Infertility is related to the body, which means that it deals with one of our most basic human needs. As long as you are struggling with it emotionally, it will have knock-on effects and hamper your ability to fully work on other parts of your life. Joanna Flemons, our guest today, is a seasoned Licensed Clinical Social Worker and has been in the field since 1998. She runs Highlands Ranch Counseling and Coaching and specializes in individual, family, couple counseling, and Highlands Ranch relationship counseling. Additionally, she is a Certified Professional Coach, helping people personally and professionally. Having worked in the infertility space for numerous years, her work seeks to provide clinical validation and a roadmap for those suffering. She has even authored a book, Infertility, and PTSD: The Uncharted Storm, which we highly recommend to anyone going through trauma around infertility. In this episode, we learn more about what PTSD is and how it relates to infertility. Joanna sheds light on some of the symptoms that can manifest when the body perceives an active threat. As PTSD is a stress disorder, it means that the body does not feel safe, which can then collide with other issues. Joana also talks about different kinds of trauma and how it’s difficult for our bodies to get ‘rid’ of recurrent trauma.
Infertility is related to the body, which means that it deals with one of our most basic human needs. As long as you are struggling with it emotionally, it will have knock-on effects and hamper your ability to fully work on other parts of your life. Joanna Flemons, our guest today, is a seasoned Licensed Clinical Social Worker and has been in the field since 1998. She runs Highlands Ranch Counseling and Coaching and specializes in individual, family, couple counseling, and Highlands Ranch relationship counseling. Additionally, she is a Certified Professional Coach, helping people personally and professionally. Having worked in the infertility space for numerous years, her work seeks to provide clinical validation and a roadmap for those suffering. She has even authored a book, Infertility, and PTSD: The Uncharted Storm, which we highly recommend to anyone going through trauma around infertility. In this episode, we learn more about what PTSD is and how it relates to infertility. Joanna sheds light on some of the symptoms that can manifest when the body perceives an active threat. As PTSD is a stress disorder, it means that the body does not feel safe, which can then collide with other issues. Joana also talks about different kinds of trauma and how it’s difficult for our bodies to get ‘rid’ of recurrent trauma.
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Speaker 2:Hi everyone. We are Rena and Dara, and welcome to fertility forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai hospital in New York city. Our fertility Ford podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate. Joanna lemons is the owner of Highlands vantage counseling and coaching, and has been in the field since 1998. She has a seasoned LCSW specializing in individual couples and family therapy and Highlands ranch, marriage counseling. She also maintains a certified professional coaching designation and provides personal and professional life and relationship coaching and therapy solutions to clients at Highlands ranch, counseling and coaching in Colorado and virtually nationwide via telehealth. Joanne is also the author of infertility and PTSD, the unchartered storm, a valuable resource that offers clinical validation and education and a practical roadmap for those suffering. Okay, so we're so excited to welcome to fertility for today. Joanna lemons all the way in Colorado. Thank you so much for joining us via Skype. Thank you so much for having me. I appreciate it. I was so excited because so Joanna is the author of a book. I recommend to so many of my patients and fertility and PTSD, the uncharted storm. And I kind of slid into her DMS on Instagram and said, Hey, you know, we're doing this podcast. Would you be interested in coming on? And I had a total fan girl moment when she responded and said, sure, absolutely. It came into my office. She's like, you won't believe me. And we're getting her on this podcast. We're very happy to have you. So thank you. So I think, you know, your work is so important to so many of my patients and I know Doris patients as well, since we collaborate, I talk with so many people every day. I feel like kind of the sentence, you know, infertility and PTSD go hand in hand, comes out of my neck many times a day. And so I was so happy to find a book in the space that I could refer to, and that has great exercises and really kind of delve deeper into what that means. So I would love to dive in and talk to you, you know, about trauma and PTSD and how it's related to infertility. But first let's see, I would love to know your background and how you kind of got involved in this realm in this space. Yeah. I'm glad to talk about this. Probably about 20 years ago, I have a colleague that is going through some infertility and some treatment and to be honest, that's where the journey of understanding the struggle really developed. And then at that time, shortly thereafter, I worked in a postpartum unit, labor and delivery
Speaker 3:At a hospital. So I started encountering a lot of different cases where there were fertility related losses on an ongoing basis, which really opened my eyes into this struggle. And then eventually I went into private practice and then I also worked at a reproductive clinic and really saw how much PTSD was going on with so many people and realized that there wasn't really, I mean, there had been some studies that were done on in fertility and PTSD, but there wasn't actually a book out there yet. So that was my interest was really just trying to help people that were having all these symptoms and couldn't explain what was happening. But so many people stating I feel like I'm going crazy or I'm losing my mind. And, and just to have something to normalize and ground them to understand really what the diagnosis was, what they were going through. And that really the reaction was normal given what they were going through. So it's my history of working in healthcare. I went through some infertility in myself and not in comparison to what many, what some people will go through. So personally and professionally I've been impacted by this and really just wanted to provide a resource for people.
