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Reprinted
with permission from Contemporary Sexuality, a monthly newsletter
of the American Association of Sex Educators, Counselors and Therapists.
January 1992: Volume 26, Number 1
Failed Infertility Treatments May Devastate a Woman's Sexual
Self image
During eight years of treatment for infertility, Julia was the
perfect patient. She never cried. She never did anything
to acknowledge the toll of several surgeries, three unsuccessful
attempts at in vitro fertilization and about 20 intrauterine insemination
procedures.
But over time Julia lost all interest in sex. Cunnilingus, which
she had once enjoyed now made her sick to her stomach. She participated
in sex like an automaton, until finally her husband brought her
in to see AASECT member Aline P. Zoldbrod, Ph.D., for therapy.
Using hypnosis and guided imagery, Zoldbrod helped Julia to begin
to express the pain she had repressed as she tried to conceive a
child. "At times when they put the sperm in it hurt deep inside,"
Julia told Zoldbrod. while under hypnosis. "I would just lie
there, my vagina open with the speculum, and wait for the pain.
It was like the pain when the dentist is drilling."
Julia said that part of her knew that she was forcing her vagina
open, forcing herself to stay still and to relax. Another part of
her was screaming to get up, but she ignored that part. "I
was split off from my vagina and subjugating it. I would wait for
long periods of time alone with my vagina forced open. People, always
someone different, would come in, would withdraw the tube and then
the speculum. I would get up, dazed, and go pay the bill or whatever.
At that point, I didn't want anything to do with my vagina and my
vagina didn't want anything to do with me. We were in two different
worlds."
Like Julia, women who have undergone extensive but unsuccessful
treatments for infertility may wind up with feelings of disgust
and unworthiness similar to those often felt by survivors of rape
or child sexual abuse, Zoldbrod says.
These feelings seem more common among "strong" women,
those who endure painful medical procedures without complaining.
"If you're a strong woman there's a tendency to ignore how
you're feeling." Zoldbrod says. Repressed feelings may end
up devastating a woman's self image and her subsequent sexual
relationships.
After months or years of painful, unsuccessful infertility treatments,
some women "distance" from their bodies, Zoldbrod says.
Others feel disgust. Addressing their bodies in Gestalt therapy,
they'll say things like: "You're disgusting. You're useless.
You're defective. You're revolting."
"Useless is the one that really kills me, because a body that's
useless for producing children can still produce sexual pleasure,"
says Zoldbrod. "Feeling physically useless these women may
"split off' from their bodies.
One cause for this split is the way that infertility treatments
are sometimes performed, according to Zoldbrod. Often in the
course of treatment the focus is so much on creating a baby that
the woman's pain may be deemphasized. 'When you have a medical treatment
for cancer, everyone asks you 'How do you feel? Are you nauseous?'
And they often offer ways to deal with side effects from the treatment.'
But when you're having these treatments so you can have a baby,
people are saying. 'Oh, we hope it will work. Keep your fingers
crossed."
To circumvent the negative feelings that may result from unsuccessful
infertility treatments, it's important that doctors and medical
personnel be careful to inform a woman whenever a procedure may
be painful, according to Zoldbrod. Particularly in cases of "strong"
women, the woman may not permit herself to experience pain unless
the doctor first acknowledges the difficulty of the procedure.
"People are having children they never could have had a few
years ago," Zoldbrod says. "No one wants these high tech
procedures to stop. But there can be a downside. The technology
has outstripped the ethical and psychosocial sequellae of these
interventions."
With therapy, Julia was able to reestablish a healthy, enjoyable
sex life with her husband. In time they adopted a child. But the
key to Julia's healing, according to Zoldbrod, was that she was
able to overcome her stoicism and grieve for her physical and
emotional pain.
"Once she owned how upset she had been and how
much it had been like a rape for her, she was able to get back ownership
of her vagina," Zoldbrod says. "She regained ownership
of her sexuality."
Aline Zoldbrod serves on the national board of directors of
RESOLVE, an organization that helps women undergoing treatment for
infertility. Zoldbrod's book on the psychological aspects of infertility
treatment will be released this year. Her pamphlet, "Getting
Around the Boulder In the Road: Using Imagery to Cope with Fertility
Problems," can be purchased for $9 per copy by writing Aline
P. Zoldbrod, Ph.D., 12 Rumford Road, Lexington. MA 02420.
For information, resources and referrals regarding infertility,
contact RESOLVE at www.resolve.org.
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