Experiencing infertility is a life changing event and contrary to many assumptions, not all people walk away as a parent.
For Providers: What to do When We Identify a Gap in Our Mental Health Training
When we realize we have been unprepared for work with certain clients, it's ethical to figure out how to do better. We can feel shame and defensiveness, but I hope we also feel that we are on the edge of a great opportunity to learn more.
What happens when there aren't many options for continuing education related to the gap? Or, even more commonly, what if the continuing education that does exist was not created by someone with lived experience?
These are just some of my ideas and what I've noticed can be helpful. One workshop isn't going to be quite enough, so I'd suggest that all of these sectors are important. Any others ideas?
Note that I didn't say "ask your client to educate you about the larger issue," and I hope by now we all know that this is an unfair and potentially therapy-ending burden to place upon them.
"Katie, if being childless is not your entire personality, then why did you put 'non-mom' in your bio??"
I held a pretend Ask Me Anything* in my mind and this question arose. Why did I feel that tug to put ‘non-mom’ in my professional bio?
My answers and their tones:
Because I want to be clear that the material in this account is from lived experience (authentic)
Because moms do on their professional accounts (contrary and rebellious)
Because I've rarely seen it (lonely)
Because we need more representation and I'm willing to look like 'it's my whole personality' to do so (annoyed)
Because people might wonder (upfront)
Because it points out the fact that we don't have a good word for a 'me' (once again annoyed)
Because it's been a transformative shift to not be a mom one day. While I am many other things this experience has shaped me in ways I didn't expect (honoring something)
Because I am personally OVER receiving education/training from those outside the target identity and topic, and I want to help create this new norm in our field (driven)
Because it might make someone else feel less excluded (caring)
Because.... I'm sure there are many other reasons. I highly recommend hosting your own brain's ask me anything, it was an interesting thought experiment indeed!!
*This is how my brain works, I guess? lol.. My interior dialogue is quite vivid!
Bias in our clinical work with nonparent clients
I am enthusiastically committed to increasing childless affirmative practices within the therapy world. I’ve never heard anyone say that they entered the field to marginalize their clients, but we all carry with us aspects of power and privilege that can show up in our work. When I consult with or train other clinicians, here are some examples of questions I often ask to help guide the discussion about bias. Take a look and think how you might answer these:
Was your own decision making about parenting from a place of empowerment and opportunity and so you misperceive most other people felt this way?
Is it challenging to recognize your childless client’s grief as healthy instead of wishing they could move to a place of acceptance so they can embrace “childfree” life?
If you struggled to become a parent in some way is it possible for you to allow your client to also struggle, but with a different outcome, and see that outcome as equally worthy?
Who in your personal or professional life is a nonparent? What aspects of their lives are pitied or esteemed?
Are you hearing voices of childless clinicians? Where are they obscured?
When your client shares a story do your thoughts go quickly to an urge to share something related to your own parenting status? Or offer one that can justify your own parenting status?
What messages have you gotten from our profession about parenthood, ambivalence, and infertility?
If any of these sparked an aha moment, please take your insight to your colleagues, consult groups, and supervisors! This kind of exploration needs a community and often a good dose of self compassion. Once we know better, we can do better by our nonparent clients. I’d love to help support your work as well, you can find out more here on my website, or through my Instagram content.
Ambivalent, undecided, and circumstantially childless people, I see you!
Non-parents are a frequently misunderstood group in general. Who really understands the ambivalent, undecided folks or those who are facing circumstances that prevent parenthood?
You may be hearing:
Just relax, you’ll figure it out!
Why are you so relaxed about this? Time is running out!
Focus on your career to build a foundation for your life.
If you focus too much on your career you’ll miss out on finding the right person ‘in time' to have kids.
I just always knew I wanted to be a parent!
I’ve always known I didn’t want to be a parent!
You may be feeling:
Confused, alone, worried, unseen, isolated, undervalued, misunderstood, counter-cultural, lost, ashamed, rebellious, powerful, independent, content, connected, unique… all at the same time.
This can be a place that feels very conflicted with lots of judgement from society. I’d like to let you know that you are on your own path and there is not one simple answer for what comes next. It can help to find some community with others who get you or who have been in your shoes.
(A reflective note to therapists reading this: How were you trained to sit with ambivalence and disenfranchisement with your clients? Do you have an urge to help them decide quickly compared to other issues clients bring to session?)
About the author: Katie Maynard is a psychotherapist working with people on the brink of large decisions and transformative experiences, with a special focus on those reckoning with having kids or remaining childfree. Her trauma-informed training and warm presence create an atmosphere of acceptance while she examines and co-creates new life narratives with clients.
