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Healing the pain of infertility through poetry


The experience of infertility can lead to individual emotional distress and problematic relationships. The acts of writing and reading poetry on this issue serve to synthesize and release intense emotions including loss, betrayal, frustration, and anger. The author chose to examine a number of themes both within and across poems that appeared poignant in their relationship to infertility: women's bodies, social obligations, feeling like an outsider, grief, relationship deterioration, and resolution.
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Journal of Poetry Therapy
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Healing the pain of infertility through poetry
Lea Tufforda
a Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
To cite this Article Tufford, Lea(2009) 'Healing the pain of infertility through poetry', Journal of Poetry Therapy, 22: 1, 1 —
To link to this Article: DOI: 10.1080/08893670802708068
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Healing the pain of infertility
through poetry
Lea Tufford*
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West,
Toronto, ON M5S 1A1, Canada
The experience of infertility can lead to individual emotional distress and problematic relationships.
The acts of writing and reading poetry on this issue ser ve to synthesize and release intense emotions
including loss, betrayal, frustration, and anger. The author chose to examine a number of themes both
within and across poems that appeared poignant in their relationship to infertility: women’s bodies,
social obligations, feeling like an outsider, grief, relationship deterioration, and resolution.
Keywords Grief; infertility; poetry; women; writing
From religious prescriptions of ‘‘Be fruitful and multiply’’ to Henry VIII and
Napoleon’s alleged abandonment of their partners for their failure to produce an heir
to the execution of women in the developing world for suspected infertility, child
bearing has been viewed throughout the ages as essential not only to the social and
political life of a society but also to the survival of a species (Diamond, Kezur,
Meyers, Scharf & Windshel, 1999). Mathews (1991) maintained that in the modern
age, couples marry with the expectation of having children and as part of their
‘‘suitable-mate criteria’’ the person’s potential to parent. When a child is not
forthcoming, infertility often is a life crisis for both the couple and the individual.
Infertility is defined as the inability to conceive a pregnancy after a year or more
of regular intercourse without contraceptives or the inability to carry a pregnancy to
live birth (Merck Manual, 1992). Infertility is subdivided into primary and secondary
infertility. Primary infertility indicates that no pregnancies have occurred to live
birth; secondary infertility denotes failure to conceive following one or more
pregnancies carried to live birth. Estimated prevalence rates range from between
one out of six and one out of 10 married couples (Daniluk, 1991; Edelman &
Connolly, 1986; Forrest & Gilbert, 1992; Williams, Bischoff & Ludes, 1992).
Numerous treatment options exist today and include fertility drugs, artificial
insemination, in-vitro fertilization, egg and sperm donation, and in-vitro maturation,
each with varying success rates.
*Corresponding author. Tel: (416) 524-3010. Email:
Journal of Poetry Therapy
(March 2009), Vol. 22, No. 1, pp. 19
ISSN 0889-3675 print #2009 National Association for Poetry Therapy
DOI: 10.1080/08893670802708068
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Infertility entails a number of losses, which occur repeatedly throughout the life
cycle. Typical losses include: creating a genetically related child along with the
associated experiences of pregnancy, for example, breastfeeding, purchasing baby
clothes, arranging a nursery, carrying on a family name that links the past to the
future, creating a child with one’s partner, attending celebrations (baby shower,
birthdays, graduations), and having grandchildren (Inhorn & van Balen, 2002).
Developmental losses include the lack of the childbearing stage within the lifecycle
and meeting life goals. Physical losses include privacy around the couple’s sexual
relationship, loss of faith in one’s body, and control over one’s life. Couples suffering
from infertility lose the sense that the world is a just place and that life is meaningful
(Diamond et al., 1999). In addition, couples experiencing infertility typically do not
feel part of a child-centered community (schools, community centers, playgrounds,
children playing on the street) and also experience the anticipatory loss of not
knowing whether or not they will ever have children (Sandelowski, 1993). These
losses, unlike stillbirth or the death of a child, are intangible and generally remain
unseen or unrecognized by those outside the affected couple.
Themes of loss, grief, and psychological distress saturate the research literature
regarding infertility (Blake, 2002). Several authors have attempted to capture the
phases or stages of grief, similar to those put forth by Kubler-Ross. Frias and Wilson
(1985) distinguished between two separate phases with the first characterized by
shock, anxiety, and denial and the second involving anger, blame, guilt, sadness,
despair, and depression. Daniluk (1991) examined stages of surprise, denial,
isolation, anger, guilt, unworthiness, depression, and grief while Diamond, Kezur,
Meyers, Scharf & Windshel (1999), in qualitative interviews with infertile couples,
spelled out five phases including dawning, mobilization, immersion (early, middle,
late), resolution, and legacy. Burke, Hainsworth, Eakes and Lindgren (1992)
described the experience of infertility as ‘‘chronic sorrow’’ which is an ‘‘intense,
recurring sadness’’ and ‘‘serves as a constant reminder of the loss’’ (pp. 231232).
