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“By the beginning of the 21st century, there were nearly 40 ways to have a baby that do not involve sexual intercourse.” This sentence in the opening paragraph of the edited volume, Frozen Dreams: Psychodynamics of Infertility and Assisted Reproduction, lets us know right away that assisted reproduction is part of the human technology revolution that challenges core psychoanalytic theory and practice. What's at stake is nothing less than an essential erotic transformation — the separation of conception and eroticism — that threatens to replace the libidinal body with a mechanistic one. Add to this the estimate that infertility effects 6.1 million people — roughly one in ten couples of reproductive age — and it becomes clear that this is a revolution in which we cannot afford to be bystanders.
Yet, few clinicians have been trained to navigate the maze of psychodynamics, medical procedures, and business arrangements that surround infertility. Perhaps the most difficult task confronting the therapist is translating what we already know into useful therapeutic exchanges. The daunting medical trappings and science fiction atmosphere of assisted reproduction distract us from recognizing oedipal dynamics, the fate of desire, and the nature of kinship mired in infertility.
Allison and Jay Rosen's book is designed to chart this territory particularly from the point of view of the therapist. They rightly point out that most books about infertility deal with the emotional toll on the patient. Instead, here the charge to each contributor was “to write a jargon-free chapter about his or her experiences on a difficult topic, to speak about themselves, to come out from behind the curtain of professional expertise, to reveal doubts rather than certainties, to discuss messy decisions under less than optimal circumstances that evoked anxiety.” It was the goal of the editors to illustrate the therapeutic issues regularly encountered when dealing with infertility — namely, evaluation ver