Fertility & Positive Thinking: Tool or Trap?

Two recent pieces of news/writing have prompted this post:

1. A new article in Reuters about a study showing that stress may not have any impact at all on IVF outcome: http://www.reuters.com/article/2011/02/25/us-fertility-stress-idUSTRE71O0B520110225
2. A post by the wonderful Deborah Lynn of The Resource Guid for Pregnancy at 40: http://www.over35newmoms.com/testimonials.html?entry=on-becoming-our-infertility

So here's my take on positive thinking, negative thinking, and the stress of feeling overwhlemed by infertlity:

In the world of women over 40 who are trying to conceive, the latest mandate is not to take your prenatals or avoid coffee: it’s to think positively.

In the more than two years I’ve spent in my “40+-and-TCC” online group, positive thinking has come up more frequently, and passionately, than any other topic.  When to start thinking positively (Envision your follicles growing with every shot!), what daily actions you can incorporate into your visualization-regime (Keep imagining a baby seat in the back every single time you drive your car!), and, most importantly, what to do when spirits flag (Never, never let the negative get inside your head.)

The advanced-maternal-age sector, along with the infertility community at large, has embraced the pop-culture trend of “if you build it, they will come,”  spawned from such best-sellers as The Secret and Creative Visualization: Use the Power of Your Imagination to Create What You Want in Your Life. But nowhere today does the admonishment to visualize success seem to ring more loudly—or, I’ve begin to think, more problematically—than in the Over-40-and-Trying-To-Conceive sector.

The support and caring and love that accompany the admonishments I mention above from my TTC online group: these are real and admirable and invaluable, and in no way to I mean to diminish that.  But their insistence on forcing us to deny or push away the stress and even the feelings of hopelessness that are an inevitable part of having our hopes dashed month after month: this is what I fear is harmful, actually.

As one oft-cited expert has written, “You can think yourself (in) fertile! It’s your choice.” And herein lies what makes the positive-thinking mandate so tricky: the corollary that the failure to conceive stems not from biology but personal shortcoming.  Similar criticisms have been made of applying positive thinking to the effort to overcome cancer, depression, etc.

But there’s another problem with compulsory optimism: the stress it can cause through denial of the natural lows accompanying infertility.  A handful of experts are starting to explore this paradox and the link between the suppression of negative feelings and an increase in cortisol, a chemical that may inhibit conception.  As Dr. Lisa Rouff has written, “It can be common for some infertility patients to [try to] maintain a very optimistic outlook… [But there are] pitfalls of this type of thinking as it relates to infertility treatment.” (http://www.lisarouff.com/blog1/index.php)

I’d like to propose an alternative to enforced optimism—and the only mind-set that has worked for me after four IVF cycles, one miscarriage, diminished ovarian reserve, and eight pregnant friends: allowing ourselves to experience our full range of emotions, and limitations, with compassion and acceptance, and then embracing our fierce potential to create our strongest possible bodies, ones that will eventually support either a healthy pregnancy, a deep appreciation of all we’ve already built, or a vibrant child-free life.  I’m not advocating giving into the despair infertility can cause, or allowing it to overtake us forever.  But I am advocating allowing ourselves to acknowledge it―and not blame ourselves for it―and even to feel it fully, before we expect ourselves to move on to what I believe is the true opposite of negative thinking: not willful positive thinking, but realistic thinking, supplemented with pride in ourselves for all that we achieve and create when we make it through one more day of infertility.