Speaker 2:Oh, I have no idea. I mean, I think both there and I also personally and professionally struggled in fertility and I find so many people I made in the space got into it for that reason. I think, you know, it really impacts those that go through it in such a deep way. So to find out, you also went through it too, and it kind of guided you professionally, I think is powerful. And also, you know, speaks to how deeply this really affects us.
Speaker 3:Absolutely.
Speaker 2:What do you for, you know, our listeners and people, how would you define it?
Speaker 3:So PTSD is now considered a stress disorder. I know it was considered an anxiety disorder, but they've changed it in our DSM manual to being a stress disorder. And really, it's just a reaction to a past trauma that's been stored in your brain and body as unfinished. So like it's still being re-experienced as though it's happening, even though it's over. And so there's all these symptoms that arise, obviously with your body and your brain feeling, it's an active threat or there are active threats. And so that's what PTSD is. There's symptoms that qualify for the criteria. Re-experiencing the trauma through flashbacks, nightmares, panic triggers, avoidance behavior. So avoiding things that remind you of the trauma, negative changes in your thoughts and booths. And then there's a hypervigilance component and that's a really high acuity of anxiety so that your body and your mind are always in high alert, waiting for the next shoe to drop. Essentially that's coming into
Speaker 2:The fertility space for the first time. They've never undergone treatment, et cetera. Now, could they have PTSD from day one or this is something that would develop as you go through treatment or even post-treatment I would think.
Speaker 3:Absolutely. Yeah. So by the time that someone comes into a clinic, they've probably experienced stacked trauma or recurrent trauma just through the fertility process itself of month after month experiencing loss. However, one of the key pieces that we look at as trauma therapist is the history of trauma. So are there traumas outside of infertility that have occurred that are impacting also that stacks trauma, so that potentially someone could have PTSD from the sexual assault when they were younger or from childhood abuse. And so they've always had a hypervigilance let's say, or some post traumatic stress, but then they come into the infertility process and it exacerbates symptoms that were always there, but maybe we're in a season of being more dormant or docile.
Speaker 2:Okay. Yeah. I was actually going to ask, so I've had a couple of cases, both patients that have had a prior experience with sexual assault. And so I wanted to ask your opinion, you don't, how do you see that linking to then coming into the fertility process?
Speaker 3:Well, that's a very good question. And I know there's some research out there. The main key that I see there when I'm assessing that is that already there is a non harmonious relationship with their body, many times if they've gone through a sexual assault. So there's already this dissonance and then they come into infertility and that's just add a dissonance that I want to feel this way about my body, but yet my body is the enemy or my body stores feelings that feel really bad. Yeah. There's a true link there. And what about also eating disorders? Same thing. It's that disconnect from the body that occurs where the body is something to be dissociated from or the body is something to fight against or the body is something to punish. It's amazing how many of these cognitive associations carry from different types of stressors, but they're all with the theme of my body is unsafe or my body is not something to value or my body is the threat.
