Menopause is often discussed in terms of its symptomology, and it is essential that women, non-binary people, and trans men have sufficient understanding of the process, and can access the right kind of help, treatment or support to manage the transition as well as possible. There are some fantastic people working hard to improve awareness and services which sadly are often lacking. In this blog, however, I’d like to step away from the paradigm of symptom treatment and share some of my thoughts and observations of menopause as a threshold time, and an existential passage.
In my psychotherapy practice I have worked with numerous clients going through menopausal transition and for my research I have interviewed a sample of women about their feelings around ageing and appearance. For these individuals the experience of menopause triggers a profound questioning of who they are, how they wish to live and there is often a sloughing away of what no longer serves them. It is as if they sculpt a new shape for themselves, which is felt literally as the body changes as well as metaphorically and existentially.
The process that they go through is often fraught, emotional – with highs and lows – and can be messy. Many of those I’ve worked with have gone through menopause in midlife and this has brought a confrontation with mortality. As they may grieve the transition away from youthfulness and encounter their ageing, new insights and perspectives often emerge. While the years manifest in the body they can also manifest in experience and wisdom.
The psychoanalyst, Guillermo Julio Montero PhD, shared his view in a talk that during menopause we may respond in one of three ways. We may react with depression, we may act out or we may choose to face it and follow an elaborative path of working through it. This path of working through it is what ultimately leads to transformation.
Working through is an individual process. Menopause has common symptoms but the combination of symptoms and the degree to which they are felt are different. Typically, menopause takes place between the ages 50 to 51 but some go through early menopause before the age of 45. Perimenopause can last up to ten years before menopause. Cultural expectations, social structures and family expectations influence our experience. Cultures that prize eternal youth with embedded prejudices around ageing make the transition more difficult. As individuals we can’t help but internalise some of these views and we may have to visit our own prejudices and find new definitions of ageing.
Psychotherapy can offer a supportive space to work through this transition. It can be turbulent, painful and confusing and a therapist can be alongside you, listening and facilitating the process, and helping to grapple with the deeper questions that emerge.
I want to emphasise that menopause can bring gifts. It is often couched in negative terms as something to endure and get through. Whilst I have no intention of undermining how difficult it is for many people, I have witnessed individuals shaping their lives in more meaningful ways, discovering greater authenticity and feeling less shackled by invisible bonds such as having to achieve, impress or give too much of themselves. I see them grow in wisdom and flourish and live their lives in ways that previously would not have been possible.
Psychotherapy can offer a safe space to explore your feelings, YOU CAN LOOK FOR AN ACCREDITED THERAPIST ON THE UKCP WEBSITE