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Infertiliy – from a family therapy/systems therapy perspective
Uschi Van den Broeck Clinical psychologist Family therapist Leuven University Fertility Center (LUFC) Leuven, Belgium
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Overview
1. Introduction to family systems theory
“you can’t have one without the other…”
22. Family systems therapy and infertilityF il t th d i f tilit
“we are family – so what’s in a name?”
3. Navigating through clinical practice
“the land of ‘if’ and ‘maybe baby’…”
1. Family systems theory
• “people are best understood in the context of
their mutual interactions and systemic
relationships” (Bertalanffy, 1968)
connected, interdependent, interrelated
families are dynamic
individual ≠ unit of analysis
“You can’t have one without the other…”
The basics
Holism
Inter dependence
Equilibrium
Hierarchies Boundaries
Feedback loops
Goal orientation
Theoretical frameworks on sale…
The shoe that fits one person, pinches another.
There is no recipe for living that suits all cases. ~ C. Jung
Specialize in psy crisis & treatment & psycho- education
Childwish & Family Systems Theory
Client-centred Therapy (empathic listening )
Relationship issues (e.g. communicatio n strategies, EFT,…)
Theory
Develop- mental Theory
Cognitive Behavioral Therapy (e.g. relaxation, cogn restructuring, …
listening,…)
2. Family systems therapy and infertility
- Couple = unit of analysis
- Couple relationship =
- Powerful system of mutual influence andPowerful system of mutual influence and
interaction
- Explains infertility experience (coping, emotional
reactions) better than looking at men and women
separately
(Peterson et al., 2006)
From family systems theory
- ‘hierarchy’: families organize themselves into
smaller subunits e.g. parents, siblings,
couple,…
- ‘interdependence’: all members are
influenced by each other
- ‘boundaries’: who is in or outside of the
family system?
2. Family systems therapy and infertility
A. Understand child wish
B. Insight into couple dynamics in
infertility and its treatmentinfertility and its treatment
C. Social and societal perspective
Æ insight into burden of treatment
A. The wish for a child
• Child wish: a complex phenomenon
‘Biological parenthood’
= implicitly valued and primary role in western society
= ‘script’= script = developmental milestone
Multifactorial Motives:
= Individual = Relational
= Transgenerational = Sociological/Society
Infertility: unfulfilled wish for a child
Continuum:
Imaginary child
Real child I am pregnant A child in me Birth
Psychologically, the wished for child is present.
Physically, the wished for child is absent.
- Wish for a child: process of attachment and growing towards an ‘imaginary’ baby and confronting reality e.g. the ‘wished’ for child versus the ‘actual child’
- Crisis of infertility as a transition to non-parenthood
- Boundary ambiguity
B. Couple dynamics
• Infertility: “layers of meaning”
• “couple congruence” (McCubbin, 1993)
Æ Adaptation to stressorsp
• “gender differences” (Jordan, 1999)
Æ Social meaning and expectations, coping with,…
• Impact on marital relationship:
- Positive or negative
- Many stressors (sexual functioning, social family networks, quality of life,…)
- Literature: conflicting findings
C. Social and societal perspective
• Burden of treatment:
– ‘Life on hold’
– Uncertainty and confrontationsUncertainty and confrontations
– To tell or not to tell (boundaries)
3. Navigating through clinical practice
• “the land of ‘if’ and ‘maybe baby’…”
The Land of If got its name not only because IF is the abbreviation for “infertility” in the online world but also because there are so many ifs inherent in b ibeing here. There are what ifs and if onlys and if this, then thats. If (there’s that h Th h t if d if l d if thi th th t If (th ’ th t word again!) you are accustomed to having a pretty tight rein on your life— accustomed to working hard and seeing the desired outcome, or being able to predict what comes next—the Land of If is going to be a particularly difficult stopover for you. Being here is all about living in uncertainty and doubt and wonder and hope: If only I had gone to the doctor earlier. What if I hadn’t bought my husband that package of tight briefs from Costco? What if my wife hadn’t laid out our adoption profile to look like a scrapbooking-store explosion? If I go past the baby aisle at Target, then I will have a nervous breakdown between the onesies and binkies. ~ Melissa Ford: http://thelandofif.blogspot.com/
3. Navigating through clinical practice
• How can family systems theory help?
- Broad perspective on complex issues
- Helps to understand the complexitiesp p
- Take the system into account
- Enlarge the system (couple dynamics!)
- Listen to the narratives and the stories
- Help create different stories
- Help make sense and give meaning within the
greater system
3. Navigating through clinical practice
• Clinical techniques:
– Emotionally focused couples therapy
– Communication techniquesCommunication techniques
– Creative techniques (non-verbal)
– Narratives
Case illustration
- “I’ve been in treatment for 2,5 years and I barely recognize myself. I get so angry and bitter – I blame all the world and myself with it. I don’t understand why this is happening. Everything has changed; the way I look at myself, my husband b tbut also my family. Their lives will go on; my sister will become l f il Th i li ill i t ill b grandma one day and we just won’t. What will I be, who will I be once this is over? Will it ever really be over?”
THANK YOU FOR YOUR
ATTENTION! QUESTIONS?
For more information:
Uschi.vandenbroeck@uzleuven.be