The cyclical nature of loss is captured by Forrest and Gilbert (1992) who note that
phases do not occur in a set order and ‘‘recycling through phases is common’’ (p. 44),
particularly during menstruation, anniversaries, holidays, and interaction with family
members who have children (Conway & Valentine, 1998).
The arts have long served as a vehicle for individuals to express intense emotions
of sadness and despair. Poetry, in particular, can vocalize the grief of infertility and
crystallize the myriad emotions experienced by the individual or couple. Writing
poetry creates a landscape for relating to a painful human experience and compresses
experiences into the expression of words (Szto, Furman & Langer, 2005). Barney
(1992) postulated that poetry may serve as a mechanism to work through grief and
explore difficult emotions. Some speculate that an author writing from a personal
experience of infertility is able to create a surrogate child through their words, a
common metaphor described by Minh-ha (1999) as ‘‘writing-as-birth-delivering-
labor-concept’’ (p. 262). Capturing emotions and experiences on the page can serve
a therapeutic purpose by providing a new perspective on loss and enabling
individuals the opportunity to enter fully into the pain of involuntary childlessness.
Chance (1988) aptly described the relationship between pain and resolution: ‘‘we
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must be enveloped by pain. We must receive it into our minds and undertake the
responsibility of it if we would ever free ourselves from it’’ (p. 96). In addition,
exploring the poetry from an author who has shared the same experience may help
detract from the solitary nature of personal pain, as is often the case with infertility,
and may provide expression for poorly understood feelings of one’s experience.
Viewing the pain of another human through the medium of poetry can provide
healing of one’s own painful emotions and experiences. As a therapist working with
individuals, couples and families, the author encourages clients to write their
thoughts and emotions in poetic or prose form, as this exercise can be cathartic and
helps release clients from negative ruminations. Clients with an artistic temperament
may appreciate the opportunity to project their pain onto an artistic medium.
Poetry has enjoyed a resurgence of popularity through community and literary
poetry readings as well as the abundance of poetry writing by both professional and
novice authors. Researchers are also recognizing the benefits of using poetry as a tool
for social inquiry. Richardson (1992) used poetry to describe the life histories and
capture the ‘‘lived experience’’ of unwed mothers through the compression of life
narrative interviews and the parsing of key words and phrases. Poindexter (2002)
developed research poems to examine the relationship of HIV patients and their
caregivers. Other developments in the use of poetry include auto ethnographic
research to explore the emotional dynamics of friendship loss (Furman, 2004) as well
as the stress of completing a doctoral dissertation (Chan, 2003).
The gendered nature of the following poets may reflect the gendered response to
infertility. McEwan, Costello and Taylor (1987), in measuring psychological distress
of infertile couples, found distress affected 37.3% of women and 1% of men.
However, Frias and Wilson (1985) noted that variation in distress levels between
men and women may reflect the socialization of grief responses between men and
women and not the degree of sadness experienced. What is more, the cyclical and
rhythmic nature of menstruation is both a visual and physical reminder of infertility
on a monthly basis and may lead to a depressive reaction among women. The author
chose to examine a number of themes both within and across poems that appeared
poignant in their relationship to infertility: women’s bodies, social obligations, feeling
like an outsider, grief, relationship deterioration, and resolution.
Women’s bodies
Forty, Trembling
She bore no children
but ghosts emerged
from between her legs. (Blake, 1994, p. 101)
Healing the pain of infertility 3
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Land of the Living
Once again, I have given up
the having of children,
and celebrate instead
a monthly flowering
...(Norris, 2002, p. 203)
The above poems (excerpts) by Rose (1994) and Norris (1995) respectively, reflect
on women’s bodies as the vehicle for menstruation, conception, and birth. The
emptiness of women’s bodies is apparent throughout the poems with intimations that
they are not of this world. There is some acceptance in the final poem that the author
will never bear children; however, the act of acceptance is repetitious and described
as ‘‘once again.’’
Social obligations
Family funeral
‘‘You all need a bunch of kids.’
‘‘You need some sense,’
Is what I want to say.
