A diagnosis of infertility often results in multiple stresses for couples including changes to their social and family relationships, changes in their marital relationship and decreased spontaneity in their sexual relationship. As well, couples are faced with committing to expensive and invasive medical treatments with uncertain outcomes. These factors contribute to grief, depression and anxiety for many couples diagnosed with infertility. One psychological treatment approach that offers a great deal of hope for couples experiencing infertility stress is Acceptance and Commitment Therapy (ACT).
ACT is an acceptance based therapy that utilizes mindfulness to increase cognitive flexibility and decrease experiential avoidance. Experiential avoidance is characterized by avoidance of unwanted internal experiences as well as situations that may trigger such thoughts and feelings. Avoidance coping (insert link), frequently used by women to manage infertility stress, has been linked with increased depression and marital dissatisfaction. With experiential avoidance many couples find themselves increasingly cut off from their social support systems because they avoid family events and social situations which involve children. Furthermore, couples often find that their intimacy is eroded by lack of sexual spontaneity and avoidance of difficult conversations about their own reactions to infertility.
ACT first seeks to highlight the costs of avoidance based coping for managing infertility stress. By examining the high personal costs of avoidance, ACT seeks to increase a couples’ willingness to learn new ways to relate to their thoughts and feelings. This is designed to open the door to develop new ways to cope with infertility stress, that is to move into the stress rather than away from it.
Mindfulness and compassionate acceptance are taught to help couples observe and become aware of their thoughts, feelings and sensations related to infertility without struggling to make these internal experiences stop. By learning to let go of judgments couples can begin to come to terms with the sadness, loss, disappointment and sense of inadequacy that a struggle with infertility often engenders. Cognitive defusion techniques teach couples to view thoughts as mental events that can be observed rather than something that must be believed and acted upon.
Central to the ACT model is the clarification of values that are important to couples. Couples are asked to define their values in several life domains and examine behaviors that would be in line with these values. Equipped with the skills to be open and nonjudgmental to their experiences, couples are asked to engage in valued activities that they may have previously avoided due to their infertility stress.
Here are some specific ACT principles that may help you live a full life during your fertility journey:
- Begin a mindfulness practice. Develop your capacity to attend to your present moment experience with kindness and compassion.
- Learn to distinguish between yourself and your mind. Practice cognitive defusion techniques to begin to create some distance from your thoughts. Click here for some specific exercises to try.
- Get in contact with your values. Take some time to think about what values you would like to embody in your life. It might be helpful to consider the following domains: family, work, relationships, community, health and friendships.
To read more about Acceptance and Commitment Therapy please explore https://contextualscience.org
Dr. Angela Williams is a licensed clinical psychologist at the Rowan Center for Behavioral Medicine. She specializes in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention, which she uses in the treatment of patients who are struggling with infertility. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating , she helps her clients move through difficult experiences and be more present in their lives.