How Therapy Can Help With Infertility: A Conversation With Perri Shaw Borish

This week, Binto sat down with Perri Shaw Borish, MSS, LCSW, BCD, a psychotherapist practicing in Philadelphia, PA with over 15 years of experience in Maternal Mental Health. She treats a range of issues across the reproductive journey including anxiety and depression, postpartum anxiety and depression, fertility challenges, and birth trauma. We talked to her about how therapy can help you on your fertility journey.


BINTO: Would you like to give our readers a brief introduction about who you are and what you do?

Sure! I’m a Psychotherapist in private practice, and the founder of Whole Heart Maternal Mental Health. I’m also a mom of three.


BINTO: What is your favorite part about what you do?

Honestly, I love my job. All of it – even the admin parts. But for sure my favorite part is when people come in, do hard work, and then get better and don’t need me anymore.


BINTO: What is the most challenging part of what you do?

In the beginning, it was not taking my work home with me – in the emotional sense. I had to work hard on my own boundaries to accomplish this. Now, as a more experienced therapist with a small team of therapists who work with me, the hardest part of my work is finding sufficient time to supervise the other therapists.


BINTO: In what situations would you recommend infertility counseling?

I recommend it for anyone who is experiencing this as a loss and/or if you’re experiencing it as your body failing you. Often fertility challenges can feel like a crisis in identity and if that’s how you are experiencing this, I would encourage you to find a trained therapist. I also recommend it for anyone who just wants some extra support during fertility treatments as the process itself can be very stressful and anxiety producing.


BINTO: How would you know it is time to seek out infertility counseling?

Any time is a good time for counseling and we really are seeing people at various points along their journey. Often, they begin therapy when there is some symptomatology such as difficulty sleeping, anxiety, feeling overwhelmed or frequent tearfulness. That said, people also come when the challenges are leaving them feeling hopeless or helpless or maybe it’s when the fertility challenges are impacting their relationships. My advice would be to seek therapy before you start experiencing any of these things.


BINTO: What is the best way to find an infertility counselor or other support?

I would start by asking whoever your fertility doctor is for recommendations. I always encourage people to meet with therapists and see how it feels to them -  schedule maybe one or two appointments with different therapists and see how it feels to share space with that therapist because it’s really a relationship like any other, and there has to be the potential of trusting that person. In addition, you want a therapist who is licensed and trained in working with whatever issue you are seeking help for.

Just like in dating, there are red flags for bad therapists. Some questions that are important to keep in mind are: does this person ignore confidentiality? Do they make you feel inferior? Do they over-share or try to be your friend? Do they seem overly affected by your problems? Do they habitually miss, cancel, or show up late to appointments? Do you feel in any way judged, shamed, or unsafe? Do you feel heard and listened to? Do they try to talk over you? If in your experience with a therapist you notice red flags, don’t be afraid to try someone else.


BINTO: How do you know if a therapist is right for you?

You have to feel that there is the potential to feel safe and trust this person, even if you don’t necessarily trust them right off the bat. I think you have to feel confident that they are licensed and trained in the thing that you are coming to them for. If you are seeking infertility counseling, you want to find someone who has experience working with fertility challenges. You want your therapist to (at minimum) have a basic understanding of the different types of treatments and options so that they can be right where you are with you and the focus of the therapy can be on what you need and processing your feelings rather than having to explain treatments, etc. to the therapist.


BINTO: How can therapy be impactful when you are dealing with infertility?

It’s kind of the same answer as the other question. First of all, having an unbiased person to bounce things off of can be really helpful. A strong therapeutic environment is a place where you can say everything and explore all of your worries, loss, grief, and thoughts around this process. It can also help with symptom relief – often, immediately.


BINTO: How can therapy help when you are dealing with loss?

It’s called providing a holding environment, that is to say – the therapist creates a safe space for the patient to feel whatever comes up for them and gives them emotional space to be in those feelings, without judgement. A strong therapist will give you the sense that they are emotionally holding you and that there is room for all of your thoughts and feelings no matter how difficult or painful. Often therapy is the first place where people feel this type of acceptance for all parts of themselves. It is hard to articulate in words but it can be so profound and healing.


BINTO: How do you help people move forward from a loss?

The only real way I know how to do that is that you have to go through it to get to the other side, so it’s really about processing it and allowing yourself to feel that grief, letting that be okay and giving yourself permission to do that. I would say my role as a therapist is to be on that path with my patients. They are doing the hard work, but I am there walking beside them, so-to-speak.


BINTO: How do you define wellness?

There are some basics that I rely heavily on. I would say creating time in my schedule for self-care is key. That can look like spending time with family and friends, laughing out loud, exercise, eating really well, and sleep. Getting enough sleep is super important for me. But also, job satisfaction. I’ve created a life that feeds me, and is satisfying and healthy for me. I also take my Binto regularly!


BINTO: How do you channel your ideas about wellness into your work?

Well, my work is about wellness. It’s all about being your best self and showing up for your life the way you want to show up for it.


BINTO: Specifically regarding your patients who are facing infertility, what vision of wellness would you like for them to have?

Often people feel like their body has failed them in some way, and there is a lot of self-blame and shame that can come up for people on the fertility journey. I think the number one thing would be kindness to themselves, and being gentle to themselves and working really hard not to judge themselves. I find people are usually their worst critics and this can lead to even more depression and anxiety.


BINTO: What advice would you give to our readers who might be facing infertility and considering seeking counseling?

 First, therapy can really work. I would also say to remember that everyone’s situation is different, everyone’s body is different. I think therapy can really help through the process and with the challenges of identity, expectations, and loss that come up or can come up during this process. It’s important to remember that everyone’s journey is different and comparing yourself to other people is not helpful.


BINTO: What would you say to people who are reluctant to try therapy?

In my experience, most of the time by the time my patients get to me, they are wanting to be in therapy.  I would encourage you to just try it… meet with a couple therapists and see what feels right to you. Share whatever reluctance or doubts you have with the therapist and see how they respond to your thoughts and feelings… you may be surprised how powerful and validating that can be!


For more on Perri or her practice, Whole Heart Maternal Mental Health, you can check out their website, linked here.


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