When I Interviewed... a Fertility Counsellor
Updated: Jul 2, 2018
We are sitting in our NHS Fertility Clinic at our first consultation. The consultant is asking me to tell her the dates of my last 3 menstrual cycles. I explain they are not regular and the only way I can remember the (totally erratic and in no way memorable) dates, is by looking at my “period tracker” app on my phone. But it isn’t loading.
She tells me to stop looking at my phone and to tell her the dates.
I tell her I need to look at my phone if she wants the (f*&%^-ing) dates. (I don’t actually swear at her). Then I cry.
This doctor and me; we don’t seem to be…getting along.
The doctor says I am ‘clearly stressed’ and she’s going to refer me for counselling.
PFFFFFFFT!!! I think: I don’t get stressed. I am a very capable person. I have never had counselling and I don’t need it now.
Oh, how much I have learned since that fateful, emotional, stressed out day. How humbled, grateful and aware I am now about what it means to recognise when you are stressed and when you need support. How to take ownership of how you’re feeling. How to say: I need help. And be OK with that.
I had an amazing counsellor through the amazing NHS. And she changed my life at that point. I felt safe, supported and ‘held’. I got stronger because of my counselling. Acknowledging that I needed help was not a sign of weakness. It was a sign of strength.
So, of course for my book and the blog and Instagram, this is a HUGE message that I feel very passionate about and I believe is sooooo important to get the hell out there!
Please. Please get support if you need it. It doesn’t have to be counselling, but counselling might be a good place to start. And FYI: if someone else goes through what you have and ‘coped’ without counselling, that is neither here nor there.
It doesn’t mean you are ‘weaker’ than they are. It doesn’t mean they get a medal at the end of it all because they didn’t seek help. They might just not have needed it and that’s normal too.
It’s all normal. We are all normal whatever we need. We just need to learn to UNDERSTAND, honour and love ourselves enough not to berate ourselves for needing it.
I interviewed an absolutely wonderful fertility counsellor who explains a bit more about what counselling can do and why it can help people going through fertility.
Ladies and Gents, meet the gorgeous, kind and generous: Vicky Parkin.
Vicky is a specialist infertility counsellor and an holistic fertility therapist which is AWESOME. She has some brilliant insights which I hope will help.
A:Vicky, why did you train?
V: I had trouble conceiving both of my boys and that prompted me to do two things. I trained as counsellor because like you, I realised what a massive difference having counselling made through my journey. I also trained as an holistic fertility therapist, as this made a huge difference to me getting pregnant.
I work as a counsellor independently, and for various fertility clinics. I have also recently set up Fertility Fit. My idea is to forewarn people and get them into the best place they possibly can be before they even start treatment. I think that’s becoming more and more important now people are paying for their treatment. I often see people who are going through a cycle and they say to me things like –I hadn’t done that, I wasn’t really fit, I wish I’d stopped etc…
It just occurred to me to revisit the training I did 10 years ago to try and get people in a good place before they even start. I would like to see everyone who has fertility treatment do that before they even think about having treatment.
A: That echoes something my doctor said when I interviewed him. He talks about trimester zero. It’s good to hear from a medical perspective that that’s what people should be doing.
V: Yes, and I know from my own experience! It took me 7 years to conceive my 2nd child ,in the 7 years I tried fertility treatment which didn’t work, I had endometriosis which left me in agony. My aim to try to get pregnant actually changed at this point to: “I just want to be able to play with the child I’ve got, and not be in pain”. And for me, seeing a therapist who helped me change my lifestyle, my diet and my stress levels stopped my pain- but also got me pregnant.
I’ve had first-hand experience that it does work. Initially I had tried doing it myself. Self-medicating, researching on the internet and it didn’t work for me, I needed someone to look at me from an impartial point of view. And that’s where fertility fit came in, I just feel that people need somebody to help them get it all right, to be “fertility fit” in the lead up to treatment in a really un-stressful manner! So, that’s my vision.
I continually see people who say to me, “I stopped drinking coffee this cycle, but now I am drinking it cos I read something else saying I should” so the conflict was massive.
I really notice the difference it makes for people who are having some support. I think that most who are having their treatment when they’re offered counselling think, ‘I don’t need counselling, I don’t want to see some weirdo who’s a bit of a hippy!”.
And in a way, they’re quite right. If they weren’t having fertility treatment, they probably wouldn’t need it. So, it is a bit conflicting. I also think quite a lot of people are a little bit frightened of being labelled; they fear someone asking for counselling means they can’t cope and worry that their clinic may say they can’t have any more treatment because of this.
