When my husband and I had our daughter in 2001, I was 30 years old and Chief Executive Officer of a company named CarePlus Health Plan. The path to parenthood was stress-free and instantaneous; we conceived the week I went off the pill while on vacation (which we sentimentally commemorated by naming our daughter after the town of Ana Capri, Italy). Three years later, we wanted to give her a sibling, but a lot had changed since her birth.
My husband had decided to make a career change and was starting a new profession. I had my hands full preparing our company for a sale. Due to these reasons, we decided to delay having our second child until we were more secure with our career and financials.
We started trying to have a second child in 2004 and that is when we had our first miscarriage. I was 33 years old at the time and never expected it. I had a perception that because an amniocentesis was only indicated for women over 35 years old, that somehow this miscarriage was unusual. I also never expected that I would have such a strong emotional reaction to the miscarriage. I had been through significant challenges both professionally and personally, yet I found myself sobbing and despondent over the loss of the pregnancy for weeks. My husband similarly suffered feelings of loss and grief. We tried coming up with reasons for the miscarriage and went through a litany of theories including my stress level, his new medication, and the list goes on. The act of trying to find an answer created a lot of self-blame and anxiety. While we were going through this, at no point did my OB/GYN educate us about the statistics of egg quality decline with age.
"I had been through significant challenges both professionally and personally, yet I found myself sobbing and despondent over the loss of the pregnancy for weeks." Photo Courtesy of Connor Evans
Over the next four years, we suffered six more miscarriages and a devastating loss in our sixth month of pregnancy. My OB/GYN sent me for every diagnostic test imaginable, including expensive endocrinology testing, sonograms, autoimmune testing and genetic testing. I was sent to specialists to rule out underlying health conditions that contribute to miscarriages. I had numerous D&Cs (better known as dilation and curettage procedure, where the uterine lining is scrapped to remove abnormal tissues) after each miscarriage, which showed there was a chromosomal abnormality in the embryo but a different one each time.
During this whole process, I was never referred to a reproductive endocrinologist or fertility clinic and when I asked my doctor why, she said that I didn’t suffer from infertility because I didn’t have a problem getting pregnant. I wish I knew then what I know now.
During those four dark years, I learned to compartmentalize my emotions. When a woman is suffering from infertility or pregnancy losses, she can’t go to work and discuss it openly like other medical diagnoses for two main reasons: either the loss occurs during the “secret” period which is the first three months of pregnancy, or a woman is fearful that if her employer knows she is trying to get pregnant, her level of commitment to the job will be questioned and she will be passed over for opportunities. So, on top of the emotional and physical pain of the medical procedures and losses, it was such an isolating experience. People who knew what we were going through either minimized it by saying things such as, “you are lucky you have one child” or said things like, “maybe you should quit your job to reduce your stress and focus on what’s really important in life.” Or they simply avoided us altogether. All we needed during this time was support and love, yet we were treated like we had leprosy by many people, with the exception of our parents and closest friends and family. My sister called me every day to say, “I’m thinking of you.” So simple and supportive, yet so difficult for many people to understand. The only person who truly understood me was my incredible husband. And he paid the price for it by having to absorb all of my anxiety, depression and by having to prop me up when he surely felt like falling apart too.
I often say that the only person who feels more isolated than a woman suffering from infertility is her partner.
It finally reached a point where I knew I needed to seek a mental health professional. I was diagnosed with PTSD due to the compounding effects of loss after loss, without enough time to grieve and process in between. I tried my best to hide my suffering from my young daughter and colleagues, acting as if nothing was wrong. I didn’t realize until later the additional emotional toll of trying to act “normal” was taking on my psyche until I hit rock bottom and agreed to medication. That is when I was finally able to come out of my daily fog and when my doctor called to tell me that she recommended that I seek a surrogate and egg donor because my body could not withstand any more miscarriages.
