Welcome to IVF This, episode 158, IVF and Unwanted Thoughts. 

Hello, hello, hello, my beautiful friends. I hope you're all doing so, so well today. 

This episode is a little bit more of like an education around some of the words that we use.

I think the way that our cultural lexicon has kind of taken on a lot of psychological terms like boundaries and narcissism, and this would be an example of one that I think has been kind of captured in our cultural lexicon and is being a little bit misused. And so I just wanted to provide this kind of context, but also how it fits in with our experience of IVF, particularly around. The types of thoughts that we think about ourselves, the types of thoughts that we think about our friends, our family, the people we work with, the IVF experience as a whole, all of those things. Okay, so what I wanna start with is I was talking with a client of mine who had said she was having some intrusive thoughts, okay? Now, intrusive thoughts, that is a very clinical term. And so all of a sudden my ears peaked, right? My interest was very, very piqued. I was very curious as to what they meant as an intrusive thought. So when they were kind of going through their example and we were talking through what their experience of those intrusive thoughts were, we were talking about things like, I'm never gonna get pregnant. I am not worthy of being pregnant, being a mother, my relationship, pecifically regarding their relationship. My partner will leave me because I cannot give them a child, I cannot give us a child in relation to their friendships. I can't believe she's pregnant again before me. Why does it seem like everybody else has such easy experience? And I'm gonna put easy in air quotes because I think we all intellectually know that nobody's journey is easy or everybody's journey is very different. So we intellectually know that but that is not what our brain tells us, right? And so the way that they were describing how they felt when they thought these things was very much like very uncomfortable feelings, right? So the feelings around never being able to be pregnant or not being worthy of being a parent was very much like that shame, that sadness, that grief that we carry with us, sometimes all of the time. In relation to her relationship, they felt very disconnected from their partner because of thinking, you know, they're gonna leave me, this is gonna destroy our relationship, this is gonna destroy our partnership. And that felt very, not only disconnecting, but also like there's grieving on top of that, right? There's that anticipatory grief, there's also fear, that abandonment wound for many people runs incredibly deep.

And then we had the relationships with their friends, which a lot of those thoughts, which I think if you lined up a hundred IVFers, probably 99 .9999 % of us would experience those types of thoughts like, why is it so easy for them? They have no trouble getting pregnant. Right, all of those thoughts. I could list off a hundred, but this episode would be much longer. All of those thoughts that we have create emotions in us, right? That's the model that I work under, it's very cognitive behaviorally based, our thinking creates our feelings and our feelings drive our actions. The difference, right, this is where the psychologically based terms, those clinical terms are being kind of absorbed into our cultural vernacular. Those are not intrusive thoughts. They are uncomfortable thoughts, they are unwanted thoughts, they are unintentional thoughts but they are not in a clinical sense intrusive thoughts. So I wanted to give you guys a little bit of a kind of a background as to why that this is a really important designation. This is a really important distinction. And also what to do with those unwanted thoughts. Cause we don't want them to begin with and they make us really uncomfortable. We don't like the way that we feel those tend to be the thoughts that we get caught in the thought loop around and how to kind of break out of that thought loop. So, Let's talk about intrusive thoughts. Intrusive thoughts are really persistent and very difficult to manage. They're often very sudden, they're very distressing. They involve themes of harm, taboo subjects, fears. They're much more disturbing. Sometimes even people who do experience it, yeah. For people who do experience intrusive thoughts, they are very, very disturbing and very, very intense, vivid, much more so than unwanted or unintentional thoughts, right? Very often, one of the things that makes them so distressing is that they tend to go against what people's value systems are, right? Violence, inappropriate sexual content. They're frequently associated with psychological or mood disorders like obsessive compulsive disorder, anxiety disorders, a lot of other mental health disorders. You guys all know, I talk about it all the time, I have ADHD. That intrusive thoughts also can be an aspect of ADHD. I experience intrusive thoughts. I can tell you they are very graphic, they are very violent, it's often images in my mind of like something happening to my children, something happening to my husband. If I'm on the top of like a very tall building or something, like I will have the intrusive thoughts of just yeeting myself off the top of a building, right? They cause a significant amount of anxiety and distress and they're really hard to dismiss. I will sometimes get like intrusive thoughts, around, I'm terrified of the ocean. I don't know if anyone knows this particular Emily trivia. I enjoy the ocean -ish, but I'm very terrified. I was a child that was exposed to the movie Jaws very young in my life. I loved the movie Jaws. I loved that entire franchise for a very long time, but it also made me absolutely terrified to go into the ocean, any open body of water. And so I will have graphic images literally just sitting on my couch of being attacked in the water. Like it will just pop into my mind, this very visual image of being attacked by a shark. Sometimes it will cause me to even like wince with like pain, but psychological pain. Those are intrusive thoughts. Now, if you experience intrusive thoughts,

