No description available.

The central theme of this thesis is infertility. It links different areas of my work as a chartered counselling psychologist working with clients experiencing difficulties conceiving. I currently work in private practice specialising in this area. Previously I worked as an NF counsellor at the Assisted Conception Unit of the Lister Hospital in London. Although the term `infertility' is commonly used, being `infertile' means a total absence of reproductive function and this condition is rare (HFEA, 1999). The majority of people presenting with difficulties in conceiving actually have `sub-fertility', where one or more parts of the reproductive system are impaired. Throughout this thesis the term `infertility' is used to refer to both infertility and sub-fertility. I initially became interested in the psychological impact of infertility when a number of close friends started having difficulties conceiving. I observed that whilst there was a wealth of medical support available, psychological and emotional support was somewhat lacking. This led me to reflect on the counselling psychology of infertility. After conducting a review of the infertility literature it became apparent that research contributions from counselling psychologists were somewhat scant. The main body of literature is comprised of contributions from nurses, medical practitioners, clinical psychologists and counsellors working in the field. Part of my motivation in undertaking this degree was to establish the role that counselling psychology can play in the field of infertility. Linked to this, was the motivation to make a difference and raise the profile of infertility within the field of counselling psychology. The thesis focuses on three different areas of infertility that are all linked to the practice of counselling psychology with this client group. Firstly there is an exploratory piece of research. It focuses on the psychological and emotional impact of the infertility experience and the role of counselling. Secondly there is a case study. This is reflexive exploration which focuses on some of the challenging issues that I encountered in my clinical work with an infertile female client. Finally there is critical review of the literature that explores infertility and counselling from a historical perspective. The review places infertility in a historical context so that the complex psychological aspects of the infertility experience today can be more fully understood and appreciated. An overview of each section is now provided.

The purpose of this study was to investigate and describe the experience of infertility of African women, men and family member. It is hoped that this description will contribute to a deeper understanding of the psychosocial difficulties involved in the area of infertility and ofthe ways in which people respond to the situation of infertility. A qualitative research approach was used, and in particular social constructivist-interpretive research and feminist research approaches. The sample consisted of39 participants: 19 women, 10 men, and 10 family members faced with infertility. The research orientation was field-based, concerned with collecting data using the technique of in-depth semi-structured interviews. Each participant was interviewed individually. The interviews were recorded on tape, transcribed in their full length and translated into English. Data were analysed on the basis of the interpretive feminist approach. Analysis of individual cases and crosscase analysis were employed. The findings suggested a contextual definition of infertility, for example, for some, having had an ectopic pregnancy or a miscarriage meant that they did not fit into the definition of infertility. The findings revealed that for many African women and men, blood ties still defined the family and the persona. Thus, failure to have a blood child resulted in courtship and marital break up, extramarital relationships, polygamy, and divorce and remarriage. Infertility had serious psychosocial consequences for both the infertile individuals and their families. Participants experienced repeated periods of existential crisis, which began at different points for different participants. Analysis of gender differences indicated similarities in the experience of the crisis, but differences in terms of expression and ways of responding to the crisis. Family dynamics within the context of infertility were coloured by ambivalent feelings, resentment, insensitivity, and miscommunication, but also affection, and social support. Traditional and modern medical health systems offered the possibility of finding explanations and treatment, but there was further strain from the negative experiences with the health care system. The findings in this study suggested the need for policy reformulation, for psychosocial intervention as part of the treatment plan, and for future research on the outcome of using various coping strategies. / Psychology / D. Phil. (Psychology)

The purpose of this study was to investigate and describe the experience of infertility of African women, men and family member. It is hoped that this description will contribute to a deeper understanding of the psychosocial difficulties involved in the area of infertility and ofthe ways in which people respond to the situation of infertility. A qualitative research approach was used, and in particular social constructivist-interpretive research and feminist research approaches. The sample consisted of39 participants: 19 women, 10 men, and 10 family members faced with infertility. The research orientation was field-based, concerned with collecting data using the technique of in-depth semi-structured interviews. Each participant was interviewed individually. The interviews were recorded on tape, transcribed in their full length and translated into English. Data were analysed on the basis of the interpretive feminist approach. Analysis of individual cases and crosscase analysis were employed. The findings suggested a contextual definition of infertility, for example, for some, having had an ectopic pregnancy or a miscarriage meant that they did not fit into the definition of infertility. The findings revealed that for many African women and men, blood ties still defined the family and the persona. Thus, failure to have a blood child resulted in courtship and marital break up, extramarital relationships, polygamy, and divorce and remarriage. Infertility had serious psychosocial consequences for both the infertile individuals and their families. Participants experienced repeated periods of existential crisis, which began at different points for different participants. Analysis of gender differences indicated similarities in the experience of the crisis, but differences in terms of expression and ways of responding to the crisis. Family dynamics within the context of infertility were coloured by ambivalent feelings, resentment, insensitivity, and miscommunication, but also affection, and social support. Traditional and modern medical health systems offered the possibility of finding explanations and treatment, but there was further strain from the negative experiences with the health care system. The findings in this study suggested the need for policy reformulation, for psychosocial intervention as part of the treatment plan, and for future research on the outcome of using various coping strategies. / Psychology / D. Phil. (Psychology)