RTL Episode 39: Therapeutic Coaching for Fertility with Dr. Loree Johnson
RTL Episode 39: Therapeutic Coaching for Fertility with Dr. Loree Johnson
On today’s episode, I am joined by Dr. Loree Johnson. Dr. Loree is a Licensed Marriage and Family Therapist (LMFT) and Coach in private practice with more than 25 years of experience as a clinician, educator, and clinical supervisor. Specializing in women’s mental health and reproductive health, Dr. Loree helps her clients overcome the emotional challenges that come with infertility - including pregnancy loss and emotional trauma. She also helps couples, who have become divided by their fertility journey, strengthen their connection. Dr. Loree is a clinical fellow of the American Association for Marriage and Family Therapy and has served on its state and national boards. She is also a member of the American Society for Reproductive Medicine.
Today, Dr. Loree and I will discuss:
Effects of infertility stress and trauma
How to heal and thrive in spite of the challenges: container exercise
How to cope with pregnancy loss
How to care for your relationship while trying to conceive
To connect with Dr. Loree: https://drloreejohnson.com/
IG - @drloreejohnson / Facebook: Dr. Loree Johnson, LMFT / TikTok: drloree
Be sure to check out Dr. Loree’s free Fertility Self-Care Guide https://drloreejohnson.com/fertility-self-care-guide/
and a free guide to coping with Pregnancy and Infant Loss: https://drloreejohnson.com/grief-guide/
Episode 39 Transcript
Josephine Atluri:
On today's episode, I am joined by Dr. Loree Johnson. Dr. Loree is a licensed marriage and family therapist and coach in private practice with more than 25 years of experience as a clinician educator and clinical supervisor specializing in women's mental health and reproductive health. Dr. Loree helps her clients overcome the emotional challenges that come with infertility, including pregnancy loss and emotional trauma. She also helps couples who have become divided by their fertility journey, strengthen their connection. Dr. Loree is a clinical fellow of the American association for marriage and family therapy and has served on its state and national boards. She is also a member of the American society for reproductive medicine, Dr. Loree lives in the Los Angeles area with her husband and toy poodle in her spare time. She enjoys salsa, dancing, traveling, reading, and writing her motorcycle today, Dr. Loree and I will discuss the effects of infertility stress and trauma, how to heal and thrive in spite of the challenges, how to cope with pregnancy loss and how to care for your relationship while trying to conceive.
Welcome to the show Dr. Loree, I've been so excited to have you to talk about all things in fertility, miscarriage and coping strategies. We have a few connections with clients in this community, so it's great to finally speak to you in person. It's so great to be here. Thank you for having me. Absolutely. So let's dive right in. I think the best way for us to start is to talk about what you do. As many people may have not had the pleasure of working with a fertility coach. I know myself, I would have loved the idea of having a fertility coach and wish that I could have had the extra support back when I was trying to conceive over a decade ago. So let's start with what one can expect from working with you. So as a coach, I do, I wear a lot of hats. And first and foremost, I think that my, my experience as a coach is informed by my practice as a therapist. Um, because I, you know, I've been working with women in the field for
Dr. Loree Johnson:
Quite a while. And, and when, like you said, it, it would have been nice to have had coaching when we were going through treatments before this wasn't as much of a thing as it is now. But, um, usually what I do is I really help guide women through the process from beginning to end so that they can manage their emotional reactions to what's happening medically. Um, and, and so that they're able to have the best result possible because we all know that undergoing infertility treatments is incredibly stressful, but data is very clear that the more we focus on mind, body techniques, the better the outcomes. And when you are further along in the treatment process too, it's like your, your needs change. And so I help women from beginning to end, kind of understand a little bit more about what they need and just to help them feel more supported in the process.
Josephine Atluri:
And that sounds wonderful. I definitely wish that I had someone like you on my side when I was going through all those ups and downs and all of the challenges that one encourages when they're trying to conceive. So you mentioned then that you combine both of those backgrounds of being a therapist and a coach. And so in terms of actual like tools and homework and discussions that you have with a client, what would that look like over the course of one's path to trying to conceive and their work with you?