There are many, many ways that you can manage those thoughts with medication, cognitive behavioral therapy, mindfulness, but that's not what we're talking about today, okay? And I want to draw that distinction, that delineation, because the tendency, because much more of the psychological kind of verbiage is used on social media,within just kind of our cultural setting within our society, it can be really easy to pathologize very normal behavior. What happens when we pathologize very normal behavior is it stops being accepted as normal. It stops being accepted as expected behavior or expected things that happen to everyone rather than someone who is experiencing some sort of psychological distress based on mental health or physical health diagnoses that are contributing to things like intrusive thoughts, right? Not suggesting that the thoughts that you have are not distressing, but there is a difference in the type of thoughts, right? So those are intrusive thoughts, right? Really difficult to manage, cause a high level of stress and distress.

They tend to be very violent or cover a lot of taboo subjects, very uncontrollable and very hard to dismiss. Unwanted thoughts, however, they come to you when you would prefer not have them, right? They can be about anything or something really specific. They can be distressing, negative and unhelpful to be sure, but it kind of covers a vast array of topics.

Right, it can be worry about the future, regret about the past, things that you have done in your past, maybe like reliving a really embarrassing moment, that's an unwanted thought. It's a common experience by most people at varying times in their lives, right? And that's truly what my client was referring to, were these unwanted thoughts, right? They're a little bit less, intense? I mean, that's hard to gauge. I'm not someone who can say, well, my intrusive thoughts are much less intense than your unwanted thoughts, but that's a clinical definition. It's a clinical distinction. They are more often linked, unwanted thoughts, I should say, are more often linked to like personal concerns and stresses rather than like fears or phobias or violent graphic images, things like that. And they're easier to dismiss or ignore than intrusive thoughts, right? Now I did say at the top of this episode, the unwanted thoughts are some of those thoughts that really get us caught in that just spiral of negative thinking, kind of however you think about it, right? I sometimes I'll call it the spin cycle, where you're just sitting there and kind of ruminating.

And that's what we're focusing on. And that's what my client was truly referring to. Now, sometimes, no, not that. When I talk to my clients, a lot of the unwanted thoughts that come are either about them specifically, right? Them not being able to get pregnant, IVF is never gonna work, it hasn't worked yet, so it's not gonna work in the future. Those are unwanted thoughts. And those are thoughts that keep us spinning.

The ones that are particularly challenging are the ones that are applicable to their relationships, whether it's their relationships with their partners or with their friends or with their family. And those are the ones that I wanted to kind of dig into today. Those are the, why do they get to be pregnant? Life isn't fair. They don't deserve this. When we think about things that make us question whether or not we're a good friend or partner or family member.

Those are unwanted in such a specific way because it's not just the thought we have, it's all of the story that we tell ourselves behind the thoughts, right? So one of my favorite things to kind of gauge whether or not, you know, we believe something is normal is that if we lined up 10 IVFers with similar stories to your own and they just had their friend having their, let's say second kid and you're still working on kid number one.

Well, the thought is maybe I feel left behind, something is wrong with me, this person deserves it more, why do they get to be pregnant? You have those thoughts and then all of a sudden the trickle in of why can't I just be happy for my friend? I'm a horrible friend. Like I can't even be around them, I can't even be happy for them. That's the part that I wanna make sure we are really crystal clear is normal, is expected.

There's nothing wrong with you and it doesn't mean anything about you as a person, as a friend, as a partner, as a family member, as a daughter, as a whatever, right? Whatever your role is where you're telling yourself because you can't be universally happy 100 % of the time, there's clearly something quote unquote wrong with you.

When, no, hang on. this is what I was gonna tell. I had a client who talked about how she was sitting at a restaurant. One of her best friends had come and they were just catching up. She kind of knew that maybe the best friend was like that she had kind of organized this dinner because she wanted to tell her that she was expecting. And in this interaction,

I'm sorry and before we got into this interaction when we were working together before the dinner One of the things that she said was she said Emily I want to make sure that I Can be excited and happy for my friend and I don't get lost in my own emotions Which is a fantastic goal, right? It's a very realistic goal It's a very coachable goal and that is what we worked on So one of the things that we talked about was what are some of the thoughts that that are gonna come because we have to address those We've got to be aware of them

One of the biggest disservices that we do to ourselves is that we don't plan for these things to happen in our brain. You know your brain. You know what you're gonna think, or at least you can give a really good guesstimate as to what you're gonna think. That gives us a playbook to follow, right? So she came up with all these things about how everyone is farther ahead than her. She's worked really hard, and if they did get pregnant, if that's what this is about, then they probably just got, you know, drunk one night on vacation and we're able to conceive, whereas we're dumping tens of thousands of dollars into this process and it's painful and it's hurtful and it's scary and all of this stuff, right? Normal, very normal thoughts, okay? And so one of the things that we talked about was she was worried that she was going to react based on these thoughts, right? React negatively, I should say, to these thoughts. And so this was a story that was told to me kind of a, I don't know if it's a parable or something. I was told in graduate school when I was working on my master's in social work, and it was if there are three frogs sitting on a log and two decide to jump off, how many are still there?

