There are two sides to this; the obvious one being that I am a Clinical Psychologist and so tend to look at things through a certain lens and attempt to develop a better understanding. That lens is a scientific, evidence based lens that looks at biopsychosocial factors that contribute to a situation or issue. It’s also a compassion focussed and trauma focussed lens, as that was my area of specialism. The second side of this, well you may as well throw all the previous out of the window! Because it’s the experience of the person who is living it and what they make if it. People have often said “oh you must be really good at parenting because you’re a psychologist and know what to do” – Ha! No! It impossible to apply logic and meaning to yourself when you’re in the thick of a tricky situation. This is because of the different areas of the brain that take over in different situations. Under stress our primitive fight or flight brain kicks in and the thinking brain goes offline temporarily. That’s why we often do or say things we later regret! Although our brain only ever does what it needs to keep us safe. After the situation is over, our thinking brain kicks back in and we can be plagued with over analysis, guilt and worry. These are higher level emotions than pure fear or rage. I would like to think, however that being a parent has helped me to be a better psychologist. So I’m hoping, the same is true here of applying psychology to the Perimenopause- it doesn’t necessarily always help and I’m not able to fully formulate it yet, as I’m still in it, but going through the perimenopause will hopefully help me to grow a little more as a psychologist, with yet more insight and empathy. Despite me not being able to reconcile both sides of my experience yet, psychologist and case study, I am go to try to attempt to develop a bit of a formulation of my own situation (sharp intake of breath fellow psychs! Why would she do this? I know, I think I’ve finally lost the plot!). This is a work in progress…
Like any other life stage Perimenopause is a time of transition. This can create stress and activate previous difficulties, traumas, and ways of coping. Us humans are complicated beings and anything we experience is best understood by looking at the many intertwining factors that are at play. It’s not just our bodies, it’s our minds. We are one whole person made up of physical matter and soul. To simplify this, one of the most basic models in clinical psychology is the 5Ps model (audible groan from fellow clinical psychs!) This model is just one way that prompts the assessor to consider the following on meeting a new client or situation for the first time:-
Problems – what is the person presenting with that they are finding difficult to manage? For me it was memory difficulties, loss of confidence, exhaustion, tearfulness and erratic periods becoming much heavier later on. Maybe note down all of your “problems” including physical, emotional and social if you want to join in!
Predisposing – what factors in earlier life have shaped how a person copes in life and shaped their beliefs and relationships with self and others. Woh okay potentially lots of personal disclosure here- let’s just say moving house age 11 was a big deal for a sensitive, quiet little thing (honestly I am!) , some bullying but nothing major, stomach problems which I now know are linked with stress, need to please personality and wanting to make everything better. We’ll leave it there! Obviously there’s a loooooot more to it! You could have a think too, noting any major life events, losses, traumas, hurts, illness, difficult relationships but positive ones too and strengths. We develop attitudes and beliefs and these range from big important ones called core beliefs like, “I can trust others, the world is dangerous, bad things happen, I’m weak” etc to little every day ones like “I must be productive, if not I’m lazy, I need to be in control, others don’t care, or what if I’m not ok?” Are you aware of your beliefs and how these influence your decision making, your health, your mood, your actions? Have a think about your default beliefs and assumptions. Simply doing this separates you from them, creating an opportunity for reflection, but also helps to see these as cognitive events not defining truths.
