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Fertility patients' self-care: counselling and support during the COVID-19 pandemic

30 March 2020
By Angela Pericleous-Smith
Chair, British Infertility Counselling Association (BICA)
Appeared in BioNews 1041

This is an unprecedented time, never in living memory have we experienced the dreadful and extraordinary repercussions of a pandemic. As an infertility counsellor I am turning my thoughts to the numerous fertility patients who have had their fertility treatment disrupted, postponed or cancelled. If you are one of those patients, whether you were about to begin your treatment or if it was already underway, it is highly likely that your vulnerability and anxiety levels have been intensified by the decision to halt treatment services.

It is likely that you have already endured a long, painful and gruelling journey, with many challenges along the way, to finally reach a point of commencing or being about to commence treatment. The unexpected and sudden loss of treatment options has left many patients with fear, no sense of control and a heightened feeling of uncertainty about their fertility future. A sense that everything has changed, whilst at the same time nothing has changed for the better, hence a range of emotions are to be expected at this time.

You may experience a multitude of reactions, including: sadness, frustration, anger, guilt, fear and, perhaps for some, even relief. If you have experienced the pain of unsuccessful treatment, abandoned cycles, miscarriage and loss, you may also find that painful memories are re-triggered.

'Alone' is a word I hear on a daily basis; trying to conceive can be an isolating journey, so at a time when clinics have closed their doors and the government is asking everybody to isolate, it is understandable that already heightened anxieties are exacerbated.

When our world has been turned upside down it is vital that the we acknowledge how we're feeling. Support is essential in finding meaningful ways of validating our feelings and giving us the permission to experience the full range of emotions we might have. The help of a specialist fertility counsellor can help empower you to name and feel your feelings, resulting in the ability to process and find meaning in your pain and grief.

It is common to dismiss painful feelings and replace them with thoughts of people who are worse off, particularly at this time during a public health crisis. Whilst not denying that this is true, life is also subjective and it is imperative that, to avoid a downward negative spiral, we do not dismiss our own feelings, as this often leaves us with a sense of worthlessness.

It is completely natural to imagine scenarios with negative outcomes, which is known as 'anticipatory grief'. The future is uncertain and any sense of control we previously had has been unexpectedly snatched away, leading to thoughts of worst case scenarios.

Validating our emotions and thoughts is vital, as is setting aside a time limit to focus on them, which can be hugely helpful. With no time limit we may quickly find ourselves spiralling downward, losing optimism and only focusing on the negatives. It is crucial we reach a place where any negative thoughts can be replaced with more balanced, rational and healthy thoughts. Whilst it is common and completely natural to have negative thoughts interweaved with positive surges, the primary goal is to find balance.

When we are completely overwhelmed and struggling in our discomfort, it is often helpful to focus on the present time, using a grounding technique for a sense of calm, bringing you back to the here and now. Focus on your breathing, your sensations of breathing, the ground beneath you, five things you can see around you, four things you can hear, three things you can touch, two things you can smell and one thing you can taste. Breathe and acknowledge that in the present moment none of your negative scenarios have happened.

Identifying something that will add value to your day can generate positivity and a sense of achievement. This is something you can control at a time when you have little control. Now is a time to be positive about your future, which you can begin to work towards right now:

  • Self-care is no less important when you are not in active fertility treatment. Focus on becoming healthier and eating well.

  • Our physical and mental health is inter-linked, hence creating a routine that includes some form of physical exercise can help.

  • Mindfulness techniques, like the one above, or other relaxation methods, including meditation or music, can be useful to help calm the mind and learn to let go, as well as simply going with the flow at this moment.

  • Writing or maintaining a journal of your feelings and experiences can be a therapeutic outlet allowing thoughts to be processed.

  • Joining a group can help immensely, such as a book club or other past time you enjoy, many of these can now be accessed remotely. Fertility podcasts are increasingly popular and there are also thousands of non-fertility related ones.

  • Gardening can often be therapeutic as you tend to something you can control.

  • Learning new hobbies can help to shift focus and keep your mind distracted.

  • Working through a 'to do list' of jobs in the home will keep you both busy and feeling positive when you tick off jobs completed.

  • Practise gratitude. Remind yourself every single day of one thing you are grateful for.

The most essential coping tip at this time is communication. Allowing time in your day to talk about your feelings can make a significant difference to the sense of isolation you may be feeling. Think about your support network – your family, friends and colleagues, and if you haven't shared your journey yet perhaps now is the time to identify at least one person you can talk to. Communication is extremely important for everybody, particularly if you are single and facing this challenging time alone.

No two individuals will ever have the exact same experience but an opportunity to connect with somebody who has a shared experience can make a difference. The more informed we are, the easier it can be to cope. The national patient charity Fertility Network UK, All About Fertility and the useful links sections on the British Infertility Counselling Association (BICA) website all provide reliable information, factsheets, and peer support networks.

It is normal to need support at a time when you may be feeling stuck and distressed. Counselling can help to aid mental health, support wellbeing and build resilience with the ongoing uncertainty during this pandemic. Although fertility clinic doors are temporarily closed, the fertility counsellor in your clinic may still be continuing to offer support remotely via telephone or online. Please do not hesitate to contact your clinic for details. If this is not available to you, the BICA website also has a directory of specialist accredited fertility counsellors offering telephone and online sessions.

SOURCES & REFERENCES
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