Psychotherapy of a Relationship Break-Up in the Context of Assisted Reproductive Technologies

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Abstract

The paper is focused on ethical issues of making decisions about cryopreserved embryos in the context of relationship break-up in the framework of the embryo’s legal status and the church’s stand on the matter. All these issues can be viewed as part of a broader problem of intuitive and rational foundations for decision-making when facing difficult situations in life. On the one hand, the stressful context of the situation implies intuitive-driven decision-making; on the other hand, assisted reproductive technologies are largely counter-intuitive. We describe the peculiarities of family psychotherapy with mixed-agenda couples going through a divorce who have joint cryopreserved embryos but disagree on what to do with them. We introduce a protocol for psychotherapeutic work in the situation when one partner wishes to continue with the fertility treatment and have a child while the other partner is determined to utilize joint embryos as unwanted biological material. In addition, we discuss emotional and social complications that may arise (guilt, unfaithfulness of one of the partners, other losses, and grieving).

General Information

Keywords: bioethics, moral dilemma, decision making, stress, unfaithfulness, divorce psychotherapy, partner relationships, assisted reproductive technologies, cryopreserved embryos.

Journal rubric: Workshop and Methods

DOI: https://doi.org/10.17759/cpp.2021290108

Funding. This work was supported by Russian Foundation for Basic Research (project № 18-00-00245).

Acknowledgements. The authors are grateful to professor Yu.I. Alexandrov and family counsellor V. Naumova.

For citation: Znamenskaya I.I., Travkova M.R., Arutyunova K.R. Psychotherapy of a Relationship Break-Up in the Context of Assisted Reproductive Technologies. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2021. Vol. 29, no. 1, pp. 132–148. DOI: 10.17759/cpp.2021290108. (In Russ., аbstr. in Engl.)

