The Wisdom of Menopause

by Christiane Northrup

  THE CHILDBEARING YEARS: BALANCING

  PERSONAL AND PROFESSIONAL LIVES

  My husband’s life didn’t change much when we had our two daughters. Mine, however, became a struggle—one that millions of women will recognize from their own experience—as I tried to find satisfying and effective ways to mother my children, remain the doctor I wanted to be, and at the same time be a good wife to my husband. Nonetheless, these were happy years, for both of us adored our daughters from the beginning and enjoyed the many activities we shared with them—the weekend walks, the family vacations, the simple daily contact with two beautiful, developing young beings.

  I did sometimes resent the disparity between what I contributed to the upkeep of our family life and what my husband did. Once, when the children were still young, I asked him if he’d consider working fewer hours so that I wouldn’t have to give up delivering babies, an aspect of my practice that I dearly loved. He replied, “You’ve never seen a part-time orthopedic surgeon, have you?” I admitted that I hadn’t, but suggested that this didn’t mean it couldn’t happen with a little imagination on his part. It was not to be, however. It was I who, like so many other women, became the master shape-shifter, adjusting my own needs to those of everyone else in the family.

  In the early years of our family life, I was also becoming increasingly aware that the inequities that bothered me in my marriage were a reflection of inequities that existed in the culture around us. I saw many people like my husband and me—people who had started their marriages on equal ground financially and educationally, even people who, like us, did the same work—and always, once the children arrived, it was the wife who made the sacrifices in leisure time, professional accomplishment, and personal fulfillment.

  Change Yourself, Change the World

  During those often exhausting years, I began to put into action some of the ideas I’d been developing about women’s health—while always being careful not to say much about those ideas at home, where I knew they would not be welcomed by my husband. Inspired by my own experiences as well as those of my patients, and buoyed by the conviction that my ideas could make a difference in people’s lives, in 1985 I joined three other women in the venture of establishing a health care center we called Women to Women. Though the idea of a health center run by women for women might seem unremarkable now, it was virtually unheard of at that time. Our central mission was to help women appreciate the unity of mind, body, and spirit, to enable them to see the connection between their emotional health and their physical well-being. I wanted to empower women, to give them a safe place in which to tell their personal stories so that they could discover new, more health-enhancing ways of living their lives.

  I knew that sometimes this would involve challenging the status quo, because the inequities of the culture take a terrible toll on women’s bodies as well as their spirits. But as I practiced this new, holistic form of medicine, which was quite revolutionary for its day, I realized that the fact that I had a normal, happy family life, as well as a husband with conventional medical ideas who practiced in the same community, provided a kind of cover for me. It made me appear “safe” at a time when my ideas were considered unproven at best, dangerous at worst.

  My three partners in Women to Women and I bought an old Victorian house that we could convert into a center for our new practice. We all agreed that we wanted to keep our husbands out of our new venture, lest their participation undermine our enthusiastic but still tender confidence in ourselves as businesswomen.

  Of course, in my case, at least, that didn’t necessarily mean that I didn’t want my husband’s support. I clearly remember a day at the beginning of the building and site renovation. Two bulldozers sat on the lawn, workers were everywhere, and the existing building had been torn apart. At that moment the whole project suddenly became real for me, and I realized that my colleagues and I were now responsible for paying for all of this. This was an overwhelming thought. When I came home that evening, I uncharacteristically reached out to my husband for help in calming my fears. “I’m scared,” I told him. “I’m not sure I can do this.” He replied, “I hate it when you’re disempowered like this.” I quickly realized that he wasn’t about to coddle me emotionally.

  His response to my uncharacteristic and risky moment of emotional vulnerability simply reinforced the coping style I’d developed in childhood, a stoicism that was a necessity in a household where emotional neediness was frowned upon and we were told to “keep a stiff upper lip.” Another favorite saying in my family was “Don’t ask for a lighter pack, ask for a stronger back.” So, as usual, I pulled myself up by my own bootstraps, dug into my inner resources, and pretended that I wasn’t afraid.

  As it turned out, Women to Women became a great success. Our work struck a resonant chord with our patients, and the center grew steadily by word of mouth. As excited as I was about what I was doing, I could never interest my husband in any of the ideas about alternative medicine that were at the core of my new clinical practice. We did, however, have enough other areas of mutual interest that I didn’t think his attitude toward my work mattered. In fact, I was rather proud of myself for being able to sustain a loving relationship with a card-carrying member of the American Medical Association.

  Marrying My Mother

  Looking back, I see that in marrying my husband I had made a secret and mostly unconscious vow that I would do whatever it took to make this marriage work and be the woman I thought he wanted—as long as I could also pursue the work that I loved. (Back then, like most women, I didn’t know that the secret to happiness for both ourselves and our loved ones requires that we first and foremost become who we really are—not who we think we should be!) Unbeknownst to me, I was re-creating with my husband many aspects of the unfinished business I had carried over from my relationship with my mother, a fact that would only begin to dawn on me some twenty-two years later, as I entered perimenopause.

