Suite G1, Intercare Medfem Clinic, 1 Nursery Lane, Bryanston, Johannesburg, Gauteng , South Africa
I'm Here to Listen
But Also Here to Learn
Who am I
My Practice
I have been in private practice for nearly thirty years. My career started as the Deputy Director of the Brixton/ RAU Centre for HIV/AIDS in the early 90's. This culminated in the development of a ten-week cognitive behavioural stress management programme. I was offered a joint post as. lecturer for the University of the Witwatersrand and psychologist at TMI's Child and Family Unit, working with children and families. Following my own journey with infertility, IVF and early miscarriages, my passion grew to private practice focussing on infertility, coping with fertility choices and the impact on marriage. This broadened to include forensic work for the field of ART and developing a stress management programme for women prior to, or undergoing ART. The programme was adapted to manage a range of stress-related challenges including burnout, corporate coaching and cancer. Since then, I have specialised in miscarriage, infant loss, Post Natal Depression and grief. I lost my beloved mother to Covid, resulting in work done on the frontline, as a conduit between families and their loved one's isolated by the pandemic. I am the Chairperson of the SIG Counselling Group for SASREG, working on accreditation for clinics in patient care; as well as a contributor to the European Fertility Society's Standards Development Group.
My Treatment Focus
My focus is Cognitive Behavioural Therapy which strongly recognises that thinking drives action. Sometimes we can't change our circumstances but we can change the way in which we think about them. I am amazed at the insights I learn everyday from my patients. As a therapist, I never believe I have all the answers, but every person I meet fills in the blanks- to help others and myself!
My Patient Promise
I became a therapist because I know that all of us need a hand along the way. Freud said: "There are no happy lives, there are happy moments." I am there when the not-so-happy moments happen. It may be that I am here for a reason or for a season.
My Focus
Infertility
This is such a rollercoaster of emotions. Decisions are many, and the helplessness and lack of control can lead to depression, post traumatic stress and marital isolation. Having struggled to have children myself, it is a journey I know only too well. I have helped couple's make decisions, plans and perspective about their journey.
Egg, Sperm and Gamete Donation
Making the decision to use an egg or sperm donor is filled with loss and confusion. There are also many issues on disclosure and transparency. It is a process, but one that can be managed. I have assessed donors for many years, and helped couple's come to terms with moving forward when other avenues have been exhausted. This includes the assessment of known donors and recipients, resulting in Known Gamete Agreements.
Surrogacy
Perhaps one of the hardest and most invasive forms of fertility treatment of which not much is known. A beautiful gift of proportions that are inexplicable but an unknown journey that can be made easier with support. I have been doing forensic surrogacy reports for almost thirty years. South Africa is at the forefront of surrogacy in the world with specific law culminating in a Surrogate Motherhood Agreement, through the High Court. I also focus on mediating surrogacy journeys once the application is granted, managing the relationship between the parties.
Other Areas of speciality
Couple Therapy
Miscarriage and Infant Loss
Miscarriage and Infant Loss
When the question becomes "Is this it?" or "This is it", it's time for some guidance.
Communication skills and relationship decisions. How to navigate challenges in one's relationship.
Miscarriage and Infant Loss
Miscarriage and Infant Loss
Miscarriage and Infant Loss
Losing a baby at any stage of pregnancy or an infant due to premature birth or a child is the most heart- wrenching pain to go through. It feels as though there is no-one who understands and sometimes there are no words...
Grief
Miscarriage and Infant Loss
Grief
Grief comes in waves, and those waves are overwhelming. We initially feel we grabbing onto anything to keep afloat. The waves never stop but the waves become more predictable.
