Understanding and treating infertility: psychoanalytic considerations

This article describes how the intrapsychic, psychosocial, and social ramifications of infertility may be addressed when infertility patients present with distress at the psychotherapist's office. Self psychology provides a valuable framework for the therapist, given the profound and multiple narcissistic assaults on self-esteem, consolidation of identity, developmental aspirations, and other self attributes which infertility causes. The therapist's empathy becomes the primary tool of both understanding and alleviating suffering resulting from infertility. The current medical and interpersonal experiences of the infertile person must be part of the therapeutic process. A psychodynamic model of treatment is outlined which includes goals of reestablishing narcissistic equilibrium, diminishing internalized stigma, and ameliorating other adverse psychological consequences of infertility diagnosis and treatment.