Dr. Loree Johnson:
So, because of my background in working with trauma and let's face it in fertility can register like a trauma, I tend to work with a lot of women. Who've come to me with recurring pre pregnancy losses and, and just the trauma that the grief that's associated with that. So I do a lot of, um, not just kind of coaching per se, but there are some kind of techniques around understanding the scope of the loss, how their body has responded to it. And then also looking at specific tools to help them kind of reprocess for lack of a better way of saying it, their experience of the losses that also end up helping them feel a little bit lighter emotionally and approaching their fertility treatments as calmly as, as they can. So it's really understanding how does that presentation look for each person and then kind of tailoring strategies to help self-soothe and, and, and usually apply those to, to their treatment processes. So, so that's usually a little, that's a little bit of a snapshot of, of how I work and, and the tweets that go along with that, um, are these kind of verified, like mind, body, not just cognitive behavioral, but, um, you know, are these relaxation techniques that I think that we kind of talk about, but there's some, some techniques rooted in, in, in my trauma background that I do like to, to bring out when appropriate. So I, I
Josephine Atluri:
Love that. Well, not love, but it's interesting to me the usage of the word trauma, because I often felt that that's what I was going through back a decade ago, and didn't have quite the words to express what I was going through. So in terms of infant infertility trauma, how then do you approach that? Or how do you look at that and how does it compare in terms of other trauma that people may be more familiar with, or have heard of such as trauma of losing a loved one or the trauma of having an accident or going to war? How do you treat them the clients in the scope of the uniqueness of what we're referring to as fertility to trauma?
Dr. Loree Johnson:
So I, first of all, I think is important to, you know, to identify or are, you know, talk about the definition of infertility trauma and or trauma in and of itself is basically like the psychological damage that has been inflicted. And so we have a trigger, it could be anything within the fertility process that registers for the person as, as, as particularly bothersome or overwhelming. And it influences one's ability to cope or really integrate those emotions in a way that feels productive. And when we start to see more in, you know, here, people talk about infertility stress versus infertility trauma, and they can look very similarly, whereas, you know, stress, it's like, you know, feeling very emotional or easy to anger or noticing triggers. Um, we might notice difficulty that people have with eating and sleeping. Those are stress responses that the body has. And, and so the difference between stress and trauma for me as a clinician is really about the amount of time that somebody has been experiencing these issues or symptoms and not just the amount of time, but what is the, the degree of impact as well. And is there some kind of, um, in the therapeutic community, we'll talk about impairment and functioning, but in coaching I look at, okay, well, how is your life being negatively impacted by this? Um, and, and how are you functioning in a way that is very different than before? And how can we get you back to that? Or, you know, some more of that, like the more, the ultimate kind of, uh, optimal, excuse me, kind of functioning.
Josephine Atluri:
Okay. That totally makes sense. And I love how you compared the effects of stress and trauma on someone who's trying to conceive and sort of how that in a manifest and is differentiated. And, you know, oftentimes as we all know, in being in the infertility community, it's a roller coaster ride of emotions of loneliness and frustration. You feel a lack of control, many of us feel a diminished sense of self-worth and failure. So what are some strategies that you would recommend to your clients for how to heal and with these overwhelming feelings?
Dr. Loree Johnson:
So, first of all, it's recognizing when you are feeling incredibly overwhelmed and, and, and also the ways in which that overwhelmed feeling manifests in your body, you know, do you notice changes in your breathing? Do you notice, you know, just repetitive thoughts? Um, one thing that I like to recommend to my clients is also something that's called a container exercise and a container exercise means that you're visualizing something that can contain, um, all of those negative, intense, just thoughts that you find problematic and visualize putting them into that container. And the idea behind that is when we feel some sense of containment, then we're able to help with the sense of flooding, emotional flooding that we have. And so when we work with that, you know, we also think about, I like to encourage clients to think about, okay, well, you have a little bit of control over this container, so that what you put into it, you get a chance to decide what you put into it, but also what you take out of it. And so it's really learning and training yourself to, to identify, okay, well, what do I need to, to deal with right now? Do I have the skills to do that? And if I do, that's great. If not, okay, let's, let's work on building some skills around that. So, so that's one exercise that I like to use with, with my clients to help them have a little bit more mastery over feelings when they're feeling overwhelmed.
