~ Being threatened with physical or emotional pain (need for comfort, safety, intimacy, or healing touch)
~ Having an important or pleasurable event postponed or canceled to suit someone else’s convenience (need for support, integrity, fun, joy, pleasure, or grieving)
~ Not obtaining something we feel should legitimately be ours (need for fairness or recognition)11
If, before menopause, a woman hasn’t learned to identify her anger and what it is telling her (and this describes many women), perimenopause is her best remaining opportunity to do so. At perimenopause, the rewiring of her brain makes her vision clearer and her motivations easier to identify. Using anger as a catalyst for positive change and growth is always liberating.
In the early stages of perimenopause, the irritability you feel may be subtle. Irritability is a low-voltage form of anger that doesn’t usually lead to lasting change—or any change. Irritability is like keeping a pot on simmer but always adding more water or turning down the heat just before it boils. If we do not attend to the unmet needs that lead to irritation, nature will turn up the flame on the burner in an attempt to mobilize us.
GLADYS: Never Bringing the Pot to a Boil
Gladys was a poster child for menopausal irritability. In my office she complained often about her husband, her children, and her job. She had chronic sinusitis, a condition often linked to emotional irritability and anger simmering beneath the surface. Whenever I asked Gladys when she was going to take steps to actually change the aspects of her life that so constantly irritated her, she’d always recover herself immediately, give me a big smile, and say, “But, dear, my husband is really a wonderful man. And my children are really very loving. I really can’t complain about any parts of my life.” Gladys went to her internist and was put on Prozac, but she never felt as though it, or anything else, ever really helped her. Over the years I cared for her, Gladys’s health never improved.
Killing the Messenger: Medicating Our Anger
and Irritability to Maintain the Status Quo
In our culture, unfortunately, the usual approach to perimenopausal symptoms such as mood changes and irritability is to prescribe something to soothe us and make us feel better. We seldom ask ourselves—and certainly our doctors rarely ask—“What is out of balance that needs to be changed?” If we look to hormone replacement therapy for relief without addressing the underlying issues, then even appropriate doses of hormones may not help much.
The women who are most vulnerable to the effects of hormonal swings and have the most difficulty finding relief from hormone replacement regimens and other medication are those who have had problems with mood during menarche, postpartum, and during perimenopause.12 If the emotional issues in their lives are not attended to, if their midlife losses are not fully grieved and released (if, in other words, they don’t listen to the need fueling their anger and take action), they may end up with full-blown depression—which is sometimes described as anger turned inward. Depression, in turn, is a very well-documented independent risk factor for heart disease, cancer, and osteoporosis.
Emotional turmoil affects the brain and all its functions. Continuing in the same upsetting situation virtually guarantees that a woman’s hormones will stay unbalanced. The longer she allows negative situations to persist, the more out of whack her hormones will become, and the more physically uncomfortable she will feel. A prescription for estrogen may stop this cycle temporarily, but the body will eventually demand that its message be heard.
DORIS: Bypassing Anger
Many women downplay their pain by comparing themselves to someone else who is much worse off. If unresolved, this pattern can be a setup for health problems, especially at midlife. Here’s an example from my practice.
Doris was suffering from high blood pressure and slightly elevated cholesterol, both of which were getting worse as she approached the end of her menopausal transition at age fifty-two. Doris told me that her socialite mother had devoted herself to her husband and his career in an unbalanced way that led to rather significant emotional neglect of her children, who were cared for by nannies and household help. Doris had unwittingly created the same pattern with her husband, who was so caught up in his work that he simply wasn’t available to her emotionally. But she would not permit herself to state her needs for emotional support to either her husband or her mother. Doris, like so many women whose lives appear relatively privileged, said to me, “I feel so selfish and foolish for feeling sorry for myself. I really have nothing to complain about. After all, there are all these women who’ve been raped or been victimized by incest, or whose husbands have left them penniless at midlife. I have so much to be grateful for.”
I call Doris’s approach the intellectual bypass—intellectual because the logical part of our brains can always come up with good reasons why we have nothing to complain about. And on the surface this may well be true. However, there’s a deeper problem. Comparing our pain to that of someone else invariably takes us away from our own emotions and the messages from our souls that are crying to be heard and acted upon. Attending to our emotions is a crucial part of remaining healthy because the part of the brain that allows us to feel emotions has far richer and more complex connections with our internal organs, such as the heart and cardiovascular system, than does the area associated with logical, rational thought.13 Comparisons keep us stuck in our intellect and out of touch with our bodies. It’s not enough to simply think about our feelings or talk about them. Remember, the word emotion contains the word motion within it! Our feelings are meant to move us toward greater fulfillment.
Healing doesn’t take place until we surrender to our feelings and allow them to wash over us. Doris won’t be able to create full cardiovascular health until she allows herself to feel how painful it is to have a husband who is emotionally unavailable to her, a situation that mirrors so many aspects of her childhood. When she finally surrenders to the grief and rage that have been bottled up for years, first during her childhood and again during her marriage, she will be on her way to creating not only cardiovascular health, but the gift of a healed life as well. She will find that hiding behind her grief and rage are desires, legitimate needs, and dreams that have been patiently waiting for years to find expression.
