Welcome to IVF This, Episode 164 IVF and The Window of Tolerance

Hello, hello, hello, my beautiful friends. I hope you are all doing so, so well today. I've got an interesting topic. If you've listened to this podcast for any length of time, you know that there are some things that I draw from my therapeutic past to introduce for concepts, for you guys to have a language to explain to yourself and to other people what's going on for you. Like what's happening in your body, what's happening in your brain. And today's one of those episodes. Today we're gonna talk about a therapeutic concept called the window of tolerance. I'm gonna give you some background, what the window of tolerance is, why we talk about it, why it's important to understand, and then some ways for you to kind grow your window of tolerance. It'll make much more sense once you know the background of the window of tolerance. But the idea again is to introduce concepts to you. These are not my concepts, this was a concept developed by a PhD psychotherapist I believe. I'm actually a big fan of his work. But the idea is to give you concepts and ideas not just from me but from the therapeutic world around us to help you contextualize, I think most of what we struggle with, with IVF or infertility or really any extremely stressful or tense time in our lives is that our brain is gonna do brain things, it's gonna do the things that comes naturally to our brains, but if we don't have the language to explain what's happening to ourselves and to other people, and if we don't have the context, if we don't have the language to do that, then it makes it very challenging, which nine times out of 10, we're gonna turn it against ourselves, right? If you're getting really frustrated very easily because you're going through a tense time, that might have to do with what I'm gonna explain with the window of tolerance. But if you don't know that, if you don't have the language to express and you just feel like, maybe you just feel like you're pissed off all the time or you're an angry person now or that you just can't even have a conversation with someone without getting snappy or irritable or something like that, when there's actually a lot of neurobiological and therapeutic concepts that can help you understand what you do and why you do it. And that's a big part of why we're here. It's just to understand what we're doing and why we're doing so that we can make the infertility, the IVF experience a little bit easier on ourselves, right?

One thing I do wanna say, and I haven't talked about it in quite a while on the podcast, is if you like what you're hearing, you like a particular episode, it really resonates for you. If you like the whole podcast as a whole, and you just enjoy every single episode, I knock it out of the park every single time, then please share it, right? This is a really niche topic. Most of the stuff that's talking most of the stuff that's in the infertility or fertility space has to do with medical, understandably so, but medical advice, medical concepts, medical understanding, right? I don't do a lot of that, if any, on this podcast. I think I'm going to in maybe a couple of months, I'm gonna have a medical expert on, and we're gonna do like an IVF crash course for the newer IVF experiences or the newer IVF, people who are maybe just finding this podcast or have only been, only, who have been going through infertility and are now ready or considering pivoting to IVF, and they just wanna understand a little bit more about the process, I'm gonna do an IVF crash course. But by and large, what I talk about has to do with your mental and emotional experience through the process, how to be regulated mentally and emotionally through the process. And so if that is helpful to you,

Please share it, I know that there are a lot of subreddits on IVF, IVF Podcasts, in Facebook groups if you're involved in them, in fertility support groups, if you have a therapist, or if you go to a fertility clinic and they don't really have a resource like that, please share this so that more people can experience what you get to experience, which is understanding what the heck your brain is doing. In this really, really challenging, really stressful time in your life. So that's my small ask. I appreciate all of you for tuning in, listening. And here we go. Let's talk about the window of tolerance. So you know me, you know I'm gonna give some background. So the window of tolerance is a concept that gained a lot of prominence in the field of psychotherapy and mental health, mental, emotional regulation, things like that. It was coined by Dan Siegel, who's at the time, I'm not sure if he still is, he might still be a clinical professor of psychiatry at the UCLA School of Medicine. So he's a medical doctor, right? And that's why he's tended to be considered a psychotherapist rather than a therapist, right? He has the medical background too. But a lot of Dr. Siegel's work is around neurobiology, attachments. He really has spent a lot of work mindfulness and how it can provide a really robust framework for understanding how the brain and the body respond to stress, which hello, if we're at IVF, our brain and our body is responding to a hell of a lot of stress, right? So the concept describes like the optimal zone of arousal and arousal, not in a sexual sense, but arousal is in you're awake and you're responding to the stimulus around you, right? So there are three zones of arousal that Dr. Siegel talks about, right? And the idea is when you understand the three zones and where you are in that zone at any given time, then that allows you to function effectively, manage stress, maintain emotional balance. When we're within that window, people can think clearly and make rational decisions even when we're under an immense amount of pressure. So, no.