Speaker 2:And so for a patient that comes in with those kind of preexisting symptoms or experiences, what kind of treatment, if any, would you recommend they undergo while going through fertility, either in parallel or before coming into treatment?
Speaker 3:So the reality of going through infertility is that for so much of the time and space, it doesn't feel safe. It doesn't feel that they're out of the woods, so to speak, they're in the middle of this storm, that's violent and raging and there's no break. And so we know from a trauma perspective that there is a certain level of healing that cannot happen as long as people experience that they're in the middle of a threat that they're not in a safety zone, there's no space and time between them and that's red. And that is what is so tricky and so stressful for people going through this is there's no break really. So to speak from the very thing that continues to feel vulnerable, feel like a threat, feel like potential loss might occur. So we always keep that in mind when treating people that there is not a full sense of safety. A lot of times, what I will look at is obviously the trauma history evaluate that looking at coping skills and then also looking at, are there things that they can work with to change, to alleviate some of the stress that they're carrying while they are going through this? Cause it's not that they can necessarily remove the threat, but what can I do to cope better? How can I change myself to be able to manage us a lot better or different? And I think that's such a good question because so many, many, many people that go through this are such strong individuals, which are very driven people. And so to come to this place of really experiencing this disease, this infertility, it feels so out of control. And so the things that they have used prior to cope with life stresses no longer work. So helping them kind of develop a wellness plan to create some sense of restored agency that, okay, I can't control this. I can't get the results I want. What can I create? What kind of plan for myself can I create that does actually help me to feel better, even in the midst of this storm. And so that's what we look at.
Speaker 2:So coming up with strategies, tools in their current life that can actually be actionable and realistic.
Speaker 3:Absolutely. And the other piece of this is psychoeducation, you know, spending quite a bit of time with people, helping them understand their nervous system, the fight or flight response, the parasympathetic sympathetic nervous system, all of that, so that they can understand that the reactions they are having are perfectly normal and identifying with their physiology. So that in itself, I think lends a lot and helps people to feel more grounded like, Oh, this is normal. I'm not having an abnormal reaction.
Speaker 2:I agree. I mean, I think it's, as you said, it's not as strong people in this space. It's not a very smart people in this space. And I think, I always tell my patients, you know, knowledge is power. So are you able to, even on that a bit to the fight or flight and the sympathetic nervous system and the para sympathetic nervous system, I know, you know, you talk a lot about that in your book and I think you explained it so well, but maybe just try listeners now kind of a brief overview of that. I think it will be.
Speaker 3:Yeah. Thank you. I get so passionate that I almost start shaking.
Speaker 2:[inaudible] positively.
Speaker 3:I love educating about, you know, our body, cause it helps to explain so much. So typically I always use the analogy. If you get out of your car, you park your car in the driveway, you decide to walk in the front door this time and a dog comes down the street and it's barking and it's going to attack you. You're probably going to run in your house or yell out to the owners or whatever. And you're going to make sure that that never happens again. So because you have the guarantee or the 99.9% guarantee that it's over, then you're going to be able to come back, park your car, or I should say, you're going to have greater ease coming back, parking your car. Yes. And just feeling secure that, okay, I can walk through the front door again and that's not going to ever happen again. What happens with many situations in life, however, is that there's something called recurrent trauma. And that means it's a repeated trauma that happens over and over. And so the example of the dog initially, what happens when you see it's red is that your brain alerts, the autonomic nervous system that we got an issue here. And at that point, your nervous system decides, is this a true threat or is it not? And if it is a threat, then your body goes into the sympathetic nervous system where the fight or flight is housed. And out of that, it releases a chemical response, adrenaline and lots of other hormones as well to prepare your body for either fighting this threat or sliding and running away. And as a result of fighting or flighting, then eventually the threat is gone and your body can come back down from that heightened state of readiness and restore back to homeostasis. Just being back to where you were before you even saw the dog, what happens with recurrent types of traumas? Like typically that's what infertility is. Repeat trauma one after another is that your body goes into the fight or flight response, but then it just continues to have repeat