This book has been, among other things, an invitation for you to ponder how this experience could turn out to have been surprisingly beneficial.  Read these stories.  Which resonate?

Growth from adversity always involves coming to terms with something that you would never have chosen.  Looking for what is to be gained from any adversity is not what concerns you at first and may even annoy you.  But it is a way to assign meaning to your life and avoid living with bitterness.

Not Just Strength but Inner Strength

When I was a little girl my grandmother used to use an expression that I did not connect with at first.  She would say, “You should do such and such – it will put hair on your chest.”  Hair on my chest?   I was preoccupied with the not-so-hidden message that she thought it was better to be a man.  Eventually I understood that she was saying more than that.  She apparently thought that men had a corner on the strength market.  On another level, ‘such and such will make you strong’ was the communication I was supposed to derive from her words.  There are other less judgmental expressions of the “what doesn’t kill you will make you strong” ilk.

The issue is not just about getting strong.  It is about feeling strong, owning the strength that can build in the face of challenge.  The life force, the Popeye Effect, whatever you want to call it, is a hard-wired aspect of our nature.  It is just there, but some of us are more purposeful about developing it than others.  Developing inner strength can be both a conscious and an unconscious byproduct of adversity.

Melissa, an artist, put it this way: “If it had not been for this amazing challenge in my life, I would still be afraid of the great unknown and would wonder if I had the balls – I mean ovaries – to get through it.  I now know that I can and will get through anything.”

But some of us are born into environments where developing inner strength is not encouraged and may even be discouraged.   This kind of environment can rob us of the drive to feel and use our capacities, leaving us likely to form an inaccurate picture of ourselves.  Personalities, or aspects of our personalities, get formed around distortions.  When adversity brings us face to face with ourselves, we have a chance to course-correct.  All of us get tossed around by life.  As Gilda Radner once said, “If it ain’t one thing, it’s another.”  My point is that with awareness, if our sense of ourselves has gotten distorted, we can set the record straight.

Self-awareness can open us up what needs to be changed and your resolve to work toward change can be fortified.  And as you continue to navigate turbulent waters, self-awareness can bring you to a realization of what has changed due to your efforts.  Reveling in the self-awareness that develops cannot help but call attention to increasing levels of inner strength.  In the process, we stand to discover or rediscover who we were really born to be and as a consequence, connect with our in-born authenticity.  Inner awareness and inner strength make for a wonderful partnership and form the substrata upon which gains from pain accrue.

The Heart of the Matter

Seeking authenticity or connection to your in-born realness does not mean that you have been inauthentic.  It just means that the lessons that come from the impact of unavoidable stress give us a chance to evaluate what feels right and what does not.  It is up to us to recognize and honor the messages which bubble up from the inside.  Honesty about aspects of our life style which are not working or facing stress warning signals are gifts if you let them be.  Recognizing these messages can be challenging.  They can be quite subtle.  Sometimes we don’t have access to our true selves.  Sometimes our suffering can block access to hearing that inner whisper.  Sometimes we don’t hear what is coming from within even if it screams at us.  As Oscar Wilde once said, “Some of us trip over the truth.  Most of us get up and keep going as if nothing happened.”

Realness is simple when we are infants.  When we are hungry or uncomfortable, we scream.  When we are afraid, we scream.  When we are content, we are free to vocalize and play with abandon.

As we get older, with years of experiences stamped on our templates, that inner knowing and freedom to express how we feel can get glossed over.  The infertility diagnosis all but guarantees that even those of us who are usually in touch with what we are feeling, get bumped off track.  Now you have a chance to quiet yourselves, the better to learn to hear or see or feel – and trust – the whispers or shouts from within that can put you back on track.  You will feel the resonance of you truth if who you are is congruent with where you are going.  The synopsis of how others gained from their pain can be a beacon shining on what you can gain as well.  Read on.

Ellen’s Gains

Ellen, a photo editor, called me when I had already written seven chapters of this book.  “Was it too late to participate?” she asked.  I gladly set up an appointment to speak with her.

When I opened the door, I noticed immediately how well she looked.  Her facial features were soft and relaxed.  Her twin son and daughter were 14 months old and she was back to her very challenging job.  Yet she looked younger than her 42 years and younger than she had looked when she was in the midst of the infertility crisis.

