CHANGE THAT THOUGHT!
"I'll never get pregnant." "I'll never have
a baby." "I'll never be a parent." "It's
my fault." "I must have done something really
wicked and evil." "God is punishing me."
"It's because of that abortion I had years ago."
"I should have started sooner." "I'm a failure
as a wife and woman." "I'm a failure in life."
Any of these thoughts sound familiar?? These and other variations
are all too often thoughts running like an endless tape loop through
the minds of women experiencing infertility. This negative automatic
tape gets going and is hard to stop as it spirals into worse and
worse thoughts and therefore seriously affects emotions and behavior.
Most of these thoughts are what we call irrational and distorted,
that is to say, they are not true and do not make sense. This
is what Dr. Alice Domar calls the "nasty mind" which
will not give up and let a positive thought in. Dr. Domar is the
founder of the well-known mind/body program for infertility that
has for 15 years been helping women handle the stress, depression
and anxiety of infertility. Learning to cognitively "restructure"
or "reframe" these negative thoughts is one of the cornerstones
of mind/body programs in general and of Dr. Domar's infertility
program in particular.
Cognitive restructuring is a "rethinking" process which
comes out of the field of cognitive therapy. I like to describe
it as "learning to think about how you think, and learning
to reframe negative self-talk." Cognitive therapy is one
of the most successful approaches to treating depression. While
the early research and work in this field was done by Dr. Aaron
Beck, the wider applications have been popularized by Dr. David
Burns in his Feeling
Good Handbook. The premise is fairly simple: thoughts
and attitudes cause your moods - not external events. Therefore,
if you change your thoughts, you can change your moods and emotions.
Maybe sometimes easier said than done!
In the case of infertility patients in particular, negative thoughts
such as the ones above contribute to a feeling of depression,
sadness, worthlessness and hopelessness. If the cognitive restructuring
process can be applied by the patient to that negative, often
distorted thinking, the research is very clear - depression decreases,
anxiety decreases, self-esteem increases, and stress in general
is handled better. The idea is to try to become aware of the negative
thoughts, figure out if they are true, challenge them if they
are not true, and come up with a thought/statement that is more
Clearly, however, some negative thoughts may also be accurate
and can't be restructured - the thought "I should have started
sooner" may have an element of truth if you are trying to
have your first child at age 44. Even though the circumstances
are such that you have just gotten married for the first time
or remarried, and couldn't really start a family sooner, there
is still the tendency to blame yourself for not starting sooner.
The truth is that you can't know what you didn't know, and you
couldn't foresee a problem, so sometimes it's good to cut yourself
a little slack about "should haves."
A fairly simple approach to begin to challenge some of the negative
thoughts is one which Dr. Domar uses in her program and which
I also use in my mind/body groups in Houston. As Dr. Domar points
out, and as you will find, the process is simple but not necessarily
easy. There are four questions to ask and answer about those negative
thoughts that keep jumping around in your mind:
Does this thought cause me stress?
Where did I learn this thought?
Is this thought logical?
Is this thought true?
For example, using the recurring thought, "I'll never get
pregnant," the dialogue might go like this:
Q: Does this thought cause you stress?
Q: Where did you learn this thought?
A: Well, I haven't been able to get pregnant, so I don't think
Q: Is this thought logical?
A: Well it seems logical based on the past.
Q: Is this thought true? Has anyone said you can't get pregnant?
A: I don't know. It seems true and logical to me since I haven't
been able to get
pregnant. No, all the doctors say there's no physical reason why
I can't get pregnant.
Q: If you don't think you can get pregnant, why do you keep
A: I guess part of me still thinks I can get pregnant.
A reframe of the original thought might be, "Right now I'm
having an infertility problem. I'm doing everything I can do address
that. I may be able to get pregnant. Maybe I can have a baby.
I'll leave open the possibility. I don't know what the future
The most important outcome of this process is to keep hope alive
and to stay out of depressed thinking, which feeds on itself and
makes everything appear so bleak. Practice the above process with
a friend - it helps with the infertility distress and with life
Mary Jane White, M.S., L.M.S.W. is the Director
of Wellness Works and the Mind/Body Wellness Program for Infertility
in Houston, TX. Cognitive restructuring is a major part of the
work she does with her infertility groups. For more information
on her program in Houston, contact Mary Jane at 713.874.1878 or
by email at firstname.lastname@example.org.
For more information on cognitive therapy and cognitive restructuring
applied to infertility, see:
Healing Mind, Healthy Woman, Alice D. Domar, Ph.D.
Conquering Infertility, Alice D. Domar, Ph.D.
The Feeling Good Handbook, David D. Burns, M.D.