Two Psychologists Explain How They Overcame Reproductive Trauma, And How You Can Too
Researchers Clay and Marjorie Brigance offer advice on how to not let reproductive trauma break your relationship.
By Mark Travers, Ph.D. | December 3, 2022
A new study published in Couple and Relationship Therapy follows the journey of a married couple through the tumultuous path of reproductive trauma.
Researchers Clay and Marjorie Brigance, being the subjects of their own study, share how their relationship came out stronger after the 'ambiguous loss' of reproductive trauma. Here is a summary of our conversation.
According to your research, the definition of reproductive trauma is much broader than what people usually assume. Could you tell us what constitutes reproductive trauma?
That's a very big question. Reproductive trauma includes various forms of losses that involve the process of becoming a parent. This could include:
- Infertility
- Miscarriage
- Stillbirth
- Various forms of complicated pregnancies
- Complicated deliveries
- Abortion
I argue that reproductive trauma is actually a spectrum experience in that every form of reproductive trauma is different and engenders different forms of grief yet all trace back to the journey of becoming a parent or the loss of a child. One form of the reproductive trauma spectrum may give way to a form of pain that is different from another form of the reproductive trauma spectrum.
For example, someone experiencing infertility experiences what we call an ontological death — that is, the death of a dream of becoming a parent. However, a parent experiencing a stillbirth experiences a physical death. Both engender grief, but in different ways.
What inspired you to conduct this in-depth, qualitative research on such a specific form of trauma?
The first thing that comes to mind is just simply how strong our marriage has become, even through our trauma. We were really fascinated that we just felt so incredibly bonded after going through such a tragedy, and we found it really interesting that a lot of other couples that we talked with who had experienced reproductive trauma actually experienced some of that same relational bonding.
Dr. Richard Tedesche describes the concept of post-traumatic growth, which means that some individuals experience meaningful personal and spiritual growth after a tragedy. Researchers are now showing us that posttraumatic stress and posttraumatic growth actually often co-occur. In other words, we can experience the negative symptoms of trauma while also simultaneously experiencing personal and relational growth.
This is an extremely complex and complicated experience that is hard to convey, but we wanted to try. We wanted to tell our story to show others exactly how we intentionally moved our relationship towards that growth through our attachment and communication in the midst of all of our pain.
And, we also just wanted to show other couples that they weren't alone. Forty-eight percent of individuals in the United States have either experienced infertility themselves or know someone who has, and yet this is a topic that we don't talk about. The more that we can talk about it, the more we can normalize it.
Could you describe a duoethnography for our readers and why you picked it as the methodology for your paper? How did it play out within the context of your study?
Duoethnography is really a new and cutting edge methodology for mental health research. In a duoethnography, two people who have had a similar experience of interest come together and share their experience in an open dialogue.
Through that dialogue, the reader of the research is actually invited to see the personal and relational change that these two researchers experienced. The reader is also invited to transpose their own meaning into the writing. In other words, the goal of duoethnography is not to necessarily find something new but to make new meaning from a unique experience.
This played out in very interesting ways for us as a couple. Our paper actually took us two and a half years to write because it was just so painful to revisit our journals and express our experiences in such a vulnerable way.
We often found ourselves having conversations about our experience, writing a few sentences, and then taking lengthy breaks. Going back and reliving our reproductive trauma was not fun. But, we wanted to show to others, in a very real and vulnerable way, what our relational process was like through our pain.
As an aside, I do want to thank my advisor, Dr. Phillip Waalkes at the University of Missouri St. Louis, for suggesting that we do this research. He was actually the one who suggested that we do a duoethnography and I am grateful for his guidance.
Your paper focuses on infertility and complicated pregnancy as its subject matter. Could you talk a little about the role ambiguity plays in the experience of reproductive trauma?
There is so much ambiguity embedded within reproductive trauma. As I alluded to earlier, many forms of reproductive trauma are an ontological death — that is, there may not be a physical death to experience per se, but there is the death of a dream.
Psychologist Janet Jaffe talks about the reproductive story in her theoretical approach with clients. Essentially, Dr. Jaffe suggests that we all have a subconscious expectation for how parenthood should happen for us. Moreover, we also place some of our life worth on the experience of becoming a parent.
Dr. Jaffe describes our reproductive story as a woven tapestry through time, with all of our unique experiences of childhood, family, and culture weaving our story and our own subconscious expectations for ourselves. When that tapestry is torn by reproductive trauma (such as infertility or miscarriage), we then feel this intense grief for ourselves, our child, and our future, but there is no funeral.
When a physical death occurs, we have rituals to process this loss. However, there is no ritual with the grief of infertility or early pregnancy loss. We often suffer in silence. Dr. Kenneth Doka calls this a disenfranchised grief in that we grieve intensely but have no societal way to express that grief. We are then met with well-meaning advice ("oh you can just try again," or my favorite, "have you tried relaxing during sex?"). This advice just leaves us feeling invalidated and is actually very painful.
