I remember when I was a 12 year old girl at summer camp in the Poconos, living with a group of girls who were right on the cusp of becoming "women."   Early that summer one of the girls began menstruating. We all envied her entry into womanhood. On that eventful day this camper happened to be wearing a colorful cotton scarf around her neck, which she had borrowed from one of our bunkmates. We all decided that the scarf must have had some lucky charm attached to it. For the rest of that summer we took turns wearing the scarf.  I do not remember how many girls actually became women while wearing this scarf. I know that although I went home without reaching this stage of my life, this article of clothing remained significant for me.

The scarf was an important symbol to all of us.  Although we knew that there was no scientific connection between the change in our hormones and the cloth touching our skin, the scarf did its magic by bonding us in a shared experience.   This helped us to be a supportive community while we waited with anxiety and excited anticipation for the next important stage in our lives and in our world as females.  Although getting one's period is something we all assumed we would eventually attain, it also gave us hope that we would soon join the club that our mothers and grandmothers had entered and not be left behind by our friends.

This kind of thinking is called ‘magical thinking.' It is the inaccurate belief that one's thoughts, words, or actions will cause or prevent a specific outcome.  As a very young child, magical thinking can feel real to us, and we believe there is a real cause and effect. As we grow up we realize that the correlation between events is not real but the thinking brings us some sense of control where we know we do not have any.  Athletes often wear shirts with certain numbers or carry certain objects that they feel will bring them luck in their game.

During the infertility process, fraught with anxiety, self-doubt, and feelings of pessimism, finding ways of feeling lucky and in control can be helpful. Often friends will share a necklace or other piece of jewelry that they felt had given them good luck. This sharing can help you feel less alone on the journey. I once searched all over Martha's Vineyard looking for a fish pin for a relative going through infertility treatments because I had heard that in the Chinese culture the fish symbolizes fertility.  The gift was welcomed as a sign of faith instead of words of reassurance, which can make one feel misunderstood rather than supported.

Ideally, ‘magical thinking' should bring one a sense of comfort or control.  Unfortunately, it can often take a negative turn and become a source of self-blame.  For example, some women imagine that their infertility is their punishment for some prior action or thoughts they feel guilty about.  Many women blame their infertility on their past sexual experiences even without any medical evidence that might indicate a real connection between the two. Another woman felt that she was being punished because she was very insensitive to a friend who had gone through infertility treatments two years before. One woman's self-blame and guilt over her tumultuous relationship with her mother led her to believe that she did not deserve to have children. These examples of ‘magical thinking' illustrate how our desire to have an explanation for what happens in our lives, and hence to have some sense of control, may actually cause more harm than good.  If the explanation that a patient comes up with is one in which they are to blame for their infertility, this is quite likely to increase their feelings of despair, guilt, and shame.

Another way in which "magical thinking" can become problematic is when it takes on an obsessive or compulsive quality. For example, wearing the "fertility pin" can be comforting, but feeling the need to wear it everyday, sleep in it, and panicking when you cannot find it is not comforting... instead, the pin becomes a source of anxiety in its' own right.   Many infertility patients report that they have developed some type of obsessive or compulsive behaviors during the course of their treatment, most of which trace back to some desperate effort to feel control.  

 It is understandable that we like to feel we have some control in our lives, and that we become anxious when we lose this feeling.  For many people, infertility is the first (or most significant) loss of control that they have experienced.  And yet the truth is that virtually everyone will have at least one crisis in which they have no control over events, such as illness in a family member or loss of a job. Instead of finding burdensome ways to fool ourselves into thinking we have some control, it is ultimately healthier to develop new skills for being able to tolerate the loss of control, and to develop a support system to help you through this difficult process. The support system should consist of people or activities that bring you comfort and guidance: family, friends, a house of worship, psychotherapist, yoga teacher, acupuncturist and of course the doctors and nurses.

It can also be very helpful to speak with a psychologist or social worker specializing in work with infertility patients.  RMA can recommend a therapist to you, many of whom have personal experience with infertility and are knowledgeable about its enormous emotional impact.  What can a professional counselor [m1] do for you? When we are helped to express and identify the emotions that we are experiencing, the intensity of these feelings decrease. Then we can cope more easily. In addition, a therapist, who understands the myriad of emotions associated with the infertility experience, can validate your feelings. This means the therapist can help you realize that your reactions to your life and the people in it are understandable and not subject to judgment. Together we can help you identify those coping mechanisms that you may be using that are not helping you, such as "magical thinking" You can discover constructive ways of handling your emotional reactions to important people in your life. You will find that these new coping techniques can be useful throughout your life and instill confidence that will last beyond the infertility journey.

Many patients find it beneficial to receive professional counseling at some point during their infertility treatment. The counselor understands the emotional complexities and challenges of fertility treatment and related issues. Sometimes this is done individually, and sometimes as a couple, depending on your specific issues and areas of concern. Often this is done when couples are at critical "decision points" in their treatment, i.e. whether or not to do IVF, use an egg donor, give up treatment, or pursue adoption.

Dr. Lisa Tuttle is a clinical psychologist who sees many of our patients in the Norwalk area, and she can be reached at 852-9099.

Jane Elisofan, LCSW, is a licensed clinical social worker who sees many of our patients in the Danbury area, and she can be reached at 431-3830.

Lisa Rosenthal

Lisa has over twenty-five years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for seven years and is currently Patient Advocate and Blog Editor-in-Chief.

Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.

Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.

Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.

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