Judith C. Daniluk

Infertility: intrapersonal and interpersonal impact

Few experimentally rigorous studies have been conducted to determine the emotional impact of the infertility investigation on the infertile couple. In response to the deficit in rigorous experimental research, a longitudinal, exploratory study of 43 primary infertile couples was conducted. The study was conducted to determine if changes occurred in the marital relationships, sexual satisfaction, and levels of psychologic distress of the couples in the study as they progressed through the medical investigation of their infertility. Changes were assessed based on sex, diagnostic information, and time spent trying to conceive. Results indicated that significant distress was experienced by couples during the initial medical interview and at the time of diagnosis. Relationship quality did not appear to deteriorate as a result of the medical investigation; however, questions were raised regarding the sexual relationships of couples receiving an unexplained infertility diagnosis.

The Meaning and Experience of Female Sexuality: A Phenomenological Analysis:

The influence of medicine, religion, media, and sexual violence in constructing and confining the experience and expression of female sexuality was underscored in this qualitative analysis of the sexual themes experienced in the lives of 10 adult women. Structural and institutional barriers to the development of female sexual health were identified. Areas of central importance to women for experiencing their sexuality included sexual expression, reproduction, body image, and intimate relationships. Both positive and negative themes were identified, emphasizing the importance for women of assuming an active role in the construction of our own sexual paradigms.

Wounds to the soul: The experiences of aboriginal women survivors of sexual abuse.

AbstractMuch of the clinical and research literature on the consequences and treatment of sexual abuse assumes relative homogeneity in the abuse experience. Little differentiation is acknowledged on the basis of race, ethnicity, or class, despite the known salience of these variables in the construction and interpretation of human experience. A phenomenological examination of the experiences of six adult aboriginal women who were sexually abused as children identified six themes common to their experiences. These findings led to specific recommendations for working with aboriginal survivors of sexual abuse.The last ten years have witnessed an explosion of interest and research into the issues of incest and child sexual abuse. This research has led to estimates of the incidence of child sexual abuse ranging from 16% to 22% for girls (Briere, 1989; Browne & Finkelhor, 1986; Russell, 1986) and from 3% to 8% for boys (Finkelhor, Hotaling, Lewis, & Smith, 1990), to theories on the dynamics that mediate the impact of abuse (e.g., Courtois, 1988; Finkelhorn, 1984; Herman, 1992), and to a host of negative short-term and long-term consequences associated with the aftermath of childhood sexual victimization (e.g., Bass & Davis, 1988; Briere & Runtz, 1990; Browne & Finkelhorn, 1986; Butler, 1978; Cole & Putnam, 1992; Lundberg-Love, Marmion, Ford, Geffner & Peacock, 1992; Ratican, 1992; Westerlund, 1992; Wyatt, Guthrie, & Notgrass, 1992). Among adult survivors of sexual abuse, common responses include profound feelings of shame and guilt, somatic disturbances, repressed affect, low self-esteem, depression, isolation, inability to trust, problems in developing and maintaining intimate relationships, the employment of maladaptive coping strategies, and self abusive behavior (e.g., Bass & Davis, 1988; Briere & Runtz, 1990; Browne & Finkelhor, 1986; Butler, 1978; Cole & Putnam, 1992; Courtois, 1988; Lundberg-Love et al., 1992; Ratican, 1992; Wyatt et al., 1992). Survivors of sexual abuse frequently blame themselves for the onset of the abuse, mistakenly believing that it must have been some character flaw in them or some action of their part that caused the abuse to occur (Courtois, 1988; Herman, 1992; Meiselman, 1990). Similarly, many survivors report confusion and difficulty in separating concepts of love and sex, believing that they are unworthy of love and are profoundly defective (Bass & Davis, 1988; Maltz & Holtzman, 1987; Westerlund, 1992).Among clinical populations, 30% to 33% of clients present with a history of sexual victimization (Cole & Putnam, 1992). Since Butlers provocative assertions in 1978, a considerable amount of treatment literature has been published to assist mental health practitioners in working more effectively with sexual abuse survivors (e.g., Bass & Davis, 1988; Blume, 1990; Courtois, 1988; Herman, 1992; Maltz & Holman, 1987; McCann & Pearlman, 1990; Meiselman, 1990; Russell, 1986; Westerlund, 1992). However, most of this literature assumes relative homogeneity in the abuse experience; it is based on research with women and men from mainstream North American society, and specifically on research with white people. These intervention strategies are not sensitive to race, ethnicity, or class, despite the known salience of these variables in the construction and interpretation of human experience (Wyatt, 1985). We contend that cultural, historical, and economic factors are important in constructing the experiences of aboriginal women survivors of sexual abuse, and that these factors may limit the application of existing treatment approaches when working with aboriginal survivors of child sexual abuse.THE CANADIAN ABORIGINAL EXPERIENCEFormal studies that examine the prevalence of child sexual abuse among native communities do not exist. However, clinical and anecdotal evidence suggests that the incidence of sexual abuse among Canadas native peoples are as high as 80% (The Nechi Institute, The Four Worlds Development Project, 1988). …