My Blog
Guide for family and friends
April 21, 2020
An American Infertility Support Group (RESOLVE) issued the following advise for their members to give to family and friends. One of the contributing stressors in the journey of infertility is how to manage the reaction and support from family and friends who may not know themselves how to broach the topic. Their well-intentioned support sometimes causes more distress than comfort. Some fertility patients choose not to tell anyone about their journey, but may end up feeling more isolated and alone. Others are forced to tell family or friends, even employers or colleagues, out of necessity to take time off work or to miss significant events. Others choose to share their sadness with those closest to them but sometimes find that the support they long for is not forthcoming. This is not from a heartless disinterest or a deliberate attempt to make one feel worse, but stems from an inability of what to say or a naivety about the subject or just using the incorrect timing to address the subject. The fertility support group, RESOLVE, recommends sending family and friends the following extract to help them understand your journey better.
One of the most difficult challenges of infertility is communicating with the people around you about what may be a devastating crisis. Even the most loving relative or friend might offer a "helpful" suggestion that will appear to be incredibly insensitive and hurtful. Hopefully, this will help the people around you get a grasp on what you are going through.
Well meaning advice
When someone we care about has a problem, it is natural to try help. We often draw on past experiences or people we know and their prior dealings with a topic. When someone has a car in need of repair, the first thing you do is recommend the place you or someone you know took their car to. Generally, though, baby-making advice isn't transferable. What you and your husband did or your first cousin did will generally not impact the person you are talking to. Not only can't your friend use your advise, the sound of it will probably upset her greatly. She is in fact, inundated with this sort of advise at every turn. To the couple who is undergoing infertility treatments, making love and conceiving a child have very little to do with one another.
Every month the husband and wife are confronted with the brutal reality that they have failed yet again. Your well-meaning advise is an attempt to transform an extremely complicated medical problem into a simplistic little problem. By simplifying the problem, you have diminished the validity of their emotions. The best thing you can do for your friend is to simply listen and be sentsive. Think clearly before you speak and before you address topics like reproduction, baby showers and pregnancy. If your friend needs to avoid baby showers or children's parties for a while, don't take this personally. It is not a jealousy about you. She is happy for you, and happy you have achieved your pregnancy or your child's birthday, but this is a painful reminder of what she doesn't have. Sometime it is too painful to deal with so she has to take some "time-out" for a while in order to allow you time to enjoy your special time without feeling guilty or ill at ease.
Why infertility is so upsetting
Most women have the general expectation of motherhood. They have imagined themselves in a motherhood role ever since they played with dolls. When a woman who expected to carry a child is confronted with the possibility of infertility or "barrenness" it is a shocking blow; the same as if she were told she had a terminally illness. Not having a baby can literally feel like a matter of life and death. In the Bible, Rachel was barren. She said to Jacob: "Give me children or I will die..." (Genesis 30:1). infertility counsellors are beginning to view the infertility journey, and coping processes, with Post Traumatic Stress Disorder (PTSD). The experience of infertility is literally the death of a dream. Infertility is the death of the idea of pregnancy and parties celebrating the special nature of pregnancy. It means no maternity clothes, shopping sprees, gender reveals and no strangers commenting on your growing belly at the mall. It is a sacred, assumed state that the woman is counting on that doesn't come through. It is a painful and difficult state. Our culture puts a tremendous focus on reproduction. How many times have you heard people say whilst intently staring at your newborn: "oh, she's got your eyes and his hair." It is a sign of continuation, an investment in the future. And remember, just like with PTSD after a hijacking, certain symptoms start occurring. People, after a hijacking are consumed with anxiety about the event. They think about it all the time. They try to avoid any hooks or triggers that remind them of the event, and they seem to notice newspaper articles and headlines all over, all reminding them of the hijacking.
So they start avoiding situations like driving alone or driving in the dark that might remind them of the trauma. They have difficulty sleeping, and depression may follow. Women going through infertility go through similar reactions. There are constant triggers on social media, at work, in the shops that remind them of their infertility and everyone else seems to be falling pregnant. All conversations seem about babies and children and they begin to feel very isolated and alone. Don't give blanket advise. If your friend received a diagnosis of brain cancer, you wouldn't say: "go on a holiday - that can do wonders for your cancer." Infertility is a medical disease as defined by the Who Health Organisation. Going on holiday will not cure or fix the problem. Other friends you must try avoid saying to your friend: "you're trying too hard", "relax and you will get pregnant" or "what about considering adoption?"