I wonder if this cousin
Also asks blind people for their favorite color. (Blake, 2002, p. 202)
Only now I have to see him,
I prepare myself,
Until I rock him
And a friend remarks
‘‘You seem like a natural.’’ (Blake, 2002, pp. 203204)
These two poems (excerpts) by Blake (2002) examine the reality of dealing with
insensitive family members and meeting social obligations involving children when
coping with the experience of infertility. The first poem is tinged with humour that
covers feelings of anger and frustration. Balancing the joy of a new mother with a
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devastating personal loss is evident in the second poem. The decision not to attend
the baby shower serves to protect the author but also to isolate her from others. In
the end, she must brace herself for meeting the child.
Diffusion of Grief
Grief unobserved
No memories to concretize
... (Blake, 2002, p. 201)
Evidence of depression and grief are observed in this poem (excerpt) by Blake
(2002), written before a medical diagnosis of the factors contributing to infertility.
What is poignant is the lack of physical loss commonplace during infertility. Unlike
other losses where memories were left behind, infertility denotes a grief ‘‘unob-
served.’’ Because there are no answers to the author’s questions, this contributes to
the silence surrounding infertility.
September 27, 1995*
The remainder of my life will be defined by this day.
...The empty, bottomless flood
Of drowning tears. (Blake, 2002, p. 203).
Blake (2002) identifies the date she received a diagnosis of an irreversible medical
reason for her infertility. Intense grief reactions of shock and depression are apparent
through the words ‘‘empty’’ and ‘‘bottomless.’’ Perhaps as a coping mechanism, the
author dawns the persona of ‘‘a puppet’’ in order to fulfill her daytime duties. Grief is
allowed within the privacy and safety of her home.
Summer Night
I thought last summer
That after almost two years
Healing the pain of infertility 5
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Of trying and wanting
I was pregnant.
I was wrong.
(Blake, 2002, p. 201)
The above poem (excerpt) reflects the state of chronic grief felt by many couples
experiencing infertility over a period of years. Anger, frustration, and disappointment
are evident.
Relationship deterioration
I Get My Period, September 1964
How can I forgive you this blood?
Which was not to flow again, but to cling joyously to my womb
To grow, and become a son?
When I turn to you in the night, you sigh, and turn over
...(DiPrima, 1975, p. 51)
In the above poem (excerpt), DiPrima parallels the start of her menstrual cycle with
the relationship with her partner. Menstruation belies the absence of the much-
desired son. The flow of blood and life potential from her body symbolizes failed
attempts to connect with her partner.
That Night There Was Full Moon, Little Cloud
She sees. She tells me I am beautiful.
That I’ll never have children, but a song
for every child I might have ...
The moon’s strong pull will claim as a daughter. No blame.
No wrong. (Meehan, 2000, p. 14)
Meehan (2000) describes a conversation between grandmother and granddaughter
following a reading of the granddaughter’s future. The vision presages a future of
childlessness for the granddaughter but resolution and procreation through the
writing of song. She concludes that there is ‘‘No blame, No wrong’’ in her situation.
6L. Tufford
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March Afternoon
I think about my husband,
My work,
The cats*
I’ve seen first-hand that life offers goodness,
Offers hope. (Blake, 2002, p. 203)
This poem was written before receiving a medical diagnosis. The author continues to
display some evidence of depression but the concluding lines reveal the beginning of
a resolution. The author also presents a balanced perspective of children.
Infertility Group
Several of us in a room once a week,
you pick your way through the serious, uninhabited mountains.
Smaller now, and smaller,
but never out of my sight. (Bernstein, 2001, p. 12)
Bernstein achieves resolution to her experience of infertility through the longed for
pregnancy and childbirth. The author notes being ‘‘rescued’’ thus implying that, her
former group members continue to remain lost and adrift. Bernstein (2001)
describes being ‘‘dragged into life’’ which implies that life only begins with the birth
of a child.
The Desert
I’m going to survive*
At least now I have a name,
Have a reason.
Let me be.
Let me heal. (Blake, 2002, p. 204)
The above poem (excerpt) reflects a survival spirit of the author who now knows the
cause of her infertility. It is unclear if having the ‘‘name’’ and ‘‘reason’’ for her
infertility is facilitating the author’s ability to move forward but the final two lines are
indicative of her potential to journey toward resolution.
Healing the pain of infertility 7
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It is her that I first realize
That for the most part I’ve healed.
I take my husband’s hand.
I am loved.
I am happy. (Blake, 2002, pp. 204205)
I cannot have a child.
But I can love,
Share life, be.