Josephine Atluri:
I really love that container exercise and that just visualization of being able to put one's feelings into, into a vessel and that you are in control of that. I think that's really empowering for a person to be able to use as a strategy. And you touched upon this briefly before about, um, miscarriage and pregnancy loss, and, you know, one in four women experienced pregnancy loss. And I wonder what sort of advice can you offer those who have experienced such a loss
Dr. Loree Johnson:
Leaning into the grief, which is the hardest part I think of dealing with loss. I mean, even though we know that one in four women are experiencing or will experience pregnancy loss, it still doesn't, it still doesn't take away from the fact that it hurts. It's, it's still a shock when it happens to you, it's happened to your body and, and, and, and that has, has this really intense impact on your sense of self or emotionally. And so I think it's learning how to lean into that grief. Um, and, and, and naming it, knowing that you don't have to like it, but knowing that you can't outrun it either, and that if you allow yourself to experience what needs to come up in that grading process, you know, it's like, I promise you that you want to stay there. Even though I think we, we sometimes really with like going to that sad place and thinking, Oh my gosh, I'm never going to stop crying if I start and, and all of that, but it's like, once you learn how to lead into those really challenging feelings, that's where your power is. And so much of our power feels so much of this IVF or fertility processes is out of our control to begin with that. We need to have ways where we do feel like we're in control. And so I think it's knowing what skills you have to, to, to handle the grieving that's coming up and normalizing that.
Josephine Atluri:
Well, I totally resonate with this idea of leaning into grief and you're so right in that it can be very scary to, to actually open up to all of those feelings and to be vulnerable and to those feelings and emotions, because I was right there with you in terms of when I ha experienced a loss at 17 weeks, I was so scared of being trapped in that grief forever. At a certain point, I felt like I was never going to get out of it. But at that time I didn't care. I was perfectly fine just being in it. And it didn't matter to me that there was no sort of end in sight at the time, but solely as I was going through it, that's kind of where that shift occurred. And there wasn't really anything in particular that happened in that moment, that, that made me shift over and decided that it was time to, to move on.
But that idea of staying there finally, didn't really resonate with me and didn't seem palatable to me. And that's when that's when I made the steps to move on, but it really is, you know, can be very scary just in general, even if you haven't experienced a pregnancy loss or miscarriage, even the little loss of an expectation of a cycle itself is a loss and, and opening yourself up to those feelings is so scary, but you're, you're right in that moment of power of being able to be in those emotions, you really get to claim it. So thank you for talking about that. Yeah,
Dr. Loree Johnson:
No. And, and just to piggyback on what you've said, because it's like every part of the fertility journey right. Is about grieving, you know, because nobody gets comes to this community, um, you know, prepared like, Oh, this is going to be my experience. And so it's a, it's a loss along the way. And so whether the loss is like you set up a cycle or the fact that you have to pursue treatments where the fact that you've gone through pregnancy losses, it's like, yeah, there's, there's grief woven into the entire process. So yeah, that really resonated for me.
Josephine Atluri:
Yeah, you're right. I love that. You, you said that it is weaved into every step of it, whether or not it's blatantly in our face and acknowledged. And so, you know, we, in our own journey, we had to come to a crossroads of where we to make a decision of what to do next and whether we realize it or not after every cycle that we do, we do have a choice of what to do next, whether it's a different procedure, different medication, different doctor, so many different choices, but oftentimes we're so scared to, to switch, switch things up, feel like we're taking a step backwards in our process. And so I'm curious, how do you sort of speak to your, to your clients about that decision-making process about re-evaluating, you know, where they are in their journey and what next steps they should be considering, or how they should approach that whole, that whole decision-making process.
Dr. Loree Johnson:
So, first of all, what I like to encourage clients to do is number one, give themselves the gift of time, which, you know, obviously when I think people are coming to the fertility process, there's this sense of urgency. It's like, I've got to make a decision. I need to jump on this. Um, and, and so what that does, unfortunately, is it increases the level of anxiety. And, and when you're feeling really anxious about every step, because everything feels so big, it's hard to really clue into what your, your, your view and your partner may really need and also what your body needs. So I do like to kind of, you know, suggest, okay, we might come in with a plan, or you might create one plan, but also know that we'll be gently creating a second plan to, you know, to get them thinking about, all right, if this first plan doesn't work, you know, this is where, this is what you thought about before.