Okay, so when we talk about the three different states, we want to identify when we are or we are not within the optimal zone, right? So there are three zones, right? Optimal is exactly how it sounds. That's where we want to be. That's where we can make logical choices. That's where we feel the most emotionally regulated. That's when we feel the most grounded. And then you have the upper and lower parts of the arousal.

window, right? So hyper arousal. That is when you feel overwhelmed, stressed, irritable. You're reacting to maybe things that people are saying in a way that you wouldn't normally. You feel very emotionally dysregulated. Now when I talk about hyper arousal and when I talk about hypo arousal in just a moment, what I want to make sure that you understand is this isn't explaining the emotions that you experience, the natural, normal human emotions that you're going to experience inside of the context of infertility and IVF and outside of the context of infertility and IVF. Everyone at some point in their lives, at some point throughout their day, at some point for some of us, within the hour can be in the optimal zone and then move to hyper or hypo arousal, okay? So I just wanna make sure, I don't think I added that caveat before I started, but I wanted to make sure that you guys understand that from the get -go that you're not trying to explain away, the optimal arousal window is just that, right? It's not the perfect arousal window. It's not the ideal one. It's not the one that you should be 90 % of the time. You're gonna fluctuate between all three of them and that is normal and expected. And Dr. Siegel talks about that a lot in his work. But, So when you're in the optimal zone of arousal, you are in a state of calm, you can handle stress effectively. When you move outside of that window, that's the window of tolerance. When we talk about the window of tolerance, that is the optimal zone. But when we move outside this window, we can either become hyper aroused, which is that anxious, overwhelmed, irritable feeling, or we can become hypo aroused which is numb and disconnected. Recognizing these states allows us to employ strategies to return to the optimal functioning zone, right? It is not expected that you automatically pivot when you're experiencing hyper or hypo arousal, that you can just flip a switch and go immediately back into the optimal zone. That's not how it works. Emotions are still gonna be present, you're still gonna have to focus on processing through and allowing those emotions to be there. But the idea is you can recognize, maybe I feel really anxious, I feel really overwhelmed, I am outside of the window of tolerance, big time. And so now I know what kind of strategies, maybe I'm gonna move my body or whatever. 

So when we talk about, when I talk about the window of tolerance, I'm talking specifically about the optimal. When you move outside of it, that's when we get the hyper or hypo arousal. I might repeat myself a few times in this podcast episode, just bear with me if you get it, wonderful, but I am gonna say those things a few times because this is a relatively new concept, and if you've never really worked with a therapist or are a therapist or have a history in psychotherapy, you might not be familiar with this concept yet all so I am going to try to make it as easily understood as possible, right? So when we are in our optimal arousal window, when we are in the window of tolerance, we get to experience improved emotional regulation, okay? Effective decision making. When we're outside the window, The stress impairs our decision making. It impairs our cognitive function. It can lead to poor decision making, increased reactivity, that irritability. I can be a pretty emotionally reactive person when I am outside of my window of tolerance. If I am feeling overwhelmed or anxious, I am gonna be very reactive to people. I've been working on it for many years. It's gotten considerably better than it has, but overwhelm is one of the fastest ways for me to experience that irritability in reaction, or reactivity, I should say. So when we can understand when we're inside and outside of our window of tolerance, we then get to make thoughtful, informed choices, right? Let's say you're experiencing a lot of anxiety about an upcoming cycle, and maybe your partner is wanting to ask a bunch of questions, but you're feeling so overwhelmed that you can't even respond to the questions without feeling defensive or even attacked. And so if you have that language, you can be like, I'm feeling really overwhelmed. Or if you want to introduce the concept of the window of tolerance to your partner, you can even say, I'm really outside my window. Like I am so outside of the window of tolerance right now. It's not even funny. Can we table these questions for later?

