Have you ever snapped at your partner and realized later that it wasn't really about what they said? If you are going through infertility, that anger may be carrying something heavier underneath it.
One of the most common things I see when I work with couples going through infertility is shame coming out as anger. It showed up clearly in our conversation with Emily Hoekstra on the podcast. Emily was open about how, during her and her husband Nate's infertility, she turned away from him, and how she was processing her shame as anger. Ginny Lupka and I sat down afterward to talk through that dynamic, because it is so prevalent in the therapy room.
The tree: shame, anxiety, and anger
I have several pages on this in my book, Couple Therapy for Reproductive Grief. The way I usually describe it to clients is as a tree.
Infertility can be very identity-focused. My identity as a man or as a woman is often attached to who I am as a potential parent. When that identity is disrupted, it can bring up a lot of shame: that I'm not good enough, that I have less worth now. Who am I? Who am I to my partner, to the world, to my family, to myself?
The deep roots of the tree are shame. And shame does not want to be seen. It wants to stay hidden, because if we bring it out and it is not met with compassion, the shame and the hurt only grow.
The trunk is anxiety. It is the fear that I am going to be found out, that I'll be seen as less of a man or less of a woman.
The branches and the fruit are anger, because anger is a protective emotion. It is how we protect ourselves. "Don't see me. I'm pushing you away. I don't want to be seen."
I think this can happen in less than a second. Shame shows up, turns into anxiety, a tension in the body, and comes out as anger. You can see the same thing outside of infertility, when people sabotage a relationship before they can be abandoned. It is a way of protecting the shame.
That lines up with what Emily described. Because she felt so much shame about what infertility meant for her identity as a parent, she pushed Nate away. She did not want him to see the version of herself she believed she was. This happens across all genders, though it can express itself differently from couple to couple, and even from day to day.
A check engine light
Ginny offered a picture I find helpful. She described anger as a check engine light: it often signals that something else is going on underneath. That does not make anger any less valid on its own. But anger usually has a buddy. Ginny also drew the distinction between guilt and shame this way: guilt is the idea that I have done something wrong, and shame is the idea that I am something wrong. If that feels like it might be discovered, keeping people at a distance with anger can feel safer.
Healing happens when that shame is seen by someone in a safe, emotionally intimate relationship. Much of our work with couples is helping partners hold each other's most vulnerable emotions and lean toward each other without judgment.
Ginny also reminded me that grief itself moves through anger and sadness, over and over. Of course there is anger. It is part of grieving, and it deserves space.
What this looks like in the therapy room
I often tell couples that anger never travels alone.
When I first start working with a couple going through infertility, they will often tell each other, "I'm frustrated about this. I'm frustrated about that." I think "frustrated" is a blanket, a catch-all. So I push a little. "Okay, you're frustrated. Go deeper. What else are you feeling?"
Anger can land as a critical emotion. That connects to what John Gottman calls the four horsemen: criticism, defensiveness, contempt, and stonewalling. If I am on the receiving end of your anger, I feel like I'm in the hot seat. But if you can tell me what you are feeling underneath the anger, it becomes much easier for me to care for it.
If I am feeling disconnected or lonely, if we are doing fertility treatments and it feels like we are on two separate paths, if I feel like I'm about to come unglued because I don't know the future of our family, then that is the place to start. Something like:
"Babe, I feel like I'm doing this alone. That's not a criticism of you, but I feel so distant from you, and I need us to be at a place where I feel like we're doing this together. I really need to feel heard."
Compare that to: "Why do you always check out after you give me the shot?"
The emotion behind the second one is still valid. It is just a reactive way to express it. When we are curious with each other and clear about what we feel and what we need, we can start to have a dialogue. Then we can hold the vulnerability, and then we can find connection.
The morning we recorded this episode, I watched a couple process anger together in session. At one point the husband looked at his wife and said he really appreciated her listening and that he felt heard. Then he started crying. Feeling heard can be that powerful. Shame and anger can be big roadblocks to it, but they do not have to end the possibility.
The burner story
Here is a small example from outside of infertility. (Poor Marjorie. Because she is married to me, she ends up in a lot of my stories.) I love to entertain, and when we have a lot of people over, I sometimes forget to turn off a burner on our gas stove. It has happened more times than I can count.
One evening, most of our guests had left, and Marjorie came in and said, "You left a burner on again. This is going to burn our house down. What are you thinking?" Totally valid, by the way.
Because Marjorie and I learned to be mindfully attuned to each other during infertility, we are much better at doing it in little moments too, so things don't escalate. I used a skill I teach a lot of couples: take a five-second pause. You don't have to respond right away. Take a breath, whether it's three seconds or seven, notice what you are feeling, and name it.
What I noticed was that I was embarrassed. So I said something like, "Babe, I get it. I'm really embarrassed right now." That vulnerability lends itself to mercy. Marjorie had mercy on me, and I was able to come back, apologize, and suggest we come up with a system so I would remember.
Later that evening I was able to say, "Sweetheart, I see the anger, but I think there's a lot of anxiety and fear under it." She said yes. She could picture the house burning down. Whether that was likely or not does not matter. We validate the emotion. (For the record, our house has never burned down. It came close once, but that was the old wiring, not the burner.) That is holding two things true at the same time: this anger doesn't feel good, and I see that you're feeling something else underneath it, and I'm here for it.
If you are going through infertility or reproductive grief
When embarrassment or shame comes up, name it. Take the pause, whatever length you need. If you are overwhelmed, you can say, "I'm feeling a lot of shame and I'm overwhelmed by it, and I can't really talk about it right now. Can we bring it up later?" That can be a powerful tool for connection.
It works best when both partners lean in. The partner on the receiving end needs curiosity too. If you are in a fighting mood and only want to win the argument, you won't be interested in your partner's vulnerable emotions. I like to say that couple therapy is about taking "What the hell is that?" and turning it into "Hey, what's that?" I don't need to shape a narrative or react. I can be curious in the moment.
This connects to the first two pillars of connection I write about. The first is mindful attunement: slowing down enough to be aware of what I am feeling and what my partner is feeling. That is hard during infertility, miscarriage, or adoption, because our stress systems are overloaded. The second is navigating heightened conflict with non-reactivity and curiosity. When we can do that, we can keep feeling heard in the middle of the stress and the pain, and in that constant cycle of anger and sadness.
It is easier said than done. There were so many small moments when Marjorie and I struggled to attune to each other because the stress was through the roof. But as we flexed that muscle, it became more second nature. That is why couples who build these skills during infertility and reproductive grief find their relationship is stronger afterward. It carries into everything else, and many of the couples we have talked with say their relationship is thriving whether or not they had children. As Ginny put it, they are building the skills inside the stressor, and that can make them last.
