Family Matters: Shalom Bayit and Fertility – Dr. Sara Genstil

Many of us live in communities where building a bayit ne’eman b’Yisrael and rearing a large family are central values and mitzvos held in high regard. The problem begins when either of these don’t exactly go as planned. If the former isn’t functioning  properly, the latter is negatively affected, and vice versa.

Every individual is part of various  systems, such that the degree to which these systems are healthy  or unhealthy stems from the role of  each individual in it.” says Dr. Sara Genstil, who holds a Ph.D in Psychology and  specializes in Intersubjective Systems Theory. “Family and marriage are complex systems,” she adds. “If a couple hits a rough patch in their relationship, it means that both spouses have contributed to the kink in their system.”

“In a marriage, each spouse brings his or her very being,” says Dr. Genstil. “Each spouse’s perception of the world is based on experiences from early infancy and throughout life, which shape their individual world view (defined as their “organizing principles”). In order to improve their system, we need to identify the organizing principles (both from the distant and recent past) that  influence each spouse’s behavior—especially in cases when this behavior causes friction or conflict—and work on changing them.”

Healing a relationship means healing the system that was fashioned from both spouses’ input. Having a full understanding of and responsibility for this input is essential for change. Alter one part of the system and the entire system will be changed as a result. Dr. Genstil’s Marriage Counseling Treatment Model allows couples to share feelings and thoughts, build trust, learn how  to be responsive to each other, accept each other’s strengths and weaknesses, and thus facilitate change.

Over the years, Dr. Genstil has worked with numerous couples who had trouble conceiving. “Unexplained infertility is a condition that I have encountered throughout my career and is the diagnosis given to about 25% of couples who are having trouble conceiving  after all medical problems had been ruled out,” In addition to various other professional roles, she has served as a psychologist in a fertility  clinic and has developed a Fertility Treatment Model based on the principles of Intersubjective Systems Theory.

Believe it or not, extreme tension and stress can impact fertility for both men and women.  Research found that pregnancy is much more likely to occur when couples reported feeling happy and relaxed than feeling tense  or anxious.

A whole slew of hormones including adrenaline and cortisol—released naturally during stressful times—signal to the body that conditions are not ideal for conception. Adrenalin inhibits women from utilizing the hormone  progesterone, which is essential for fertility, and causes the pituitary gland to release higher levels of prolactin, which may prevent conception.

Sometimes, stress can be caused simply by a demanding job. “Our bodies haven’t changed over time, but stress levels have. Combined with the ticking of women’s biological clock, people put unrealistic demands on their bodies, and place their sense of worth in the  hands of achievement or social acceptance,” she explains. A tense or unstable home environment—or social pressure to have children—can exert pressure on a marriage. A prolonged inability to conceive can exacerbate an already strained situation, which then intensifies the stress.

Through therapy, Dr. Genstil’s Infertility Treatment Model helps couples identify the  subconscious issue that is sabotaging their fertility. “First we recognize the organizing principles (such as compromised shalom bayis, past traumatic experience such as a miscarriage, anxiety regarding the responsibility of becoming a mother, depression or other unknown emotional issues) and their impact on a couple’s behavior and physiological functioning. We confront a couple’s confusion,  sadness or frustration, enable them to let go  of their former organizing principles and replace  them with new ones.”

Eventually, the treatment process allows couples to build the emotional readiness to become pregnant which affects the rest of  the system – including removing barriers for  healthy physiological functioning and cultivating the relationship with their spouse.

Often well-meaning friends or family offer counterproductive advice by telling you to “just relax” or “pull yourself together.” In fact, this could generate even more stress. “Telling a person to calm down rarely results in them actually calming down,” says Dr. Genstil with a smile that says she’s been around the block more than a few times.

What she does recommend, however, is for both spouses to look into their own lives and try to find tiny spaces where they can each give  their body and mind a respite from the stresses of everyday living and family demands. “Don’t just try to relax because you think that it’s going to help your fertility but relax because it feels good. When you feel good, you’ll see your  relationships from a new perspective and you’ll be better equipped to work on your input in your various systems.”

Dr. Sara Genstil, PhD, is a seasoned psychologist with over 35 years of clinical experience. Dr. Genstil provides counseling for individuals, couples and families. She has experience working with clients both  privately and through organizations such as The Ministry of Defense and  National Insurance, working with terror victims and their bereaved  families. Dr. Genstil is a member and presenter for the International Association for Psychoanalytic Self-Psychology.

Dr. Sara Genstil can be reached at  052-260-9087 or through her website

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