Hopeful Pessimism

13 November 2025 By  Dr Devora Lieberman The Quiet Strength of Those Facing Infertility Between longing and self-protection lies a mindset that may help many navigate the uncertainty of infertility — holding on to hope, while bracing for heartbreak. I was recently listening to an episode of the Gray Area podcast where the host, Sean Illing, spoke with philosopher Mara van der Lugt about her book Hopeful Pessimism and its connection to climate change. Something she said stopped me in my tracks.  She described hopeful pessimism as a way of staying engaged in the face of uncertainty — of continuing to act, even when the odds aren’t in your favour. In that moment, I had a light-bulb realisation: this concept beautifully captures what so many people experiencing infertility live every day.   Defining Hopeful Pessimism  In my years of working with women and couples navigating infertility and IVF, where statistically we give bad news about outcomes more often than good, I advise: “Hope for the best, but expect the worst.” And people often tell me: “I’m trying to stay hopeful, but I don’t want to get my hopes up.” It’s such a human thing to say — sitting right in that space between longing and self-protection. The concept of hopeful pessimism resonated so strongly with me because it describes that very ability to hold hope and realism together at the same time. Hopeful pessimism is the mindset of preparing for the worst while still maintaining a thread of hope that things might turn out well. It’s not the same as toxic positivity (pretending everything is fine) or pure pessimism (assuming failure). Instead, it’s a pragmatic balance — acknowledging the challenges and uncertainties of infertility while still investing emotionally in the possibility of success.

  It isn’t giving up; it’s an act of emotional wisdom. It’s how many people protect their hearts while still daring to dream. In the uncertain world of fertility treatment — where science and chance are intertwined — it can be an adaptive, even courageous stance. By preparing for disappointment, people often find a way to stay grounded and keep going. This mindset doesn’t make hope smaller; it simply holds it more carefully. It’s a flexible hope — one that can bend without breaking. As clinicians and support people, we can honour this balance by not pushing relentlessly for positivity, but by creating space for both hope and fear to coexist. Real compassion lies in recognising that strength doesn’t always sound like optimism — it often sounds like quiet realism spoken through tears. Holding hope, while knowing it might hurt, is one of the bravest things a person can do. A patient of mine who works in disaster relief wrote to me after reading an earlier version of this article: ‘The parallel between climate anxiety and infertility is SO interesting, and in some ways it’s like IVF is the climate anxiety and negative outcomes are the disasters (the flood, fire, cyclone) and for some those disasters become compounding and concurrent, along with several other challenges in life.”

  Where the Idea Comes From The term hopeful pessimism isn’t a formal psychological diagnosis, but it captures something many people living with infertility instinctively practise — holding on to hope while preparing for disappointment. Its roots can be traced to two key psychological ideas. Defensive Pessimism — coined by psychologists Nancy Cantor and Julie Norem in the 1980s — describes how people manage anxiety by imagining possible setbacks and planning for them. Far from being negative, it can help people stay motivated and emotionally prepared. Tragic Optimism — introduced by psychiatrist and Holocaust survivor Viktor Frankl — reflects the ability to maintain hope and purpose even amid pain and loss, saying “yes to life, in spite of everything.” When we talk about hopeful pessimism in the context of infertility, we’re describing the meeting point of these two ideas: emotional realism woven with a thread of hope. It’s how many people protect their hearts without giving up on their dreams. Psychological Functions Hopeful pessimism offers several subtle but powerful emotional functions. It helps regulate emotions — tempering the intense swings between hope and despair that so often accompany fertility treatment. By managing expectations, people can soften the blow of disappointment while remaining engaged in the process. It also restores a sense of control and preparedness in a situation that often feels uncontrollable. Anticipating setbacks doesn’t necessarily invite them; it helps people plan for how they’ll respond, making them feel more anchored and less at the mercy of chance. Finally, hopeful pessimism sustains engagement. Research on defensive pessimism shows that envisioning possible obstacles can motivate people to prepare, persist, and refine their approach — traits that are crucial on the long, unpredictable road of infertility.

  Clinical and Emotional Implications In fertility care, this mindset shows up in countless quiet acts of courage. It might be the patient who continues IVF cycles while mentally rehearsing how they’ll cope if the outcome is negative, not to numb themselves but to stay emotionally steady. It’s the couple who begin early conversations about donor eggs, adoption, or child-free living — not as surrender, but as a way of maintaining agency and perspective. It’s also there in the small phrases patients use: “I’m cautiously optimistic.” Those words, so common in fertility clinics, carry layers of meaning — signalling emotional realism rather than defeat, a recognition that hope and heartbreak can coexist. For me as a doctor, I believe that recognising and validating hopeful pessimism can be profoundly supportive. When clinicians and friends and family acknowledge this balance instead of insisting on unrelenting positivity, people often feel seen rather than dismissed. They can engage in their treatment from a place of both vulnerability and strength. The Tension Between Hope and Realism Infertility involves chronic uncertainty — each cycle a complex blend of science, chance, and emotion. Hopeful pessimism allows individuals to maintain hope as a vital life force, a connection to meaning and future possibilities, while also cushioning themselves against the emotional whiplash that can follow unsuccessful cycles. This balanced stance helps protect against the exhaustion that comes from constant optimism, but it does require care. If pessimism outweighs hope for too long, it can slip into disengagement or depression. Therapeutic support can help people recalibrate — ensuring that realism doesn’t become resignation. A Closing Reflection In fertility care — and in life — hopeful pessimism reminds us that strength doesn’t always shine brightly. Sometimes it’s quiet, cautious, and steady. I often marvel at how many people have carried themselves through impossible uncertainty with this quiet courage. If you’ve ever balanced hope and realism through your own fertility journey — or supported someone who has — you’ll know how delicate that balance is. Because maybe, in that small space between hope and fear, we find the truest form of resilience. About the Author Dr Devora Lieberman is a fertility specialist, Medical Director of City Fertility NSW, women’s-health advocate, and host of the Empowered Fertility podcast. She writes about the emotional, social, and medical realities of reproductive care, helping people navigate their paths with knowledge, compassion, and self-trust.