A: And also frightened of it because I think there’s still a stigma to having to admit that they need support, but I want to try and emphasise accepting support is not a weakness and in face recognising when you need it is one of the most important parts of this whole journey.
V: Absolutely. Interestingly I was sort of recognising this stigma and I think it’s about counselling if I’m honest – not ‘support’. In one of the clinics we changed the name from counselling to support, it was offered to everyone in an effort to normalise it and the difference in uptake was huge. This shows when people thought they were getting someone to support them through their journey, as a matter of course the acceptance was completely different to when someone said, do you think you need some counselling.
Support counselling is divided into three main sections. Before, during and after treatment and some of that can be very practical.
People come to see me before they even start and in this session we can do a lot of practical things like make a plan for their 2 week wait; decide whether they are going to work through the first bit (most don’t even know there is the possible option of being signed off by their GP). They don’t think anyone gets signed off because anyone they might know going through IVF seems like they’re coping so brilliantly well, juggling everything.
So, support counselling before you start can be a really practical time.
A: When do you think people should seek it if they haven’t been offered it?
V: I think in an ideal world everybody would have a session with the counsellor before they even start treatment. It’s really hard to access support when you’re actually struggling. If you’ve already met your counsellor, you will probably be able to face making contact – you know your counsellor and it’s much easier to drop me an email or make a call and ask for a session.
I predominantly now work through Skype or phone and again, I think that has made a huge difference. I was finding that clients were saying, I would like some support but I can’t have any more time off work. Via skype I can get the time that works for people to make it less stressful rather than adding to the stress because they’re trying to juggle another day off work.
I firmly believe having IVF is a little like having a full-time job. If you’re trying to do your “IVF full time job” at the same time as trying to do your full time job, it’s going to be stressful! I don’t think people are told this – they think they can just slip in IVF alongside their normal life and actually it isn’t like that at all.
A: Yes, you need to concentrate on it. Not just for the practical side, but for your head.
V: Most GP’s will consider signing you off. One of the strategies I say to people is, don’t leave that until you start your IVF. Go two months before, tell them “I’m going to have IVF and I’m struggling” if the GP says no, at least you’ve got time to come up with a contingency plan, but you don’t want to be faced having to organise that during treatment.
Forewarned is forearmed so eliminating as much stress as possible before treatment, is a really good idea. Simple things can take the pressure off immensely.
A: It’s all about trying to eliminate stress isn’t it. Your approach is so practical and sensible. Having a plan.
V: Yes, before, during and after. And if it hasn’t worked it can be such a difficult time. Allowing people to express how they’re feeling and to recognise that a huge amount of people who have had a failed a cycle will be going through a grieving process.
We know it will be different for all of them, but what we also know is that the rest of the world around them will just think they had IVF that didn’t work. We know the emotions they’re going through maybe similar to those they would be having if they had lost a close family member. They’re maybe devastated, they maybe grieving, and people around them just don’t see it, they have “lost” nothing concrete – they are maybe asked if they’re going to be back in the office tomorrow, in a way they never would if they had a family bereavement – yet we know the feelings are the same
I think it can be quite frightening for people. Even the person experiencing this grief, doesn’t know why they feel so bad and may not recognise it as grief. They don’t understand why they’re feeling bereft. Talking to people, understanding that it’s perfectly normal to be grieving at this point and allowing themselves to be sad, to cry and to know that they will be ok is vital. I think some people get very frightened that they’re feeling so dreadful. It can be a relief to understand where these emotions are coming from.
A: That’s so important to validate your feelings and to say this is normal; it’s ok that I’m feeling this devastated.
V: Absolutely. Another way that fertility issues are unique, is that quite often both partners are going through this really traumatic event at the same time and that doesn’t happen in life often – one of very few situations I can think of is if a couples’ child is ill.
Usually you have one partner who is experiencing trauma and the other can be supportive. What I also notice in my work is when a treatment cycle doesn’t go well generally the couple deal with their grief completely differently. One person’s way of processing it is to talk about it over and over again, revisit it, then talk about it again. The other persons way of coping maybe to disappear into their cupboard, shut themselves away. They don’t want to talk about it with anyone, they just want to be left alone. That’s challenging because often couples haven’t got anyone else to talk to. No one else gets it.