Instead, I think what most of us try to do is power through that feeling of anxiety without really giving it its time. We do need to give these emotions their time and their place so that we can express them, understand them, allow them to be there, and then we get to go back to the work of being in that optimal zone. A big, big benefit to understanding what the window of tolerance is, is that you get You are more likely to be able to crisis. I'm sorry. You're able to prevent chronic stress and burnout. Chronic stress and burnout often result from too much time spent outside of your window of tolerance. Recognizing the signs when you're outside either hyper, remember that's the anxious, overwhelmed or hypo, which is the numb and disconnected. when you are moving outside of that optimal zone, that can help you kind of take preventative measures, maybe even building in breaks or some self -care or restorative activity that you really enjoy seeking support, things like that. When we can identify when we're not in the best head space, when we're not doing what we wanna do, we're not reacting how we want to react, that allows us that kind a really beautiful moment to pause and say, this really how I want to be? And if it's not, some of us want to, right? Some of us wanna lean into that disconnection, that numbness. Some of us want to lean into that irritability sometimes, right? Not all the time, but sometimes. Sometimes it feels better than how you've been feeling, and that's okay. But then from that place, that well -informed place where you have the language to use, where you have the language to describe these things, you then get to decide how you want to feel and how you wanna proceed. Another beautiful thing is that helps you tailor your coping strategies. Every person's window of tolerance is different sizes, it's different shapes. It is like a combination of past trauma, your experiences, life experiences, work experiences, personal experiences. stress your physical body, you experience chronic illness or some disability of some sort, your window of tolerance is probably gonna be much smaller than other people who don't experience those types of things, right? And so we wanna take in to consideration all of the things, right? My window of tolerance is not gonna be the same as your window of tolerance, is not gonna be the same as some other person's window of tolerance, right? We all have different shapes and sizes, but not just as a whole, not just as like an overgeneralization, our windows are gonna change based on what's going on in our lives. I can tell you that the last time I was going through IVF, my window of tolerance was much more like a porthole. was not very large at all. I would say probably a grapefruit -sized porthole that you would see on like a big ship or something. So that, what it was really important for me to understand that because we're in maybe the waiting or I'm going, I'm doing injections or I'm getting myself ready for a transfer or something, that window of tolerance is gonna shift dramatically based on what's going on with me mentally, emotionally and physically, okay? Though understanding your window of tolerance and being able to articulate that and where you are is actually phenomenal. to help you improve your relationships, right? Because then you get to tell people what is going on for you and what you can expect both from yourself and what you can expect from them and what they can expect from you, right? It's a beautiful symbiotic relationship where you get to say like, woo, my window's very tiny today. It's actually open just a sliver of a crack and so maybe I need a little bit more grace. from my partner or my friends or my coworkers today than I would otherwise, right? Crap morning, terrible traffic, whatever. You get the opportunity to articulate your needs and let people know how they can show up for you. It is always the other person's choice how they're going to show up for you. But oftentimes the people that really love us, the people that really care for us and the people that really value us want to show up for us in a way that's supportive. Sometimes they just don't know how. Mostly because they can't read your mind. So if you tell them where you are and what you're needing, they're much more likely to rise to that occasion, okay? And then of course the added bonus of like personal growth and resiliency. Which, know, if you've heard me talk about resiliency before, it's kind of a double -edged sword because we don't get resilient unless we've been through some really hard, horrible things. So Some people wear resiliency as a badge of honor, which they can, it's totally fine. Some people don't, and that's also okay. Some people kind of resent their resiliency, and that's all right too. It just depends on where you are in your growth, in your healing experience So the window of tolerance can be very helpful in the context of IVF because it is a very emotionally, physically, financially demanding process. And oftentimes it pushes us outside of our window of tolerance. I can't tell you how many times I, if we're talking about, if we're using the phrasing around the window of tolerance, I can't tell you how many times during the IVF process I was very hypo -aroused. I was scrolling social media, maybe even shopping when I didn't need to be. Felt very disconnected, very numb. And then there were moments where I was incredibly hyper aroused, very reactive, very overwhelmed, very moody, things like that, right? This process, it's not that you can't handle things, it's that it is asking more of you than I think we maybe recognize or verbalize to ourselves and to other people. And so understanding your window of tolerance, you can actually manage expectations and emotions a little bit better. the episode prior to this one where I was talking all about realistic expectations for yourself. So we can feed into what we learned from setting how to set realistic expectations last week to now how can we apply that to understanding our window of tolerance. 