They all discount the medical condition and imply that your friend is defective or too stupid to figure out procreation without your help. Do not criticise your friends medical choices. Medical options are plentiful but they aren't for everyone. Not only that, but people take different time and space to make important decisions. Just because it's an easy decision for you to make from the outside looking in, does not mean that your friend can process what's happening to them as quickly. Don't ask how it's going. No news is always bad news. Let your friend open up and share how her cycle is going. It's better to let your friend decide how and when to share this information. Don't suggest miracle cures or the suggestion of third party options like "just adopt." The insinuation is that infertility isn't so bad - you have other options. It also implies that adoption is second best.
Each holiday marks the passage of time. Other people are progressing in their lives but the infertile couple is in a holding pattern of "hurry up and wait." This is what they do cycle to cycle. Mundane activities like going to the mall is packed with landmines. Seeing pregnant women, families at the park, the baby clothing section at Woolies - all of these things are reminders of infertility and the family they might never have. Even TV adverts remind them of what they don't have - so even watching TV can be scary.
So now what?
Because she is infertile, life is extremely stressful for your friend. She's doing her best to cope. Please be understanding. Sometimes she will be depressed. Sometimes she will be angry. Sometimes she will be physically and emotionally exhausted. She's not going to be the same person she used to be. She won't do many of the things she used to do. She has no idea when, or if, her problem will be solved. She's engaged in a emotionally and financially taxing venture which gets harder with time. Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a childless life. At present, though, she has no idea of what will happen. It's all she can do to keep going from one day to the next. She does not know why this is her lot. All she knows is the horrible anguish that she lives with every day. Please care about her. Please be sentive to her situation. Give her your support. She needs it and she wants it.
Back to you, the individual. As mentioned, the reaction to infertility is completely devastating. It's like a rollercoaster. The beginning of your cycle is met with hope and expectation, only to be followed by two weeks of anxiety as you wait. The arrival of your period is met with despair, tearfulness and feeling all alone. Then it starts all over again. These feelings are pretty much the same as those that accompany PTSD and may include the following:
1. Constantly reliving the trauma: you even dream about it and cannot think of anything else
2. Talking about it all the time or avoiding it completely
3. Struggling to make sense of it
4. Constantly being reminded of it when you see babies in prams, pregnant women and pregnancy announcements and it starts to dominate your life
5. Putting your life on hold. All your plans and goals revolve around "when I'm pregnant" so you end up focussing on where you will be when you ovulate - in the short term - and stalling long term plans like new jobs, holidays, moving house - in the long term.
6. Feelings of helplessness, hopelessness and isolation
7. Feeling that you have little control
8. Suffering from anxiety and depression.
If you are struggling with any of the above symptoms while you are trying to conceive, seeking professional help can go a long way in helping people cope in the situation.
This was altered from RESOLVE's guide to family and friends in the interest of giving family and friends guidelines on how to manage your fertility journey. Mandy's passion is working with couple's and individuals going through the fertility journey, making decisions as to the next step, making use of third party options like surrogacy or donor gametes and reducing stress so as to maximise pregnancy. Mandy has undergone two early miscarriages, along with three IVF's to have her family. She also presented with cancer a few years after having her third child, and went through the same grief of emotions with her diagnosis. However, she found that with her cancer diagnosis, there was more support, less advise and more compassion. There was also a high rate of recovery with her particular cancer following chemotherapy and surgery; higher than her chances of conceiving a child. What she also found very different was that her oncologist took control of the situation, not leaving her to ponder on the next step forward. She recalls feeling more in control with her cancer than with her infertility journey. Mandy is active on all forms of social media posting minute clips on all topics related to infertility.