Precipitating- what triggered this episode of distress? 🙋♀️ we all know the answer to this one and yet there’s almost definitely more to it. Speaking personally, it was a combination of factors that led to me feeling like I wasn’t coping as I used to- yes hormonal changes and the onset of the Perimenopause but also life stage specifically the ages of my children (young teens), other life stresses and responsibilities at work. The nature of my work I think also contributed and although each case was so rewarding to work with, the total sum of the total weight of the work felt heavy towards the end. Symptoms of the Perimenopause simply tipped it over the edge from yep we’re just about keeping all this together into nope I’m losing the plot, something’s got to change. As well as triggers to the episode, it’s also useful to consider daily triggers ie what makes me feel worse and better daily. I’m getting my head round this now- I know I need to make an effort to engage with people otherwise I can feel left out (early life link), I need sleep, I need to try to eat well, I need to be outdoors, I need to be boundaried and say no to some things (early life link) , but under stress we all slip back to our default and these are the times I can feel less great – busy times when I’ve over scheduled, times when I’ve isolated too much (I’m an introvert mostly so will happily potter on my own but I need contact too!) , when I’ve slept badly or am worrying about others. There will be other biological triggers but I find these harder to identify. I think my diet influences my mood sometimes. Obviously hormones fluctuating at the moment is the biggie. Certainly it’s these additional biological fluctuations have shifted something for me as I was ticking along okay before. I could identify that PMT was a factor in my mood before and this seemed predictable and I eventually got used to it, but when periods started to be more erratic, it was much harder to predict. Definitely when bleeding or cramping now, this effects my mood. We know that pain massively effects concentration too so this is a tricky combo when you’re trying to work and concentrate and you have brain fog too. So maybe you could have a think. Roughly when did you start to think “Maybe I’m Perimenopausal”? What else was going on in your life? What stresses, responsibilities and changes were happening and providing a perfect storm to feel like you weren’t coping as well as before? Bear in mind you might not be Perimenopausal yet! But the same process of making sense of how you’re feeling still holds at any point in life.
Perpetuating- this is the bit that gets interesting but tricky to disentangle. What factors are keeping me feeling stuck and not coping? This is interesting as it often points to what we can do to change things or what we need to work on accepting, in a psychological way. For me the things that were keeping me stuck were a sense of responsibility to those around me that meant I often ignored my own needs and took on too much. I’ve needed to accept my limits and work on self compassion including looking after myself equally to others, plus being a bit more assertive. Looking back I spent too much time in drive mode, working and being productive and neglecting just being and resting.
I spotted some unhelpful thoughts that were keeping me stuck and preventing me from seeking help from those around me and from going to the doctor when I should have, eg “just get on with it, you’re not that bad, other people are far worse off, you should be so thankful, you’re making a mess of this, you’re not a good psychologist or mum in fact you’re not doing anything well….” Bla bla critical and noisy and yet we accept what this bully has to say every day without stopping to think whether it is accurate or not. What are you saying to yourself that’s keeping you stuck or making you feel bad about yourself or scared? I was also stuck due to lack of awareness and education about Perimenopause and for this I blame society. It’s still taboo, massively misunderstood and not taken seriously. To those men that have rolled their eyes at me and other women – shame on you. Look after your wives, daughters, nieces, mothers and sisters. Let’s face it, many marriages break up after women reach their 40s so it’s worth your while investing some compassion and understanding if you want to prevent that. More needs to be done to prevent women from reaching this point in their lives and feeling bad about themselves, losing their confidence at work, not knowing what’s happening to their bodies . We need more education and more support to accommodate women on this rollercoaster that our bodies take us on. Ultimately this will keep women at work, keeping the skill set high in those environments and will potentially keep families together, and reduce mental and physical health problems associated with Perimenopause.
Protective– what positive and helpful things have I got in my life that I can build on to reduce distress and cope better? I’ve already listed some of mine. In some cases it was doing more of what I love and with who I love. In addition I needed to try new things and rediscover what I like and be honest about this rather than trying to people please or do what others like. Sometimes this is no bad thing as it moves us out of our comfort zone but be authentic to who you are as this is where the treasure lies. So ask yourself what’s important to me and is there enough of it in my week? Do I need to link up with a good friend more, or prioritise rest or try something adventurous-has life just got so damn boring? Then shake it up! What else can you do to protect yourself in this difficult life phase? It might be yoga, meditation, weights and walking, prioritising nutrition and goodness for the body and mind, vitamins, supplements, natural remedies or medication. Put more good stuff in! Then we’ll get more balance and bolster ourselves. You might need to make a big change, like me or little changes that all add up. We can do this! Let’s help each other ❤️
Sea change 