“An excess of sorrow is as foolish as profuse laughter; while, on the other hand, not to mourn at all is insensibility.”

The inability to become a parent when and how we want to is, for most people, an extremely stressful experience. Sometimes it can be devastating. Most of us grow up expecting that someday we will choose a partner, get pregnant, and become a parent. When that doesn’t happen, the losses start mounting.

We lose time. We lose a sense of control. We lose trust in our bodies. We lose the ability to stay in sync with our peers who are transitioning into the parenting stage of their lives. We are deprived of a feeling of moving forward, and we feel stuck. We stay in jobs too long because of insurance benefits or flexibility, we postpone large purchases, and we don’t take certain vacations because we might be pregnant at the time we planned to go.

But all of this pales in contrast to the ultimate loss we experience when we are ultimately unable to have a child that is genetically related to us, or to our partners. Through all the months and years of trying to conceive, we have so much time to fantasize about whom our children will look like or be like. We imagine in some detail that they will have our partner’s nose or our grandmother’s laugh. Quite often we picture a child of a certain age, with us engaged in some activity with them. Most of us imagine dressing our girls in cute outfits or playing sports with our boys or girls. We ascribe to our fantasy children that they will be good in math or weak in science, as those qualities match us, our partners, or our relatives. We keep trying to bring that child into the world and we can’t.

The hardest thing about reproductive loss is saying goodbye to someone we never said hello to. Our sadness and depression over the loss of our genetic offspring is grief. But unlike the grief we feel when a real person dies, infertility grief means saying goodbye to someone who was never really here. When there is an actual death, we have ritual around it. We have funerals and wakes, or we sit Shiva, and make social calls. We go to church or temple, and often light candles. People bring casseroles to our homes and say, “I’m so sorry for your loss.” But when we are told that we need genetics from someone else in order to conceive, when we need to confront that our child may not look like us, be like us, laugh like our grandparent, or have our partner’s intelligence, no one brings us a casserole and no one says they are sorry for our loss. There is no name to give to a person who died, even though we feel exactly like a real person has passed. That’s because the person has been so real to us for so long, even if we didn’t realize it.

The fantasy child we tried to create can take up a lot of room in our heads, our hearts, and our homes. There isn’t enough room in our home for the child we originally wanted and the child/children we will eventually have. So we need to say goodbye to the child we can’t have to make room for the children we can. Our ability to cope with family-building challenges as they arise will depend in part on the degree of resolution we have achieved prior to creating a family through ovum donation. At the pinnacle of this decision is the loss of the genetic connection of the mother to the child. The more we work through this loss, the more comfortable we will feel during the many reminders throughout the life cycle that our child/children do not come from our genetic lineage. And the reminders can be many.

Some therapists recommend an exercise that most people find extremely helpful in grieving genetic loss. It is an exercise that grew out of support for patients who miscarried, as they try to say goodbye to the loss of a potential being whom they never got to meet. The idea of this exercise is to try to bring the child “to life” so that you can then say goodbye.

Most people find it very helpful to write a letter to the child they will not have, the fantasy child, the perfect child, the perfect embodiment of all that you imagined, usually in some ways a “mini-me,” or “mini-him” or her. The letter can be whatever you need to say, but might include a name for that child—a name you will not give to a child you do have because it belonged to the child that will never be. You might talk about how you imagined that child, or activities you imagined doing with the child. You might explain in the letter why you now have to let the child go, why you need to say goodbye. It is helpful to do this as a couple, but is most important for the person experiencing the genetic loss. The rest of the exercise really should be done as a couple, regardless of who has the loss. Yes, it is a very sad exercise and patients almost always cry when it is being described and cry when they do it. Goodbyes are hard.

At the completion of the writing of the letter, or the song, or the painting, or whatever creative outlet you use to “bring the child to life,” it is important to then do something with it to let it go. This is akin to a funeral, where we can see a burial, or release ashes somewhere. Many people will plant a tree or bush in their homes and bury the letter in the ground along with the plant. This has that feeling of a burial. Patients also find it very helpful to go to the beach, which has an eternal, ephemeral feel, and read the letter to the fish and seagulls, then rip up the letter and throw it into the ocean. Some people who like to hike or ride bikes will wish to go to their favorite spot or shady tree and bury their letter under the tree. Others will burn the letter in their fireplace.

There are certainly no rules about these exercises; whatever works for you is what works. The idea is to be able to make a fantasy concrete, bring it/her/him forward, and then release the fantasy to make space for whatever is to come next. While it is not a panacea, most people find a huge degree of relief after completing these exercises. It is very helpful to accomplish these exercises in conjunction with visits to a mental health professional, both before and at least once after doing them, to help understand and talk about the feelings that may arise in the process.

Carole LieberWilkins, M.A., M.F.T. is a Licensed Marriage and Family Therapist in private practice in West Los Angeles.

A specialist in the field of reproductive medicine, adoption and family building options, Ms. LieberWilkins became a founding member of Resolve of Greater Los Angeles and served on the Resolve Board of Directors in various positions for the next 14 years. Currently, she is a mental health advisor on the Board of Directors of Parents via Egg Donation.

Having created her own family through adoption and ovum donation, Carole approaches her work with personal insights, as well as professional experience. She provides individual, couples and group counseling, as well as donor and gestational carrier psychological evaluations, and psycho?
educational consultations for intended parents.?

She is well known for her work regarding talking to children about family building, having helped hundreds of patients feel comfortable about talking with their kids about how they built their families. Her article on Talking with Children about Their Conception is highly respected and widely distributed to clients and patients. She has lectured on the topic of family building at important educational venues such as Resolve symposia, and meetings of the American Psychological Association and the American Society of Reproductive Medicine. Ms. LieberWilkins has also been an invited speaker for Kaiser Hospitals, as well as for industry?
sponsored nurses’ symposia.?

Carole can be reached at familybuilding@verizon.net
310.470.9049
www.LAfamilybuilding.com