traumas. And so eventually your body and brain store that this trial is not ending. This trial is not over and I do not have any control or power over this trial. And so that's why reminders triggers things like that for so many people trigger that fight or flight response because your body and brain are not really experiencing that this is ending. And so it's a completely different kind of trauma. And I know there's lots of studies. I just read one. The other actually that has recently been published that a very, very high percentage. I know there's some examples in the book are research studies, but I think the one I saw was one out of three or four women now experienced PTSD from miscarriage. And I think the one I had, I'm not sure if it was as recent, however, that is recurrent loss. That's one loss right after the other. And so the nervous system is never able to move out of that fight or flight response and this sympathetic nervous system over to the parasympathetic, which is the part of the nervous system that restores rest relaxation to the body. When I think about parasympathetic, I always think about the spa, you know, and I probably shouldn't make it that it should be. I'm going to do breathing exercises right now, right here in this moment. And that's gonna move me over and parasympathetic. But for some reason I was go to spot breathing to be exact something that you don't have to pay a lot of money for. Absolutely. I mean, there are, there are so many things like even just picking up a bottle of essential oil, inhaling that for five minutes, you know, you move your body right out of sympathetic, into parasympathetic, and then that pulls you out of that fight or flight response. And those are some of the things, as I was mentioning that you can do to cope that the storm isn't over, but you can figure out things that really help your body to be able to withstand all the stress that you're going through, which does empower that does empower you in situations where you feel helpless. Absolutely. And what about the large T trauma? Yeah. So this is a concept that has helped clinicians break down. What kind of traumas are there, you know, are they all the same and no, they're not all the same. And we all have different reactions to every kind of trauma based on a number of things like our backgrounds, our coping skills at the time, or access to treatment. There's just a lot of different things that impact how we respond to different kinds of traumas. But small T traumas are basically non life threatening types of traumas. So they can be things like death of an animal, a fight with, you know, partners, spouse, financial difficulties, things that are very, very stressful and can be very traumatizing, but there's not the threat of I'm going to lose my life or somebody else's going to lose their life. Or someone's physical integrity is in question here. Whereas big T traumas or large traumas, large T traumas are those that are experienced as very life threatening or a serious physical threat or an integrity loss to people physically. And typically within fertility, it falls more into the large T well, it falls into both actually falls into large to trauma because there is such a sense of loss of physical integrity and physical threat for many actually, and very many life threatening situations that can happen when people are going through infertility, you know, with different kinds of losses and situations that I saw all the time working in the hospital, obviously, but it also emulates small T traumas because it's recurrent. And that's one of the characteristics of a small T trauma is that there are traumas that happen more often over and over and over. And there's actually some perspective out in the community that small T traumas are more traumatic because it's their recurrent versus like maybe one isolated large T trauma kind of describe it to patients as, you know,
Speaker 2:Very Tablo lobby and this sort of negative reinforcement, right? It's like, you're sticking your finger in the socket and you keep getting burned every time. And so your baseline is just totally frayed. And you know, all you learn to expect is this negative response. It's very hard to continue to weather the storm
Speaker 3:Absolutely
Speaker 2:Meant plans. You know, what do you recommend or coping
Speaker 3:Mechanisms for a large T trauma or a small T trauma. And also my question would be, I'm sure it's different when
Speaker 2:Day to day when we're,
Speaker 3:You know, experiencing some stress, but also how it varies when we are in that fight or flight. Would it be a little bit different when you change it up a little bit? Yeah. Good questions. So I want to touch really quick on that side or flight response first, before I lose this thought, which might happen if I like this moment. So the other thing with trauma that we look at is in with recurrent loss is there's not only the fight or flight response that occurs for many, but there's also something called the freeze response. And that's a big part of response to trauma. And what essentially that means is that you freeze in the moment it's instinctual. It's not anything that consciously you're planning out. It's just a very innate physical survival response. And one way to think about this as a deer in the headlights, which incidentally happened to me about three years ago, I was driving down and I was driving the speed limit for once.