How does that still feel to you? So it's like you have your plan a, but then you've also have your plan B and then your plan C. So you get a chance to reevaluate, you know, at, at various junctures to see, all right, do I, does this decision still feel right to me? And it's, sometimes it can be hard to, to know if that feels right or not. Because again, you've got so much anxiety in the, in the process. So it's, it's, it's understanding that you need time. It's also understanding that sometimes you might need information, um, but also identifying what other needs might, you know, what other information or what other things could be helpful and help, you know, and making whatever decision and, um, that that's best for, for, for you and your partner. And it also could include what does the doctor say obviously, and what's the medical prognosis of a treatment plan or related to that. So it's, um, it's a constant evaluation process, but managing that with, you know, with, with, with, uh, with having perspective and, and taking, taking whatever time you can.
Josephine Atluri:
Well, you know, that actually is what happened to us, uh, during that grief process, because I hadn't given myself a gift of time. As you had mentioned back when I was doing back-to-back cycles, I just kept going because of that sense of urgency that you, you mentioned, and that time sensitivity to the whole process. And so I was, I ended up being forced into this moment of pausing during that whole grief process, which was beneficial for me in, in that I finally had time to reevaluate our situation, and frankly, what I felt that I could could do and could no longer do at that time. So I am a big proponent of the power of the pause as I call it, because, you know, even if it's just a pause for a day, or like an hour out of this whole process that you're in, it gives you that moment of, like you said, of re-evaluation and you constantly have to be understanding and evaluating what you're going through so that you can make these informed decisions and, and become an advocate for yourself. Um, so in your bio, you mentioned that you also help couples care for their relationship while they are trying to conceive as those who have been in the thick of trying to conceive know over time, the experiences that you go through can change your views and your desires for what you want and how you want to achieve your goals just as happens in life in general. So, in what ways do you offer guidance and support for couples when they start to diverge in their opinions and desires as they continue along their path to Parenthood?
Dr. Loree Johnson:
So I re I like to remind couples that they are a team, and I like to talk a lot about, and I want to hear more about their story. Um, you know, like about how they got together, what, you know, what attracted them to each other, how did they decide they wanted to hang together long term and commit to each other? I want to know more about that story, because that's where the richness and the beauty is of, of what their strengths are as a couple. And, and also there's a lot of power that comes from listening to each of them tell their story, uh, and, and how they found each other, found their way to each other. That can be a nice way of reconnecting, because when you have diverging opinions, like you mentioned, or, you know, just ideas of how to move forward, that can create incredible tension and conflict.
And so if there's some difficulties around managing the conflict, then, then we, we address that, um, you know, in my job at that point is really to hold space for, for both of them, but also reminding them that I'm going to be on your relationships side. So while it might seem like I'm, you know, it might be validating one partner, and then I'll be validating someone else. But my, my ultimate objective is helping you learn to nurture your relationships. So that's going to be the ultimate theme and, and everything that we do is going to be tied back to, okay, how is this working for the two of you? How is this bringing you closer to each other? And can you remind yourselves and do the things that you did before and fertility took over and also, can you allow each other space to grieve because sometimes the conflict that's rooted in or might come across as anger and, and then just this discord, because one person wants to do something else and somebody doesn't, um, it's, it's, it's part of loss and there's that grief that comes up again, you know, this, isn't something that you all expected to deal with as a couple, and even when, you know, so it's like, even when you get together and you think, okay, we're going to learn how to manage difficult things.
It's like, okay, it's, it's a little different when you're actually in it. So walking couples through that process is, is really rewarding. And seeing them kind of come back and kind of closer to each other, um, and, and really work toward settling in fertility together, or battling grief together, um, as a unit is, is, is powerful and it's possible.
Josephine Atluri:
Well, I love that. And I love how you, you approach it by getting back, starting off by understanding the roots of, of where they came together as a couple, and then strengthening from there. And it's a such a tough process going through this. And, and it's, it's really helpful to know that there could be someone that guides you and supports you in, in terms of one's relationship as they go through it. And so in that same vein of relationships, what advice can you offer for someone listening, who knows someone trying to conceive and is at a loss for how to best support their friend or their family member?
Dr. Loree Johnson:
I think the first point it personal, I think it's going to be so hard for that person to be on the sidelines, watching somebody that they love struggle in a painful way, and with any person, you know, I think that we run to, you know, we, we have this idea of where we want to try to fix things. You know, it's like, Oh, I don't want to see someone in pain. What can I do? And I think the most important thing that someone can do is really listen, not jump to solutions or trying to fix things for the other person, because this isn't something that you can be, that can be fixed for them. It's something that they have to live through and navigate. And so leaning too into, you know, maybe your own, that person's own sense of powerlessness and that they can't fix this for their loved one. But knowing that there's power and just listening and saying, that's gotta be so hard. I hear you, what do you need from me? You know, I'm here for you. I'm listening. Tell me more about that. You know, those, I think that stances is really the most kind of powerful kind of thing that someone could say or do for, for a loved one, struggling with, with loss or infertility.