When IVF is fraught with so many stressors, anxiety, medical procedures, uncertainty, things like that, when we can understand the window of tolerance, we're better able to anticipate those stressors, that anxiety. When we're able to better anticipate those stressors, those anxieties that maybe even grief or loss, that's when we're better capable or at least better positioned to kind of navigate it without it enveloping us. I talk a lot about the failed transfer that we had in the summer of 2020. And how I had walked into that with so much confidence that I hadn't even considered that it wouldn't work. In fact, I think I was willfully ignoring the more logical part of my brain. was like, maybe it didn't work. And I was actively suppressing that. And so when we did get the news, It was like my whole world just blew up, right? And so when we can kind of anticipate some of those things, when we allow ourselves to think through, okay, this might happen, this might happen, this might happen, instead of having the pendulum swinging all the way like this is all horrible or if you're like me, this is all just blindly naive, right? When we're in more of that middle zone, then we can anticipate and then we're better able to navigate those experiences.

When we can understand our window of tolerance, then when we're talking with our partners, our friends, our coworkers, our family, we're actually better able to understand if they're going through something, right? Maybe they're really irritable or overwhelmed or whatever, or they're really, maybe seem like they're disconnecting. Then we can be like, maybe it's not me, right? It's not actually me, they're not angry at me, they're not upset with me, they're not whatever, at me, not, it doesn't have anything to do with me. They are outside of their window, right? And maybe you can even give them that verbiage, that those words, that language to explain to them, I think this is what's happening for you, right? I know that because this is what's happened to me and this is how I react, right? So it really gives us the ability to see past what we're doing at that exact moment.  Where are we on time? 22 minutes. Damn, I've talked too much. Okay. So we understand what the window of tolerance is, why we do it, and why it's important to understand what the window of tolerance is and all of that, right? So these are some like actionable steps to help you expand your window of tolerance. And it's much more involved with like cultivating habits and practices for overall emotional resiliency and flexibility.

So you've probably heard me talk about these things a million times. Mindfulness, meditation, there are people in this world that can meditate. I am not one of them. I am not. So I don't often advocate or say explicitly, you you should meditate. For some people, it's a wonderful practice. For me, I would rather have my nails pulled out from my nail bed than sit down and meditate for even a minute. But mindfulness, Just being aware of what's happening in your body in the present moment and staying there is one of the most beneficial ways that you can expand your window of tolerance because it's requiring you to be present with yourself in that moment, right? Instead of getting caught up in the anxiety of hyper arousal or trying to disconnect from your emotions in hypo arousal, right?

