3. 1 Los escenarios y el encuentro con las participantes

Several papers discuss theoretical perspectives on ways of coping. The following are brief overviews of three key papers that help in the understanding different aspects in coping styles.

a) Psychosocial influences on cognitive coping strategies

Folkman and Lazarus (1980) defined coping as “the cognitive and behavioral efforts made to master, tolerate, or reduce external and internal demands and conflicts among them” (p. 223). Making efforts can be influenced by an individual’s appraisal to a stressful event encounter. According to the authors, a stressful situation can be evaluated in three forms, which are the feelings of being: “harmed, threatened, or challenged” (p. 223). Based on this, a person makes an effort to manage or alter the stressor itself (problem-focused coping), and/or regulate emotion (emotion-focused coping). This forms the transactional model of stress and coping (Lazarus & Folkman, 1984).

For women going through fertility treatment the problem is that of conceiving. Under this circumstance, although emotion-focused coping may also be involved, a woman may make an effort to manage the situation by trying a different type of fertility

treatment as a way of problem-focused coping. For permanently involuntarily childless people, coping resources for managing their childless situations may be limited.

Chochovski, Moss, and Charman (2013) emphasise the importance psychosocial influences have on coping strategies in such situations. The authors were interested in the impact of resilience, and the quality of relationships that a partner or husband has on women’s cognitive coping strategies. Data were collected from 184 childless women (age range: 21–29 = 19%, 30–39 = 64%, and 40–49 = 17%) who all “had unsuccessfully completed IVF treatment” (p. 123). More than 70% of the participants ended their last IVF within the past six months. The study used self-reported scale-based questionnaires examining resilience, relationship quality, and depression (level

of stress). The results demonstrated that women who showed a high level of resilience reappraised their feelings positively and regulated their emotions. However, the effect this had on coping tended to be temporary, whereas relationship quality with partner or husband seemed to provide a secure attachment as the time following IVF progressed.

This helped with developing a positive coping attitude to the situation. The paper suggests the necessities of looking at psychosocial factors that can help in reducing emotional demands and facilitate positive coping.

b) Life longings: a self-regulatory strategy

An underpinning of self-regulation involves conscious control to change the self, and

“the capacity to self-regulate in order to manage complex social relationships [that]

constitutes an essential skill that holds families, groups, and even whole societies together” (Forgas, Baumeister, & Tice, 2009, p. 3). Broadly, there seem to be five features in self-regulating processes: ‘controlling one’s thoughts’, ‘controlling emotions and moods’, ‘confining impulses (automatic responses) by behavioural changes’, ‘regulating motivation’, and ‘regulating performances’ (Forgas et al., 2009).

Kotter-Grühn, Scheibe, Blanchard-Fields, and Baltes (2009) introduced the concept of

“life longings” (p. 634) that have six underlying characteristics: ‘feelings of

incompleteness’, ‘dealing with utopian conceptions of life that are not fully attainable’, temporal or ‘tritime focus – from the past and anticipated meaningful experiences in the present and future’, ‘reflection and evaluation – comparing actual situations with ideal ones’, ‘ambivalent emotions’, and ‘symbolically rich in emotional and mental meaning – for the object of longing’. The authors applied a quasi-experimental

questionnaire design to examine whether childless women regard having children as a goal or a life longing, and how the experience of life longing has been an influence on their lives. Data were collected from 168 middle-aged (age range: 33–53, mean age = 45.2) childless women, of which the main findings were drawn from 102 involuntarily childless women.

The hope to have one’s own children for involuntarily childless women was found to be an unaccomplished goal that resulted in a considerable loss in their lives. Since the

intensity of the wish was strong, it appeared to be difficult to let go of the desire. The findings refer to this point as:

When a goal was unsuccessfully pursued over a long time, women might finally disengage from active goal pursuit (i.e., they withdraw effort) but continue pursuing it at the level of imagination (i.e., they remain cognitively and emotionally committed) (Kotter-Grühn et al., 2009, p. 641).

This indicates that having children is not merely a failed goal, but also influences tritime (temporal continuity), as well as self-regulation. The experience of life longing provided participants who were still unable to adjust the goal with a way of dealing with loss by replacing it with “meaningful fantasies that persons can engage in to feel more complete” (p. 635). This was accompanied by having control over the life longing situation. The results suggest a potential functionality over the experience of life longing as “a loss-based compensatory strategy” (p. 635) - another way that self-regulation operates.

c) Empathic activism

Nouel (2007) presented the concept of “empathic activism” (p. 236), a compassionate and transformative coping strategy.

It requires that a person move toward grasping others’ experiences and be moved to act on their behalf, as well as to address the conditions from which these situations may arise (Nouel, 2007, p. 239).

The author goes on to explain that this process takes a “Buddhist conception” (p. 239) and “a way of bridging a duality common in [our] Western thinking of action and relationship” (p. 240).