Speaker 2:Yeah.
Speaker 3:Yeah. I'm one of those people I only go to about right. But anyway, was driving and there was a deer that came out of nowhere and I saw the eyes and unfortunately I hit it and I killed it, which was a very sad day. That was, that was a very sad day for me. Yeah. But anyway, it is that response, that survival response like, Oh my goodness, I have nothing I can do here except to freeze. And hopefully I won't die. Hopefully I can get through this. Even you think about like with wildlife and hunting and training and all that, you always hear like play dead, play dead. You know, there's just a lot of power instinctually and even calculated sometimes to just remain still in the moment and hope the threat passes.
Speaker 4:You know, if you see a Tucker runaway, you stay still and try to pretend that you're calm.
Speaker 3:Exactly. And so that's what can happen for many people going through these experiences and that when you do enter that freeze state a lot that does eventually create a very complicated trauma type of response, which I hit on briefly in the book, which I won't go into now. But I just wanted to point out that there are three different responses that do happen in trauma. So back to your question about treatment with these different types of trauma. So the purse piece and assessing trauma for people is I look at safety. Are they in a place where they feel safe? And obviously for many people going through infertility, they don't feel safe. Like, no I have, this is what's happening. I'm having this medical issue that's happening reoccurring. And I don't feel safe. I feel that at any point something bad is going to happen. If I tried this again, it's not going to work. How am I going to handle it? How am I going to cope? And so things that I typically assess with people, or what is the thinking, and so we'll make a thinking plan for them or a cognitive plan for them and create like, you know, you hear like people have their fight songs, Katy Perry, everybody clings to, we create, we create like a fight plan for their thinking. And so it might be really looking at, okay, what is the thinking that you're having on a regular basis? It might be like, I don't know what I'm doing. I can't handle this. I can't create the life. I want, I feel helpless. I can't handle my feelings. I don't feel like myself. I don't feel right. And so out of those thoughts, then we'll create this plan for new thinking, which might be, I can handle my life. I can figure out my life. I will figure out my life, look at all these things I've been through in the past. And I will figure this out. I know what I'm doing. I can trust myself. I can trust my judgment, you know, and just really talk positive affirmations.
Speaker 4:I think that's super empowering too. And to help someone frame their, their thinking as of
Speaker 3:Control. Absolutely. In fact, there was a study. I mentioned it in the book, they studied the brains of people under different types of MRI scans who practice daily affirmations versus people that don't. And they found that people, that practice affirmations actually fare much better in the face of threat than people who do not practice daily, positive affirmation and cognition. So yeah, thinking is imperative. So we'll create like a new thought plan for them. And then we also look at ways that they can work with their nervous system. So we're looking at a lot of the different elements that can aid them through this process, which can include all the different things that we think about for keeping you out of the fight or flight. So we look at yoga, acupuncture, diet, you know, just all the different things to help. And I'm sorry, I'm leaving out so many disciplines right now. And there's so many that are so important that that help people move into the parasympathetic. But we'll look at a lot of things like that, then community. Yeah. Are people too isolated and if they are, then we look at, okay, what groups can you get connected to where, you know, there's so much power for people in groups, especially when you're having PTSD, because it's so alienating, it's a disorder that's so alienating and you feel that nobody else is going through it. And so to come around, people that totally get it, I think reduces so much hypervigilance for people like, Oh, other people are having these same feelings and it's not just me. And it's not just my body. This is pretty normal actually. And I think there's so much comforting power in that for people.
Speaker 2:Yeah. I think it really normalizes it and it's super empowering, you know, and you could have nothing in common with the other person at all, never have crossed paths, but to share one of these common experiences, right. You know, in fertility or PTSD or what have you, you know, it's such a strong connection.