Five Welcoming Resources for Life after Infertility. (Yes, there is life after infertility!)
Image credit: Coffeegeek.tv
When you are in the thick of infertility it can be hard to imagine walking away from trying mode.
Trying to conceive feels like movement towards a goal, something to focus on that is perhaps more pleasant than being angry at your body for not working as you assumed it would. It turns out that more people that you would expect walk away from infertility treatment without a birth of a child. This is not advertised on the brochure, let me tell you. It certainly doesn’t show up in movies or books this way either.
When you are pondering what life may be like after infertility, or if you have already embraced this shift, here are some resources that may feel like coming home, where people ‘get you’ in a way that you haven’t felt in a long time. Each has its own flavor and feel, try them out and see what’s right for you!
Gateway Women- The global friendship and support network for childless women. “Whether you're childless due to infertility or circumstance you're in the right place. Pull up a chair. Get a cup of tea or something stronger and make yourself comfortable. Things are just about to get a whole lot easier.” This website is full of great resources and the Gateway Women online community site is lovely too.
Chasing Creation- “My aim is to fill these pages with stories, resources, research, and insight that will do the same for you. On Chasing Creation, you’ll find posts about:
Recognizing and working through grief.
Processing the aftermath of infertility.
Designing a childfree life.
Redefining your identity.
Strengthening your relationships.
My favorite books and resources.”
Clan of Brothers- “A group to give childless not by choice (CNBC) males a safe place to find support and encouragement from their brothers around the globe. Please note this group is for males only and is not for anyone who has had a child (biological, adopted) or still trying to conceive.”
Childless by Marriage- “In a society where most people have kids, some of us don't because our partners are unable or unwilling to make babies. That's what this blog and my book, Childless by Marriage, are about. Let's talk about what it's really like.”
Savvy Auntie- “SavvyAuntie.com is the first and only community for Aunts: Aunties by Relation (ABR), Aunties by Choice (ABC), Great-Aunts, Godmothers, and all women who love kids. SavvyAuntie.com enables and empowers Aunts to exchange ideas, get advice, find gifts and connect with other Savvy Aunties.”
The sentence my childless ears needed to hear from a medical provider... and didn't
“Katie, you might have kids but if you don’t life will still be awesome.”
No one along my ‘journey’ of potential parenthood thought to give me this particular insight or support. A few were very supportive of whatever mood I brought into my appointment but still didn’t quite get into the territory of helping me see that life without children would still be vibrantly awesome.
Instead I heard:
“Just relax, I bet it will happen in Maui.”
“You’re so healthy, I’m sure you’ll get pregnant!”
“You have plenty of time” (I was 42. That was.. perhaps inaccurate?)
“Don’t give up yet.”
“I can just feel it, next year at your checkup you’ll be a mom.”
“Stay hopeful and positive.”
“It’s probably just…. (insert weird stereotypes, medical myths, and pop psychology)”
I was such a compliant and provider-pleasing patient that I actually smiled and nodded during this crap. I’d cry in the car or be grumpy for days after without understanding why. I learned to tell myself what I needed to hear. My husband and I repeated it to each other frequently “We’re going to get through this and life will be amazing no matter which path!” or, on less perky days “This sucks, but we can still have a house full of dogs and craft projects one day if we don’t have kids, right?”
I started peeking over into the books, podcasts, and blogs of childless folks to make sure it was ok there. It was! It was the most authentic and validating space. I lurked around but didn’t participate until childlessness felt like my full identity. I learned a lot and could name what I was going through - disenfranchised grief, ambiguous loss- and that it would transform my life and sense of self in unexpected ways, but not always horrible. They gave the first confirmation of the reality that life is still shiny and happy without kids.
Should providers stop saying hopeful things? Perhaps not, that would be kind of a bummer too. At the very least, stop telling people to relax. The support we give our clients and patients needs to resonate with their mood and the circumstance and give permission for the person to take off the mask of positivity. Make sure to check in with the ones that smile through the appointment too.
A Therapist’s Reflections on the Pandemic
Let’s start by saying there is A LOT I could tell you about what it has been like to provide therapy during a pandemic. Many articles worth of content, for sure. I would like to share the lessons I’ve learned and some things that I’ll be taking away from the experience.
The most prominent question in my mind is:
“Why hadn’t therapists embraced telehealth as a norm before we had to?”