Maybe it was the new reality I faced after that conversation, or the new medication, but I decided that I would not go down without a fight. I had read online about a test called preimplantation genetic testing that was fairly new at the time and performed at RMA of NY down the street from my office. I vividly remember Dr. Benjamin Sandler empathizing with my husband and I for all that we went through and apologizing that we had to suffer for so long when we could have addressed this condition earlier through IVF. He shared that I likely had an egg quality issue which was normal for my age, and with IVF, we could screen our embryos to ensure that we only implant a chromosomally normal embryo to greatly reduce the chance of a miscarriage. I think back on that meeting and remembered the only emotion I felt more strongly than hope was anger.
"I wanted to change the perception of fertility treatment as being optional."
I was furious that my doctor had allowed us to suffer for so long, which impacted my physical and mental well-being.
I was furious that there was IVF treatment, widely available for people suffering from infertility. Yet, for me, it was viewed as an “optional” treatment. I often say that if my OB/GYN noticed that I had high cholesterol, she would have referred me to a cardiologist immediately. But why was infertility treated differently?
This is what I sought out to solve seven years later. As a health plan executive, I had kept tabs on all the money the insurance company spent during those four years which included: diagnostic testing, physician visits, outpatient procedures and mental health costs. The end total was three to four times the expense of fertility treatments. We even had coverage through my husband’s company, but it was exhausted during the diagnostic testing phase. This meant there wasn’t much left over to cover our IVF treatment. Through all of this, I was intent on finding resources so that no one would ever have to go through what we had, without educational resources and emotional support. I wanted to change the perception of fertility treatment as being optional and instead drive employers and health plans to provide equitable coverage for infertility like any other disease. Fortunately, I met others willing to support this concept and today we have Progyny, a company increasing access to fertility care by carving out a fertility benefit for employers. There is still so much work to do in expanding access to fertility benefits and in recognizing that infertility is a disease that deserves full treatment coverage like any other disease.
In the meantime, there’s something more powerful that we can all do. It’s to remove the stigma of fertility conversations altogether so that women trying to conceive, newly pregnant or suffering from infertility can talk as easily about this as one talks about diabetes or heart disease. I realize now that if I was able to tell friends and colleagues during my first three months that I was pregnant without fear of social and professional reprisal, then I would have been more willing to discuss my miscarriages and fertility struggles, which could have led to the societal support and recognition that I so desperately needed. Together, let’s end the suffering in silence and talk about the F word. One conversation can change someone else’s life.
For decades, women have been unknowingly suffering from PSD and intergenerational trauma, but now Dr. Valerie Rein wants women to reclaim their power through mind, body and healing tools.
As women, no matter how many accomplishments we have or how successful we look on the outside, we all occasionally hear that nagging internal voice telling us to do more. We criticize ourselves more than anyone else and then throw ourselves into the never-ending cycle of self-care, all in effort to save ourselves from crashing into this invisible internal wall. According to psychologist, entrepreneur and author, Dr. Valerie Rein, these feelings are not your fault and there is nothing wrong with you— but chances are you definitely suffering from Patriarchy Stress Disorder.
Patriarchy Stress Disorder (PSD) is defined as the collective inherited trauma of oppression that forms an invisible inner barrier to women's happiness and fulfillment. The term was coined by Rein who discovered a missing link between trauma and the effects that patriarchal power structures have had on certain groups of people all throughout history up until the present day. Her life experience, in addition to research, have led Rein to develop a deeper understanding of the ways in which men and women are experiencing symptoms of trauma and stress that have been genetically passed down from previously oppressed generations.
What makes the discovery of this disorder significant is that it provides women with an answer to the stresses and trauma we feel but cannot explain or overcome. After being admitted to the ER with stroke-like symptoms one afternoon, when Rein noticed the left side of her body and face going numb, she was baffled to learn from her doctors that the results of her tests revealed that her stroke-like symptoms were caused by stress. Rein was then left to figure out what exactly she did for her clients in order for them to be able to step into the fullness of themselves that she was unable to do for herself. "What started seeping through the tears was the realization that I checked all the boxes that society told me I needed to feel happy and fulfilled, but I didn't feel happy or fulfilled and I didn't feel unhappy either. I didn't feel much of anything at all, not even stress," she stated.