Speaker 3:Absolutely. It really is. And then there's, trauma-based therapies that we use a lot, which I'm sure you guys aren't totally familiar with, but like cognitive behavioral therapy, which is a lot of that thought work that we do EMDR, which stands for eye movement, desensitization, reprocessing is another one that's very effective for helping people work through traumas. Sometimes people will use prolonged exposure therapy, just a lot of walking through verbally each thing that has happened, you know, what responses have been stored from that and trying to help create desensitization through that and then cognitive processing therapy. Again, just a lot of cognitive types of therapy. Are we good? What about breathwork? Oh, hands down. That is really, really powerful. And that's actually, one of the things that I love to teach about is breathing techniques, especially those that trigger the vehicle nerves in the body. And what that means for people is that it creates an immediate, very strong relaxation response. When you breathe certain ways, there's one called four seven eight, and that triggers the vagal nerve and the root of your mouth and creates this really powerful relaxation response. And I talked to a lot of people about that, especially as they're getting treatments and there's so much hypervigilance and triggers and everything, but you have so much power to work with your nervous system and these moments that are very overwhelming and frightening, and it doesn't cost anything like you were saying previously, can you tell us what the four, seven, eight? Oh, absolutely. So essentially what it is is you breathe in for four seconds. You hold the breath for seven seconds and then you breathe out for eight seconds. Like you're breathing through a tiny black coffee straw. So you kind of pucker up your lips and when you breathe that way, that's what triggers that bagel nerve. And it works tremendously. I mean, if you do work for five minutes, even you're going to see a dramatic change in your day
Speaker 2:For four hold for seven, out for eight. As though you're breathing out through a straw. Pete, I always tell people, you know, I know this sounds really basic, but breathing is very helpful.
Speaker 3:That really is. That could be also a great meditation, which can for many people seem quite overwhelming and a nervous thing to do if they've never done it. And I feel like the breath work can be a great precursor to starting a mindfulness practice. Absolutely. Yeah. Anything that triggers, you know, the right side of your brain, which is responsible for all the senses, it's going to be really therapeutic. So breathing, I'll tell you about light a candle that have plugins in your office. Those things deescalate the stress from your body, which is really a lot of what PTSD and trauma therapy is about is keeping your body in that really calm, comforting space as much as can be. Obviously there's lots of stressors all around, but yeah, breathing meditation, stretching a lot of people experience benefit from chiropractic work. There's just so many
Speaker 2:Putting a plan that works for you financially with your time, but it is very possible for everybody. And then also I think too, can we talk about Maslow's hierarchy of needs? I think, you know, that pertains so much to, to this work and explaining to people kind of the pyramid and when your basic needs aren't met, it's really kind of impossible to achieve self esteem and feel happy. And I think in fertility really takes away sort of your baseline.
Speaker 3:Absolutely. Yeah. I love this pyramid because for, so people going through this journey, there's a description of I've lost myself. I'm not who I used to be. I'm not hanging out with the same people anymore. I avoid all these things like what's wrong with me. And this is a perfect description of what occurs that when your basic needs, which is a foundational need on this pyramid and the bottom need is not met, then you're not going to accelerate or you're not to be able to thrive in other levels. So basic needs are food, shelter, health, sleep, basic needs. When those needs are compromised, then you're not going to thrive in other areas of greater self actualization, for instance, community thriving, maybe on your job, or just feeling like you're thriving and infertility is a physical threat for everyone that goes through it. It is a basic need. And that's why there's such a struggle there with that basic level being mad. I mean the world health organization rates in fertility and women, the fifth highest serious global disability. So it's alarming, it's alarming, but it is that basic need that basic physical medical needs that is compromised. And so until that need is met, other areas are going to be changing. People are in survival mode, all their energy is just going to this basic level, trying to get this Nene bat. There's not energy for all these other areas that maybe they had before.