Gone But Not Forgotten

Abstract A qualitative, phenomenological approach was taken to explore how women in midlife experience and meaningfully construct the recent death of their mothers. During in-depth interviews, 9 women between the ages of 42 and 65 reflected on the loss of their mothers within the previous 2 to 5 year period. Despite differences in the perceived closeness of their relationships with their mothers, the data analysis yielded seven common themes in the experiences of the participants as they attempted to live with, and make sense of, what each perceived to be a very significant loss in her life.

Psychological and relationship changes of couples undergoing an infertility investigation: Some implications for counsellors

Abstract The emotional and psychological aspects of the experience of infertility have been largely ignored by researchers. A study was accordingly undertaken of 43 infertile couples who were undergoing medical investigation of their fertility problems. Preliminary analysis of the data suggests that the infertility investigation was most stressful for the participants at the time of the initial medical interview, and that distress was greater for those who were themselves identified as having an organic fertility problem. A substantial number of the men and women involved indicated a need for the provision of psychological counselling services. The nature of the most appropriate forms of such help is explored.

Childless women's beliefs and knowledge about oocyte freezing for social and medical reasons.

STUDY QUESTION What factors inform a womans decision-making about oocyte freezing to preserve fertility for social and medical reasons? SUMMARY ANSWER Women lacked knowledge about the costs and viability of oocyte freezing as a fertility preservation option for social and medical reasons, and identified health consequences, costs, and viability as being particularly influential in their decision-making. WHAT IS KNOWN ALREADY Having only recently become a viable fertility preservation option, relatively little is known about childless womens beliefs or knowledge about oocyte freezing for social or medical reasons. STUDY DESIGN, SIZE, DURATION A cross sectional study of 500 childless women was conducted in August, 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 500 childless, presumed fertile, women from 18 to 38 years of age completed an online, self-report questionnaire assessing beliefs and knowledge about oocyte freezing to preserve fertility for social or medical reasons. MAIN RESULTS AND THE ROLE OF CHANCE Financial costs (85.6%), health risks to themselves (86.4%) or their offspring (87.8%), and success rates (82%) were the primary factors that women felt would influence their decision to freeze their oocytes. Partners feelings (88.6%), prognosis for a full recovery (85.4%), and concerns about the health effects of the hormones or oocyte retrieval procedure (85.4%) were identified as being particularly important when considering oocyte freezing for medical reasons. Consistent with their perceptions of having little or no knowledge about oocyte freezing, there was an overall correct response rate of 33% to the 12 knowledge questions. LIMITATIONS, REASONS FOR CAUTION The online format and use of a survey company to recruit participants may have increased the risk of self-selection bias and limit the generalizability of these findings. The findings may also be limited by the fact that the participants were not facing cancer treatments, and the younger participants were not nearing the end of their reproductive lifespan, and therefore would not have had reason to learn about, or consider, fertility preservation for medical or social reasons. WIDER IMPLICATIONS OF THE FINDINGS Given the worldwide trend towards delaying childbearing and the increasing availability of oocyte freezing as an option to preserve womens fertility, it is likely these results could be extended to wider North American, European, and Australasian populations of English speaking childless women. STUDY FUNDING/COMPETING INTERESTS No specific funding. No competing interests.