Josephine Atluri:
Yeah. I know that that is excellent advice. Even for someone such as myself who has already gone through so many years of infertility, I still am at a loss sometimes for how I speak to people who are going through it right now and finding the right words to say. And oftentimes also, you know, drawing upon my own experiences versus just being a listening ear. And so sometimes I have to check myself and remember that this person just like myself back in the day, just needed someone to listen to them. They needed that ear. They needed that shoulder of support. They didn't need me to give them my advice or what I went through unless they get to a point where they actually ask. So for me, in a growing process of being on the other side of it, actually. And so I just, you know, I loved going through your site and seeing the positive messaging about empowering oneself and their fertility journey with, you know, self care and creating this wellness plan for themselves. So to, to wrap up, I'd love for you to share with all of us listening, who are in the midst of trying to conceive any last pieces of advice on what they can do for themselves to help them thrive in this process versus just surviving.
Dr. Loree Johnson:
Remember who you are before fertility and fertility took over, remember who you are. That is the, I think the biggest piece of advice, because you were an art, you know, someone outside of your fertility journey. And I often say that infertility does not have to define you what does define you as how you choose to deal with it. And so I think when it becomes something that you're dealing with, as opposed to I am, you know, that when you use those words, I am, it's like an identifying statement. It becomes a part of you. And, and so therefore it can be life altering and defining which I know it happens to a certain degree, but it, it can be. So all-encompassing that you can lose sight of the fact that you are so much more than your motherhood fertility status.
Josephine Atluri:
That is beautiful advice. I think it's such a great way to, to approach one's fertility journey in, in a more mindful and positive way. You know, oftentimes many of the meditations that I like to do with, with clients is just this reconnection of their inner power and their inner strength because I, myself going through it, remember that I completely lost sight of who I was way back before when I started all of, all of the IVF and the adoption and the surrogacy, and not to say that we don't change over the course of life. We do, but throughout the whole process, I didn't stay connected to who I was. And I definitely did let the infertility take over me because I became, so single-minded about the end goal and it just consumed my entire being. So I love that you remind people to just remember who they are, and that's almost as like a lifeline, you know, their connection to, to life outside of it so that they can always come back and go back and forth and know that they have something outside of their fertility path. So, um, I have so much just, I could keep speaking to you forever, Dr. Laurie, you know, the way we approach fertility and wellness is someone lined. And so it's been so wonderful speaking to you. I always like to shift the end of the podcast by shifting to a state of positivity and one way that I encourage clients and followers to do that is to practice gratitude. So in that spirit, I'd love for you to share with us some of the gratitudes that you have for today.
Dr. Loree Johnson:
my gratitudes for today. My, hubby, um, my family, my immediate family, my just wonderful source of support. Um, I have a wonderful husband. I have wonderful, um, bonus kids. I have a wonderful dog that just, you know, they're just really, they really sustain me. Um, I love the strength and resilience that, um, my, my journey has just reminded me and, um, and I'm a big travel buff. And so my was just literally having a conversation with my husband the other day about some of our experiences traveling, um, to, to various parts of the world and feeling that just immense gratitude of what we've been able to experience because of our journey, because of the, the heartbreak and loss, um, that, that we were able to have these beautiful enrolled experiences that we wouldn't have had otherwise. So I'm filled with gratitude.
Josephine Atluri:
I love those gratitudes. It's so wonderful. And in the spirit of giving and receiving, I'd love for you to share with our audience, how they can connect with you, how they can learn more about you and your services.
Dr. Loree Johnson:
Yes. So you can find me on Instagram @drloreejohnson you can also find me on my website at www.drloreejohnson.com. I do have a free kind of grief guide and self care guide for people if they're needing a little bit of extra help, which so you can find on my website as well.
Josephine Atluri:
Wonderful. Well, I'll be sure to add all of your information in the episode summary, thank you so much again, Dr. Laurie for joining me today, it was such a pleasure, and I know that the people listening will definitely take away some wonderful wisdom nuggets of wisdom from you. So thanks again.