Ellen told me that she had a breakthrough moment recently which made her say to herself, “Oh my God, I want to contact Helen and be a part of her book.  All of a sudden, I realized that I am using all of these things that I learned.  I’ve grown from this experience.

I realized the incredible joy that has resulted from our pursuit of this goal.  It is a miracle.  Miracles are possible if you really set your sights on them.  I am joyous every minute that I’m with the babies and never forget that feeling when I am away from them.”  No wonder she looked so good.

This breakthrough came at a point in time when Ellen had been feeling stressed and tired from her two full time jobs – work and motherhood.  She felt jubilant to realize that not only did being a mommy bring her to a place where joy, all kinds of joy,  were central to her life, but she now was realizing that she had the tools to apply to this next challenging phase of her life when the combination of parenthood and professionalism intensified demands on her.  When she realized that the self-awareness tools she had learned and used to get through the infertility crisis were the tools she could recruit now to deal with her new life stressors, she called me immediately because she wanted you, the reader, to know it.

In her twenties and again in her thirties, Ellen had participated in Outward Bound.  They had been the biggest challenges of her life.  Now she understood that infertility “was like Outward Bound in that it strips you to be face to face with yourself and shows you your inner strength.  I now know that infertility was the biggest Outward Bound of all.”  I might add that it can also be the biggest inward bound experience if you let it.

Ellen also wanted you to know that “when you are at the beginning of any challenge, it is never obvious which path you should take.”  She began her quest to parenthood at 39.  Herbs and acupuncture did not bring her FSH down.  Clomid and inseminations got her nowhere.  Ultimately, the third Reproductive Endocrinologist and the second Ovum Donation cycle was when she hit the jackpot.  Her babies were born when she was 41.

Authenticity for Ellen cuts a wide swath.  It resides in the awareness of her inner strength, in an unshakeable resolve to do everything possible to get to any goal, and in never letting herself move very far away from experiencing joy.  Along with joy has come an intense love. This struggle really opened her heart to the babies and her husband in ways that had been unimaginable.

Ellen also takes great pleasure in the awareness that her level of self-esteem has risen.  She has achieved a belief in herself and a faith that if she needs help, she can get help.  If she has one regret it was that she did not reach out to me for emotional help sooner, now thinking that the struggle might have been shorter.

An important aspect of living from a place of authenticity for Ellen that she wanted to be sure I shared with you, was the importance of acceptance.  “I realized along the way,” she told me, “that people who are successful don’t keep trying to do something the same way when it doesn’t work.  I had to step back from myself and look at the bigger picture with flexibility.  I accepted ovum donation and I was prepared to accept adoption if need be.” … .

For many more examples of how it is possible to benefit from struggling with infertility, read the rest of chapter 10 in On Fertile Ground: Healing Infertility.

Anger and Infertility

Show me someone in a situation of infertility or questionable fertility and I’ll show you someone who is either: 1) openly angry, 2) coping with the very natural feeling of anger by denying it, or 3) using significant mental muscle to manage feelings such as impatience, disappointment and lack of control that are components of anger.

You always knew that someday you would have a family. Life went mostly as you planned it. Depending upon what aspect of the American culture you hearken from, you would have had certain expectations as to when the time would be right. The confluence of variables such as education, career path and meeting the right mate became settled and you were good to go. So you thought. Nature had another idea, and now your plan has exploded in your face. Struggling with infertility? Anger is a likely traveling companion.

In this age where women have been led to believe that they can have it all, to arrive at the brink of the next planned phase of life only to be met by what feels like a cruel joke is unbearable and enraging. And to make matters worse, it is typical in these times to buy into the myth that things should be easy. What makes the anger response to the infertility news so intense and yet so poignant is its attachment to an existential reality: the injustice of it all.

Your thoughts travel to how unfair it is. You can name a list of people who have children that they can only complain about. Then there is so-and-so who has children she didn’t plan. You may find yourself thinking about someone from work who regrets having had a child. You feel sorry for the babies and you and your spouse know that you would make wonderful parents and you’re so ready! How could this be happening? On good days, you feel your determination will get you through this nightmare. You and your spouse might even feel closer to each other because of this struggle. On other days, you could care less about rational thinking and derive a perverse pleasure from marinating in your anger.

