Menopause – It’s a woman thing!

 

‘And the beauty of a woman, with passing years only grows’ Audrey Hepburn

 

How much do you know about the Menopause?  I am guessing if you are a woman or have a partner, friend, relative or colleague of a ‘certain’ age,, you may know more than you once did.  The Menopause is not something we are very aware of before we encounter it in some way and yet, the Menopause is something that all women will experience during their lifetime.  Like death, the Menopause is something, that as women, we can guarantee will happen to us at some point in our aging years, it is a normal and natural process.

 What is the Menopause?  Simply put, it is when the hormones Estrogen, Progesterone and Testosterone fall, the Menopause begins a year after our last period. Leading up to this time, many women experience Menopausal symptoms; this is referred to as the Perimenopause, these symptoms can continue once your periods stop and you are Menopausal. Thankfully, there is a time when we are considered Postmenopausal – I haven’t reached this point yet, but I imagine it will be bliss with no symptoms at all!

 What age does the Menopause occur? The average age for UK women is 51 but some women with underlying medical conditions or treatment for cancer can mean an early Menopause. On average women can expect to experience menopausal symptoms for about four years but one in ten women can experience symptoms for ten to twelve years.

Some women make the transition through the Menopause barely noticing the changes, but for many of us, Menopausal symptoms can be distressing, uncomfortable and often incredibly disruptive.  Most of us are aware of the well-known symptoms: hot flushes, night sweats and irregular periods (during the Perimenopause) and yet there are over 30 symptoms. I hear conversations among my friends and colleagues discussing these common symptoms, but we don’t often talk about the other, equally distressing and disruptive symptoms.  We often joke about having a hot flush, but rarely do we talk about vaginal atrophy!  For more information on all symptoms, go to: https://www.menopausedoctor.co.uk/menopause/topics/symptoms

In my experience, both personal and through my work, women’s lives can be turned upside down by Menopausal symptoms.  Hot flushes are so much more than just ‘feeling’ hot! For me it comes with an unpleasant sensation working its way up my back and neck, around my head, followed by brain fog and ending with sweat pouring down my head and back (not attractive at all!).  Disruption to sleep is another common symptom, perhaps waking early or being woken by sweats throughout the night and yet still having or expecting to be fully functioning the next day.  Anxiety, low mood, mood changes, irritability, brain fog, and memory difficulties all can be extremely distressing, debilitating, and confusing and yet again, we continue to place huge expectations to carry on as ‘normal’ – perhaps being superwoman; organising home life, cooking, cleaning, shopping, supporting and caring for family members or friends and that’s on top of working!

What can help?  It is important to consult your GP to be sure you are experiencing Menopausal symptoms, ruling out any other health issues.  Please be aware that GP’s are not necessarily specialists in the Menopause, so be persistent if you need further support and information.

 

“Your face is marked with lines of life, put there by love and laughter,

Suffering and tears.  It’s beautiful” Lynsay Sands

 

I have found the following helpful in helping me navigate this Menopausal storm!

Do your research – information on the Menopause from your GP may be limited, read and research to understand your experience and symptoms, see the list below for ideas of where to look.

 

Exercise – Regular exercise, however much or little is great for lifting the mood, easing joint pain and stiffness, maintaining a healthy heart and strong bones.  Exercise really can be enjoyable! do something you enjoy and can manage every day such as walking or dancing in your kitchen.  I joined a walking Netball Team, not only did we get a lot of exercise we laughed a lot too.  It was good for my fitness, my health, and my soul.

 

Eat well – Eating a healthy balanced diet is critical, so include plenty of fruit, vegetables, and wholegrains.  Check out information on Menopausal friendly diets (https://lizearlewellbeing.com/healthy-food/healthy-menopause-foods/).  I no longer drink tea or coffee, I have a significantly reduced sugar intake and have a plant based, wholegrain diet, I do feel better as a result.  You do not have to be this drastic but find a healthy balanced diet that works for you.  Many women find taking supplements can be helpful, talk to your GP as there are varying degrees of success.  I have not found any that helped – and over the last  years, I have tried everything!

