Couples therapy

Fertility Counseling


Fertility struggles are a tremendous stressor, both individually and as a member of a couple.  My fertility counseling with couples centers on the following five areas.  Which areas we focus on depends on you – some couples want help with all five, while others find that there is really just one or two that they need to focus on.  If any of the following rings true for you and your partner, counseling may help.

How infertility affects interactions with the outside world:  Infertility is often very isolating.  Friends and family often say the wrong thing, asking intrusive questions or minimizing the problem with comments like, “Just relax!” or “there’s always next month!”  Sometimes couples want help strategizing how to support each other in dealing with the outside world.  Sometimes they find they have real differences of style around this issue, with one partner wanting to be very open and the other desiring much more privacy.

How infertility affects interactions with each other:  Fertility issues can take an enormous toll within a relationship.  Sex becomes less spontaneous and sometimes can be tinged with anxiety or grief.  One partner may become quite depressed and the other partner doesn’t know how to help, or may feel inadequate or resentful.  This can lead to a feeling of isolation within the couple – isolation from the one other person whom we feel “should” understand what we’re going through.

Thinking through the emotional and developmental implications of decisions we make on the fertility journey:  Fertility interventions require us to make big life decisions that we (1) have no expertise in and (2) have really, really big emotions about – never a great decision-making combo!  Often we need help putting ourselves in another person’s shoes, whether that person is our partner, our future child, or someone helping us achieve our dream of a family by donating an egg or sperm, becoming a surrogate, or placing a child for adoption.  Often we need help explaining our feelings to people we love.  For example, a couple may find themselves at odds when one person’s religious convictions prohibit certain fertility procedures, causing the other person to feel he or she is being deprived of the best possible medical care.  A woman using a donor egg may be terrified of telling her child about the donor, believing that it will impede her relationship with her child and cause the child to favor the father, not thinking about what a secret will do to the relationship.

Fertility issues have caused old wounds in the relationship to surface, causing a generalized level of distress in every day interactions and at times making it feel like the partnership is at risk.  At these times, fertility issues like boundaries and decision-making can feel like lit matches in a room filled with gasoline.  But believe it or not, it’s possible to work through significant relationship issues and fertility issues together.  Using EFT as our guide, we can help you regain the sense of trust and teamwork necessary to face life’s challenges.

Medical Couples and Family Counseling

Acute or chronic illness affects not just the patient, but everyone in the family.  Just as I do with individuals, I base my approach with couples and families dealing with medical issues on collaboration with other health care professionals, a family systems approach, a developmental approach, and a life cycle of illness approach.  Much like fertility counseling, my approach with medical issues will explore the following:

How illness interfaces with the outside world:  Couples and families need to negotiate how and when they will interface with the outside world around an illness.  Sometimes one person wants much more or less privacy than others in a family, for example.  Sometimes an illness progresses to a point where a family that has successfully cared for a patient on their own needs outside help.  Illness can affect custody schedules, childcare needs, the ability to plan outings with friends and families.  People who have never relied on others may suddenly find themselves in need of help.  All of these things are normative challenges brought on by illness, and with some flexibility can be handled with grace and ease.

How illness affects family relationships:  Illness can turn certain things upside down in familial relationships.  Power dynamics can become askew when one member of a couple becomes ill.  Children may need to take on new responsibilities.  Often these changes can bring with them emotions of guilt, anger, or resentment.  These are all normal challenges that can feel super-charged and exacerbated by our feelings about the illness itself.

Making major decisions regarding disease:  The opinions of family members often differ radically regarding such things as ending treatment, seeking second opinions or experimental options, preparing wills and health care directives.  Mediated conversations with a therapist can help family members approach one another around delicate topics, lower the heat around highly charged topics, and ensure that everyone gets to say their piece.

Exploring how the illness is affecting the couple relationship, and whether old wounds are making it difficult to effectively mobilize around the illness.  Sometimes “stuck” places in a relationship can make it difficult to tackle issues around medical care.  Acknowledging and working on these places can help to move forward in illness management.

Emotionally Focused Couples Counseling (EFT)

Couples often come to see me because they find themselves locked in a negative pattern of interaction that they can’t seem to get out of.  They love each other dearly, but one person is always criticizing the other, while the other feels constantly on the defensive.  One person feels unfulfilled and the other inadequate.  If they are parents, different parenting styles or beliefs may be exacerbating the wedge between them.  Infidelity may have complicated and intensified everything negative, or introduced new negative patterns based in mistrust.  In this situation, one or both members of a couple may be in a state of despair.  Will they ever be able to feel uncomplicated joy and trust in their partner again?  Will they ever be able to cooperate and feel like they are part of a team?

The answer is yes. While all couples have moments in which they wound each other, the difference between those that thrive and those that merely – or barely – survive is the ability to share vulnerabilities and reconnect and repair with each other.  EFT helps couples identify the negative patterns in their relationship and the emotions driving those patterns.  Identifying the pattern helps the couple move from blaming each other for negative interactions towards working together to break the pattern, producing more intimacy, closeness, and joy.

EFT is a extensively researched and empirically proven to work.  Indeed, the data show that over 70% of couples report recovery from relationship distress after EFT, and that 86% report significant improvement over controls.  For a summary of EFT research, visit the International Centre for Excellence in Emotionally Focused Therapy.