Anger does have its rationale. To feel angry at your body for failing you, or angry at your spouse’s body for failing him/her, makes sense. So does anger at the insensitive comments of well-meaning family members, friends or coworkers. Insensitivity of any kind makes your blood boil. Your medical team may be highly skilled as technicians, but why hasn’t someone trained this doctor or that nurse or secretary to be more delicate with the presentation of facts or news? And let’s not even talk about insurance companies. In fact, there’s hardly an aspect of life that is untouched by this predicament. Decision-making about career, housing, vacations and money, when so much is up in the air, is enough to make anyone feel in a real frenzy.

But anger can be sneaky and present with the violence of a tsunami without the recognition that it was the earthquake out at sea that caused the tidal wave in the first place. Likewise within us, sadness, disappointment, jealousy and other emotions happen (like the earthquake), and sometimes without conscious awareness convert into anger (the tsunami). Anger can always be justified and is therefore an easier emotion to experience.  Anger’s energy legitimizes making its discharge feel like a relief; sadness, disappointment or jealousy demand self-reflection, which feels like a job for which you are in no mood. Though anger may seem easier, it is not without its cost. If we think about the energy it takes to be angry, we will realize that anger is a big emotion. Perhaps you want to scream, punch or stomp. If you have a habit of internalizing anger, it costs even more. Unless anger is attended to in one way or another, it simmers like a pot au feu. And like a pot au feu, is always hot.

Both the pot on the stove and the anger within us drain energy. Whether you are aware of feeling angry or not, if anger is part of the gestalt of infertility for you, then given the mind/body connection, the value in dealing with our anger has the enormous benefit of giving ourselves a respite from the physiology of stress. It is stressful to be angry. Although the anger is legitimate and may seem impossible to tame (unless a baby resulting from a full-term pregnancy could materialize in your arms NOW!) – taming anger is not impossible at all.

Years ago I conducted a study using 39 respondents from 7 mind/body support groups. For this study, the women were asked to fill out a questionnaire (which included 3 self-rating scales) before and after the 10-week group experience. My hypothesis was that by learning and practicing stress reduction techniques, participants could reverse the physiology of stress. These techniques are designed to intervene in the vicious cycle of stress from both mind and body perspectives.  I predicted that changes would be measurable on the self-rating scales as improved mood and outlook and lowered subjective experience of bodily stress. To my delight, the data from all 3 assessment instruments demonstrated a trend toward improvement in mood and outlook and a lessening of physical tension. The best news was that as a by-product of the mind/body interventions, there was a statistically significant decrease in levels of anger.

What does this tell us? For one thing, a mind/body support group for infertility patients, which includes instruction in a whole array of stress-reduction techniques, can be a real boon. These techniques must be practiced and if they are, we give ourselves a respite by returning our physiology to neutral as a balance for all of the demands on us at a difficult time. This alone, can make an enormous difference.

In addition, attending to our anger may mean teaming up with a therapist who can help acknowledge and examine, understand and discharge aspects of your anger which may be an emotional heirloom. An emotional heirloom is the inheritance of a family style of dealing with distress by imitating family elders. The process of imitation is largely unconscious and is so strong that it may as well be genetic. (But unlike the genetics of blue or brown eyes, emotional inheritance can be changed.) By becoming mindful of your anger, it is possible to transform the energy of it and thus dissipate it. This stops the leak of energy and allows for connection to feelings of well-being and emotional growth. This process ultimately enhances your sense of self rather than drains you – even under these painful circumstances. You always knew that someday you would have a family. You want to reclaim the confidence of this feeling and keep the space open for hope. Embrace the unwanted symptom of anger and learn from it.

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.

The Concept of Stress Revisited

This entry is very simple.  It is just meant to call your attention to what might be a more panoramic view of stress than you might currently be aware of.  Consider my “3 A’s” approach to coping with stress: If you ACCEPT the reality, if you become more self-AWARE, and if you learn ways to ADAPT to the infertility experience, you can shift from feeling vanquished to feeling victorious.

