How to #StartAsking for Support: The Journey of Secondary Infertility

This week is National Infertility Awareness Week (April 24-30, 2016) and the theme this year is “#StartAsking.” One of the goals of the #StartAsking campaign is to raise awareness, reduce the stigma and encourage people struggling to get the support they need. 

While infertility itself is seldom discussed at dinner parties, secondary infertility is even more of a hush hush subject. Sharing your experience with secondary infertility can help invite those who love you to advocate for you and support your family during this challenging time. 
 

What is Secondary Infertility? 

You have a child, or maybe two or three. You want to grow your family but it's been 6 months or 12 and still nothing. Or you've gotten pregnant but have miscarried. Again, perhaps. 

You discover on your own through your late night dates with google what you've got—secondary infertility. No one's said it but that's what you've got. According to Resolve, The National Infertility Association, secondary infertility:

is the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications. 

Why hasn’t anyone mentioned it, you want to know? You wonder why your doctor shrugged you off and told you to keep trying. Are they ignorant? Optimistic? Lazy? What are they waiting for!? 

There are so many complicated aspects to secondary infertility and coping with those who love you but who just don't get it. But the only way for them to know how hard it is and how lonely it is, is if we #StartAsking them to take a peek inside your world, to pay attention to your struggle, and understand what it’s like to experience secondary infertility. 

Consider sharing this list with them as a way to help them understand what you’re going through. Tell them the number of the struggle listed below that's hardest for you today. Add your own. Let them in. Let them help you! 

Common Struggles of Secondary Infertility 

1. You’re depressed and overwhelmed that you might not have another baby. 
2. You're mourning a loss. The loss of a baby. The loss of your dreams. Your life isn't going as planned and you have no control. You feel helpless.
3. Your relationship is strained— it can be difficult to get on the same page about treatments and to connect on a deeper level outside of your timed TTC (trying to conceive) "appointments". 
4. The judgement— You feel judged in online communities and sometimes in the real world too because you have a child already and others don't. You wish you could tell them— there's enough sorrow to go around, folks! 
5. The appointments! Who has time for all the appointments (the other kinds!)? Your RE, OB, the HSG, the routine ultrasounds. Let's not forget your acupuncturist! All the work you need to miss or childcare you need to arrange. It's a LOT. 
6. You struggle with envy as those around you, unintentionally or not, become pregnant.
7. Anniversaries hurt- your due date, when you had your (first/second/third) miscarriage, the holidays that coincide with those now infamous dates that are forever marred. 
8. The well meaning but unintended hurtful things your friends and family say in an effort to comfort you.
9. Your child(ren). Yes- so lucky to have that source of light. but dealing with the emotional weight of repeat losses, the TWW (two week wait), negative tests... it's intense. If you'd like some suggestions on maintaining your bond with your child through this dark stage, you might find this article helpful.
10. Your physical pain. The hormonal impact of infertility drugs- the anxiety, mood swings, weight gain. Or the nausea that comes with each hopeful pregnancy. 

If you feeling inspired to #StartASking for support, consider sharing this article with someone you love who can help you through your journey.

If you’re struggling with primary or secondary infertility and think you could benefit from the support of a trained psychotherapist, reach out! In San Diego, call Rachel Rabinor, LCSW for a free 30 minute in-person consultation. She maintains a private practice in the Banker’s Hill neighborhood where she specializes in Maternal Mental Health including infertility and loss. Resolve is a great resource for those outside of San Diego. 

3 Reasons to Try Walk and Talk Therapy

I just hung up the phone with a colleague who wanted to pick my brain about providing Walk and Talk Therapy. Our call got me thinking about all the incredible benefits of this, seemingly to some, out-of-the box therapy, and why more people should consider trying it.

Walk and Talk Therapy is just that—walking while talking with a trained therapist. It’s exercise but not cardio. Collaborative and professional. Walk and Talk is a useful type of treatment for many people. Anyone suffering from anxiety or depression, coping with grief or loss, or those feeling stagnant in life may find it beneficial. This article talks about the benefits for new moms and also talks more about what Walk and Talk is, and what it isn’t (How walk and Talk Will Change Your Life, Mama).