...(Blake, 2002, p. 205)
In the first poem, Blake uses the metaphor of the wounded bird as a personal
metaphor. She will still achieve happiness in spite of the experience of infertility and
draws from the love she receives from her husband. In the second poem, written five
years after a diagnosis of infertility, Blake refuses to be defined by the term
‘‘infertility’’ and notes the divergence between an absence of life and an ability to love
and to share life. The themes of resolution are evident in these last two poems.
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... Tamura, 1998). In other recent research, Tufford (2009) explained how engaging in practices of reading and writing poetry about the experience of infertility can help infertile individuals "synthesize and release intense emotions including loss, betrayal, frustration, and anger" (p. 1) and Kreuter (2005) also explained how the use of poetry by prisoners in a group therapy setting "creates the possibility of insights for the prisoner, leading to change in their internal thought process and increased self-esteem," and that "By opening up an appropriate emotional channel, the prisoner regains a wider range of human expression" (p. 97). ...
... Berridge & Kringelbach, 2011;Busseri et al., 2012;Fredrickson, 2006;Robinson & Von Hippel, 2006;Seligman, 2010Seligman, , 2011Tang et al., 2013;Vallerand, 2012), and since several studies have indeed suggested that engaging with poetry can contribute to positive emotions (cf. Boone & Castillo, 2008;Brillantes-Evangelista, 2013;Furman, 2005;Ingram, 2003;Kreuter, 2005;Mohammadian et al., 2011;Tamura, 1998Tamura, , 2001Tegner et al., 2009;Tufford, 2009), there are good grounds for maintaining that the practice of poetry can positively contribute to psychological well-being. ...
... Resultantly, since positive relationships can contribute to psychological well-being (cf. Baumeister & Leary, 1995;Berridge & Kringelbach, 2011;Bornstein et al., 2003;Cove et al., 2005;Froh et al., 2007;Hicks & King, 2007, 2009National Crime Prevention, 1999;Noble & McGrath, 2012, 2014Prilleltensky & Prilleltensky, 2006;Roffey, 2012;Seligman, 2010Seligman, , 2011Steinebach et al., 2012Steinebach et al., , 2013Zins et al., 2004), and since several studies have indeed suggested that practicing poetry can contribute to positive relationships (cf. Abell, 1998;Alvarez & Mearns, 2014;Morris et al., 2005;Stovall, 2006), there are good grounds for maintaining that the practice poetry can positively contribute to psychological well-being. ...
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In “Flourish,” the psychologist Martin Seligman proposed that psychological well-being consists of “PERMA: positive emotion, engagement, relationships, meaning, and accomplishment.” Although the question of what constitutes flourishing or psychological well-being has been long debated among scholars, the recent literature has suggested that a paradigmatic or prototypical case of psychological well-being would manifest most or all of the aforementioned PERMA factors. The recent literature on poetry therapy has also suggested that poetry practice may be utilized as “an effective therapeutic tool” for patients suffering from a variety of ailments so it seems plausible that practicing poetry can positively contribute to one flourishing with greater psychological well-being. However, recent studies on poetry therapy have not yet been reviewed and integrated under the PERMA framework from positive psychology to further explore and explicate this possibility. This article therefore contributes to extant work by reviewing recent research on poetry therapy and psychological well-being and offering support for the claim that practicing poetry can positively contribute to one flourishing with greater psychological well-being by positively influencing their emotions, engagement or “flow” experiences, social relationships, sense of meaning or purpose in life, and personal accomplishments.
... Poetry therapy can be used with adults, adolescents, couples, families, and groups. It can be used with an array of presenting issues, such as depression (Laitinen & Ettorre, 2007), gender identity (Teman, 2019), pain (Evans & Glover, 2012), infertility (Tufford, 2009), trauma (Wright & Thiara, 2019), and self-esteem (Yücesan & Şendurur, 2018). Despite its variations, the essential ingredients of expressive poetry therapy are the space for a client to express themselves through writing and an aim to achieve the goals mentioned above. ...
... One case study (Ribner, 2006) did start with a focus on low desire but shifted gears when the client revealed a sexual trauma history. Other sex-POETRY IN SEX THERAPY 10 related issues covered were sexual orientation (Teman, 2019), infertility (Tufford, 2009), and chronic pelvic pain (Evans & Glover, 2012). In all of the articles found on poetry therapy and sexual issues, writing was found to be beneficial for the author and/or the client. ...
Poetry therapy has been shown to have benefits with many types of clients with many presenting issues. The goals and mechanics of poetry therapy lend well to the integration of poetry therapy into other therapeutic models, such as cognitive and narrative therapy. Sex therapy is an area of therapy that can easily integrate poetry therapy into its practices. Sexual exploration, comfort level talking about sex, and the meanings made of sexual experiences are all components of sex therapy that poetry therapy is uniquely capable of addressing. There are many techniques to help incorporate expressive poetry therapy into a sex therapy practice, as well as limitations and cautions that should be observed.