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my blog
Guide for family and friends
April 21, 2020
An American Infertility Support Group (RESOLVE) issued the following advise for their members to give to family and friends. One of the contributing stressors in the journey of infertility is how to manage the reaction and support from family and friends who may not know themselves how to broach the topic. Their well-intentioned support sometimes causes more distress than comfort. Some fertility patients choose not to tell anyone about their journey, but may end up feeling more isolated and alone. Others are forced to tell family or friends, even employers or colleagues, out of necessity to take time off work or to miss significant events. Others choose to share their sadness with those closest to them but sometimes find that the support they long for is not forthcoming. This is not from a heartless disinterest or a deliberate attempt to make one feel worse, but stems from an inability of what to say or a naivety about the subject or just using the incorrect timing to address the subject. The fertility support group, RESOLVE, recommends sending family and friends the following extract to help them understand your journey better.
One of the most difficult challenges of infertility is communicating with the people around you about what may be a devastating crisis. Even the most loving relative or friend might offer a "helpful" suggestion that will appear to be incredibly insensitive and hurtful. Hopefully, this will help the people around you get a grasp on what you are going through.
Well meaning advice
When someone we care about has a problem, it is natural to try help. We often draw on past experiences or people we know and their prior dealings with a topic. When someone has a car in need of repair, the first thing you do is recommend the place you or someone you know took their car to. Generally, though, baby-making advice isn't transferable. What you and your husband did or your first cousin did will generally not impact the person you are talking to. Not only can't your friend use your advise, the sound of it will probably upset her greatly. She is in fact, inundated with this sort of advise at every turn. To the couple who is undergoing infertility treatments, making love and conceiving a child have very little to do with one another.
Every month the husband and wife are confronted with the brutal reality that they have failed yet again. Your well-meaning advise is an attempt to transform an extremely complicated medical problem into a simplistic little problem. By simplifying the problem, you have diminished the validity of their emotions. The best thing you can do for your friend is to simply listen and be sentsive. Think clearly before you speak and before you address topics like reproduction, baby showers and pregnancy. If your friend needs to avoid baby showers or children's parties for a while, don't take this personally. It is not a jealousy about you. She is happy for you, and happy you have achieved your pregnancy or your child's birthday, but this is a painful reminder of what she doesn't have. Sometime it is too painful to deal with so she has to take some "time-out" for a while in order to allow you time to enjoy your special time without feeling guilty or ill at ease.
Why infertility is so upsetting
Most women have the general expectation of motherhood. They have imagined themselves in a motherhood role ever since they played with dolls. When a woman who expected to carry a child is confronted with the possibility of infertility or "barrenness" it is a shocking blow; the same as if she were told she had a terminally illness. Not having a baby can literally feel like a matter of life and death. In the Bible, Rachel was barren. She said to Jacob: "Give me children or I will die..." (Genesis 30:1). infertility counsellors are beginning to view the infertility journey, and coping processes, with Post Traumatic Stress Disorder (PTSD). The experience of infertility is literally the death of a dream. Infertility is the death of the idea of pregnancy and parties celebrating the special nature of pregnancy. It means no maternity clothes, shopping sprees, gender reveals and no strangers commenting on your growing belly at the mall. It is a sacred, assumed state that the woman is counting on that doesn't come through. It is a painful and difficult state. Our culture puts a tremendous focus on reproduction. How many times have you heard people say whilst intently staring at your newborn: "oh, she's got your eyes and his hair." It is a sign of continuation, an investment in the future. And remember, just like with PTSD after a hijacking, certain symptoms start occurring. People, after a hijacking are consumed with anxiety about the event. They think about it all the time. They try to avoid any hooks or triggers that remind them of the event, and they seem to notice newspaper articles and headlines all over, all reminding them of the hijacking.
So they start avoiding situations like driving alone or driving in the dark that might remind them of the trauma. They have difficulty sleeping, and depression may follow. Women going through infertility go through similar reactions. There are constant triggers on social media, at work, in the shops that remind them of their infertility and everyone else seems to be falling pregnant. All conversations seem about babies and children and they begin to feel very isolated and alone. Don't give blanket advise. If your friend received a diagnosis of brain cancer, you wouldn't say: "go on a holiday - that can do wonders for your cancer." Infertility is a medical disease as defined by the Who Health Organisation. Going on holiday will not cure or fix the problem. Other friends you must try avoid saying to your friend: "you're trying too hard", "relax and you will get pregnant" or "what about considering adoption?"