What do I mean by all of this?  We often think of stress as “out there”—something that is happening to you.  Certainly this is true with infertility.  One of my patients described the rigors of treatment as, “I feel as if my body has been hijacked.” And certainly, the feeling of losing your mind can’t be left out of the story.

But if you revisit the concept of stress, if you look at it from a different angle, the stress of infertility is more or less difficult based upon how your style of managing stress has evolved.  Before you ever heard the word infertility, did you tend to be a worry-wart?  Did you easily loose your grip?  And now, does your coping style mesh or conflict you’re your partner’s?  Even if you have developed sophisticated coping mechanisms over the years, everyone—and I mean everyone—eventually feels swamped.  In other words, stress feels easier or harder based upon what comes from “within you.”

How is it possible to feel victorious?  If you do not know already, mind/body coping skills will take you a long way toward reclaiming your sanity and sense of calm and optimism.  Women who have attended mind/body stress reduction classes have described the relief.  Of course, the hitch here is that you must invest the time and effort into learning these techniques.  Often, this is the last thing you’d be in the mood for, but it is well worth the effort.  For a complete guide to learning these skills, you might find my book (On Fertile Ground: Healing Infertility) useful.  It has the potential to teach you what you need to know in order to ride the wave of the stress instead of being swamped by it.  You would find it empowering.

The Stigma of Infertility

The results of a recently released study of 50 infertile couples claims that couples hold back from sharing their infertility because they feel stigmatized.  While couples might feel stigmatized, in my 32 years of practice I have observed that it makes sense to hold back from sharing their infertility because it’s nobody’s business but theirs.

The report also indicated that there is more of a tendency to withhold this information if it is the male partner who is infertile.  I have seen this in some cases where macho attitudes—interestingly, held by both men and women—hold sway.

The report also stated that some couples reveal their infertility rather than have people think that the woman is too career-driven and therefore too selfish to meet the social expectation to have a family.  I have never seen this.  Many women are career-driven but still want a family—desperately.

Couples do need to communicate so as to be clear as to who is invited into the sanctity of their relationship and who is to be kept out.  But agreement is not always easy to arrive at.

There are so many areas in the infertility struggle that can lead to discord, both personal and interpersonal.  To tell or not to tell is certainly one of them.

The report left out the most important fact, namely that the crisis of infertility creates many opportunities.  Deciding whom to tell creates an opportunity to seek counseling and to learn how to navigate adversity together.

I don’t like the word stigma.   It smacks too much of victimhood, which is akin to powerlessness.  You may be out of the mainstream, but the opportunity to build strong and effective coping skills—together abounds.  Learning new coping skills that allow you to rise to the challenge is empowering.

On Fertile Ground: Healing Infertility – Update

On Fertile Ground: Healing Infertility is being reprinted and may be temporarily unavailable from Amazon.  You can still get it through my publisher, www.createspace.com/3452243 and you can still get the Kindle edition on Amazon.

Reviewers have identified one of the bonuses of this book, namely that people who are not dealing with infertility benefit as well.  Comments like “You don’t have to be infertile to appreciate many of the chapters in this book.” or “On Fertile Ground had something that everyone could relate to” or “You encourage and uplift the reader with real life examples of personal growth …” or “great writing with humor to lighten it up. It also could be read by men just as easily as women.”

That being said, infertility patients might be curious how the vast topic of infertility is handled in this book.  So here it is:

Preface     – You can feel inspired to grow from adversity

Chapter 1 – You can be hopeful

Chapter 2 – You can turn the tables on the way this unwanted change impacts you

Chapter 3 – You can maintain intimacy despite the impact on your relationship

Chapter 4 – You can manage friendships and family and assuage feelings of isolation

Chapter 5 – You can manage depression and anxiety

Chapter 6 – You can learn mind/body coping skills

Chapter 7 – You can experience the power of self-hypnosis

Chapter 8 – You can honor the mystery and invite the miracle

Chapter 9 – You can deepen self-awareness

Chapter10 – You can gain from the pain – believe it or not!

Chapter11 – You can give birth to a new, improved you