  Until then, in my marriage I would continue to play the role of the eager-to-please child I had once been, while my husband would fill the role of my remote, emotionally unavailable mother. As the quiet, sensitive child in a family of outgoing, athletic siblings who loved to spend every moment of life charging full speed ahead up mountains and down ski slopes, I had always been the type who tended to disappear, going off by myself into a quiet room where I could listen to music, read fairy tales, sit dreamily by a fire, or gaze out onto the ocean. My mother was much more tuned in to the other members of our large, bustling family, and she and I were a temperamental mismatch, with completely different innate interests. Although my father supported my studious side, he, like most men of his era, left the hands-on parenting to my mother.

  Longing for my mother’s approval, I tried to win her love by being good. So I worked and studied hard, never got into trouble, and made myself into my mother’s little helper, cooking, cleaning, creating centerpieces for holiday dinners—whatever I could think of that would prove my worth, other than athletic pursuits. Intuiting that my mother was in some pain—though it would be many years before I understood the nature of that pain—I tried to be a comfort as well as a help to her, just as I would later try in my marriage to heal my husband’s childhood wounds, to give him enough love to make it possible to overcome his early fears and hurts.

  Meanwhile, I looked to my teachers for the applause I couldn’t get at home. My search for acknowledgment made me a classic overachiever at school, a pattern that would continue all the way through medical school and into my marriage.

  Eventually, just as I had turned to my schoolteachers for the support and approval I didn’t get at home, I would one day turn to people other than my husband to meet my emotional needs. But until I began the process of self-knowledge that culminated in the dismantling of my marriage, I simply accepted the fact that, like my mother, my husband could not really see or appreciate me for who I was. In fact, I never expected him to. I was operating under the assumption that I was fundament
ally unworthy of being cherished by such a special person.

  Had I felt more worthy of love, I never would have chosen someone like my husband. Several of the boyfriends I was involved with before I met him did admire and value me. But when your working belief about yourself is that you have to earn love—earn it both by overachieving in your own life and by rescuing someone from the pain of their own—then you will attract a person who reflects those beliefs back to you. Inevitably the young men who were supportive of me were not the ones I wanted. I wanted precisely the kind of emotional unavailability that felt most like home to me—and I got it. My colleague Doris Cohen, Ph.D., a clinical psychologist and the author of Repetition: Death and Rebirth, points out that re-creating the unfinished emotional business of our past is not neurotic. It’s the way we heal. And at perimenopause, our need for healing the past arises with great urgency.

  With the wisdom of hindsight, I realize now that my husband was a true soul mate, and I do not blame him for what happened between us. It was only when I was able to be true to my soul—to change from the inside out, in the most fundamental of ways—that we ceased to be life partners. In retrospect, he was one of the biggest gifts of my life, contributing more to my personal growth than I ever would have dreamed possible.

  After my divorce, I found myself face-to-face with my unfinished business with my mother—a very common theme—and eventually worked through that. (See my book Mother-Daughter Wisdom [Bantam Books, 2005] for all the details.)

  WHY MARRIAGES MUST CHANGE AT MIDLIFE

  When we look at the typical dynamics of intimate family relationships in this culture, it’s reasonably safe to say that the vast majority of the nurturing, supportive, subordinate roles fall to women, as does most of the self-sacrifice. Yes, it has become somewhat more common for women to achieve high-ranking positions in corporate, political, and scientific arenas. According to The Shriver Report: A Woman’s Nation Changes Everything (Center for American Progress, 2009; www.shriverreport.com/awn), women now make up 49.9 percent of the workforce for the first time in history, and more than 39 percent of women are their family’s primary breadwinner. But even so, whenever career concessions must be made for the sake of the family, it’s still likely to be the woman who steps down or cuts back. The Shriver Report notes that 85 percent of women bear the primary responsibility for taking care of their families, including laundry, school matters, transportation, and meals. That’s why we have the term “mommy track.”

  It’s true that a woman’s biology tends to encourage her involvement with her family at the expense of other interests during the childbearing phase of her life. But it’s also true that the culture’s atmosphere of gender inequity exploits this tendency to an extreme. This can lead to an incredible surge of pent-up resentment when the hormonal veil lifts and a woman suddenly sees with clarity what has happened in her life.

  The emotional changes that come about in the years leading up to and during menopause can feel earthshaking and even terrifying, particularly for those of us who are accustomed to thinking we’re in control. It’s one thing to resist change from some external force. It’s quite another when the change is coming from within, and everything you cling to that’s comfortable in its familiarity, including your very identity, is metamorphosing from the inside out. There are only two ways to avoid this abrupt, jolting level of change: defy social and cultural dictates throughout your childbearing years, so that by the time you approach menopause you will already have put into effect many of the changes that cry out to be made at midlife, or defy your body’s wisdom at perimenopause and ignore its call for truth, creative expression, and personal fulfillment. The latter course can have disastrous consequences for your own health as well as the health of your significant other, not to mention your relationship, which would then be based on something other than mutual respect and love. And you’d never find the treasure that perimenopause is desperately trying to bring to your attention—a life based on true freedom and joy!

