Examining Infertility and Pregnancy Loss Through a Psychodynamic Lens

Examining Infertility and Pregnancy Loss Through a Psychodynamic Lens

Delving into the unconscious mind to discover unresolved conflicts and traumas that are specific to your journey through infertility and loss.

By Renata V. Hackley, Psychotherapy Intern at Depth Counseling

Infertility and pregnancy loss are common yet incredibly isolating experiences that can have devastating mental, emotional, and physical effects on the individual experiencing this trauma. We often hear statistics thrown around, such as “1 in 8 will experience infertility” or “10 to 20 percent of pregnancies end in miscarriage before the 20th week,” and while these statistics may be true, they are neither comforting nor helpful to the individual going through it.

When a person or couple experiences this kind of trauma, doctors and medical professionals are quick to provide help and support through a medical lens: physical examinations, prescriptions for medications, a treatment plan to resolve the terminated pregnancy, etc. Often this medical approach is accompanied with comments or statements from the medical team such as “it’s a numbers game!”, “keep on trying!”, “I am sure you can get pregnant again,” which can often feel dismissive or invalidating to the patient’s very real feelings of grief, loss, and emotional pain.

So, in a world that can be so heavily reliant on medical data and clinical information, what can, or should emotional support look like for a person experiencing infertility and pregnancy loss? This is where therapy comes into play, and more specifically, where something such as psychoanalytic psychotherapy can be incredibly beneficial.

What is psychoanalytic psychotherapy?

Psychoanalytic psychotherapy delves into the underlying causes of emotional pain and trauma. Through an empathetic and trauma-informed lens, it explores all the ways past experiences and unconscious thought patterns may be motivating or influencing not only behaviors, but responses to challenges and difficulties in present-day situations. Psychotherapy is multidimensional, and through talk therapy and free association, it delves into emotions, thoughts, feelings, experiences, relationships (past and present), the therapeutic relationship, as well as an examination of fantasies, dreams and hopes the patient may have.

Some psychodynamic psychotherapists also place emphasis on spiritual needs and strivings (spiritual needs being defined here in a broader sense as self-analysis and honest introspection). The idea is to find a sense of self through exploration that will have positive effects on one’s mental health and well-being. Throughout the process there may be skepticism or doubt, but being able to maintain confidence in the process and keeping an open mind as one explores on such a deep level is key to further self-discovery.

psychodynamic therapy for infertility

Infertility and pregnancy loss through a psychodynamic lens

The experience of infertility and/or pregnancy loss goes beyond the loss of the unborn child. The pain and grief that come up after these losses are interwoven with feelings of dashed hopes, destroyed dreams, hopelessness, loss of control, uncertainty, fear of the unknown, loss of connection in relationships, feeling misunderstood and unheard, and more.

Thinking about these themes more deeply: How are they connected to the inner self? How does the past impact how people respond to trauma in the present? When feelings of hopelessness or destroyed dreams arise, is there something one can explore with a trained therapist to help better understand these feelings and how to manage them in a less all-consuming way? This is not the same as uncovering repressed memories, but rather, looking to expand the mind and sense of self-awareness. Are there unconscious patterns that can be explored to find a better sense of self-discovery? Examining this can lead to acceptance, understanding, refined coping skills, and more.

On the surface, of course the actual loss of a pregnancy is the catalyst for the feelings that emerge. Loss is a trauma that affects people deeply. But looking to explore this further with the goal of healing or understanding/acceptance, the therapist and individual can delve into underlying motives, experiences and unconscious patterns that may be impacting the healing process. The goal for this framework of therapy is never to “fix” or “solve” one’s problems, but to identify themes and patterns through honest exploration. This type of work helps people become more mindful of their experience in the here and now. It is through this self-discovery that one can find more healing and acceptance; however, this process takes time.

therapy for infertility

How to find the time for psychotherapy

So, what kind of commitment is this? For an individual suffering from pregnancy loss or infertility, committing to any structured format may at first feel daunting and overwhelming. The emotional impact of loss and trauma can make day-to-day functioning difficult, and that’s okay. Part of the important work in psychotherapy is to ensure the therapist is meeting the client where they are both mentally and emotionally. This might mean meeting once to ensure there is rapport and a sense of safety. Beyond that, this psychotherapy normally involves meeting 1x/week or more, if needed. You and your therapist will work together to find the right frequency, respecting your pacing and comfort level, while allowing the process to evolve in an organic way.

How to find the right psychodynamic therapist?

Part of the psychodynamic process involves finding the right therapist. This can take time. As in personal relationships, the therapeutic relationship involves a deep sense of trust, safety, and feeling heard and validated. Beyond that, the relationship must grow and develop in a way that it will become a window into what is happening in the individual’s relationships in general. This is critical for anyone struggling with infertility and pregnancy loss because relationships can become so adversely affected.


The pain and trauma that come with infertility and pregnancy loss can feel insurmountable. It is an isolating experience that leaves many feeling alone in their grief and pain. The benefit of doing psychotherapy when experiencing infertility or pregnancy loss is that you will no longer be alone. Inherently through the process of psychotherapy, you are exploring yourself with a partner. It’s not necessarily an intellectual process, but an emotional one, aimed at uncovering what’s beneath the pain and finding a path forward.

While this may feel daunting, it’s important to note that the time and work put into psychotherapy will benefit the individual in the long run. Healing from infertility and pregnancy loss takes a long time, there is no quick fix. Similarly, psychotherapy does not provide a quick fix, but instead a meaningful analysis that builds slowly and, in the end, will be worth it.



McWilliams, Nancy. Psychoanalytic Psychotherapy: A Practitioner’s Guide. The Guilford Press. 2004.