Speaker 2:A big reason. I went into this work too. You know, like again, we sort of touched on at the beginning of this as our own personal experiences. And I just, as I continued to learn more, both for professional reasons, it ties into personal reasons in my own journey and kind of evolvement. And I like to say, I don't live with regrets, but I just, I regret so much that I didn't understand this. Or there was nobody there to tell me this, as I was going through this myself, you know, I always say going through infertility, it was two of the darkest years of my life. And now I have an understanding of the why, but I just think back in Michigan only I had known this when I was going through this, would I have said that those were really the two darkest years of my life. Sure. They would've been difficult, but they were maybe unnecessarily dark for me. And, you know, I wish there were more people like you like us
Speaker 3:Doing this work to help people through it, to understand this process of what you're doing is part of your healing.
Speaker 2:Million percent. Dara has seen me go from a very bad energy place to, I think hopefully she will agree with a much better one. I've really gone through a lot of personal things in my work here. And I think absolutely yes, part of this has definitely been healing, but I feel like
Speaker 3:You've actually been able to use mindfulness tools to help
Speaker 2:Oh, a million percent, but it's also, you are. I mean, I've definitely practiced what I preach. You know, gratitudes, meditation, journaling, random acts of love and kindness, all that stuff. Oh my gosh, it's been a huge, played a huge impact in my life, in how I respond to things too. You know, things before would have, I would have been super reactive, really mad now.
Speaker 3:So much easier to roll with it,
Speaker 2:Or just be grateful for the moment and present, which I think, you know, better serves me in my work to help other people going through it, to help get them to that space too. Because if I wasn't in that space, there's no way I could help anyone else get in that space. I think the other thing I really wanted to talk about what we still have you too, it'd be sort of the cognitive dissonance and the mind versus body aspect of everything.
Speaker 3:Yeah. That is such a big part of this journey. So the cognitive dissonance piece of this whole journey, or just in general in life is when you're carrying and embodying two opposing beliefs based on whatever the situation is at hand. And I don't know why as human beings we're able to do that, but it's pretty miraculous that we can do that, that we can carry two parts of us that are fighting against each other, essentially at the same time. So for, in fertility, it might look like I very, very much want to keep trying in one breath and then five minutes later it might be, Oh my gosh, I don't want to do this. I'm done with this. And so it's, as I think I said in the book, a mental ping pong all day long sometimes where I want this, I don't, I can handle this. I can't handle this. I'm excited about this. Oh my gosh, I'm dreading this so much. And so it's this back and forth all day long and typically in life, the way that we resolve dissonance is that eventually we choose one side the angry. Absolutely. And so trying to regulate this, you know, people have said many times, I feel like I'm going crazy. And then we talk about the, yeah. And then we talk about dissonance. Like, Oh, that's what this is. And so what they have found, uh, the national Institute for health, I believe that's who the researchers were on this study, did a study and found that meditation, mindfulness practices are those that are linked to helping people regulate that dissonance more than any others that have been studied. So there's a lot of power for people to access through these mindfulness practices and mindfulness, meaning things that force us to be in the moment and bring our body to a place of, Oh my gosh, I'm actually comforted right now. This feels good. Which when you're going through those for so many, it's like, how do I ever feel good again? I feel so horrible. And so mindfulness are, you know, powerful practices that help to regulate not only dissonance, but the everyday demands of this journey. I think it's super powerful. And I think we talked about in another episode of doctor, but can sort of write this, how do we feel the juxtaposing emotions? Right. So how do I feel happy that I have gotten an egg donor and I can continue with my journey, but also really sad that I can't have a biological child. You know, how do I feel those emotions? Is that okay? How did I kind of reconcile the two? Because people often think is, you know, you just tends to bond and have to be one or the other. They don't understand. It can mean both until they're this fight. Well, I need to feel one or the other, but you know, as you said, it's, you can feel the, you know, there is space for both. There is. And I think part of that process of resolving the dissonance is that as you allow yourself to be in the moment to accept that, okay, these are the two things that I'm struggling with and then you just let them be, instead of necessarily trying to resolve them is that eventually subconsciously one of them gets resolved through desensitizing, through allowing accepting space for both things to exist at the same time. So yeah, that is such a big part though, of this journey is the different levels of grief that come with each step with each choice. Cause it can feel like I'm abandoning this part of me. That's so much wanted this and I'm trying to allow accepting space for me to want or desire or move into this new choice. There's so much intangible loss that goes with this.
