Welcome to IVF This, Episode 210-IVF & Trauma Bonding

Hello, hello, my beautiful friends. I hope you are doing so, so well today. 

I’m really excited about today’s topic. 

Today we're going to talk about IVF and trauma bonding.

And before somebody comes for me in the comments, I know.

I know that I am not using the term "trauma bonding" exactly the way it is clinically defined.

So let's start there.

A trauma bond is traditionally understood as an intense emotional attachment that can develop between someone experiencing abuse and the person causing that abuse. It can be strengthened through cycles of harm and reconciliation, fear and relief, punishment and affection.

That is the actual concept.

And obviously IVF is not an abusive person.

IVF doesn't have agency.

IVF isn't sitting in the corner twirling its little evil mustache plotting how it's going to fuck up your life next.

So when I call this "IVF and Trauma Bonding," I am not suggesting that IVF is an abuser or that continuing IVF means you are somehow participating in an abusive relationship.

I'm borrowing the framework because I think some of the psychological mechanisms involved in trauma bonding give us a really interesting way to understand the relationship we can develop with IVF.

Especially when we look at intermittent reinforcement.

Because IVF can hurt you and give you hope.

Sometimes within the same fucking hour.

And over time, the source of the pain can become deeply entangled with the source of the hope.

When the Thing That Hurts Is Also the Thing Offering Hope

One of the mechanisms that can strengthen a trauma bond is intermittent reinforcement.

Something painful happens.

Then there is relief.

Something frightening happens.

Then something good happens.

Something is taken away.

Then something is offered.

And because the relief or reward is unpredictable, the cycle can create an incredibly powerful attachment.

Again, IVF is not intentionally creating this cycle.

There isn't someone behind the curtain deciding when to give you enough good news to keep you coming back.

But your nervous system doesn't require malicious intent in order to learn a pattern.

And IVF is basically a fucking masterclass in unpredictable reinforcement.

You get a good follicle count.

Then fewer eggs are retrieved than expected.

But wait, most of them were mature.

Then fertilization is lower than you hoped.

But you still have embryos growing.

Then you lose several before blast.

But two made it.

Then you're waiting on PGT.

One is euploid.

Then you're preparing for transfer.

The transfer works.

The beta is positive.

But it's lower than you expected.

Then it doubles.

Then the first ultrasound is measuring behind.

But there's a heartbeat.

Hope.

Fear.

Relief.

Fear.

Hope.

Loss.

Possibility.

Sometimes all before fucking lunch.

And this creates a really complicated relationship with IVF because the thing that has repeatedly hurt you may also be the thing offering you another chance.

The source of the pain becomes entangled with the source of the hope.

You can hate IVF and desperately want access to another cycle.

You can feel traumatized by treatment and devastated when insurance won't authorize another round.

You can dread walking back into your clinic and simultaneously feel panicked by the possibility that you may never walk into it again.

You can swear that you cannot fucking do this again and then find yourself two weeks later wanting to know when you can start.

Those things aren't contradictions.

They're evidence of how complicated this relationship can become.

What Do We Do Next?

And I think one of the places we see this most clearly is in the question that comes after something doesn't work:

What do we do next?

Another retrieval?

Another transfer?

Another test?

Another protocol?

Another doctor?

Another opinion?

Something happens that devastates you, and almost immediately there is another possible path.

And sometimes that next step is exactly what you want.

Sometimes planning is grounding.

Sometimes information helps.

Sometimes knowing that there is another option genuinely gives you hope.

There is nothing inherently unhealthy about wanting to know what comes next.

But I think it's worth noticing that sometimes the next step also becomes relief from the pain caused by the previous step.

Because grief is uncertain.

Waiting is uncertain.

Not knowing whether this will ever work is fucking unbearable.

But a protocol?

A protocol is concrete.

Appointments are concrete.

Medication schedules are concrete.

A retrieval date is concrete.

Suddenly there are things to do again.

And doing something can provide temporary relief from the unbearable experience of not knowing.

So the nervous system can begin learning something very interesting:

When IVF hurts me, more IVF makes me feel better.

Not permanently.

And not because there's something wrong with you.

But because action can create relief.

Possibility can create relief.

Hope can create relief.

And that relief can make it incredibly difficult to know what you actually want when you're standing in the immediate aftermath of loss.

Am I ready to do another cycle?

Or am I desperate to stop feeling what this cycle left behind?

Do I want information?

Or am I looking for certainty?

Do I want to know my options?

Or do I need there to be another option because I'm not ready to confront what it would mean if there wasn't one?

None of those questions are accusations.

They're invitations to understand yourself.

When IVF Becomes Synonymous With Hope

Because eventually something else can happen.

IVF stops being simply a medical treatment.

It becomes possibility.

It becomes forward movement.

It becomes the thing standing between you and the future you're trying to create.

And then stopping—or sometimes even pausing—doesn't emotionally register as:

I'm taking a break from a medical treatment.

It can feel like:

I'm giving up on my baby.

Those are very different things.

And if IVF has become psychologically synonymous with hope, then of course stepping away from IVF feels like stepping away from hope.

If another cycle represents possibility, then of course saying no to another cycle can feel like choosing the loss.

This is why I don't think the answer is simply to ask:

When is enough enough?

I actually hate that question.

Because who gets to decide what enough is?

There is no morally superior number of retrievals.

There isn't some emotionally evolved version of you who will suddenly know that it's time to stop.

Continuing doesn't mean you're in denial.

Stopping doesn't mean you're giving up.

Taking a break doesn't mean you're letting go.