Sexual Transitions in the Lives of Adult Women

Sexuality is an important and complex aspect of life. It encompasses “physical, psychological, social, emotional, spiritual, cultural, and ethical dimensions of human experience” (Duplassie and Daniluk 2007, p. 263). Sexual expression involves “the sensual pleasure that comes from the stimulation of the body, often with the anticipation of an enjoyable, erotic feeling” (Westheimer and Lopater 2005, p. 24). Sexuality includes attitudes, beliefs, and expectations about self and others. These are inevitably shaped by external forces such as societal and cultural norms, media portrayals of sexuality, and relationships with others who are important. Women’s sexuality at all stages of the course of life is developed through and influenced by interactions with others based on a woman’s age, life stage, and significant roles (Daniluk 1998). How women experience their sexuality changes and shifts across the lifespan, especially during key transitions such as infertility, pregnancy, mothering, menopause, and physical illness and disability. Not only do these transitions involve biological processes and changes, but the meanings that women attribute to these events and experiences also have implications for women’s sexual self-perceptions, expression, and satisfaction (Daniluk 1998).

Traditional Religious Doctrine and Women's Sexuality: Reconciling the Contradictions

Abstract For many women the connection between sexuality and spirituality is frequently experienced in the context of their past or current religious beliefsbeliefs that privilege intercourse and male pleasure while ignoring much of what is rich and important in womens sexual experiencingresulting in feelings of shame, guilt and disconnection from a vital source of their power and pleasure. The focus of this paper is on the differences between religiosity and spirituality, and how women can be assisted to develop more positive and affirming sexual self constructions and nurture a more empowering sense of spirituality in their lives, in the face of sometimes oppressive religious teachings and beliefs. Suggestions are provided for helping women create more positive connections between their spiritual and sexual selves, irrespective of their religious affiliations and beliefs.

Child Sexual Abuse: Ethical Issues for the Family Therapist

Marital and family therapists working with families where child sexual abuse is disclosed or suspected face ethical confusion that may not be clearly addressed by professional codes of conduct or legal statutes. Ethical dilemmas commonly encountered in family sexual abuse cases are discussed and recommendations for ethical decision making and action are provided.

Integrating Quantitative and Qualitative Methods to Evaluate an Online Psychoeducational Program for Sexual Difficulties in Colorectal and Gynecologic Cancer Survivors

Sexual health is an integral component of quality of life for cancer survivors, and is often negatively impacted by treatment. Geographic limitations often prohibit survivors from accessing sexual health programs designed to address their needs. This study examined the efficacy of an online, 12-week psychoeducational program, which included elements of mindfulness meditation, for sexual difficulties in survivors of colorectal or gynecologic cancer. Complete pre- and postintervention data were available for 46 women (mean age 55.0, SD 9.6) and 15 men (mean age 59.7, SD 6.8). Women experienced significant improvements in sex-related distress (p < .001), sexual function (p < .001 and p < .01), and mood (p < .001); these results were maintained at six months follow-up. Mens improvement in desire was not significant (p = .06), whereas intercourse satisfaction was (p < .05) immediately after the program, but not at follow-up. In order to more fully explore womens experiences, interviews were carried out with six participants and analyzed using narrative inquiry. Women shared a feeling of renewed hope for regaining their sex lives, and expressed that they would have valued an interactive component to the program. These findings suggest that an online, unidirectional psychoeducational program is feasible, and may be effective for women survivors of gynecologic and colorectal cancer, but further work is needed to ensure that online interventions address the sexual health needs of male survivors.