Employing this as a conceptual framework, the author interviewed four mothers who lost their children through tragedies. Although these circumstances are different from the invisible losses of involuntary childlessness, there is a potential link through the concept of understanding ways of dealing with the physically absent but the

psychologically present childless situation (Boss, 2006; Burns, 1987). Data were examined through existential and phenomenological lenses. The women’s shared accounts were illustrated as a form of narrative. The processes emerging were

reactions to what happened with emotional struggles, recollective accounts that speak of their hidden sense of loss, and a sense of isolation from the world around. However, the mothers appear to find connections with other women who had similar experiences and are able to share or support each other. Through these new connections, the

women seem to regain their sense of usefulness by making use of their own experience.

Helping others also helps her in return by giving her a sense that she is making a difference. She becomes aware that the knowledge and compassion gained from her experience can make a difference for others (Nouel, 2007, p. 243).

The author emphases that dealing with a loss “does not necessarily require letting go”

(p. 254) of the sadness but instead transforming it, by actively and empathically engaging in helping others. In other words, empathic activism could facilitate the transformation of relationships from symbolic features of loss into a gradual, and psychologically and socially involved coping strategy.

2.4.5 Summary

The first theme of involuntary childlessness was discussed from clinical viewpoints.

Issues around infertility and the experiences of having ARTs were the main concerns.

The studies report that the impact of infertility could be temporary. However, they also show the great psychological distress among infertile women, particularly that of depression and anxiety.

The second theme described a continuous sense of loss and grief that further seemed to entail a passage towards non-motherhood. The prolonged desire to have children, and regrets over children not being present appear as the sources underpinning such distress. When women stop their fertility treatments, the medical consequences of

infertility can become tritime experiences, and the influences of childlessness over one’s life course were discussed.

The third theme pointed to the psychosocial experiences of involuntary childlessness.

The studies around self and identity, relationships with others and society, and social expectations have shown the relational impact these have on women. It appears that the complexities of gendered discourse and stigmatised women’s accounts highlight the legitimacy of biologically childless women and the challenges they face in their everyday lives.

The final theme elucidated involuntarily childless women’s ways of dealing with life.

The influences of the partner or husband on coping have been evidenced in several studies. Three studies that capture coping strategies were also discussed looking at different aspects of coping styles.

This section has shown the disparate issues existing among involuntarily childless women, and papers reviewed here have revealed the intricate nature of the

psychological impact that childlessness has on women and their lives. While many studies have focused on infertility and issues around fertility treatments, little is known about what it is actually like to be involuntarily childless, living without the children one hoped for. In addition, women who are involuntarily childless, but have not experienced medical interventions, have not featured in the research.

Methodologically, much existing literature has tended to employ questionnaires and standardised measures. The dominance of quantitative approaches is noticeable, particularly in studies looking at infertility from medical viewpoints. Quantitative research is useful to examine, for example, the levels of depression childless women might have when compared nomothetically with other women with children. However, such research can undervalue a personal account or feeling associated with depression caused by the absence of children.

In contrast, more qualitatively-oriented methods have appeared to be used in investigating involuntary childlessness from life-span perspectives. These often accompany psychosocial inquiries. It has also been noticed that extant literature

examining qualitative aspects of life without children appears to emphasise socially constructed viewpoints, and intrapersonal features of involuntary childlessness appears to be less focused on. The diverse themes that emerged from the literature reviewed tells us that experiences of childlessness cannot be quantified under a one-dimensional focus. Both intrapersonal and interpersonal processes can be considered qualitatively in order to gain rich data.

Increasing numbers of phenomenologically-oriented studies have also been identified with their focus on experiences. However, they try to investigate core structures of experiences, rather than looking into the process of what individuals are experiencing as they live. Furthermore, those studies have looked at infertility experiences several years post-failed-fertility treatments. It is vital, therefore, to investigate the experience of childless people living beyond this point in their lives.

Considering these points, I would argue for a need for approaches that take participant-centred experiential perspectives, and with a particular focus on idiographic features.

Childlessness is increasing. Midlife develops dynamically. Research that can raise social awareness of involuntary childlessness, as well as a deeper psychological understanding of women living with involuntary childlessness, is clearly needed.

Chapter 3

Methodology

3.1 Introduction

Having identified the dominance of quantitative approaches, the lack of understanding of involuntary childlessness in midlife, and the need for the development of meaning-centred approaches in the previous chapter, I will now discuss methodological considerations for tackling these limitations.

In the following sections, after presenting a summary of the development of qualitative approaches, I will introduce Interpretative Phenomenological Analysis (IPA: Smith, Flowers, & Larkin, 2009) as my chosen method. I will then give an overview of the philosophical underpinnings of IPA: (a) phenomenology, featuring four key thinkers – Husserl, Heidegger, Merleau-Ponty, and Sartre – who have influenced philosophical stances into psychology, and (b) hermeneutics, a branch of philosophy that also plays an important part in IPA. Following this, the ways in which IPA draws on these philosophical stances and takes idiography into practice, as well as the value that IPA plays in my research process will be discussed. My rationale for using IPA will be remarked upon in the conclusion.