And deciding you're done doesn't mean you didn't want it badly enough.

Sometimes stopping isn't peaceful.

Sometimes there isn't some beautiful moment of clarity where you suddenly know you're ready to move on.

Sometimes stopping sounds like:

I still want this. And I can't keep doing this to myself.

Those two things can be true at exactly the same time.

You can stop treatment while still wishing with every part of you that you didn't have to.

You can decide the cost of continuing has become too high without deciding the thing you were pursuing matters any less.

Because there is no path without pain. There are only choices about which losses you are willing—or able—to carry.

The point isn't to get you to make a particular decision.

The point is to help you understand the meaning you've attached to the decision.

What does continuing mean about you?

What does stopping mean about you?

What does taking a break mean?

What does another cycle promise you emotionally?

What are you asking IVF to give you besides a baby?

Because IVF cannot guarantee you the outcome you came here for.

And when we acknowledge that—not as hopelessness, but as reality—we create a little more space to ask:

What do I actually want to choose from here?

And Then There's the Relationship We Haven't Talked About Yet

Because I've spent this entire episode talking about your relationship with IVF.

But I don't actually think that's the most important relationship here.

I think the more important question is:

What kind of relationship do I want to have with myself while I'm here?

Because IVF gives us opportunities, over and over again, to abandon ourselves.

My body doesn't respond the way I wanted it to, so I turn against my body.

My embryo doesn't implant, so I interrogate everything I did.

I'm terrified, so I criticize myself for not being more hopeful.

I'm hopeful, so I criticize myself for being naïve.

I want to stop, so I accuse myself of giving up.

I want to continue, so I wonder if I'm incapable of letting go.

I'm angry that this is happening, and then I'm angry at myself for being angry.

I'm jealous, and then I shame myself for the jealousy.

I'm exhausted, and then I tell myself I should be handling this better.

At almost every turn, IVF gives us an opportunity to abandon ourselves.

And maybe this is where the conversation about trauma bonding becomes useful in a completely different way.

Because maybe the goal isn't to fix your relationship with IVF.

Maybe the goal isn't to detach from IVF.

Maybe the goal isn't to need IVF less.

Maybe the goal is to change your relationship with yourself inside of IVF.

Not despite IVF.

Inside of it.

Because IVF is part of your life.

Right now, it may be an enormous part of your life.

And I'm not going to tell you to make it smaller than it is.

I'm not going to tell you that it's "just one part of your story," because sometimes that phrase is used as another way of asking us to minimize something that is profoundly important to us.

IVF may eventually become a footnote in your life.

It may become one of its defining chapters.

That part isn't entirely up to you.

But neither one requires you to give up pieces of yourself to the cause.

You don't have to sacrifice your relationship with your body.

You don't have to sacrifice your ability to experience joy.

You don't have to sacrifice your friendships, your marriage, your sexuality, your humor, your interests, your identity, your ability to imagine a future.

And you certainly don't have to sacrifice your relationship with yourself.

Not because those things matter more than having a baby.

I'm not interested in asking you to rank the things you love.

But because you are the person who will still be here when you find out what happens.

Whatever the outcome.

Whatever the next decision.

Whatever IVF ultimately becomes in the story of your life.

Remaining in Relationship With Yourself

The work isn't learning how to need IVF less.

It isn't learning how to care less.

And it isn't learning how to protect yourself from wanting something this badly.

It's learning how to remain in relationship with yourself while you want it.

You can desperately want IVF to work without making your worth contingent on whether it does.

You can pursue another cycle without requiring that cycle to redeem the last one.

You can grieve what IVF has cost you without needing to make IVF the villain.

You can acknowledge that treatment has traumatized you and still choose more treatment.

You can take a break without calling yourself a quitter.

You can continue without calling yourself obsessed.

You can hate IVF today and be incredibly grateful it exists tomorrow.

You don't have to resolve the contradiction.

You don't have to break your relationship with IVF in order to change your relationship with yourself inside of it.

You can notice when fear asks you to abandon yourself.

When disappointment asks you to attack yourself.

When hope asks you to disappear into the future.

When uncertainty asks you to surrender your agency to anyone who sounds more certain than you feel.

And you can keep coming back.

Back to yourself.

Back to what you know.

Back to what you want.

Back to what matters to you.

Back to the person who existed before IVF and the person you are becoming because of it.

Not because we're trying to preserve some pristine pre-infertility version of you.

She's allowed to change too.

You are allowed to be changed by this.

You are allowed to have scars from this.

You are allowed to someday look back and say IVF was one of the defining experiences of my life.

And you are allowed to someday look back and think:

Jesus Christ. That was fucking awful.

Anyway.

Neither version means IVF won.

Neither version means you did infertility correctly.

The question isn't whether IVF changes you.

Life changes us.

The question is whether, in the process of pursuing something you desperately want, you believe you have to continually trade pieces of yourself for the possibility of getting it.

You don't.

You don't have control over whether IVF gives you the outcome you came here for.

But you are not powerless inside of the experience.

You still have agency in how you relate to hope.

How you relate to another cycle.

How you relate to stopping.

How you relate to uncertainty.

How you relate to your body.

How you relate to yourself when something doesn't work.

IVF can be the path you're taking toward your baby without becoming the authority on whether your life gets to move forward.

It gets to be part of your life.

It might be a footnote.

It might be a defining chapter.

But neither requires you to disappear from your own story.

IVF gets to be part of your life.

It does not require you to disappear from it.

That is what I have for you today. I hope you have a wonderful week; I’ll see you soon!