As a licensed therapist currently working as a grief counselor for hospice patients, and as someone who believes in and has sought therapy before, it took me longer than you might think to seek help for infertility.

For one, I didn’t think I would be going through it for this long. I also failed to realize how time-consuming and exhausting trying to have a baby would become—a full-time job on top of my full-time job. After a long workday and then more hours Googling the difference between HSGs and SHGs, or why DHEA and DHA aren’t the same things, I didn’t want to be researching infertility therapists when I could be bingeing The Bachelor and escaping my life.

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Infertility contradicts our society’s “vending machine mindset” of getting out what you put in. You study hard for a test, you get an A; you save for a trip, you’re snorkeling in Oahu; you put in a dollar, push B2, and out comes a Twix (a personal fav). But if infertility was a vending machine, it would be the absolute cruelest kind, where you put in tens of thousands of dollars, only to be mocked and handed angst in just about every life category: emotionally, physically, financially, spiritually, sexually, professionally, and socially (let me know if I forgot one).

I’ve always wanted my own children, and to think that may not happen has felt like an unbearably jagged pill to swallow (thank you, Alanis). After two failed IUIs and three egg retrievals which resulted in only one PGS-normal embryo, this possibility was hitting home. Then, with a change of clinic, protocol, and diet, we had a miraculous fourth egg retrieval, getting three normal embryos! Now with four embryos total, we could finally move forward with a transfer.

However, instead of success, this past year has brought COVID delays, two failed transfers, surgery to remove blocked tubes, a fifth and last egg retrieval (which failed), newly discovered autoimmune issues that could impede implantation, and an ER visit for a kidney stone caused by my infertility diet (definitely research oxalates and go easy on the spinach!). I couldn’t win, and I was at my lowest point.

I also hadn’t pursued therapy yet because, as a therapist, I thought I should have it all figured out. I had a toolbox full of coping skills, but I felt like Dorothy from the Wizard of Oz, with all reasoning flying out the window as my house spun wildly up into the storm. I was stuck and needed to figure out how to feel whole again despite the constant disappointments.

Here is what I’ve learned from my own professional practice and from pursuing therapy, infertility coaching, and support groups.

Grief

People often associate grief only with the death of a loved one. But we’re all grieving something, big or small: past regrets, unmet hopes, loss, disappointments. In my hospice work, families know their loved one will die, but they don’t know when. This “not knowing”—anticipatory grief—can be as stressful, if not more so, than the death itself. It can be a state of high anxiety, uncertainty, and trauma.

Infertility can involve anticipatory grief, with its ups and downs. Whether it’s getting your period, a delayed treatment, a miscarriage, or a number of other possibilities, the continual setbacks and constant whiplash of this emotional rollercoaster can be agonizing. I often think if I simply knew from the beginning that I wouldn’t have my own children I could really grieve and then move to the next plan. Whatever your grief looks like, make sure to identify and nurture it.

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Thoughts and Feelings

Understanding my thoughts and feelings has been one of the best gifts I could give myself during the infertility process. I’ve felt lots of anger, envy, bitterness, resentment, and abandonment. I’ve blocked my share of people on social media after a pregnancy announcement and have even felt the sting of jealousy if I scrolled past pictures of dogs or cats cuddling their litters!

When news broke about the first rhino to receive IVF, instead of feeling happy at preserving a rare species, I yelled to my husband, “That rhino better not get pregnant before I do!” And I’ve even reported baby-product ads that pop up on my feed, flagging them as “offensive” and experiencing brief satisfaction in doing so, only to have that feeling replaced with crazy-infertile-woman shame that maybe I just assisted in ruining someone’s small business.

The bottom line is that such feelings are normal and can even be protective. They make us less vulnerable—you’ve already imagined the worst, so you can’t be disappointed when it happens. You’re in control. Sometimes our negative thoughts and feelings shield us from the pain of fear, sadness, and grief, vulnerable and exhausting emotions that can leave you sobbing in the fetal position at the end of the bed, splotchy-faced, with your mascara running.

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When I took a step back to see where my emotions were really coming from, I became less self-critical. I wasn’t a horrible person who didn’t want happiness for others (or innocent animals). I was reacting from a place of fear and negativity: “I can’t do this anymore, it’s too painful,” “What if I never become a mom?” “What if I’m never happy again?”

When similar thoughts bog you down, one strategy is to try replacement thoughts: “Look at how strong this has made me!” “This WILL happen—one way or another,” “You will NOT feel like this forever.” The more you practice, the more automatic these new thoughts will become.

I also like to visualize my negative thoughts as separate from myself, each written on its own little chalkboard traveling slowly past me on a Whole Foods conveyer belt (right after my gluten-free bread, pineapple core, and brazil nuts, of course). Thoughts are separate from our identity and don’t define us; we can observe them for what they are—just thoughts.

At the beginning of this process, I was “in it to win it”—I wouldn’t be walking away from my infertility vending machine with empty arms! But as we move into our fifth year of trying to conceive, I know our story may not end that way. This still feels like a very painful pill to swallow, and it would be silly to think that it could ever go down like a smooth, sugar-coated capsule. I just hope it can go down a little less jaggedly and I can find peace despite the outcome.

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Emily Blank and her husband live in California and are in their 5th year of TTC. Emily is a licensed therapist currently doing grief counseling with hospice patients and hopes to start a private practice offering infertility therapy and coaching services. She has recently converted her infertility journal to an Instagram page, detailing her story with humor and honesty in hopes of helping others in this community. You can follow her at @Infertile_therapist_in_therapy.