Here are three MORE reasons to consider Walk and Talk Therapy:

1. Walk and Talk Therapy allows you to take small steps towards your goals. It’s a great metaphor. With each step, you’re moving forward in life, leaving your problems behind figuratively and literally. You’re no longer thinking about starting therapy, you’re engaging in it actively. You’re no longer thinking about exercise, you’re moving. Small steps change lives.

2. You’ll feel Better—Both therapy and exercise are linked to improved mood and a decrease in symptoms of depression and anxiety. Physical exercise releases endorphins, which naturally spark positive feelings that help to reduce levels of depression and anxiety and prevent depressive symptoms. Being in nature is not only restorative but can improve your positive outlook on life and your ability to cope and recover from stress and illness.  Walk and Talk Therapy leaves many people with improved self-esteem and sleep, and a greater overall sense of well-being.
    
3. Hello multi-tasking! Life is busy, and carving out time for exercise, fresh air and your mental health can be daunting. Combining movement and therapy in nature is a convenient way to make progress in multiple areas of life that need tending. We've all heard sitting referred to as the new smoking. It’s not enough to just think about our need for more exercise, we need tools and plans that allow us to implement exercise in ways that don’t add greater stress to our lives.

 If you’ve been thinking about starting or resuming counseling, could Walk and Talk would be a good fit for you? What do you think? Please chime in below in the comments section!

If you’d like to learn more about Walk and Talk therapy and live in San Diego, schedule your free 30 minute in-person consultation to find out if I might be the right fit for you!

Bonding With Your Littlest Valentines: Staying Connected Through Infertility

Secondary infertility doesn't get a lot of press these days despite the fact that as many as 3 million couples are experiencing it at any given moment. Coping with your own emotions, managing doctor appointments and healing from physical loss(es) is consuming, and we haven't even discussed the laundry, the dishes, the food shopping and the cooking! With so much on your plate already, maintaining your relationship with your toddler or preschooler can be an added challenge when infertility enters your world. You might feel your motivation, energy and/or ability to maintain a strong connection with your living child(ren) slipping under such distress. 

When you're feeling badly physically or emotionally, you may not know HOW to strengthen your relationship with your toddler or preschooler. 

Connecting with your little one

Here are 3 easy steps to bond with your littles while navigating secondary infertility:

1- Schedule it. Plan a time of the day that you have five minutes to spend 1:1 with your child. Pick a time when both you and she are at your best, typically (avoid the notoriously challenging times like before nap or bed). Make sure you can completely dedicate yourself to your child for the entire 5 minutes. 

2- Set yourselves up for success. Give your child a choice of 1 or 2 (depending on their age) open ended toys to pick. What's an open ended toy? One that has no rules to play by. No winner. Think coloring, blocks, Legos, animals, cars, dolls...

3- Play. Be intentional. Let them know you're present. How?

• Describe what he's doing in his play. Say something like, "you're putting the green Lego on top of the yellow one," or "you're building a tower."
• Copy her play. Say,"I'm stacking the green lego on top of the yellow one too, just like you, or just do what she's doing. Copying is the greatest form of flattery, no? 
• Praise him. Find something you like about the way he's playing (ignoring what you don't like as long as it's not dangerous). Say, "I like how gently you're playing with the Legos," or thank him for sharing the Legos with you. 

These three steps are a good place to start if you're having difficulty maintaining your connection with your little one during this difficult time. In five short minutes you can let them know that you are really paying attention.

If you are struggling emotionally with secondary infertility, I encourage you to reach out for support. You are not alone!  If you are in San Diego, I can help. I maintain a private practice in Bankers Hill where I specialize in helping families struggling with secondary infertility, parenting and other areas of maternal mental health. Please call me for a free phone consultation to explore how I can support you and your family.

Setting New Year's Resolutions: Seeing Past Your Infertility

New Year's day has come and gone and if you haven't set a resolution for 2016 yet you're likely reminded through various forms of media multiple times a day. When you're struggling with infertility, "having a baby" feels like an obvious goal that's constantly on your mind. However, I encourage my clients to choose a resolution that they can be 100% responsible for. Infertility, as we know, is very often outside our control. So when you're consumed with thoughts about your next treatment, phone call with xyz adoption agency, finding your surrogate, or the miscarriage you're still mourning, it's important to find a way to harness your energy to navigate this stressful, anxiety producing time of life.