Talk – Talk about how you feel to trusted friends and family. Your GP is there for medical support, but you may also find that talking with a Menopause coach, Therapist or Counsellor is helpful to explore your thoughts and feelings relating to the changes you are experiencing.  We see in the BBC programme The Truth about Menopause (see link below) a small group of women attend CBT workshops, following which report being able to cope with their symptoms more effectively because of the techniques they had learnt.   Talking can be helpful – try it!

 

Rest – Pace yourself, take time for you if you can, even a 10-minute cup of tea every day doing nothing else, helps slow you down; take time to breathe and relax.  Try Mindfulness or Meditation to help cope and manage your symptoms.  I find when I focus on my breath, the hot flush becomes less intense.

 

Have fun! – This may be hard, especially during a Pandemic, but laughing and having fun will help you feel better, find your inner child! play games, dance, sing, do some art, bake – whatever you enjoy.  give it a go – you might even enjoy yourself!

 

Be compassionate – be kind to yourself, or if you are reading this with a Menopausal woman in mind, be kind and compassionate towards them.  The symptoms of the Menopause are not easy to deal with, not only do we have the symptoms to contend with, but we may also struggle with a body we might not recognise anymore, weight gain, hair loss, sagging or wrinkly skin and to add to this it is often the time of life when we experience a changing family, children leaving, grandchildren arriving and aging parents.  The least we can offer ourselves is kindness!

 

Embrace it!  – Yes, this may be a difficult time of life, the symptoms are horrible but be encouraged by a brighter future – no more periods, more freedom to be yourself – age gracefully (or disgracefully if you prefer!) but above all take care of yourself.

 

‘The years have touched her only to enrich her; the flower of her youth had not faded

It only hung more quietly on its stem’   Henry James, The Portrait of a Lady

 

Anne Duke – Counsellor, Supervisor, and Trainer

 

References and suggested resources:

Dr Louise Newson – https://www.menopausedoctor.co.uk/menopause

Liz Earle – https://lizearlewellbeing.com/healthy-living/menopause-every-woman-needs-know/

Mariella Frostrup –  https://www.bbc.co.uk/iplayer/episode/b0bt4c3m/the-truth-about-the-menopause

Gaby Logan Podcast – The Mid-Point

Diane Danzebrink –  https://menopausesupport.co.uk/

 

 

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Self-Care – How do you look after yourself?

I hosted a CPD workshop at Network Counselling and Training with my colleague Louise Mill, she encouraged us to think about the importance of taking time to care for ourselves.

This led me to think about the last few months and whether I have actually been taking care of myself or have I just been kidding myself that I am good at it. Probably the latter if I am honest.

When I began as a counsellor I decided that I would take the month of August off every year.  It was easy back then as I was working almost full time as a school counsellor and so this break fitted nicely with the school terms and it’s what all school staff do………hang on until the summer break, counting down the days until the most wonderful day of the school calendar arrives – yes the last day of term!  Despite, always loving my work as a Counsellor, it was wonderful, I could really scale back on my work and take a good lengthy break, often falling ill within the first few days of the holidays as I allowed my body and mind to rest.

I realise, now, that this is not the healthiest way to manage my health and well-being.  I now only work two days a week in school and largely self-employed so not able to afford the luxury of taking a whole month off.  I have had to establish a new routine of self-care and it’s not just waiting for the school holidays, I realised this had to be an every-day exercise.

We often forget how important it is to look after ourselves, perhaps because we have received messages over the years that make this difficult to achieve; such as ‘it’s selfish to take time out for ourselves’, ‘resting is lazy’, ‘put others before yourself’ or perhaps we just find it difficult to relax or spend time in our own company.

In many work place situations there is kudos in being busy, we are considered successful if we work long hours or fill every waking hour ‘doing’.  In truth this is just a slippery slope to ill health and/or burn out. We have pressure to work hard and earn well, whilst at one level there is nothing wrong this, at another we can be driven to an unhealthy way of living, increased stress, anxiety, depression and physical ill health.  We forget that there is more to life than work and striving, we are existing not living.