It was interesting to see your study interpret and batch trauma in 'waves'. Could you help us understand the logic behind it?
I think this helped us process all of the complicated feelings that we experienced through our reproductive traumas. When so many traumas happen all at once, it can be helpful to compartmentalize them to further analyze the specific pain that the trauma engenders.
And, for us personally, we absolutely experienced each form of trauma in these really intense waves of pain and grief. Just the general infertility diagnosis was a wave of grief, as was our diagnosis of male-factor infertility, and the subchorionic hematoma. However, it was all kind of happening at the same time as well.
With infertility, we felt such intense fear that we would not become biological parents. With the subchorionic hematoma, we thought that our child might not make it to term, and so we had this horrible anticipation as well. Other couples of course will likely have different experiences, but this made the most sense for us.
Plus, we often use a metaphor to describe our experience, which the "waves" fit well with. In this metaphor, we often describe our experience of reproductive trauma as if each of us are alone on a tiny boat in the middle of a dark storm in the ocean. The waves just keep coming, and seem overwhelming. However, when we feel alone, we can look back and see that the other is in the boat with us.
I also suspect that these waves change through life. I have spoken with a lot of older folks who have not been able to have biological children, and now that their friends are having grandchildren, the waves of grief are coming back again even after 30 plus years. And so, the waves may die down for a while, but then they rise up again.
Could you shed some light on how a couples' attachment style informs the way they process reproductive trauma?
Attachment styles play a key role in how couples process any life event. Having that secure attachment means that couples are open to one another, they reduce the amount of times they criticize or invalidate one another, and they also empathize with one another. And so, there is just this emotional openness which allows each member of the couple to feel this intense closeness, while also having a safe place to bear their very vulnerable hurts.
In the context of reproductive trauma, this is incredibly important. For most folks who are experiencing reproductive trauma, they feel very disenfranchised and alone. Turning towards your partner can help mitigate those feelings, and actually even bond your relationship more (as was our case).
Having a more anxious attachment style or avoidant attachment style means that you might be scared to share with your partner because of how they may criticize you, invalidate you, or otherwise hurt you in the most vulnerable emotional spaces of your life. As a result, the couple may avoid one another and thus drift apart.
If the couple has a shared dream of parenthood, this can be especially damaging in the midst of reproductive trauma. Having a dream of having a child can be a huge piece of a couple's relationship, and when that dream is altered, it is vital that couples share their experiences together with love and empathy.
As an aside, I am researching this process in a quantitative study currently. If folks who have experienced infertility want to participate, it takes about 20-25 minutes, and there is a chance to win an Amazon gift card. They can just click this link and fill out the study from there. All answers are anonymous of course.
If there are three things you would want a couple experiencing reproductive trauma from your current study to know, what would they be?
- I would say first and foremost, you are not alone. So many couples go through reproductive trauma. One of the most amazing things that we have found as we have shared our story is the comment, "oh we've experienced that too". Due to the disenfranchisement and the ambiguity, it is so easy to feel alone, but you're not.
- I would also encourage couples to just sit with their emotions, accept their grief, and accept the grief and pain of their partner. Don't fix, validate. I see this a lot with male partners actually. They might try to be overly positive (as I was), or they might try to give advice. This is not what someone is looking for typically when they share their reproductive trauma. If you want to experience relational closeness, it means sitting with the pain. This could come in a comment like, "this is just so hard. I see your (insert emotion here - anxiety, sadness, hurt, etc)." Just feeling seen in this context can be incredibly healing in a couple's relationship.
- Finally, I would say to take the outside voices with a grain of salt. So many people within our families and extended families have advice or "guidance" on how you as a couple should navigate your parenthood journey. They don't get to insert themselves into your story. They can have their own feelings about your journey, but they don't get to determine how you move forward as a couple. And so, continue to turn towards one another, avoid blame and shame and criticism, and continue to process your journey together.
As a researcher, psychologist, and a father, what is the most important piece of advice you would like to give to someone who might be experiencing reproductive trauma?
This actually took me a long time to think about and process. I would say, take your journey one day at a time. Something I learned in the midst of my reproductive traumas is that life is just so fragile, and that I am guaranteed very little in life. However, I am guaranteed this moment.
This has actually helped me be more mindful of how I interact with others, and especially how I process my spiritual life. And so, take each moment as it comes. Take the grief, the pain, the loneliness, and the fear, and experience it come and then go again in all of its waves.
Reach out to others who see you, know you, and validate you, so that when those waves come, you have a tribe to process these things with. More than anything, your journey deserves to be heard, validated, and even championed by others.