Setting a goal for an entire year can certainly be intimidating. As a therapist, I've spent a lot of time helping clients develop and modify goals, resolutions and aspirations. Using the SMART acronym helps me help my clients get set up for success; every goal needs to be specific, measurable, attainable, realistic, and time-bound. I also coach my clients towards choosing resolutions that promote their overall well-being, and specifically their mental health. 

Some of the most popular resolutions I've heard that support the big picture of having a baby this year include: yoga, meditation, walking, running, reading, healthy eating, connecting... What do these have in common? They will improve your well-being regardless of when or if you bring a baby home in 2016. 

Choosing a resolution

Take a moment and think to yourself: What do I need more of in my life? Really, I encourage you to stop reading for a moment (after you read these next three sentences), close your eyes and take a deep breath. Maybe two. Then, ask yourself: What do I need more of in my life this year? If you're coming up blank, here are a few questions to spark ideas: Could I benefit from a stronger mind-body connection through yoga, or running? Should I scale back on exercise and focus on building a meditation practice, walking, or being in nature? Nothing yet? How about your connections with others? Ask yourself if you need to take time this year to reconnect with those you love, or deepen your connection with yourself? Maybe you've been holding in too much for too long and really need to seek the support of a trained therapist this year. Dealing with infertility is intense. It can creep up on you just how stressful it is to juggle this unexpected life turn along with your day to day life. 

Setting your resolution in motion

So now that you've chosen your resolution for 2016, it's time to dig in. Lets make sure it's a SMART goal. I'm going to share one of my resolutions for 2016 as an example. But before I share my goal, please take out a piece of paper and pen or open up some app on your phone and work along with me. Here we go- My resolution is to camp more. Being in nature, unplugging from all there is to unplug from and taking a break from the day to day grind while breathing in fresh air and sleeping closer to the stars always makes me a happier person. It gives me the chance to connect more fully with myself and my fellow campers... It's food for my soul. 

While I'm instantly at ease envisioning this goal coming to life, it's hardly a SMART goal as is, so lets see how using the SMART format helps me flesh it out--

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Specific
My goal of camping "more" is not very specific. What's "more" for me might be less for some avid campers, right? According to the SMART Goals Guide, make sure your goal includes the "who", "what", "where" and "when". So, I'm (who) going to camp (what) 5 times in 2016 (when) in California (where). Specific- check. 

Measurable
How will you know you've achieved your goal? Can you see, hear, feel or taste it? Camping 5 times in CA-  Measurable, yes! At the end of 2016 I'll be able to look back and see whether I've reached my goal.  
 

Attainable
This is a key step in setting a SMART resolution. It's important to reflect on your own capabilities and skills when creating a goal that's attainable. Only you know what's going on in your life, what's a comfortable stretch and what's not. If you hate bugs and must have a flushing toilet, your goal would look different than mine. As an experienced camper, I feel my goal is very doable. 

Realistic
While your resolution should urge you to stretch and grow, maybe even learn a new skill, it should also be something you are capable of doing. Is the goal you're working on SMAR so far? I feel my goal is in fact realistic. But I have a confession to make: I originally wrote my goal as camping 10 times this year. But as I thought about it, I realized that last year I only camped once!!. ONCE. So I'm glad I went through this process and reassessed what is realistic for ME this year. Five will likely be a stretch after a mere one time last year, but there were other years I camped more, so it's a comfortable stretch and goal for ME. I'm stressing the ME here because setting a New Year's resolution is personal and only applies to one person- YOU. So make sure it's realistic so you can set yourself up for success in 2016.

Time-bound
Having a deadline for completing your goal is crucial. Since we're discussing New Year's resolutions, our deadline is built in. As we close out 2016 we'll check our progress and celebrate our success!

How's this going for you? Do you have your SMART resolution now? If you're wondering what you can do next to get moving on your New Year's resolution,  I want to invite you to 1, share your resolution for 2016 in the comments below, and 2, share this blog post along with your SMART goal with one other person. Think of that someone who you feel comfortable sharing with -- a good friend, your partner, your therapist-- and put it out there. Being accountable to someone other than yourself can be extremely helpful in reaching your goals. You can do it! 

If you're struggling with infertility, pregnancy or infant loss, or a perinatal mood or anxiety disorder, and think you could benefit from additional support in setting or accomplishing your New Year's resolution, feel free to get in touch by phone or email. 