References

  1. Aleksandrov Yu.I., Svarnik O.E., Znamenskaya I.I., et al. Regressiya kak etap razvitiya [Regression as a stage of development]. Moscow: Institut psikhologii RAN, 2017. 191 p.
  2. Arutyunova K.R. Psikhofiziologicheskii analiz zakonomernostei aktualizatsii individual’nogo opyta pri moral’noi otsenke deistvii. Diss. kand. psikhol. nauk. [Psychophysiological analysis of the patterns of individual experiences in moral judgements of actions: Ph. D. (Psychology) diss.]. Moscow, 2017. 229 p.
  3. Budinaite G.L. Osnovnye printsipy psikhoterapevticheskoi raboty s supruzheskoi paroi v situatsii razvoda [Basic principles of psychotherapeutical work with couples in the situation of divorce]. In Varga A.Ya. (ed.). Sistemnaya psikhoterapiya supruzheskikh par [Systemic therapy of couples]. Moscow: Kogito-Tsentr, 2012, pp. 330—341.
  4. Budinaite G.L., Kogan-Lerner L.B. Osobennosti vospriyatiya rebenkom 6—8 let struktury sem’i v situatsii razvoda [Image of family structure by 6—8 years children in the situation of divorce]. Konsul’tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2011. Vol. 19 (2), pp. 91—110. (In Russ., abstr. in Engl.).
  5. Grazhdanskii kodeks Rossiiskoi Federatsii [Civil Code of Russian Federation] [Elektronnyi resurs]. Available at: https://www.consultant.ru/document/cons_doc_ LAW_5142/ (Accessed 15.10.2019).
  6. Delo “Evans protiv Soedinennogo Korolevstva”. Postanovlenie Evropeiskogo suda po pravam cheloveka [Evans vs. United Kingdom. European Court of Human Rights] [Elektronnyi resurs] // Available at: https://base.garant.ru/5732865/ (Accessed 10.10.2019).
  7. Isupova O.G. Vspomogatel’nye reproduktivnye tekhnologii: novye vozmozhnosti [Assisted reproductive technologies: New opportunities]. Demograficheskoe obozrenie = Demographic review, 2017. Vol. 4 (1), pp. 35—64.
  8. Meshcheryakova T.V. Bioetika na peresechenii nauchnogo i vnenauchnogo znaniya [Bioethics in scientific and non-scientific knowledge]. Vestnik TGPU = Tomsk State Pedagogical University Bulletin, 2011, no. 10 (112), pp. 216—221.
  9. Osnovy sotsial’noi kontseptsii Russkoi Pravoslavnoi tserkvi. Gl. XII. Problemy bioetiki [Foundations of social conception of Russian Orthodox Church] [Elektronnyi resurs]. Available at: https://mospat.ru/ru/documents/social-concepts/xii/ (Accessed 13.11.2019).
  10. Prikaz Ministerstva zdravookhraneniya RF ot 30 avgusta 2012 g. № 107n “O poryadke ispol’zovaniya vspomogatel’nykh reproduktivnykh tekhnologii, protivopokazaniyakh i ogranicheniyakh k ikh primeneniyu” [Order of the Ministry of Health on assisted reproductive technologies, 30.08.2012 № 107n] [Elektronnyi resurs]. Available at: https://www.garant.ru/products/ipo/prime/doc/70218364/ (Accessed 12.11.2019).
  11. Rusanova N.E. Bezdetnaya sem’ya v Rossii: politika gosudarstva i vybor suprugov [A childless family in Russia: Government policy and choice of spouses]. Trud i sotsial’nye otnosheniya = Labour and Social Relationships, 2009, no. 8, pp. 91—97.
  12. Armstrong D.S. Emotional distress and prenatal attachment in pregnancy after perinatal loss. Journal of Nursing Scholarship, 2002. Vol. 34 (4), pp. 339—345. DOI:10.1111/j.1547-5069.2002.00339.x
  13. Arutyunova K.R., Alexandrov Yu.I., Hauser M.D. Sociocultural influences on moral judgments: East—West, male—female, and young—old [Elektronnyi resurs]. Frontiers in Psychology, 2016. Vol. 7. Available at: https://www.frontiersin.org/ articles/10.3389/fpsyg.2016.01334/full (Accessed 21.10.2019). DOI:10.3389/ fpsyg.2016.01334
  14. Borkenhagen A., Brahler E., Kentenich H., et al. Attitudes of German infertile couples towards multiple births and elective embryo transfer. Human Reproduction, 2007. Vol. 22 (11), pp. 2883—2887. DOI:10.1093/humrep/dem296
  15. Collins S.C., Chan E. Sociocultural determinants of US women’s ethical views on various fertility treatments. Reproductive Biomedicine Online, 2017. Vol. 35 (6), pp. 669—677. DOI:10.1016/j.rbmo.2017.08.015
  16. Cushman F., Young L., Hauser M. The role of conscious reasoning and intuition in moral judgment: Testing three principles of harm. Psychological Science, 2006. Vol. 17 (12), pp. 1082—1089. DOI:10.1111/j.1467-9280.2006.01834.x
  17. Doherty W.J., Harris S.M., Wilde J.L. Discernment counseling for “mixed-agenda” couples. Journal of Marital and Family Therapy, 2016. Vol. 42 (2), pp. 246—255. DOI:10.1111/jmft.12132
  18. Faircloth C. Intensive parenting and the expansion of parenting. In Lee E., Bristow J., Faircloth C., Macvarish J. (eds.) Parenting culture studies. London: Palgrave Macmillan, 2014, pp. 25—50.
  19. Francis A. Stigma in an era of medicalisation and anxious parenting: how proximity and culpability shape middle-class parents’ experiences of disgrace. Sociology of Health and Illness, 2012. Vol. 34 (6), pp. 927—942. DOI:10.1111/j.1467-9566.2011.01445.x
  20. Kahneman D. Thinking, Fast and Slow. New York: Farrar, Straus and Giroux, 2011. 499 p.
  21. Kufner K., Tonne M., Barth J. What is to be done with surplus embryos? Attitude formation with ambivalence in German fertility patients. Reproductive BioMedicine Online, 2009. Vol. 18, pp. 68—77. DOI:10.1016/S1472-6483(10)60118-6
  22. Moore K.A. Embryo adoption: The legal and moral challenges. University of St. Thomas Journal of Law and Public Policy, 2007. Vol. 1 (1), pp. 100—121.
  23. Nachtigall R.D., Becker G., Friese C., et al. Parents’ conceptualization of their frozen embryos complicates the disposition decision. Fertility and Sterility, 2005. Vol. 84 (2), pp. 431—434. DOI:10.1016/j.fertnstert.2005.01.134
  24. Newton C.R., McDermid A., Tekpetey F., et al. Embryo donation: Attitudes toward donation procedures and factors predicting willingness to donate. Human Reproduction, 2003. Vol. 18 (4), pp. 878—884. DOI:10.1093/humrep/deg169
  25. Shea J.B. Catholic teaching on the human embryo as an object of research [Elektronnyi resurs]. Catholic Insight, 03.12.2006. Available at: https://catholicinsight.com/ online/bioethics/embryo.shtml (Accessed 23.09.2019).
  26. Shreffler K.M., Johnson D.R., Scheuble L.K. Ethical problems with infertility treatments: Attitudes and explanations. The Social Science Journal, 2010. Vol. 47 (4), pp. 731—746. DOI:0.1016/j.soscij.2010.07.012
  27. White P. Life on the liminal bridge spanning fertility and infertility: A time to dream and a time to decide. Journal of Law and Medicine, 2017. Vol. 24 (4), pp. 886—899.
  28. Worden J.W. Grief counselling and grief therapy. A handbook for the mental health practitioner. 5th ed. New York: Springer, 2018. 352 p.

Information About the Authors

Irina I. Znamenskaya, Associate Researcher at The V. B. Shvyrkov Laboratory of Psychophysiology, Institute of Psychology RAS, Psychologist, Charity Foundation “Light in Hands”, Moscow, Russia, ORCID: https://orcid.org/0000-0003-4021-9843, e-mail: znamenirina@gmail.com

Marina R. Travkova, Postgraduate Student, Psychological Institute of the Russian Academy of Education, Moscow, Russia, ORCID: https://orcid.org/0000-0001-7806-6366, e-mail: travkovam@mail.ru

Karina R. Arutyunova, PhD in Psychology, Associate Researcher, V.B. Shvyrkov Laboratory of Neural Bases of Mind, Institute of Psychology, Russian Academy of Sciences, Moscow, Russia, ORCID: https://orcid.org/0000-0003-3056-5670, e-mail: arutyunova@inbox.ru

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