Some answers I’ve arrived at include:
Ableism
Need for power and control
What our supervisors and educators taught us (often decades ago)
A healthy frame for therapy (confidentiality, a separate and safe space)
Technology barriers for both client and therapist
Fear of doing something different from one’s peers
Biases about certain types of communication (this is part of ableism too)
Lack of training about its benefits
Perceived difficulty in providing certain interventions this way
Disenfranchisement of the therapists already doing telehealth in years prior
Personality of the therapist
Prioritizing our needs as therapists over accessibility for clients
We all carry bias and this has been a large wake-up call for me to address what preconceived notions formed my therapeutic norms. While I am planning on going back to offering in-person services one day, I will absolutely always keep telehealth as an option for clients. Some people likely miss me in person, others are pleased as punch to use video. Who am I to decide what is best!?
This year created an opportunity for me to tap back into the creative learner that I was in grad school and during my first clinical internships. At the start of the pandemic, part of me felt like a total imposter and part felt really inspired to figure out how to serve my clients the best way I could given our professional standard of care to meet virtually. Since I hadn’t worked this way before, I got lots (and I mean LOTS) of training on therapy via video. I am greatly indebted to those telehealth savvy clinicians who paved the way for me and mobilized our profession to meet our challenges. I am so sad that we had potentially not seen them as performing ‘real’ therapy in the past since it was not in person.
I remember an article we read in grad school titled “They Don’t Come In,” which basically reminded social workers that we should be empathic to the real needs of our clients and see the world through their eyes instead of judging them for what looks like cancelling or ghosting. If a client does not bring their body into an office for an appointment and we get cranky that says more about us than them. How lovely for a client facing (insert any barrier) to be able to say “Hey, can we do a virtual session today?” and to be heard and appreciated within an authentic relationship. It didn’t take a pandemic for me to know this, but it has certainly highlighted where therapists can do a better job of listening to those we work with.
I’ve heard the phrase ‘back to normal’ about a thousand times at this point and it feels problematic to say the least. The before times weren’t normal or good, even in the therapy world. This experience has shown that real therapeutic relationships can be built via telehealth and clients can experience the same clinical benefits as those from in-person services. I’m here to enthusiastically support people through the modality that is most accessible and meaningful for them.
The Terminology of Parenthood or Non-Parenthood Carries a lot of Weight
For some of us, what to call oneself as an adult without children can feel very complicated and disempowering. Parenthood is seen as the standard and any term to describe non-parenthood includes a ‘lack’ of something. Options I’ve seen: childfree, childless, childfree after infertility, childless not by choice CNBC, childless by choice, childless by circumstance, involuntarily childless, voluntarily childfree, nonparent, nonmom, nondad.
Thesaurus.com gives us this really appealing list of synonyms to choose from:
Words can feel so invalidating to the lived experience of childlessness
It can be an identity crisis we didn’t know was coming. What does it feel like to name yourself childfree in a world that sees you as a second class adult or judges your choice? What is it like to call yourself childless to demarcate the fact that you have lived through a huge transformation in your expectations about life but then be presented with overt or subtle critique that if you really wanted parenthood you would have found a way.
Each person, even within the same relationship, may prefer a different term. It can also change! Personally, some days I feel quite childless and then others I identify with childfree. I’m a non-mom who loves aunthood. I smile at every baby but have never yearned to go through pregnancy. I have a childless home life but delight in the part of my practice that is child-full. If I abbreviated my truth it would be - CACABICBAAFR: Childfree after circumstantial and biologic infertility compounded by ambivalence and financial reality. I assume every other person I meet without kids has a unique story. It’s important to follow the lead of the person and respect the terms that they use even if they don’t resonate with you.
Mental Health professionals and childless clients
A note for any mental health professionals reading this- If you work with childless people and have yet to think about your own unconscious biases about this group, a great place to start is thinking about how the terminology of non-parenthood may enter your sessions. We are taught to both follow the client’s lead and also to examine our countertransference in the room. What about this terminology strikes a chord within you and why? In my writing on my website I tend to use “childless” and “childfree” because they are so widely known but I respect and honor all terms!
Finding a therapist if you are childfree by choice, childless not by choice, or any of the many combinations that bring us here.
I firmly believe that therapy should be a place where we can feel safe from relentless bingos and misunderstanding. (Why didn’t you adopt? Don’t you worry you’d regret your choice? Ah, you get to sleep in.. You need to move on from this anger.) We guard ourselves in so many other relationships that it may feel like second nature to give our canned response to a therapist and then retreat from the topic that had been at hand. Of course, bumps in communication and understanding will absolutely happen in every therapeutic relationship and can sometimes even lead to growth and more safety.
