Clinical Implications

A number of recommendations are made for working with childfree women aged 45-55, which can be widened to women of all ages, including those who ultimately decide upon motherhood. This is because the exploration of values, meaning, ambivalence, possible stigma, and perception of motherhood and pregnancy would be appropriate to help many women with their sometimes difficult choice. As the experience of childfreedom is one of complexity and nuance, for purposes of clarity I have here listed recommendations under the four worlds. However, the different dimensions as well as the suggestions below are neither disparate nor a ‘check list’; people do not separate themselves into neat points but are complex and moving bundles of paradoxes, overlaps and contradictions.

The Physical World

Women experience varying degrees of bodily ‘speaking’ or ‘silence’ with reference to mothering desires and therapists should attend to the embodied experiences of clients. Oscillating desires might be confusing, but are a natural process to be borne rather than poles to be reached and maintained. Assumptions about childfree women’s experience of reaching the menopause need to be avoided as this is again a very individual experience; though a natural female process, the experience of it ranges from something gladly anticipated to an unpleasant reminder of ageing. Although none of the women in my study expressed regret for this choice, this is not an impossibility and may also be seen in therapy. The existential model of psychotherapy assumes that anxiety is part of being human because we are beings toward death. Acknowledgement that being childfree means leaving no genetic legacy after death is to be welcomed into the therapeutic environment, not covered over or hidden from view. Legacy may be felt to be what has been achieved or given during a lifetime, and how that life has been lived

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The Personal World

Without direct responsibility for children, it is shown that it becomes easy to feel untethered or selfish without choosing other areas of life in which to connect and take responsibility; therapists may enable clients to recognize the dual nature of freedom from and responsibility to other aspects of their worlds.

Existential therapists also have a potentially difficult path to tread in terms of viewing people as ever changing and in flux, whilst simultaneously respecting what is felt as an unchanging personality trait. As shown by my participants, desiring childfreedom is experienced along a spectrum from unchanging certainty to continuous ebb and flow. Therapists need to be open to this spectrum without making assumptions based upon views of women or indeed personality ‘type’, as well as accepting that there is no ‘right’ answer to be arrived at. An existential approach

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to psychotherapy recognizes the nature of choice being an unavoidable aspect of existence; by its very nature, choice means sacrifice in other areas and this is again something to be embraced rather than shied away from. This might be an aspect of the therapeutic relationship that could be beneficial to both client and therapist; both must choose, or be given in the form of fertility problems, a place on the parenting – childless spectrum (Letherby, 2002), and each must therefore recognize what has not been chosen. Without judgement or comparison, this could therefore be a mutual journey of learning and growth for both client and practitioner.

The Social World

In this dimension women are free to choose how much to dedicate themselves to partners, friends and the children of others. This freedom sometimes brings up feelings of selfishness, which in turn causes confusion and guilt and is linked to feelings about their own identity as well as how they believe they are perceived by others. Existential psychotherapy has at its heart the phenomenological exploration of clients’ lived experience, part of which could be to clarify a woman’s sense of self and help her achieve self-esteem and autonomy, both qualities thought to aid midlife health (Giele, 1982; Apter, 1995). Simultaneously, work could focus on areas of navigating the social world including exploring degrees to which each client feels comfortable revealing or containing their privacy about being childfree. Normalizing the choice rather than pathologizing it is also hugely important.

My participants appeared to successfully manage their marriages and relationships in terms of differing preferences to childfreedom or parenting, but this might well be an aspect of therapy seen in both individual and couples work. As van Deurzen and Iacovou (2013) state, existential therapy encourages clients to confront conflict, difference and limitation within relationships. The meanings and implications for both parenthood and childfreedom should be explored in order for clients to achieve respect and compassion for their partner’s desire, even when it is felt to be incompatible with their own. The therapist is not there to fix the situation but to help explore and clarify, and ultimately to help the client or clients take responsibility for their own actions and the consequences of them personally and in relationship.

The Spiritual World

Non-parenthood for some means the freedom to take an inner, spiritual journey. The contrasting pole is experiencing meaninglessness within this freedom. It might be that meaning is seen to be inherent in the lives of parents, so therapists might aid childfree people in turning away from comparison to parents and seeking other areas in which meaning and purpose can be created and felt. An existential approach does not dictate where meaning might be found; the values of the practitioner are likely to draw him or her to various religious or secular writers such as Kierkegaard or Sartre, but these are personal values that may not be shared by the client. It might therefore be that the therapist is a fellow traveller along the path to seeking meaning in life, but each individual’s path may end up in a very different place. Therapists who find great meaning in being parents themselves would need to bracket this as they would bracket any other difference in order to help clients explore their own values and seek their own meaning elsewhere.

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All of the above would also apply to supervisors working with the therapists of childfree women.

Implications for Theory

The participants describe a lived world of childfreedom that is not pathological, strange, selfish, immature, or irresponsible. They live diverse lives in their middle years, took diverse routes to being without children, and experience themselves within very different social and personal worlds. I therefore posit that reproductive choice should be free of notions of normality and difference; being without children, wherever one falls on the continuum of choice and agreeableness with this choice, should be without stigma or judgement. In line with Judith Butler’s (1990) argument, the category ‘woman’ cannot be defined and understood as unified and as wholly discrete from ‘man’; the random facticity of sex into which one is born without any choice should not dictate anything more than a potential or possibility to mother. In this way all women would benefit; those who cannot, those who will not, and those who simply did not, would become of equal visibility, relevance, and validity.