A: Yes, I got to the point I didn’t have anyone I could talk to without some sense of guilt. You end up thinking, who can I talk to that can understand and offer me the support that I desperately need without me having to feel guilty about burdening them. That’s when I found my counselling such a lifesaver. I could just get it all out and you walk away feeling that someone gets you.
V: Yes, absolutely. Also, I think one of the other things I hear a lot, because IVF is so out of people’s experience and the effort of telling people about it defeats the point – you go to all the effort of telling your best friend and she says just relax and it will probably happen and then you could throttle her!
So, you’ve wasted all the effort of explaining it for him or her to say something really inappropriate, not out of unkindness, just through lack of understanding. Lack of ever being in that position. That’s what’s quite unique about fertility. Most people have experienced someone who’s died, or someone who’ve had cancer, but most people haven’t had any experience of someone with infertility, so when you talk to them they’re a little bit: ‘I don’t what to say’ or they do the ‘relax it will probably happen’.
A: Yes, well-meaning but uniformed ‘advice’ from friends can be so upsetting. It makes you think you’re doing something wrong.
V: Also, I think the other issue surrounding infertility is very often you start your journey with a peer group who are supporting you, but it tends to be that all the people start trailing off, getting pregnant, having babies, and then you start having that with your IVF clan too. You have a support group and they get pregnant and you think, oh now I’m losing these people. People getting pregnant can be incredibly difficult but it is very likely – your peer group will be probably at the age where babies are happening. So that can be really challenging for people to deal with as well.
In counselling, we can discuss how to cope – and think about how its ok to give yourself permission to say to people: it’s too hard to see you at the moment.
A: Yep, I agree with that. There were a couple of friendships I took a step back from at the time because I realised they weren’t helping my mental health. I had to take a step back from them to preserve that. To have some guidance on how to do that is so useful.
V: In a practical way with counselling, we just talk about how they can cope – maybe they are saying no to any family events, a wedding etc. and when you investigate it’s because people are asking them, “when are you going to be having a baby?”, and that’s so incredibly painful. But again, just having strategies and things to have in your mind, so that when anyone says, “when are you having a baby?”, maybe you say, “actually it’s incredibly painful, it’s not something I want to talk about”. It makes people stop and think. It’s also being able to say, if people ask, “are you having trouble getting pregnant?”: “it’s actually really private and I don’t want to talk about it”. You don’t have to give everything or nothing.
A: You take the words out of my mouth. I ended up using a similar thing. I used to say, ‘thanks for asking but I don’t really want to talk about it’. That was my line.
V: Yes exactly, just having that line in your head gives you a shield that protects you. It makes it all much more manageable.
A: I love how much you’re talking about strategies. It makes you feel calm – whatever happens, I have my strategy in place. I know how I will respond. So useful.
V: It shoots me back to the beginning. If they weren’t having these problems they wouldn’t be having counselling, because actually they are fine, but they’re going through a very tough time so it’s making it as manageable as it can be. Part of that is talking about strategies, control. So many people feel so out of control.
This is a big thing they thought they had control over – they thought they would stop contraception and be pregnant in a jiffy – and that’s been taken away. And now someone is telling them when they should have sex, what they should eat, what they should do to improve or not do…suddenly they feel like it’s all out of their control. So, we talk about how to feel back in control. And that goes back to Fertility Fit. It empowers people to take control of their fertility before they start – knowing a bit about your fertility and knowing you’re in a really good place.
A: I also found I just started to feel a lot better when I had my lifestyle overhaul because mental health was improved, energy was better – I felt in control and empowered as you say which is a lovely side effect. It also takes the pressure off – yes, these things might help get you pregnant, but also, do them anyway because you’ll feel happier.
V: Yes, spot on. I talk a lot about if you can do these healthy things for 80% of the time, don’t worry about the 20% where you have a really stressy day, eat rubbish etc. it doesn’t matter. A lot of people hear all the things they shouldn’t do – don’t be stressed is the most stressful thing anyone can say!
You need to be told how not to be stressed and given some strategies to try. I think that: ‘you should be thinner’ doesn’t help. Don’t tell someone with PCOS they should lose weight, it will be really difficult for them. Tell them a few ways to help. It’s more about being very positive as opposed to: “I don’t think you should do that” or “you must relax” which I hear more than anything.
So many people say to me “if I hear anyone else telling me to relax…I’m going to throttle them! It’s so stressful…I know I should relax but fertility treatment isn’t actually conducive to feeling relaxed!”