EMOTIONS, HORMONES, AND YOUR HEALTH
Your emotions, desires, and dreams are your inner guidance system. They alone will let you know whether you are living in an environment of biochemical health or in an environment of biochemical distress. Understanding how your thoughts and your emotions affect every single hormone and cell in your body, and knowing how to change them in a way that is health-enhancing, gives you access to the most powerful and empowering health-creating secret on earth.
Natural foods, supplements, herbs, meditation, acupuncture, and so on are all powerful tools for building and protecting your health. But regardless of what supplements you take and what kind of exercise you do, when all is said and done it is your attitude, your beliefs, and your daily thought patterns that have the most profound effect on your health. How many times have you heard someone say, “I don’t understand it—she always ate right and exercised. How come she, of all people, got sick?” On the other end of the spectrum is the person who smokes cigarettes and drinks too much alcohol, yet lives without any apparent illness well into healthy old age. The answer lies at least in part in the individual’s attitudes and emotions. You have, within you, the power to create a life of joy, abundance, and health, or you have the same ability to create a life filled with stress, fatigue, and disease. With very few exceptions, the choice is yours.
Specific Emotional Patterns Are Associated with
Specific Illnesses in Specific Parts of the Body
It has now been scientifically documented that specific patterns of emotional vulnerability can adversely affect specific organs or systems of the body. Conversely, emotional resilience in these same areas shores up health.
Dozens of medical studies on b
reast cancer alone show that feelings of powerlessness in important relationships and an inability to express the full range of emotions raise the risk of developing breast cancer and lower survival rates from it. Similarly, dozens of studies have suggested that difficulties in handling negative emotions, especially hostility and resentment, are linked to sudden death from heart attack.14 Beyond these are literally hundreds of studies showing that lack of social support, loss of or separation from one’s family, or difficulties balancing a feeling of belonging with a sense of independence can affect the immune system and increase susceptibility to infection and autoimmune diseases.
Clinical practitioners have known for hundreds of years that the connection between emotions and states of health is direct and powerful. Amazingly, our outward-focused, cause-and-effect, data-driven culture simply ignored the evidence. Even as late as the 1970s, the pioneering work of scientists such as Walter B. Cannon and Hans Selye, who did groundbreaking research on stress and the mind-body connection, was not accepted in the mainstream. It was scientifically accurate and compelling, but our culture simply wasn’t ready for it.
We midlife women are ready, and we have the perfect opportunity right now to live this knowledge for ourselves, while also sparking the fire of change in the culture at large.
Our state of health and happiness depends more upon our perception of life events around us than upon the events themselves. This is a truth that our culture does not teach. Instead, we are taught from an early age that our health is largely the result of our genetic heritage, whether or not we’ve been immunized, how many supplements we take, and how much exercise we get. There is no doubt that these factors can contribute to our state of health. But their influence pales in comparison to the power of our beliefs and attitudes.
How Your Thoughts and Perceptions Become
Biochemical Realities in Your Body
Your autonomic nervous system is the system that helps transform your thoughts and emotions into the physical environment that, over time, becomes your actual physical body. This part of the nervous system, which also governs the day-to-day activity of all your internal organs, is divided into two parts: the parasympathetic nervous system and the sympathetic nervous system. These two systems innervate every organ of your body, including your eyes, tear ducts, salivary glands, blood vessels, sweat glands, heart, larynx, trachea, bronchi, lungs, stomach, adrenals, kidneys, pancreas, intestines, bladder, and external genitalia.
In general terms, the parasympathetic nervous system (PNS) is the brake in your body. It promotes functions associated with growth and restoration, rest and relaxation, and deals primarily with conservation of bodily energy by causing your vital organs to “rest” when they are not “on duty.”
In contrast to the PNS, the sympathetic nervous system (SNS) is the gas. It revs up your metabolism to deal with challenges from outside the body. Stimulation of the SNS quickly mobilizes your body’s reserves so that you can protect and defend yourself. This is where the fabled fight-or-flight mechanism kicks in: your pupils dilate, the rate and force of your heart’s contractions increase, and your blood vessels constrict, so your blood pressure rises. Blood is borrowed from the intestinal reservoir and shunted to your major muscles, lungs, heart, and brain, preparing you for battle. Bowel and bladder function shut down temporarily, conserving energy needed to power your muscles, whether you choose to stay and fight or run away. (This is the exact opposite of the PNS’s function, which is to constrict the pupils, slow the heart, make the bowels move, and relax the bladder and rectal sphincters.)
Since the parasympathetic nervous system deals primarily with restoration and conservation of bodily energy and the resting of vital organs, any activity or thought pattern that engages the PNS puts deposits into your health bank. Conversely, SNS action makes withdrawals from that bank.