Another one and probably my favorite, which is physical exercise, right? Physical activity. It doesn't have to be running, kickboxing or weightlifting like I do. Literally just going on a walk. If you are feeling either hyper or hypo aroused, going for a 30 minute walk, a 15 minute walk, a fight, whatever, just getting maybe outside, get some vitamin D, hear the sounds of nature, whatever is gonna be a safest option for you is a wonderful way to help you get back in your window of tolerance if you're outside of it, but also help you expand it just from like the practice of routinely having some sort of physical exercise. Okay, now there are many things that we can do outside of just physical exercise, right? I'm a big proponent of physical exercise, but I'm not the barometer for what is and what is right in someone else's life, right? That fits in with my life. I've made it fit in with my life. But if there are things that you enjoy, gardening is an example of physical activity that most people don't talk about, but it is a beautiful way to be both physically active and practice mindfulness. I have a client that restores furniture. She also works out a lot, but the restoring furniture is a way that she, like she talks about it in like restoring furniture, but also restoring parts of her soul, parts of her heart, things that she feels may be disconnected from in a given Lifestyle choices. When I talk about sleep, I want you to know that that is probably outside of like the safety and health of my children and my family. Sleep is probably my number one priority because I know what I'm like if I don't have adequate rest. If I do not have adequate rest, if I do not have adequate sleep, you can bet all the money in the world that I am outside of my window of tolerance. That there's the window's completely shut, maybe even like welded shut for that moment, because I cannot access anything in that optimal arousal zone if I have not had adequate rest, okay? like when we're, we already tend to avoid things like caffeine, some of us avoid it more than others alcohol and certainly cigarettes, drugs, things like that, when we're going through IVF and infertility. But those things outside of the context of IVF and infertility can actually make it worse, make your window smaller and make you more likely to be either hyper or hypo aroused. So that's just food for thought. I'm in no position to tell anyone how to live or how much caffeine to consume, certainly. Therapy is a wonderful way to therapy or coaching. I know I love talking about therapy and coaching, but I wanna remind you that we can do both, or at least I can. I can talk about things from a therapeutic perspective in the context of coaching, because that's my experience. But if you have a lot of trouble with emotional regulation, maybe you're flying off the handle all the time, or you're disconnecting a numb all the time, there's therapeutic modality called dialectical behavior therapy that is almost entirely devoted to emotional regulation. I'm gonna talk about it a little bit more next week when I talk about self -regulation. But if you really struggle with that and that's something that you really wanna work with, I would suggest you find a therapist that specializes in dialectical behavior therapy, DBT. Another therapeutic modality that I really enjoy and that I pull actually a lot of my stuff from is acceptance and commitment therapy. And I have a whole podcast called I think lessons from ACT, which is Acceptance and Commitment Therapy, it's the acronym. And that is one of the, probably the one that I feel the most connected to because it understands that pain is an inevitable part of life, but that if you operate within your value system, then it can really help you with with the emotional dysregulation, the stress and managing those things when they do inevitably come up. Social support is a massive one. I think that when we can buffer, when we have a buffer between ourselves and our stress, which is usually where social supports come in, we get to share experiences, we can receive empathy and understanding from people and individuals who feel similar that we do, or at least can understand where we're coming from, then that will lead us to feel less isolated. And that's a big concern going through infertility and is that we feel so isolated, right? So it doesn't have to be your group of friends right now. Maybe none of them have ever experienced infertility. None of them even know what IVF stands for. But there are resources and supports out there, whether it's an IVF buddy, an IVF support group, a therapist, a coach, things like that within, maybe even within your reproductive endocrinologist office, that can offer you those social supports, or at least the resources to identify and locate those social supports. And then the biggest one for me, always, always, always is gonna be about self -compassion and acceptance. When you are being kind to yourself, even in the moments that you don't think you deserve it, even in the moments that you have no interest but to beat the crap out of yourself, showing yourself kindness is one of the fastest ways to get back into that window, okay?

 The experiences that we have in infertility and IVF are hard. Objectively, subjectively, they're hard. Whether you're getting good news, no news, bad news, it's hard. We don't have to make it harder on ourselves by being hard on ourselves, by being harsh with ourselves, or just by plain and simple being a jerk to ourselves. None of that is necessary.

So when we can practice self -compassion, when we can practice acceptance, ooh, I tell myself sometimes if I've like flying off the handle, I'm really dysregulated, and maybe I've like yelled at my kids, I will literally look at them and be like, that was not my best work. I apologize, right? If we can accept that there are gonna be times in this process, outside of this process, in your lifetime, where you are not going to show up in the version of you that you want to, in the most realistic version that you want to, and you can accept that that's inevitable, and that you can be kind to yourself in the process, I swear to you, your window is gonna be more open, bigger, and more accessible to you all the time, okay? So. That is what I have for you. know it was a big concept. If you guys have any questions you about reach out the DMs are open on Instagram and Facebook but this is what I have for you today I hope you enjoyed it I hope you find it helpful and I hope you have a beautiful week I'll talk to you soon bye.