A: I know a lot of people actually like hearing about fertility success stories, but at one point, I just felt like it was another pregnancy announcement that I was supposed to have a positive response to!
V: I think most people who are having fertility treatment are feeling fairly inadequate anyway so it just compounds that feeling of hopelessness. Positive strategies are really important as is support.
I guess one of the saddest things is that most of the clinics have a limit to the number of sessions of support you can have. This can be really challenging for people. Most of the clinics have one or zero sessions of free IVF. So, therefore people are paying for their IVF and counselling becomes a luxury item which is really tough and it is so varied from clinic to clinic.
Some offer 1 session, some 6, some 3 for the whole time you are there. So if you had 4 rounds you would get less than 1. So, there’s a very varied level of support and that can impact on people’s decisions on whether to access it.
A: What about if you’re not in active treatment, can they get it?
V: As far as I’m aware, if you access support through your GP you wouldn’t necessarily get a fertility specialist counsellor. I certainly think that makes a massive difference – not having to explain what ‘stimming’ is for example.
A: Draining isn’t it
V: Yes. I don’t do any counselling referred through a GP, which is a shame and I guess if people were referred at that point, they would be going into treatment a little bit more prepared & resilient.
A: I could have benefitted from seeing someone early on. Early access would be helpful. What can someone expect from their first session?
V: I usually start by asking people to just tell me what’s happened to them up to that point. It’s nice if they tell me from the beginning i.e. we started trying 6 months ago/5 years ago – I think that’s really relevant, how long has this been happening for them, have they had treatment at a different hospital, is this their first go.
Quite often in the first session we spend a lot of time just talking about what’s happened; how they’re feeling; how they are coping individually and as a couple. Quite often I think people are very aware of what they need: support/strategies, stress relieving techniques. It’s all about listening and supporting. There’s never a first session which is the same.
A: Do you do couples counselling?
V: Yes, I’m happy for people to see me as a couple, individually or to dip in and out; some together, some alone. Quite often I see a couple to start with and sometimes it become apparent that one half doesn’t feel they need to talk about it; but they might say: “it helps me if you talk to her because then I haven’t got to talk to her”.
Sometimes I think people will start as a couple but one of them needs more support than the other. I notice men in particular come in the lead up to treatment – they like a plan and being proactive, but tend not to come between cycles quite so much.
Women really seem to want ongoing support. They just want to be able to offload and talk about all the stuff that their mum/sister/ best friend with the brand-new baby just doesn’t understand.
Sometimes men come by themselves. One man in particular who had found out the reason they couldn’t conceive was because he had zero sperm, so they were faced with probably of using a donor and he really needed to process that privately. Without anybody around.
A: Trying to get men to counselling can be a tricky old thing can’t it?
V: Absolutely and again, one of the things I hear more than anything, is: “I didn’t think it was going to be like this”.
If there was a way of people touching base before they start or perhaps in a less formal situation – it’s a shame there’s this ‘thing’ about counselling. Maybe it’s as simple as just calling it ‘support’ or ‘strategic planning’
A: It’s exactly what it is – strategic planning. Someone I was talking to was saying that it’s the one thing about the U.S they like, people just see a counsellor or therapist as a matter of course- it doesn’t have the stigma. The more the conversations are opening up about fertility and IVF, the more we can break down the idea that accessing support is a sign of weakness. And with any mental health treatment/therapy, there’s too much stigma.
V: And part of that starts with the clinics. It’s got to be seen as integral to treatment offered before you even need it. For me the sign of a really good clinic, is when you see someone who has had 3 or 4 cycles that haven’t worked and they are still saying, my clinic was amazing, I had great support and they were really lovely.
If someone is telling me its good when it doesn’t work that’s the sign of a really good clinic. One of the things I continually hear is that for the first 2 weeks people are quite involved with their clinic. They are back and forth for scans, egg collections, transfer and then the clinic say: Good Luck! See you in 2 weeks!
I think ongoing support through the 2 weeks helps people to feel less abandoned in that moment.
I do think that if you have a cycle that doesn’t work, you may need some time to be left alone before you talk about what you are going to do now, but you do need the continued contact with the clinic.
A huge thank you to Vicky for lending her valuable time to talk to me.
Here she is saying hi:
In summary, remember: accessing support is a sign of strength.
I might get badges made and wear one on my forehead. OK not badges. Stickers. Or maybe just a hashtag. YOU GET THE IDEA!!