They all discount the medical condition and imply that your friend is defective or too stupid to figure out procreation without your help. Do not criticise your friends medical choices. Medical options are plentiful but they aren't for everyone. Not only that, but people take different time and space to make important decisions. Just because it's an easy decision for you to make from the outside looking in, does not mean that your friend can process what's happening to them as quickly. Don't ask how it's going. No news is always bad news. Let your friend open up and share how her cycle is going. It's better to let your friend decide how and when to share this information. Don't suggest miracle cures or the suggestion of third party options like "just adopt." The insinuation is that infertility isn't so bad - you have other options. It also implies that adoption is second best.
Each holiday marks the passage of time. Other people are progressing in their lives but the infertile couple is in a holding pattern of "hurry up and wait." This is what they do cycle to cycle. Mundane activities like going to the mall is packed with landmines. Seeing pregnant women, families at the park, the baby clothing section at Woolies - all of these things are reminders of infertility and the family they might never have. Even TV adverts remind them of what they don't have - so even watching TV can be scary.
So now what?
Because she is infertile, life is extremely stressful for your friend. She's doing her best to cope. Please be understanding. Sometimes she will be depressed. Sometimes she will be angry. Sometimes she will be physically and emotionally exhausted. She's not going to be the same person she used to be. She won't do many of the things she used to do. She has no idea when, or if, her problem will be solved. She's engaged in a emotionally and financially taxing venture which gets harder with time. Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a childless life. At present, though, she has no idea of what will happen. It's all she can do to keep going from one day to the next. She does not know why this is her lot. All she knows is the horrible anguish that she lives with every day. Please care about her. Please be sentive to her situation. Give her your support. She needs it and she wants it.
Back to you, the individual. As mentioned, the reaction to infertility is completely devastating. It's like a rollercoaster. The beginning of your cycle is met with hope and expectation, only to be followed by two weeks of anxiety as you wait. The arrival of your period is met with despair, tearfulness and feeling all alone. Then it starts all over again. These feelings are pretty much the same as those that accompany PTSD and may include the following:
1. Constantly reliving the trauma: you even dream about it and cannot think of anything else
2. Talking about it all the time or avoiding it completely
3. Struggling to make sense of it
4. Constantly being reminded of it when you see babies in prams, pregnant women and pregnancy announcements and it starts to dominate your life
5. Putting your life on hold. All your plans and goals revolve around "when I'm pregnant" so you end up focussing on where you will be when you ovulate - in the short term - and stalling long term plans like new jobs, holidays, moving house - in the long term.
6. Feelings of helplessness, hopelessness and isolation
7. Feeling that you have little control
8. Suffering from anxiety and depression.
If you are struggling with any of the above symptoms while you are trying to conceive, seeking professional help can go a long way in helping people cope in the situation.
This was altered from RESOLVE's guide to family and friends in the interest of giving family and friends guidelines on how to manage your fertility journey. Mandy's passion is working with couple's and individuals going through the fertility journey, making decisions as to the next step, making use of third party options like surrogacy or donor gametes and reducing stress so as to maximise pregnancy. Mandy has undergone two early miscarriages, along with three IVF's to have her family. She also presented with cancer a few years after having her third child, and went through the same grief of emotions with her diagnosis. However, she found that with her cancer diagnosis, there was more support, less advise and more compassion. There was also a high rate of recovery with her particular cancer following chemotherapy and surgery; higher than her chances of conceiving a child. What she also found very different was that her oncologist took control of the situation, not leaving her to ponder on the next step forward. She recalls feeling more in control with her cancer than with her infertility journey. Mandy is active on all forms of social media posting minute clips on all topics related to infertility.
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