Change for the better
Menopause occurs at a time in life that can be exciting, vital and transforming
By Patti Carmalt-Vener 06/24/2010
Dear Patti,
My wife Wanda is having a difficult time getting through menopause. Luckily, she has a competent, responsive doctor she trusts and who I believe advises her appropriately as to what medical support, medications and supplements are needed to minimize her symptoms. Even so, Wanda is really having a hard time emotionally.
At my urging, we met with her doctor together who explained that — due to hormonal changes — it’s common to have mood swings that, in part, are physiological. He also told us that sometimes there can be psychological reasons for these emotional lows and recommended psychotherapy.
I’m not sure Wanda is clinically depressed, but she can become extremely sad. She’s a wonderful woman who has always taken care of everyone else, and it’s very hard to witness what she’s going through. I wholeheartedly support her going to counseling but how, specifically, can this help her?
— Edward
Dear Edward,
Although menopause is a natural biological event in a female’s life, some women have a difficult time maintaining their feminine identity and sense of self-esteem when they experience the loss of fertility. Not only are there psychological issues, but there is cultural conditioning as well, in terms of commonly held perceptions and values ascribed to youth, sexiness and motherhood. The grief that you describe may stem from seeing this chapter as a serious ending to the various roles by which she has been defined throughout her life and marriage. It’s also not uncommon for this sense of loss to play directly into a fear of aging and being devalued by others.
Wanda’s therapy will support her to work through her feelings and to shift from a loss-based framework to a new definition and sense of self. Hopefully, she’ll then discard any attachment to destructive gender-role stereotypes and learn to not only respect and value the wise and mature person she has become, but to act on it with appropriate perspective, empowerment and vision. One therapeutic goal will be for Wanda to experience menopause as a transitional passage of development to a new and more liberating stage in her adult life. By striving to help her view menopause as a natural, normal process, her therapy sessions will allow her to challenge the negative beliefs about women growing older.
Compounding the biological and emotional adjustments inherent in menopause is the fact that women of this age are often taking care of dependent children as well as aging parents or grandchildren. In addition, they may be going through career changes or upheavals in their relationships. These high-stress scenarios often result in lack of sleep, fatigue, poor nutrition, lack of exercise, and leave little time for recreation/relaxation activities and can exacerbate menopausal symptoms. Accordingly, another goal of therapy will be for Wanda to focus on her own needs and well-being rather than continuing to lead a hectic life of self-sacrifice in which she has traditionally taken care of everyone else first. It’s time for her to value her own physical and emotional health, professional or academic pursuits, hobbies or interests, dreams and desires. To that end, it may be beneficial to learn how to delegate responsibilities and set healthy boundaries so that other family members can assume some of the household burden.
Keep in mind that the women of today are in a much more favorable position than their ancestors — many of whom died prior to ever reaching menopause. A therapist can educate Wanda on the resources and options available to her. Given that a female’s average life expectancy is between late 70s and mid-80s, women will spend nearly a third of their lives postmenopausal. Not only does this mean they will live over 30 years beyond menopause, but they’ll also be more vibrant than ever before.
Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at
(626) 584-8582 or email pcarmalt@aol.com.
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