Faculty Viewpoint: Helping Couples Navigate Trauma, Infertility, and the Therapeutic Process

Infertility affects approximately 12-15% of couples, and yet, it’s possible for a counselor to work with a couple and never know if they are experiencing infertility or have experienced it in their past. There can be a lot of shame surrounding infertility. In fact, literature shows that couples rarely discuss how badly they feel about infertility. It can represent an ongoing loss that can impact the remainder of the couple’s lives, which can even be amplified, depending on cultural background or history.

Dr. Niko Wilson, assistant professor and director of the Couples and Family Therapy emphasis in the MA in Clinical Mental Health Counseling program, is teaching her students to ask their patients about reproductive health and sexuality, and to help them safely navigate these conversations through the therapeutic process.

Wilson earned her PhD in Counselor Education from the University of Central Florida where she completed her dissertation, “Couples with Infertility: The Influence of Quality of Life, Relationship Satisfaction, Resilience, Depression, and Shame.” She uses the research from this year-long study with 556 participants in her current courses on Human Sexuality and Trauma and the Contemporary Family.

Wilson shares her reflections below about the benefits of working with couples and families and how she educates her students to support the contemporary family, create a safe therapeutic environment, and never to make assumptions about a couple’s lived experiences.

Q: Tell me about your dissertation and why you chose to research infertility struggles and its impact on couples?

A: When counselors begin working with a new couple, it is not common to ask about a couple’s reproductive health related to their sexuality, which means it’s possible that a counselor could never know if a couple is struggling with infertility. I chose this topic because I wanted to gain a better understanding of the impact of infertility on the emotional and psychological well-being of individuals and couples and have the ability to share these findings with my students. For instance, in my research, I was able to see how one partner’s level of shame related to their infertility impacts the other partner’s level of shame or depression. Alternatively, one partner’s relationship satisfaction positively impacted the other partner’s level of shame. Many participants shared that their experience with infertility was very private, and they felt shame even in discussing their experiences with their partner. However, we know that relationships can be a huge source of strength and support for many people, so helping couples share and connect on an emotional level can have lasting positive impact on their relationship!

Q: What is unique about working with an individual vs. working with a couple or a family?

A: There’s a different energy that comes when working with a couple because there’s richer information to work from therapeutically. Since all individuals in the partnership are present, it’s more likely that changes will stick, and clients will apply tactics they have discussed in therapy.

Of course, it’s not easy. Most of the time there’s usually one person who doesn’t want to be there, but that’s okay. It’s part of the therapeutic process to help them accept therapy and see the value. A person may be worried they are being judged or that they will be told they are the problem. In order to overcome this, I teach my students a skill called “joining” where you take a moment to connect with each person individually to get to know them better, whether it’s by asking them about a coffee mug they are holding or a picture on the wall during a telehealth session. This tactic helps people to let their guard down and feel like the therapist is not on one side or the other.

Q: One of the required courses in the Couples and Family Therapy emphasis is “Trauma and the Contemporary Family.” Can you share what defines a “contemporary family?”

A: Families come in many shapes and sizes, and are impacted by their community, neighborhood, extended family, location, as well as time and place in history. For instance, in recent years, people have been impacted by COVID, the Black Lives Matter movement, immigration, or some states limiting access to medical treatment for trans individuals, just to name a few. All layers of context will impact families. Students must be ready to work with their clients in the context of current events and public policy. It’s equally important to understand the historical and cultural context for couples who have been together for decades. Another term for the contemporary family is the modern family.

Q: One area of focus for you is teaching your students to be trauma-informed when they work with a couple or a family. Can you tell me more about this?

A: In our class, we talk about the very beginning stages of getting to know a family. The first several sessions are used to help couples or family members feel safe enough to share their stories. It’s important to understand if there’s trauma in someone’s background and how that trauma impacts them today. Trauma can be a “Big T” like war or an event of abuse. Trauma can also be a “little t” like daily occurrences of criticism from a parent or partner.

Trauma-informed therapy focuses on creating a space of safety and stabilization for patients. With couples therapy, it’s critical to hold a space for everyone to share their story and not make any assumptions. If one person has experienced trauma, it’s important to teach the other partner or family member the skills to be supportive through listening or grounding techniques, such as, deep breathing together.

Q: What advice do you have for someone who is interested in pursuing Couples and Family Therapy as a career?

A: I began my career as a mental health counselor and after a few years of working with clients, I started to see a lot of couples. I was really drawn to working with couples and families and saw the long-term impact that deep relational work can have on an individual and their family system. I was inspired to obtain additional training and become a Licensed Marriage and Family Therapist.

If working with couples and families is something that you are interested in, it is never too late to specialize, or re-specialize! In fact, William James College has a certificate program for Respecialization in Couples and Family Therapy, which allows professionals to receive the education and clinical experience to become a Licensed Marriage and Family Therapist in Massachusetts. 

Dr. Niko Wilson is a National Certified Counselor (NCC), a Licensed Mental Health Counselor in FL and MA, a Licensed Marriage and Family Therapist in FL, and a Clinical Fellow of the American Association for Marriage and Family Therapy.

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