Now, the instinct is to say one, but truly there are three, there are still three. Just because two frogs decided to jump off doesn't mean they jumped off. Meaning, just because you have a thought does not mean you have to act on it. So if you are not someone who will fly off the handle at the smallest inconvenience, if you are not someone who will, you know, is prone to having massive emotional meltdowns, in a restaurant when someone shares something that you don't like, then that's probably not gonna happen. We don't want these thoughts, they're not super fun, but 80 % of the thoughts that we think are relatively helpful for us. 80 % -ish, a lot of it we're not even aware of, a lot of it is reminding ourselves to breathe and just those normal bodily functions that we have to have.

A lot of it is kind of muscle memory, our brain telling us what to do so that we don't have to stop and think through all the steps for driving down to work or coming back home or something like that. They're really helpful. 10 % of the time, they're gonna be absolute trash. They are, they're just gonna be absolute trash. And if you're in a situation where you are stressed, where you're frustrated, where you're feeling any sort of emotion, like negative emotion or uncomfortable emotion, whatever way you describe it, you're gonna have those unwanted thoughts. We don't want them, but they're going to be there. They're going to come. And so part of it is recognizing like, okay, if I've got 80 % of the time, the thoughts that I think are helpful in some form or fashion, right? Maybe they're keeping me from danger, you know, they're keeping my anxiety just crispy enough to keep myself safe, and then 10 % of the time we get these unwanted trash thoughts that is the a -hole in your brain just yelling off nonsense, then 10 % of the time, right? So that leaves us 20%, I'm not a math major, but it leaves us 20%, if 80 % is good, 10 % is trash, we got another 10%, those are the intentional thoughts. Those are the thoughts that we get to decide how we want to think about ourselves, about our lives, about our relationships, about our situations.

So what I challenge you to do is when you kind of are walking into a situation or even just kind of on the peripheral, think something, someone's gonna tell me something at some point in the future, I'm gonna see a baby announcement on Facebook or Instagram, pregnancy announcement on Facebook or Instagram, something like that. My challenge to you is to spend a little time journaling. What do you think your brain is gonna come up with? What is it?

Is it gonna be trash talking them? Is it gonna be trash talking yourself? Line it out for yourself so that you can see what your brain is gonna do so it's not gonna take you by the ultimate surprise. It's not gonna hit you like a bus when that might happen. Once you're able to do that and just bullet point it out, it doesn't have to be a Dear Diary entry, just bullet point it out. What do you think you're gonna think? When you have that, that's your blueprint. That's your, you know, operating manual for how your brain is gonna operate that 10 % of the time that your thoughts are trash. You get to use that other 10 % and decide how you actually want to think, right? If one of those trash thoughts are, I'm never gonna become pregnant, then maybe the response to that or the pivot away from that is, I'm doing everything I can to get pregnant. Now, that doesn't feel super rosy, like yes, I'm absolutely gonna be pregnant, but If you've heard me say it, once you've heard me say it a thousand times, I don't, it doesn't necessarily matter if the thought feels good or not. If the thought is true, it's gonna give you a lot more yardage on whether or not that thought sticks, okay? So that is my challenge for you. I want you to figure out what your brain is gonna say. These are unwanted thoughts. These are thoughts that are going to come. They're not a problem. You're not going to suddenly change your personality and start, acting in a way that is, you know, in your way, completely out of character or like a lunatic or hysterical, that's not more than likely. I can't, I don't want to use absolute terms. 99 .9999 % of the chance is not gonna happen. You are still going to be you. You're going to feel uncomfortable when you have those thoughts because those are the emotions that those thoughts are gonna bring about. But I want you to challenge yourself, right?

I can do this, I can decide how my, well, not decide, I can do this. I can map out what I think my brain is gonna do and then I can also map out how I want to respond so that you don't get to necessarily bypass the discomfort because it's going to be there, but what you do get to do is remind yourself that you are in charge. You always have power and control over how you think, how you feel, and what you do.

And by giving yourself that blueprint, by giving yourself that framework, you will get to feel a little bit more empowered in those situations, right? So unwanted thoughts versus intrusive thoughts, we get to manage unwanted thoughts much more easily and with much more empowerment than something like an intrusive thought. If you are experiencing intrusive thoughts, I would highly recommend that you reach out to either a therapist or a psychiatrist.

or your primary care doctor, your OBGYN, and they can give you some resources on either support or interventions to help you with those. Okay, that is what I have for you today, folks. I hope you have a beautiful day, and I'll talk to you soon. Bye.