Speaker 4:It's interesting. Cause I know, you know, you do a lot of, of course the mind body connection, but I'm thinking about when you're mentally not in a great place that can affect your gut and your body and not being a dietician. I'm thinking it goes hand in hand mentally when you're not a good space that could negatively affect your gut. If you're not nurturing and feeding yourself with good foods that also has that feedback loop of creating more stress and anxiety and negative hormones in your brain and beyond.
Speaker 3:Absolutely. And that's, I mean, I just think to the years of working in the clinic and so many places putting people are recommending, these are the kinds of foods you need to be eating. And there is actually, I have seen so much research on the gut and PTSD,
Speaker 4:Another discussion interests,
Speaker 3:Figuring out what's going on in the gut. There's a direct association with both of those. So kind of free and access for sure. I mean the mind body connection is so powerful and you know, I live in this conversation really tend to live on mindfulness and the importance and real impact of on
Speaker 2:Our mental state and physical state
Speaker 4:Finding what works for you. And that's the fact that you're, you know, Rena and yourself to any buzzer are fabulous resources for giving the various options and customizing it to each person's needs.
Speaker 2:Well, I'm the same with you for the nutrition aspect. And I think it's, you know, as the comprehensive package kind of is really the most helpful for people. So I think before we let you go, we like to end each podcast with going around and sharing our gratitudes and saying what we're grateful for. I could eat today or just in general. So could you share with our listeners what you are gratitude is? Yes. So at this very moment, I am in my office and I am looking at my dog who I am obsessed with. He is a she Sean. So he is a very small dog, but he is awesome. And he goes, he goes everywhere with me. He goes in my purse, I sit at my desk. So I am grateful for my dog. His name is boo. Yeah. He's just this constant positive presence that I'm grateful for. I love that. I love that so much.
Speaker 4:I am grateful. You know, speaking about mindfulness, I am proud of myself for the, my self care over the past six months to a year, the support that I found through friends and family and also the realization that I need to slow down and be present. And I think that's served me well and it makes me happy when I see other people also enjoy being in the moment. It's so easy to get caught up on thinking about the, what ifs and often we lose sight of being present. So I'm working on that and enjoying it. Great.
Speaker 2:Yeah. I feel like I always steal yours, but as we're having this discussion, I same sort of vein with the mindfulness. You know, I really started doing the work quote unquote, as I say, probably I don't know, two years ago really actually saying, I need to do this. Is that, or what you know is at a pretty intense rock bottom. And so I really started doing the work, getting and doing the mindfulness and I'm so grateful for investing in myself and the difference it has made in my life. I, if you met me two years ago, I'd be a completely different person. I think it's, it's dramatically impacted my life and made me better as a mom, as a friend, as a professional. And I'm so grateful to also be in a field where I can share this and help other people and that my personal and professional life, you know, kind of lead together. I am very grateful for that. So, so much gratitude today. Yes.
Speaker 4:Joanna, thank you so much for being on and sharing your wealth of information and we'd love to have you on again.
Speaker 2:Okay. We are so grateful and we'll put info to your book and info about you and our show notes and our social media and everything. So people can know where to find you. I definitely recommend, I tell my patients to get your book. It's really a helpful tool and you put really amazing exercises and then book for people. So definitely I recommend getting your book and I'm not being paid or anything for this. I really believe in it. I'm so grateful. And also what's the best way to get in touch with you. Well, you can find me on Instagram as my handle. My handle is in fertility counseling support or my email is J F CC services@gmail.com. Those are probably the quickest ways to find me. Wonderful. Thank you so much. Thank you so much for listening today and always remember practice gratitude, give a little love to someone else and yourself. And remember you are not alone. Find us on Instagram at fertility underscore forward. And if you're looking for more support, visit us@wwwdotrmaandy.com and tune in next week for more fertility forward,
Speaker 1:[inaudible].