It is at this point that perception becomes so important. What is experienced in the body as a challenge from outside—a stressor—will vary from person to person, influenced by each individual’s past history, childhood, family background, diet, job, and activities at the moment. Many midlife women live in a state of constant anxiety overload, much of which is a side effect of the culture around us. We want to be good women. We want to do what is right. But the culture around us is changing so fast, and the information overload that it generates is so huge, that we easily become overwhelmed and confused, dancing faster and faster just to keep up. Not knowing what to choose and what to avoid, we give our bodies mixed signals. We may step on the gas and the brake at the same time. Or we may let the gas get stuck in the on position, living in a constant state of fight-or-flight—and making far too many withdrawals from the health bank.
Biologically speaking, we may be undergoing an evolutionary process that will enable our species to handle all this stress more gracefully and healthfully. Frankly, I believe that the multimodal brain of the midlife woman is leading the way. We’ve always had to be able to do at least three tasks at once. And now, at midlife, when the dictates of our souls make themselves known more fully than ever, we wake up to discover that our brains and bodies are being retooled to facilitate this beautifully.
Stress and Your Temperament
Scientific studies have found a link between temperament, personality, and the ability to deal with stressors. Have you noticed that some people, regardless of what happens to them in their lives, seem to be happy, while some are down even when life seems to be on the upswing? Or that others are anxious or fearful even when they’re safe and secure? To a degree, we are born with one of these temperaments, and there is evidence of measurable biological differences that go along with each temperament. For example, Stephen Porges, M.D., has found that each individual has—from birth—his/her own characteristic balance between the PNS and SNS, resulting in what is known as “vagal tone.”15 Your individual balance is visible on a type of EKG (electrocardiogram) and illustrates how your heart rate coordinates with your breathing rate, yielding valuable information about your metabolic balance and inherent resilience to stress. Porges has found that, even in premature babies, those who have higher vagal tone, meaning that their parasympathetic nervous system is more activated, are less stressed by external events in the nursery (such as being handled and having IVs started) than are babies with low vagal tone. He has also observed that the personality characteristics that go along with high vagal tone are happiness, resilience, and trustingness, while those associated with low tone are melancholy, anxiety, fearfulness, and feeling down—tendencies that follow each individual throughout life. These differences are also reflected in genetic differences in the body’s ability to metabolize adrenaline!
This explains much about our individual responses to life situations. For instance, it has been clearly shown that one patient may feel great stress while undergoing a relatively simple medical procedure, while a much more difficult procedure might cause little stress in another patient. However, it is also true that the same person may respond minimally to an experience at one time and then have a massive physiological response to the same experience at another time. This is why attempts to rate stressors are not very useful. A study by Charles B. Nemeroff, M.D., Ph.D., at Emory University School of Medicine found that women who were sexually or physically abused in childhood, compared to those without this history, show very exaggerated physiological responses in later life to stresses such as giving a speech or solving arithmetic problems in front of others. They are also at greater risk for depression, anxiety disorders, and other emotional illnesses later in life.16 Given the large number of women with a history of abuse of some kind, it is not surprising that so many women have mood and other problems during perimenopause.
One of the worst things people can do is beat themselves up for their inherent temperament or pattern of response to stress. That’s why I don’t want to suggest that there is some gold standard for emotions. This would be no different from telling women they should strive for an ideal weight, heig
ht, dress size, and so on. Besides, each temperament appears to predispose people to certain types of genius. If you spent your life wishing you had a “healthier” kind of temperament, for example, you would not be embracing your full genius or taking full advantage of your natural gifts.
How Menopausal Emotions Affect Our Health
Imbalances between the sympathetic and parasympathetic nervous systems, combined with the changing hormonal milieu of menopause, can increase our body’s susceptibility to symptoms or disease. The thymus (which creates your immune system’s T cells), the lymph nodes (which create your immune system’s B cells), and the bone marrow (which creates your red and white blood cells) are all innervated by the autonomic nervous system. Therefore, each area that creates immune system cells has both a gas pedal (sympathetic tone) and a brake pedal (parasympathetic tone).
Why is this important? Because it is via this system that your body records and processes your emotions and the hormones and neurochemicals they promote. As I’ve noted, if you have a backlog of unprocessed emotions from past trauma or unmet needs, they are going to surface around the time of menopause. As a result, your susceptibility to illness may increase. Over time, if the fear-driven fight-or-flight response is triggered again and again, you may fall victim to diabetes, hypertension, or possibly even an autoimmune disease such as lupus or rheumatoid arthritis. Where you are affected will be determined by the weakest link in your body, the place where your genetic structure plus your childhood programming and beliefs have made you most vulnerable.
The bottom line is that whatever goes on in your mind has well-documented effects on every cell in your body via either parasympathetic or sympathetic nervous system activity.17 Every thought and every perception you have change the homeostasis of your body. Will it be the brakes or the accelerator, a health account deposit or a health account withdrawal? This, in a nutshell, is how your autonomic nervous system translates how you view your world into the state of your health.
The Wisdom of Menopause Page 8