So what can we do about it?

I have recently read a book called The Self-Care Project by Jayne Hardy.  This is a great little book giving lots of practical and easy suggestions for self-care and explores the importance of self-care.  This is one of many books, blogs, articles written on self-care so I’m not going to cover the same ground here.  My hope is to simplify our self-care practices and help you think about what it is that can you do to take care of yourself without having yet another ‘thing’ to do, perhaps leaving you feeling ‘bad’ when you don’t manage to fit it in to your already busy day.

Self-care does not (and should not) be a burden, self-care is about genuinely looking out for yourself and doing something ‘nice’ for yourself – ideally every day or whenever you can. So my suggestion would be to do one ‘nice’ thing for yourself every day – something you enjoy.  It could be reading, TV, running, walking, breathing (yes breathing! Mindfully), smiling, laughing, cuddling your kids, partner, pets, yoga, exercise, this list is endless.  Find something that helps you feel warm inside.

I walk.

Every day I find time to walk, some days just only for half an hour but I walk every day.  I have the joy of having two wonderfully entertaining spaniels who need walking every day and so this begins each day for me.  A walk watching them chase and run like they never have before.  I watch the joy they experience chasing leaves, rolling in wet grass (and sometimes smelly things!), sniffing and just feeling the wind blowing past their nose and it reminds me to embrace the moment and breathe.  With this my body and mind relax as I take in the moment, as it is, right there and then and I am glad to be alive enjoying the world around me.  I forget the work schedule, I forget my worries – I just ‘am’, and it is wonderful.

My other suggestion for looking after ourselves is to be kind.  I always aim to be genuinely kind – to myself and to others.  I think this has always come fairly naturally to me, I was lucky that I had parents who encouraged me to be kind and I truly believe I reap the benefits of kindness.

However, I, like many others, can easily get caught up with a fearful inner voice, one that only knows how to keep me from experiencing pain or danger by being mean and critical, but this voice just keeps me down, prevents me from looking after myself, drives me to be the best I can but it isn’t always kind.  This inner voice tells me lies and would keep me fearful if I let it.  So whenever I catch this inner voice about to verbally bash me, I am gentle and kind to it.  I remind this inner part of me how to be kind and compassionate towards myself and others.

In the book ‘The Kindness Project’ by Shahroo Izadi (2018), Shahroo introduces us to the couch analogy.  Shahroo suggests we imagine a room with a couch.  As we enter the room, someone is sitting lazily across the couch giving us a constant negative narrative, this person says horrible things to us, says we are weak, lazy, tells us to give up, that we are no good.  Shahroo asks us how this would feel.  Then another person enters the room and despite not having much room, perches on the edge of the couch and in response to the negative commentary, quietly and gradually offers a more positive and gentle voice, encouraging, suggesting that the truth is that we are strong, brave, hard-working, intelligent.  Gradually and over time, this voice gets more confident and takes up more space on the couch and eventually will speak more often and louder than the negative voice.  I can relate to this analogy, as I am sure many can.  Just imagine, being much kinder and fairer with yourselves.  How much easier life would be, how much less worry and stress we may experience, if, we could encourage and support ourselves through stressful times rather than add to them by beating ourselves up.

So, I remind myself often, that kindness is something I can offer myself, not just others.  Someone today reminded me of the flow of compassion and kindness.  Kindness for others, kindness from others and kindness for ourselves.  What a wonderful world it would be if we were all able to share in this flow on kindness.

Each day I try to remember:

Do one ‘nice’ or enjoyable thing every day for myself

Be kind to myself and others.

So how do you look after yourself?

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What is Walk and Talk Therapy?

Walking is man’s best medicine – Hippocrates

Walk and Talk Therapy is exactly that, the therapist and the client walk and talk together during the therapy session.

