8. Psychological approaches toward infertility

Psychological counseling for infertility relates to raising the awareness of individual and/or couple by spreading information and skills during diagnosis, treatment, and post-treatment stages of infertility procedure; counseling is offered by a professional specialized in the field of psychology. Patients are assisted in their decisions on treatment and can thus develop coping strategies against the devastative emotions surfaced emerging because of infertility [64]. Studies in relevant literature underlined that until the 1980s, infertility was categorized as a psychosomatic case that reflected a woman's ambivalence emotions to motherhood or unsolved conflicts with their own mothers. Hence, treatment was generically administered by psychoanalytic-oriented psychiatrists [65]. Menning [66] argued that mood changes were not the cause but rather the result of infertility. Therefore, he founded Resolve the National Infertility Association (RESOLVE) to provide emotional support for infertile individuals residing in the United States of America (USA) and climb public awareness by offering courses on infertility [66]. An increasing number of literature studies started to acknowledge psychological effects of infertility and highlighted the importance of supportive counseling interventions for those undergoing infertility treatment [66].

Psychological counselors for infertility can offer services by consulting to theoretical approaches such as psychodynamic, individual-centered, cognitivebehaviorist, or solution-focused interventions. Although the methods being

employed are different from one another, all of the psychological counselors on infertility adopt a common objective in taking care of emotional well-being of the couple and when need be they strive to boost their psychological integrity and resources [67]. Responsibilities of a psychological counselor for infertility are given in Table 1 [68–70].

As a reflection of the latest multidisciplinary medical approaches, there has been a consensus among medical community that psychological counseling should be a complementary step for the biological treatment protocol of infertile couples [71]. In psychological counseling protocol for infertility, there is a wide range of intervention types catered for the different levels of help needed among different couples. In psychological counseling for infertility, there is a myriad of counseling options such as informative and decision-making, supportive counseling, and therapeutic counseling. Informative and decision-making is the first stage of infertility counseling. This stage involves comprehensive explanations on the causes of infertility, suggested treatment options, potential expectations from the treatment, and the way treatment process could affect their everyday life [72]. At the onset of psychological counseling protocol for infertility, it is suggested to openly communicate about ideas, expectations, doubts, and worries of the clients on psychological counseling so that objectives of each session could be specified. Indeed, for many couples, this session is generally the very first meeting that they have ever had with a psychiatrist for a lifetime [70]. That is why the couple may be resistant to share their private matter with a third person and feel like being labeled. It is thus suggested that in the first session, mutual duties and responsibilities, notice on privacy, and providing a safe and supportive setting to help the patients discover and manifest their emotions toward infertility are some of the items to focus on [65]. To maintain a satisfactory session, some of the essentials are active listening, empathetic approach, adopting a respectful language toward the viewpoint of each client, identifying the meaning or importance of the problem for the client, and to make the targets achievable within the control of client. In these sessions, it is aimed to help the patients understand that most of their infertility reactions are normal and predictable, to discuss about the process toward obtaining desired solutions, to conceptualize or reinterpret the problems with solution offering methods [2].

Among the main objectives of infertility psychological counseling are providing some coping strategies to the individual and couples diagnosed with infertility,


#### Table 1.

Responsibilities of a psychological counselor for infertility.

## The Psychosocial Aspect of Infertility DOI: http://dx.doi.org/10.5772/intechopen.80713

emotional readiness to the treatment process, discovering the options, assisting in making a choice, and determining the effects of infertility on the individual and his/ her immediate surroundings. Having recently renowned as a domain calling for professional expertise and skills, psychological counseling for infertility gives a chance to infertile individuals to seek the ways for enhancing, exploring, and clarifying their life quality and satisfaction. It also gives them a means to express infertility-related emotions such as deep misery, guilt feeling, anxiety, and explore the problem's traces on their self-perception and body image. Making sense of the emotional and physical changes undergone during treatment process is critically important in the future plans of individuals coping with infertility and to overcome the hardships they are exposed. It is thus suggested that psychological counseling for infertility that can offer the individuals a safe reserve for self-expression is quite a salient service catered for infertile individual and couples [73–77]. Psychological interventions play an important role in the treatment of infertility, in particular, for infertile patients who are not receiving medical treatment [78].
