Mind, body and babies

He comes from a family of 10, and his wife is one of eight. Uncle and aunt to dozens, they are parents to none. Last April, for the first time in years, he sat through an entire Passover Seder.

“I’d begin gasping for breath as soon as the children stood for ‘Ma Nishtana,’” he says. “I’d bolt from the table and sit trembling by myself, even though I knew I was leaving my poor wife alone with all those busy, happy parents.”

What was different about this year’s Seder? “I’d been in a therapeutic workshop with other childless husbands,” he says. “We’d talked openly. I realized others feel the same pain, anger, helplessness. It helped me understand my own feelings – and my wife’s. It gave me tools to deal with them.”

The group, which met weekly for 10 weeks in Jerusalem, was the first mindbody program in Israel for fertility-challenged haredi men. It was run by Keren Gefen, a nonprofit that supports and facilitates mind-body-fertility projects in Israel at no cost.

Keren Gefen was founded and is directed by psychologist Dr. Karen Friedman. “The distress caused by infertility impairs quality of life and also lowers chances of conception,” she says. She cites Harvard studies by Prof.

Alice Domar, an international leader in the field of mind-body medicine, which conclude that mind-body treatment to reduce psychological stress and depression has been shown to increase pregnancy rates by up to 30 percent in women with unexplained infertility.

The only nonprofit of its kind in Israel, Gefen was created to help fertility- challenged women bear the heavy emotional and psychological toll exacted by infertility and its medical treatment.

Its mind-body fertility therapy, cognitive behavioral therapy and restorative yoga groups are led by experienced psychologists, social workers and yoga therapists – among them, eminent clinical social worker Dr. Zvia Birman, a specialist in childbearing issues that include infertility, adoption and surrogacy, who has been treating women, couples and groups for over 20 years.

These experts help participants learn how to cope better with daily life during demanding treatment, while the group itself becomes an important support system.

Gefen began with a pilot project called Rimon in the in-vitro fertilization clinic at Hadassah-University Medical Center on Jerusalem’s Mount Scopus, with the enthusiastic support of hospital director Osnat Levtzion-Korach and IVF unit director Prof. Arye Hurwitz.

Friedman went from woman to woman in the IVF waiting room, telling them: You’re going through a hard process.

It’s normal to feel stressed. We can help. “Some were receptive,” she says, “others not, but many tried us, and most became passionate advocates.”

“We believe there’s a close connection between medical treatment provided by the clinic and psychological therapy,” says Hurwitz. “We see the Rimon Center as a valuable partner in the medical treatment of our patients.”

Rimon “graduates” express the same idea differently.

“It’s clear to me that relieving my stress directly affected my becoming pregnant,” says one.

“I’m finally pregnant after three years... I really feel the therapy and yoga were a winning combination that allowed me to become pregnant... I’m now able to cope with stress, uncertainty, I feel in control,” says another.

“I’m learning to relax and be less unhappy,” says a third. “Feeling that body and soul are together gives me strength to cope.”

Friedman, who grew up in Los Angeles and is a mother of eight, created Gefen because “in Israel, having a child is basically your calling card in society. It’s a country where children hold center stage.

Everything is geared toward them, all the holidays, from Hanukka parties to Purim dress-up. If you don’t have a child, you’re excluded, not really part of the social structure.

“In our social collective consciousness,” she continues, “the loss of the six million, our fallen soldiers, the Zionist ethos of building the land all combine to make bearing children central. Government policy encourages births, with IVF and fertility treatments provided at little or no cost until a relatively late age. But while women may be pumped with hormones month after month, with all their side effects, the government doesn’t provide free psychological support to help these women with the stress and depression they experience.”

With the Rimon pilot demonstrably successful, Gefen expanded its workshops from Hadassah into the community this year. It runs seven groups, each with around 10 participants, running 10 to 12 weeks. Among them are fertility yoga and therapeutic mind-body workshops in the German Colony in Jerusalem, and cognitive behavioral therapy for haredi women in Beit Shemesh. In the past year, 26 of 100 fertility-challenged Gefen couples have become parents.

Along with the existing workshops, two new projects are being piloted at Hadassah-Mount Scopus.

One is Transfer With Tranquility, in which women undergoing embryo implantation are offered one-on-one relaxation sessions before and after the sensitive process.

“We help the women find inner tranquility through breath work and restorative poses,” says Kady Harari, who heads this project.

The second, Pagimoms, reaches out to mothers of premature babies in the neonatal intensive care unit.

“A higher ratio of preemies is born to women treated for infertility, and the mother’s experience can be very stressful,” says Friedman.

Gefen reaches out to these women, offering calming therapy sessions.

According to one: “The session gave me an overall sensation of calm and emotional well-being. I couldn’t believe how my milk supply increased!” With many women in the IVF clinic being ultra-Orthodox, it was only a matter of time until Gefen/Rimon started a group sensitive to their needs, spearheaded by Birman. Friedman was “unsure whether they’d be amenable, but once we got approval and supervision from Toras Hamishpacha [an Orthodox resource for women’s health, fertility issues and Jewish law], recruitment to mind-body workshops and restorative yoga was rapid.”

Harari, who is religiously observant, taught the first haredi yoga group.

“I admire these women who stay true to their identity, yet open themselves to a new world of breathing work and postures and its different way of thinking,” she says.

With the success of this outreach, Gefen was invited by Bonei Olam, a haredi organization that supports childless couples, to run a workshop for its participants, and received highly positive feedback.

If the haredi women’s embrace of Gefen was surprising, what followed was still more unexpected. The women began asking for a men’s group. “You’ve helped us so much!” they insisted.

“What about a group for our husbands?” “Even in California, I suspect you’d have difficulty recruiting fertility-challenged men for mind-body therapy,” smiles Friedman. “But a group formed in no time, men coming from different sects in the haredi community.

A religiously observant male psychologist, mentored by Gefen, along with a haredi rabbi from Toras Hamishpacha led the group. They covered topics ranging from fertility facts, stress-reduction tools and husband-wife communication to dealing with the pain of infertility.

After the final session, the group refused to break up. They continue meeting, with Gefen supplying a therapist once a month.

Constantly reinventing itself, Gefen reaches out to populations with specific needs. One is women to whom egg donation has been recommended – many of whom are shocked that, youthful and healthy as they feel, they can no longer use their own eggs.

Gefen has developed a specialized protocol to address their needs and the searing questions they ask – “Will I really love this child? Will I feel it’s mine?” It helps them cope with these feelings and decide whether egg donation is right for them. It is also in the process of creating a group for women considering fertility preservation.

“Gefen believes in supporting women on their journey to motherhood in many directions,” says Friedman. “Not every mother is blessed with children immediately. There are many ways in which women can develop their motherhood.”

Yoga therapist Harari is a clarion example of “other ways.”

“I’ve been married for over 30 years and undergone numerous unsuccessful IVF attempts,” she says. “There was little awareness then that yoga, breathing and relaxation techniques could have helped, or at least relived some of the anxiety. I feel deep empathy for what the women in my classes are going through, and I’m glad to be at a point where I can help them through these challenges. I’m honored to support them through their journey. All of the love and compassion inside of me for the children I never had is now extended to them.”

Friedman strongly believes Gefen’s help should be accessible to everyone, and there is no charge for participation.

The Stanley & Joyce Black Foundation of Los Angeles and the Pratt Foundation of Australia meet part of the nonprofit’s costs, and Friedman spends each summer in North America fund-raising for the remainder of Gefen’s annual budget.

It’s a budget that needs to grow. Friedman is brimming with plans to address other stations along the fertility roller- coaster.

For more information: www.kerengefen.org