I came across the benefits of walk and talk therapy just by accident.  I was working with a young person who was experiencing severe anxiety and not able to go to school.  We began working in their home but talking and opening up was really difficult – too intense and, with already overwhelming feelings of anxiety sitting and talking seemed unbearable.  So we decided being active and talking might just help, so we played pool and talked, which was much better and somehow they seemed more at ease, laughing when I missed a shot or giving me advice on how to play better.  We laughed and relaxed and so the work began.  We both had dogs and shared a love of being outside and walking, one day we decided that it would be good to walk with the dog across the fields and so it began, our walking and talking sessions.

I find that being side by side means that clients don’t feel so exposed, vulnerable or awkward.  Silence and space for thought feels more natural.  The pressure to talk is reduced and the practice of just ‘being’ is somehow much more simple. Walking has a soothing element to it, perhaps very similar to being rocked by our care giver in our early years.

Mike Diamond of Imperial College Healthcare, NHS Trust explains:

“The natural, rhythmic, side-to-side motion, or bilateral movement caused by walking causes nerve impulses to cross back and forth between the left hemisphere (the thinking side of the brain) to the right hemisphere (the feeling part of the brain) which induces emotional and intellectual healing from issues such as trauma and stress.”

When walking with clients we become focused on our experience of being together, I am able to offer a safe listening space even though we are outside and may pass other walkers or runners.  We may slow our pace when needed, pause the conversation when needed, speed up if needed or just sit. Working outside adds a depth to the therapy than can be harder to experience during traditional sitting therapy.  Walking can reflect the emotions being experienced or the story being shared, we can walk hard and fast or soft and gentle which ever matches the situation or the needs of the client.  Being outside also means we can observe the world around us, reminding us that the natural rhythm of life is reflected in it, perhaps we will notice new growth in spring, the beauty and warmth of good summer days and in autumn or winter the need for certain parts of life to wither and even die in order for something new to grow in its place.  We can breathe in fresh air, feel the warmth of the sun or the fresh wind on our face, we feel energised and our mood is often boosted by these experiences.

We all know that a daily walk and exercise is good for our physical health, research shows that physical activity is also good for our minds.  A Department of Health report (2011) states “Being active promotes mental health and well-being.  It improves self-perception and self-esteem, mood and sleep quality and it reduces stress, anxiety and fatigue”

Researchers from the Trimbos Institute in the Netherlands recently published a study in the Clinical Psychological Science (2018) which found that teenagers who took part in sport and exercise were more likely to be happier and less likely to display difficult behaviour like social withdrawal and anxiety, they were more likely to have positive self-image and greater self-esteem.

Exercise doesn’t have to come in the form of competitive sports but can be found in many forms, walking, cycling, yoga, dancing, and what we do know is that we often feel so much better after exercising than we did before.

I love to walk and personally find walking each day helps lift my daily stresses. An early morning walk with my dogs brightens my day and wakes me up ready to face each day anew.  I also find that walking outside in nature and experiencing the world around me is a healing and spiritual experience I can breathe in all that I see and breathe out the busyness of life.

Being able to incorporate my love of walking and belief in counselling in ‘Walk and Talk therapy’ made perfect sense to me, as I know how personally healing walking is for me.  My clients have found this a very helpful way of being able to explore their thoughts and emotions with the added benefit of being able to move physically in surroundings that are neutral and natural.

Toronto psychologist Dr. Kate Hays, author of “Working It Out: Using Exercise in Psychotherapy,” said the method has “a potential for much more openness and disclosure, capacity for insight, the ‘aha’ moments that we know are facilitated by physical activity.”

Phil Gormley– walk and talk therapy

 

Further information:

Books

Walking Your Blues Away, Thom Hartmann

Working it Out: Using Exercise in Psychotherapy, Dr Kate Hays

Articles

https://www.webmd.com/balance/features/walk-and-talk-therapy#1

https://www.npr.org/sections/health-shots/2013/01/07/168616995/why-exercise-may-do-a-teenage-mind-good?t=1537701799724

https://www.bbc.co.uk/news/health-17701485

https://www.verywellfit.com/walking-for-your-mind-and-spirit-3432871

https://edition.cnn.com/2017/04/05/health/sw-walk-and-talk-therapy/index.html

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