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The menopause and psychotherapy: or why “The Change” is a great time to start therapy!

What do you feel about the menopause?  Are you safely through it, dreading its arrival, or in the middle of hot flushes and confusing hormonal changes?  Is it something you talk about?



I have just been reading a fascinating thesis looking at the role of the menopause in psychotherapy: what clients want to talk about, and the issues that come up between client and therapist.   Its written by an Australian, Margot Hinton, and I include a link to her paper at the end of this blog.

She  reflects that in some societies, such as Native American Indian and Maori, the menopause is seen as a transition to an age of power, and wisdom, and to a position of greater and different value in society.   Unsurprisingly, women in these cultures tend not to have too many problems with the menopause.  This is in marked contrast to the way Western society talks about “The Change”: a time of loss, the end of femininity, a medical problem to be addressed with drugs, the start of decreptitude, bone loss and osteoporosis, depression and mood swings.

The Victorians saw it as an affliction of the blood, with the menstrual blood going to the brain, and prescribed leeches and bloodletting. It was also linked to death as in the days when life expectancies were much shorter, the menopause would occur at the end of many womens’ lives.  Once Freud got involved things really went downhill.  Hinton builds up the case that the menopause is as much socially constructed as it is a physical reality.

This element of social construction is really important, as it means that we as women, have a choice as to how we see ourselves in this experience.  She identifies five core themes:

  • ·      Silence – that the role of the menopause is unconsidered in therapy, when in fact it may be a significant, hidden issue.
  • ·      Loss and fear of loss: of youth, of fertility, of feminine power
  • ·      Relationships with their mothers – and their therapists!
  • ·      Growth and maturity as these tensions are disentangled
  • ·      A renewed sense of self: acceptance, freedom and self determination

I can certainly relate to all of these, both in my own therapy, and in my experience with clients. It is very easy to overlook the possible impact of the menopause, particularly in the fear and sense of loss that surrounds it.  I was intrigued by it being a time when women really address their relationships with their mothers, and from this, gain a real power to be themselves.  It seems to me that this is a tremendously creative time, if we can just grasp the nettles of the change itself.

Those nettles might be the challenge of finally growing up, of accepting our mortality, of looking after our body through nutrition and exercise.  Denial can work well for much of our life, but the menopause is the time to meet, and embrace, reality.  And I believe there is life and excitement in that.

Hinton’s paper can be found at

If you are interested in health and nutrition, you might consider a hair test MOT from The Health Detectives: 

For an extremely comprehensive (long) and positive guide see Northrups book “The Wisdom of the Menopause”



What Easter means to me

Each year, despite having very vague beliefs about Christianity and some misgivings about organised religion, I find myself drawn to attend church services, to hear the Easter story once more, to get drawn into the unfolding drama.

This year I went to a thought provoking and moving Maundy Thursday service. I was touched by the vulnerability of the people who offered their bare feet to be washed, and how open they made themselves.  The service ended with the church in silence and darkness, with all fineries stripped away, and just a candlelit chapel left, in which a payer vigil would continue through the night. I went to a short Good Friday service where we laid candles on a cross on the floor, and as I watched them flickering it seemed as if we were watching the fragile hopes of everyone in the world.

Having entered into the depths of despair and fragile, flickering hope I wanted to continue the story to its conclusion, and so we attended a church in the village in which we were staying.  As we entered the sense of excitement and anticipation was infectious.  The church was full of crosses decorated in every possible way imaginable, including one made of crosswords, a peace cross of white poppies, another created with the workings of a bicycle and many, many more, of every colour and size. Instead of a sermon, five parishioners stood up and spoke about what Easter meant to them, deeply personal and moving accounts of faith and experience. It seemed that the vicar had got everyone in the village involved in some way, and I felt privileged to have been invited to share this, even if I couldn’t muster the same degree of faith in the detail of the story.

But the big story is important.  Easter is a time of hope, and so often, it seems that my work is to nurture and restore hope.  Hope is the uniquely human quality that keeps us alive, and is always there, even if at times, its flame becomes tiny and flickering.  Easter restores my faith in the capacity of human beings to recover and build again after terrible suffering and despair. 

Easter also comes at a time when we celebrate the start of spring, and the end of winter.  As I dig the ground ready for this year’s crops, and see bright green buds emerging on the empty trees, it is another reminder that life goes on, and that new life does start once again.



new: Tuesday evening sessions

I know it is sometimes hard for people to come during day time hours to counselling, so to make my practice more widely accessible, I will be offering two sessions on a Tuesday evening between 7pm and 9pm.  I will be using a room in central Ilkley as a back up to my normal therapy room at home, thus allowing a bit more flexibility. Im excited about this and look forward to welcoming new people to my practice.  For more information contact me on 07866 323291 or email me.


Is “In Therapy” typical of psychotherapy?

I have been listening to “In Therapy”; fifteen minutes of dramatized therapy sessions with psychoanalyst Susie Orbach, on radio 4 (available now on I-Player).  Played very convincingly by actors, at one level they are fascinating, as she stands back and comments on what she is doing and why, but I also found myself wondering whether I would want to go to her as a client. 

I was struck by how detached she seemed, and by the power she exerted in the room.  At one point as “Harriet” talked about her grief, Orbach seemed to me relentless in pointing out quite how bad things were, and she made me wonder if I was like that too with my clients.

I think there are some important similarities between my work and what you can hear in these programmes.  Orbach emphasises the client’s need to be heard, to be understood, to be with someone who can go with them as far as they need, who won’t bottle out when the going gets too painful.  She clearly does this well, and I would equally aspire to do this.

The differences are also important.  My training is in a more relational style, where I might well disclose how I am impacted by a client’s story and emotions.  I do help people explore painful and dark places, and it is possible that I may need to be more detached than I currently am, but it is important to me that this is done in a kind and gentle way.   I also believe in helping people build up the resources they need to move on, and to check regularly whether therapy is meeting their needs.

My sense is that Susie Orbach reminds me of a distinctly scary therapist I went to some years ago.  We are all different, offering different potential relationships, so it is really important, if you are considering therapy that you choose carefully and talk to potential therapists first before making a choice.  And use the first few sessions to decide whether you have made the right choice: it will be usually be pretty clear whether the relationship is going to work for you or not by the third or fourth session.

 If you would like to talk about what you are looking for from therapy or counselling, why not give me a call on 07866 323291 or email me.

You can listen to the programmes here


Self Compassion - Dr Kristin Neff really has a point

I have just been watching Dr Neff's very acessible TED talk,  in which Dr Kristin Neff outlines the difference between self esteem and self compassion.  She points out how self esteem is often so much at the expense of others how we are doing in relation to others.  And, as she points out, we can't all be above average.   (Even if it does feel good).  She talks about an epidemic of narcissism sweeping the US (and presumably here too) as we all need to be seen to be wonderful.  And quite honestly, most of us are pretty ordinary. Human even.

I think the most compelling argument she presents in the video is that a focus on self esteem separates us from others, whilst a focus on self compassion brings us together, recognising that we are human, we are on this earth together and we are only alive in this moment.  And it is this connection and acceptance that is key to our sanity, and indeed to the future of our planet.

That really resonates with me, even if I need to practice being self compassionate before I can really walk the talk.

You can find the talk here:

What do you think?