How to Find a Therapist in San Diego

In San Diego, we’re lucky to have so many mental health practitioners. If only everyone in all corners of the globe were as fortunate as we are; choice is certainly a luxury. But having so many choices can also make it a challenge to find a counselor when you need one most. Typically you find yourself searching for a therapist when things aren't going so well, when you really need that extra bit of support. And with so many possibilities, you’re probably wondering— how do I choose!? Where do I start? 

Below are a few recommendations for finding a counselor that’s right for you. There are many many qualified and capable therapists here in San Diego, the task is to find someone for YOU.  The good news is that with so many options there’s bound to be someone who you can connect with and confide in. It will take some work on your end, but it will be well worth it!

Let's start with the logistics of finding a counselor in San Diego:

• Define your needs. Think about what you need from a therapist. Concretely– someone close to home, work, evening hours, morning hours, takes insurance, doesn't; has experience working with postpartum issues, infertility, anxiety, depression, parenting concerns…
• Look to your friends. When I need an ENT, a dentist, a car mechanic, I ask my friends for suggestions. Likewise, when I'm searching for a therapist for myself I also see if one of my besties has someone to recommend. But sometimes you're dealing with an issue that your friends haven't dealt with, or you're just not comfortable asking around. In that case, move on to my next suggestion. 
• Head to the internet. Psychology Today is probably the most popular website with nationwide provider listings along with a smattering of everything for your psychological mind. Mental health providers post their info and you, the consumer can peruse at your leisure. There are a variety of filters you can activate to find someone who fits your search criteria. For example, if finding someone who’s close to your home is important, you can plug in your zip code and narrow down your choices instantly. You can also filter by gender, specialty, language... You get the idea. Another good place to search for a therapist is through specific associations that support the issue you’re struggling with. So if you want someone who’s experienced with infertility, for example, you will probably stumble across Resolve, which is the National Infertility Association. So even a national organization can point you to a local therapist through their provider listings.
• More internet research. So once you have some names, regardless of whether it came from a friend, Psychology Today, or Resolve, now's the time to learn more and review their website. You can read the “About” and Specialty pages, and look over the FAQs to get a feel for the counselor and see if he or she might be a good fit for you.  
• Making Contact. Once you have 3 or 4 therapists that you’d like to get to know more, start making calls and sending emails. Many therapists in San Diego offer a free 15 – 20 minute phone consultation. It’s a great opportunity to ask questions and get a sense of whether this person may be able to help you before scheduling that first appointment.
• Meeting your therapist. You might want to schedule a couple of in-person appointments before deciding on a therapist. This is a great opportunity to ask more questions. Remember, you are interviewing this person to see if you want to hire them. Yes, you are hiring your therapist to help you through a difficult time, explore a specific issue, help manage challenging behaviors, etc. Pay attention to how patient they are with the process and your questions. How do you know you'll be able to work with someone? That is such a personal and individual thing– and a lot of it depends on knowing yourself and trusting your gut.

It is widely believed that the therapeutic relationship between you and your therapist is the most important factor in successfully resolving your presenting issue. The therapeutic relationship is the collaborative relationship between client and therapist, entirely focused on the client, to gain understanding of and effectively change the client in a way that supports their overall well-being.

The ability of the therapist to facilitate a strong working therapeutic relationship is everything. Theoretical orientation may be of interest to you, but as far as resolving the issue that brought you to therapy, it’s the counselor's innate abilities that matter most. 

Below are some things to consider during your initial phone consultation and throughout the initial sessions of therapy to determine if someone might be a good therapist for you:

• Do you feel the therapist is genuinely engaged with you, focused on your well-being and motivated to help guide you? Does he or she remember to follow up or discuss topics further that you feel require more attention?
• Are you comfortable with the therapist? Are you able to share personal information and express yourself emotionally? Do you feel the conversation is insightful? Do you feel you can trust the therapist? Can you comfortably express your concerns and doubts with the counselor or is there some fear of judgment?
• Do you find the therapist comforting, empathic, and compassionate? Is he or she responsive to your emotional and verbal expressions? Are they cold when working with you?

These are just a few important aspects within the therapeutic process to pay attention to when trying to find a new therapist in San Diego. Hopefully you're feeling ready now to begin your search. 

If you’re wondering if I'm a good match for you, call me for a free 20 minute phone consultation.