Photo Courtesy of Dr. Valerie Rein
This raised the question for Rein as to what sort of hidden traumas women are suppressing without having any awareness of its presence. In her evaluation of her healing methodology, Rein realized that she was using mind, body and trauma healing tools with her clients because, while they had never experienced a traumatic event, they were showing the tell-tale symptoms of trauma which are described as a disconnect from parts of ourselves, body and emotions. In addition to her personal evaluation, research at the time had revealed that traumatic experiences are, in fact, passed down genetically throughout generations. This was Rein's lightbulb moment. The answer to a very real problem that she, and all women, have been experiencing is intergenerational trauma as a result of oppression formed under the patriarchy.
Although Rein's discovery would undoubtably change the way women experience and understand stress, it was crucial that she first broaden the definition of trauma not with the intention of catering to PSD, but to better identify the ways in which trauma presents itself in the current generation. When studying psychology from the books and diagnostic manuals written exclusively by white men, trauma was narrowly defined as a life-threatening experience. By that definition, not many people fit the bill despite showing trauma-like symptoms such as disconnections from parts of their body, emotions and self-expression. However, as the field of psychology has expanded, more voices have been joining the conversations and expanding the definition of trauma based on their lived experience. "I have broadened the definition to say that any experience that makes us feel unsafe psychically or emotionally can be traumatic," stated Rein. By redefining trauma, people across the gender spectrum are able to find validation in their experiences and begin their journey to healing these traumas not just for ourselves, but for future generations.
While PSD is not experienced by one particular gender, as women who have been one of the most historically disadvantaged and oppressed groups, we have inherited survival instructions that express themselves differently for different women. For some women, this means their nervous systems freeze when faced with something that has been historically dangerous for women such as stepping into their power, speaking out, being visible or making a lot of money. Then there are women who go into fight or flight mode. Although they are able to stand in the spotlight, they pay a high price for it when their nervous system begins to work in a constant state of hyper vigilance in order to keep them safe. These women often find themselves having trouble with anxiety, intimacy, sleeping or relaxing without a glass of wine or a pill. Because of this, adrenaline fatigue has become an epidemic among high achieving women that is resulting in heightened levels of stress and anxiety.
"For the first time, it makes sense that we are not broken or making this up, and we have gained this understanding by looking through the lens of a shared trauma. All of these things have been either forbidden or impossible for women. A woman's power has always been a punishable offense throughout history," stated Rein.
Although the idea of having a disorder may be scary to some and even potentially contribute to a victim mentality, Rein wants people to be empowered by PSD and to see it as a diagnosis meant to validate your experience by giving it a name, making it real and giving you a means to heal yourself. "There are still experiences in our lives that are triggering PSD and the more layers we heal, the more power we claim, the more resilience we have and more ability we have in staying plugged into our power and happiness. These triggers affect us less and less the more we heal," emphasized Rein. While the task of breaking intergenerational transmission of trauma seems intimidating, the author has flipped the negative approach to the healing journey from a game of survival to the game of how good can it get.
In her new book, Patriarchy Stress Disorder: The Invisible Barrier to Women's Happiness and Fulfillment, Rein details an easy system for healing that includes the necessary tools she has sourced over 20 years on her healing exploration with the pioneers of mind, body and trauma resolution. Her 5-step system serves to help "Jailbreakers" escape the inner prison of PSD and other hidden trauma through the process of Waking Up in Prison, Meeting the Prison Guards, Turning the Prison Guards into Body Guards, Digging the Tunnel to Freedom and Savoring Freedom. Readers can also find free tools on Rein's website to help aid in their healing journey and exploration.
"I think of the book coming out as the birth of a movement. Healing is not women against men– it's women, men and people across the gender spectrum, coming together in a shared understanding that we all have trauma and we can all heal."