  How Your Brain Is Hardwired for Relationships

  Nothing in our lives affects us more profoundly, both physically and emotionally, than our relationships with others. The neural pathways that enable us—that actually compel us—to relate to other human beings are laid down in our brains in early childhood. The experiences we have at this critical stage will influence the circuitry that develops and stays with us for life. If, for example, our needs as infants are met by a loving caretaker who responds to our cries by feeding or changing or stroking or rocking us when we are hungry or cold or wet or scared, then we will feel good about ourselves, and trusting of the outside world. Our needs have been validated, our emotional cravings met, with our relationship with another human being serving as confirmation of our worthiness. And certainly the biochemistry of motherhood supports this outcome. The hormones associated with birth and nursing in a happy, healthy, well-supported mother predispose her to fall in love with her baby and to fill the child with a sense of being loved and accepted unconditionally.

  Sometimes, however, our parents did not themselves experience this kind of unconditional love and may therefore be unable to give it to us. Then our cries may go unheeded or, worse, meet with active disapproval or resentment, and we will feel that the universe is not a safe place. Our relationships with others will seem undependable, even threatening.

  The feelings we develop about ourselves and others as children become etched into the circuitry of our brains and bodies, where they will continue, albeit subconsciously, to affect our relationship choices and responses throughout life. They are part of our basic emotional portfolio, easily accessible and freely expressible, sometimes excessively so. On the other hand, those feelings that were not reinforced by early experience tend to wither away, to become unavailable to us until we make a conscious effort to access our innate power to change our circuitry.

  Your ability to live successfully, however you might define success, depends to a great degree on how you relate to other people. If that part of your life is unsatisfactory, the only way you can revise the old relational circuits that determine your current relationships is to expose them and update them. Once you have a better understanding of the environment in which you were born and raised, it becomes possible—though never easy—to change some of the choices you usually make automatically, as a consequence of that old wiring.

  But change can occur only when you understand how important it is to change. You must ask yourself why you feel the emotions you feel, choose the mates you choose, act the way you act. The answer is in those early life experiences that served as the architects of your neural circuits and live on today in your very cells. Thankfully, science has now proved beyond any doubt that each of us has the ability to change our thoughts and our brains throughout life—a quality known as neuroplasticity.

  During and after adolescence we almost invariably find ourselves attracted to mates who enable us to revisit and perhaps heal the unfinished emotional business of childhood. In our culture, romantic love is where we express our deepest longings. Thus each romantic relationship we enter into can serve as a microscope into our emotional circuitry. More than any other aspect of our lives, our intimate relationships bring to light the old wounds still begging for closure. And most women have been taught to put their needs last in relationships because we feel unworthy. Therefore we don’t even know what we want until we give ourselves permission to remember!

  In retrospect, I can see that this was true of my feelings toward the man who became my husband. I was acting out with him a family drama that was still ongoing for me. And although I can’t speak on his behalf, in all likelihood I served a similar purpose for him. It took the hormonal and developmental changes of the climacteric to help me see that the role I played in my marriage was based on old beliefs about myself and my worth, beliefs that no longer served me well and were no longer valid.

  Menopause to the Rescue

  It may not feel like a rescue at the time, b
ut the clarity of vision and increasing intolerance for injustice, inequity, and lack of fulfillment that accompany the perimenopausal changes are a gift. Our hormones are giving us an opportunity to see, once and for all, what we need to change in order to live honestly, fully, joyfully, and healthfully in the second half of our lives. This is the time when many women stop doing what I call “stuffing”—stifling their own needs in order to tend to everybody else’s. Our culture expects women to put others first, and all during the childbearing years most of us do, no matter the cost to ourselves. But at midlife we get the chance to make changes, to create lives that fit who we are—or, more accurately, who we have become.

  If, however, a woman cannot face the changes she needs to make in her life, her body may find a way to point them out to her, lit up in neon and impossible to ignore. It is at this stage that many women reach a crisis in the form of some kind of physical problem, a life-altering or even sometimes life-threatening illness. Scientist and author Gregg Braden, who has traveled extensively and studied indigenous people all over the world, added an additional piece to my understanding when I interviewed him on my radio show recently. He said he routinely finds healthy women the world over as old as 120 who are agile and able to take care of their daily needs. He told me that the cultures he has studied believe that the human body can tolerate unresolved hurts without physical harm until about age fifty. After that, if not resolved, this unfinished business forms the basis for physical illness.