During the course of my practice, I’ve seen many couples struggle to make difficult treatment decisions. Should they do in vitro? Donor egg? Donor sperm? Take out a second mortgage? Do insemination in spite of what the priest says? Reduce a triplet pregnancy down to twins? It’s bad enough that we can’t guarantee outcomes. It’s bad enough that treatments are expensive. It’s bad enough that there may be ethical, religious, or moral implications to these decisions.
It’s worse when they can’t agree between themselves.
It’s not only couples with infertility who have trouble agreeing on a course of action. I would say nearly all married couples reach a point where one is ready to move forward with a decision and the other is hanging back. This usually seems to happen with high stakes decisions that have very unpleasant outcomes if they go wrong, and iffy outcomes at best if they go right. We are facing a decision like this right now. We moved from the East Coast to the Midwest for work. We sold our house, but kept our vacation home in Vermont. This place was always more home to us than any daily house. Our Christmases, Easters, summer vacations, winter breaks, dog’s birthdays were spent in this house. Most of our best memories are linked to this peaceful and beautiful place. We hoped eventually to retire there, maybe keep a horse, take daily walks on the dirt road, write, garden, ski in the middle of the week. We hoped to host Christmases with our grown children and grandkids.
For a couple of years after we moved, we managed to hold on to the house, maintain it, and travel to Vermont during school breaks to use it. But it has become clear that the expense and difficulty of maintaining the house are beyond our capabilites, and it is time to let it go.
Well anyway, it has become clear to me. To my husband, not so much.
So we are not on the same page about this. And as we have struggled each to sway the other to our point of view, I began to wonder why it has to be this way. And I began to wonder why my patients have to struggle through this discordance as well.
And I think I’ve figured it out. This was an epiphany to me, but maybe everyone else already knows it. Maybe there is even a psychological term for it that I never caught because I slept through the lecture. (Let’s be honest, I slept through a lot of lectures. Once the lights were out, so was I.)
The reason we aren’t on the same page is that we need to be on different pages. Take the example of the couple who is deciding to do in vitro. Other treatments have been tried and haven’t worked. It’s time to make a decision. On person is ready to move on. Often this is the woman, because she is the one who has to do all the treatments and she’s sick of it already. The other is not ready yet. The reason they need to be different is that the one who is moving forward is in crisis. She is devastated that she need to take this step to have a baby. She has been hopeful for a long time, and hope has run out. She is emotionally running on fumes. He is in denial. This is actually a good thing, because it allows him to remain cheerful and optimistic, which has helped her get through this crisis so that she can now consider IVF, unthinkable until now. But now that she’s able to be optimistic and hopeful, the reality of their situation is sinking into him. He is beginning to realize that having a baby “the normal way” may not happen. He is beginning to lose hope. He needs her optimism and resolve. So the couple passes hope back and forth like a hot potato. It’s necessary, but on the surface, it just looks like they disagree. Once I realized this, and was able to think of my own marriage in this way, it opened up reserves of patience and gratitude toward my husband that I would never have tapped otherwise. This doesn’t mean that we are now magically in agreement. But at least now, I think I can see why it’s not so bad that we’re not.