Here are some tips to find a therapist who either has put in the work to serve you well or will put in the work as the two of you go along. (A therapist that thinks they’re done learning is a big ‘Nope!’ in my book.) I want to acknowledge that many areas may have only a few therapists to choose from, which is so hard. If telehealth is an option for you and your health coverage or pocketbook, don’t forget to expand your search beyond your zip code! Please note that I’ve included a wide array of ideas. Some of these items may stand out to you as important and others may feel like ‘meh, not for me.’
If a therapist treats you poorly for asking any of these questions (or, really, anything else you are wondering) that is their own ‘stuff’ coming up. A quick little reality check is to ask yourself:
“Would I expect a therapist to balk at questions about their training in postpartum depression? About life transitions such as becoming a Grandfather? About working with clients who are facing discrimination at work due to their parenthood?” Mm hmm..
Questions you can ask a therapist as a childless/childfree person:
· Are you a parent? (The BIG ONE, right? Therapists may practice from a theory where they do not share personal details, which is their prerogative. It is also absolutely ok for you to want to know and to move on if their answer doesn’t feel good to you.
· If you are not a parent I am wondering if you will understand my story of how I have also arrived here- it may be different from your story!
· If you are a parent, have you received professional training or consultation about working with childless/childfree people to expand your understanding of the many dimensions that I may bring to the table as well as your own biases?
· If you haven’t received this training, are you willing to do so as we meet?
· I’ve felt misunderstood and even microaggressed in therapy in the past. Sometimes I close down to avoid feeling like this. How can I bring this up if it happens?
· What do you think might be some misunderstandings you and I could have about my life as a non-parent?
· Being childfree/childless is not the central issue I’m wanting to work on, but it will certainly be relevant at some point. How will you make sure that you and I are paying attention to this part of my identity?
· Who is your favorite childfree or childless icon, writer, character, community member etc.? (Side note: Check out Gateway Women’s Pinterest board to see several hundred of these role models!)
· If I’m not a good fit for your practice, do you know any other therapists that I might contact?
Look at their websites for biases about childlessness:
· Do they have a bio section and how does it align with your own experience? Have they included the pronatalist norm of a married couple, kids, and pets? If they’ve included this they may feel it makes them relatable but don’t understand how ‘othering’ this could feel to people without those things.
· How do their images and writing feel? Are they using phrases like ‘busy moms’ or ‘stressed dads’ or always seem to equate adulthood with parenthood?
· Are they overwhelmingly focused on kids and families? (This is kind of funny for me to write, since a third of my practice is with children. It’s an interesting combo due to my lived experience. If you do some questioning you could learn that they actually have deep experience various ages of people or perhaps they have focused on children in the past, but their heart really lies with adult work at this time.)
· What is their intake paperwork or disclosure statement like? Does it feel affirming to you? For instance, asking “tell me about your loved ones” can feel very different from “describe your family.”
· What items do they reference in their blog or resources section (books, podcasts, apps) and are they resources that you would actually use? Are they inclusive of people without children?
Sleep-ology! (More accurately, Somnology)
Most people I meet with are not sleeping well. It can be a bit of the chicken or the egg- for instance, anxiety produces sleeplessness and sleeplessness creates negative mood. I am really (REALLY) into the podcast Ologies, and just finished the sleep episode. It’s great! Dr. Winter describes the science behind sleep as well as some tips and tricks to make sure you are getting enough quality shut-eye. You can listen to it online or through your favorite podcast app.
Boundaries and bullies
It is so very hard to hear that your child has experienced bullying, racism, or hate speech. I love the heartfelt message of this video that describes healthy boundaries in a really kid-friendly way. Her forcefield metaphor is especially great! Click on the image below to head over to Hey Sigmund’s great website.
Iceberg of Dysregulation
I love this graphic! While it's intended to help explain childrens' behavior, I think it totally applies to adults too.
The Invisible String
Sometimes you find a book that's a true "keeper!" I love The Invisible String by Patrice Karst for its relevance to so many ages and life challenges. I know many families face separation anxiety and grief/loss and would benefit from this metaphor of an invisible string attaching loved ones no matter distance or time. The story is simple enough for very small children, and relatable enough for all ages. I use this in session with clients and families and often incorporate a memorable activity to drive home the message. This book is listed on my Resources page- check it out to see what else I use recommend and use often.
Why We Laugh
When was the last time you laughed? Have you ever stopped to wonder why we laugh? Dr. Provine has been studying laughter for 20 years (Which sounds like a pretty awesome job!) Check out this video to learn more.