Ready to restart treatment after the coronavirus crisis: tips from the centre ITAE for Psychology 

Collaborating Centre of Institut Marquès, ITAE PSYCHOLOGY is a psychologists and psychiatrists’ office specialised in the treatment of anxiety, stress and mood. The director of the Psychology Area of ITAE PSYCHOLOGY, the clinical psychologist, coach and trainer Laura Solana offers us a series of tips to help those who have had to interrupt their Assisted Reproduction treatment due to the coronavirus crisis and the consequent lockdown.

Fertility treatments can be emotionally complicated processes in which a series of stressors coexist that affect both the woman and her partner (in case there is one). They can put expectations management, tolerance to frustration, loneliness feeling and incomprehension, anxiety, sadness and irritability to the limit.

With the lockdown and the stopping of treatments until further notice (another element of uncertainty inherent to the situation we are all experiencing), these emotions aggravate, since inaction without an expiration date has an impact on the feeling of lack of control on the process, complicating more the day-to-day momentum. That is why constant contact with the medical and patient care team during these days, whether by videoconference, telephone or email, is so important.

Reconnect with what makes you feel good

Self-esteem is altered by the frustration inherent in not being able to conceive naturally, by the uncertainty of being able to become or not a mother (or a father), by the possible rejection of the partner for being the “cause” that natural conception is not happening, etc. It is certainly a process that can alter self-concept and hijack the mind, side-lining everything else. Attentional bias occurs: the person “only sees” pregnant women, families with babies, etc., which contributes to accentuate the feeling of inadequacy, guilt and results in lowers self- esteem.

In order to strengthen self-esteem it is important that the people work to identify their emotions so that they can be expressed. Communication, and with it, active listening, empathy and assertiveness becomes essential to express them. In this process, there are peaks and valleys that will alter the emotional world of the future parent, and it becomes essential to elaborate emotions, detect one’s needs and establish the necessary boundaries with others.

It is also desirable to fight emotional abduction that undermines self-esteem by bringing a focus to other elements of life.

Now that we are in lockdown, it is important to set rewarding routines such as cooking, exercising, doing online activities, as well as delving into some hobby (apart from working). All these can help reconnecting with what makes us feel good and charging our emotional battery. By this, we mean that it is important to remember that we are much more than the project of parenting! Another important element in reducing possible emotional abduction lies in escaping from searching the internet for information about infertility, treatments and so on: doing so will ephemerally soothe the need for control and then generate much more anxiety and insecurity.

Keep the motivation

It is important to remember that regardless of the outcome of treatment, the person remains the manager of her life. Managing expectations properly and focusing on those factors that indeed depend on oneself is crucial: here come variables such as putting on a limit duration of the treatment, limiting the time between attempts or even considering a cost limit after calibrating all variables with knowledge, (it is important to be well informed). All of this can help to regain the perception of control and therefore motivation.

To keep motivation, it is essential to give space to the other facets of life: family, friends (even in a virtual way), work, leisure and above all, regarding couples, make the other one a part of the team and not an opponent, and not allowing the issue of infertility to overshadow everything and become monothematic.

Taking care of the relationship

As we have already said, it is easy to be tempted that the issue of infertility and treatment will overshadow everything and hijack all conversations and attitudes towards each other. This, together with the emotional roller coaster of the process at an individual level, provides the ideal breeding ground at a couple level so that difficulties appear. These difficulties can appear in the form of conflicts, feelings of guilt, reproach, the absence of sexual intimacy and the mechanization of sex, feelings of anguish, fear and burden by the omnipresence of the “issue”.

How can we protect our relationship?

  • Learning together what each part of the process involves to keep you both up to date on what is going on and knowing what to expect, since it helps you team up and achieving complicity.
  • Keeping an efficient communication through empathy, active listening and assertiveness since it will provide a space to talk about emotions and share them to understand the other.
  • Understanding and taking care of the needs of the other. Perhaps a member of the couple wants to share everything that is happening in the process with other people, while the other party wants more privacy about it. It is important to agree on the management of information between the two.
  • Creation of three support systems: one for you, one for me and another for the couple. Each support system has to be different, based on the specific needs of each one. One partner may need to talk to other people who are going through the same and perhaps the other may need to be distracted and dedicate time to a hobby that has nothing to do with it. In addition, as a couple, they may need to establish a night when the topic “does not exist” so that they can devote attention to the issues that made them a couple in the first place.
  • Working consciously in the couple´s relationship and keeping alive nice details of couple´s life (displays of affection, surprises, a romantic dinner) in order to protect it from the stressors of the process. That is, to make the couple the priority, and not fertility.
  • Bringing spontaneous and fun elements to sex life. In these processes, sex tends to be mechanised in favour of the process and medical opinions. It is important to find a balance between sex for love and sex for conception.
  • Rewriting the couple’s story together, in other words, accepting the situation and letting go of previous expectations of naturally conceiving.

Facing the wait: advice from our psychologist to live lockdown in a positive way

People who have had to stop their assisted reproductive treatment or who have momentarily postponed their project to create a family because of the COVID 19 crisis and the consequent lockdown can live these days in a positive way following some relaxation techniques, tricks to manage time and tips to prepare during these days of waiting. Laura Solana, clinical psychologist, coach and trainer, is Director of the Psychology Area of the ITAE Centre and offers us her help:

Relaxation techniques:

There are countless techniques to relax: breathing exercises can help relieve stress and it only takes 10 minutes to perform them. One of the most commonly used technique is abdominal breathing. Adopting a relaxed posture, with one hand on the abdomen and another on the chest, you have to take air through your nose and expel it through your mouth, but with one condition: the hand that rises must be the one in contact with the abdomen. This results in a complete breathing with all lung capacity. Perform six to ten slow breaths per minute.

Listening to relaxing music and visualizing a “safe place” where a person feels at peace and safety, without worries. Whenever music is heard and positive images are displayed, dopamine is released, a substance responsible for providing a sense of well-being. In fact, music, in general brings countless benefits: in addition to helping to relax the mind, it improves humour, develops attention span, fosters imagination, stimulates concentration and memory in the short and long term, facilitates learning and exercises intelligence. At the physical level, among others, it helps to lower blood pressure and heart rate.

Another option could be practising mindfulness 30 minutes per day, at the beginning or the end of the day. This technique leads us to a full awareness of reality, of acceptance of the here and now, without being clung to the thoughts or emotions that provokes. That is why it is useful for managing stress and reducing negative emotions. Ideally, it is practiced sitting on the floor, in loose clothing and in a comfortable position with a straight back to facilitate abdominal breathing, away from distracting noises.

What is the best way to manage time during lockdown?

Make a routine and differentiate weekdays from weekends. We need to provide ourselves with that structure to have a sense of order and control over our daily life. It is important to get up rather early, take a shower, get ready, and start the day with schedules as similar as possible to those we would have outside of lockdown, taking into account the limitations we obviously have. On weekends, allow us to stay longer on the couch, get up later, encourage virtual encounters with family and friends, etc. It is also important to take advantage of these days to do everything that before we did not have time to do like cooking, start some hobby, do online training, etc.

Once the lockdown is over and we can go back to normality, which is the best way to prepare to restart the treatment?

As we have mentioned, it is ideal to take advantage of lockdown to recharge one´s batteries and take advantage of the time to rest, learn, exercise, read and do other hobbies and everything that restores our emotional battery. Of course eating well, sleeping the necessary hours, and taking care of interpersonal relationships, especially with the couple, if you have one. The quieter we return to normal, the more equipped we will be emotionally to deal with everything that the environment requires, including our treatment.