Introduction: Infertile women use complementary and alternative medicine (CAM) frequently, in addition to conventional therapy. The aim of the study was to explore infertile women's healing experiences of using complementary and alternative medicine. Method: This qualitative study was conducted using Van Mannen's approach to phenomenology. Individual semi-structured face to face or telephone interviews were conducted with 22 infertile women with unique experience of CAM use, who were selected purposefully from February 2019 to July 2020 from referral infertility centers of Iran. All interviews transcribed and analyzed using six-step Van Manen's descriptive-interpretive approach, in which the process of analysis occurred while interviews were ongoing to explore the essence of the experience, so that sampling was terminated when saturation was achieved. The MAXQDA 10 software program was used for qualitative data organization. Lincoln and Guba’s (1985) criteria were used to ensure trustworthiness. Results: The essence of the experience of CAM use, which emerged as the main theme from analysis of the data was “healing the body and mind”. Eleven sub-themes subsumed within this major theme included body salve, harmonious with nature, increasing love in relationships, worth enduring the trouble, fostering wellbeing, reassuring, providing mental pleasure, inspiring calm, promising and motivating, having a supportive role and creating satisfaction. Conclusion: Infertile women understood CAM treatments as a remedy for “healing the body and mind”. Therefore, the logical integration of CAM in conventional medicine seems necessary. Fertility centers need to offer counseling programs for infertility treatment based on patients' culture. Keywords: Healing, Infertility, Women, Complementary and alternative medicine, Phenomenology, Qualitative study
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This article outlines the methodological process followed in examining a portion of an interview in which an older woman tells of two incidents where she felt effects of associative HIV-related stigma. Through the process of applying different techniques of narrative analysis, the author learned research methods and deepened interpretations of the text. Data management techniques both reflect assumptions and augment understanding. In narrative analysis, the structural whole can best be understood by first examining the architectural detail. This report demonstrates how meaning can emerge from method, theory from transcription, and richness from rigor. It also argues for the utility of narrative analysis to social work research, teaching, and practice.
This study explores the use of photography and poetry as tools of qualitative social research. The question guiding this exploration is how might the visual representation of reality (photography) and the compression of experiences expressed in words (poetry) provide insight and understanding into human behavior and the social world? The authors address this question through an extended conversation to critically examine the nature of poetry and photography in the gathering, organizing, and interpretation of data. In particular, both mediums are discussed in relation to the history of social research, methodological issues, and implications for social work. A subsequent thematic analysis is conducted by a third researcher and is presented as a means of treating the conversation itself as data for qualitative research. This exploration therefore demonstrates the use of a creative medium as research and as data for research.
This article presents the findings from a qualitative research study exploring ten couples' experiences with reproductive loss, infertility, miscarriage, and stillbirth. Following the primary loss, that of a biological child, couples identified five categories of associated losses: the experience of pregnancy, childbirth and breastfeeding; parenting; control; relationships; and one's view of oneself as a fertile individual. Feelings of shock, unfairness, fear, anger, a sense of being different from others, and intense sadness characterized the grieving process. Six factors mediated the grieving process: multiple losses, existing relationships, one's perception of being the victim or "cause" of the loss, gender, recognition of the loss, and cultural factors. The quality of grieving did change over time, but the impact of reproductive loss never completely disappeared.
Losing friendships are significant events for people throughout their life span. In spite of the importance of friendships to psychosocial health, studies of friendships loss are not found in the literature. This article begins to address this gap through a qualitative study utilizing autobiographical poetry as data. This study exemplifies expressive arts research methods which are becoming increasingly influential to qualitative research.
Research on the phenomenon of chronic sorrow has been limited to samples of parents of children with disabilities. The Nursing Consortium for Research on Chronic Sorrow was formed to study this concept in individuals with chronic illness and their family caregivers across the life span. Although no research on this concept has focused on a life-span approach, the level and quantity of related research indicate that a qualitative method is most appropriate. A study of parents of children with spina bifida provided a usable instrument, the Chronic Sorrow Questionnaire. The purpose of additional study is to determine when chronic sorrow occurs and what characteristics it displays in a variety of populations across the life span, how groups suffering from chronic sorrow compare with parents of children with disabilities, whether chronic sorrow is an inherent phenomenon in chronic illness situations, and how the major subconcepts of chronic sorrow theory are linked.