The Wisdom of Menopause

by Christiane Northrup

  ~ Late menopause (after age fifty-five)

  ~ Giving birth to a first child after age thirty

  ~ No full-term pregnancies

  ~ Long-term hormone therapy (greater than five years)

  ~ Benign breast disease with biopsy showing atypical hyperplasia

  ~ Significant weight gain after menopause

  ~ Regular alcohol consumption

  ~ Low levels of vitamin D

  ~ History of high-dose radiation to the chest

  ~ Not getting enough sleep at night

  Note: Early or surgically induced menopause decreases the risk for breast cancer.

  THE EMOTIONAL ANATOMY OF BREAST CANCER

  Like all diseases, cancer has an emotional component as well as a physical one. Many women with breast cancer have a tendency to hide their emotions behind a stoic face and to stay in relationships where they give much more than they receive. The core belief at the heart of this behavior is that we’re not worthy of anything better.

  The refusal to honor and express our own emotions can sometimes reach pathological extremes. A woman once came to see me because she said she was having trouble breathing. She arrived alone and unsupported, and the tests I had done on her soon confirmed my fear that her breast cancer, which had been diagnosed a year before, had spread to her lungs. She had never sought treatment for her condition because she had not wanted to “inconvenience” her husband or her children. In fact, she had not even let them know about her illness. I told her as gently as possible that her choices, though made in the spirit of generosity and self-sacrifice, were not really helping anyone, least of all herself. She needed support and nurturance, and her family needed to be included in what was happening to her.

  In my experience, many women have been denying their needs for so long that they do not even know they have them. One of my friends recalled growing up with a mother whose automatic response to any desire she ever expressed was “Don’t ask, don’t even think about it.” Imagine what that does to a person’s ability to ask for what she needs, to express her feelings honestly or to even know what they are! No wonder so many women will do almost anything to avoid appearing self-centered—to the point of putting themselves at risk of dying of a terminal illness.

  There are now many scientific studies confirming the idea that our emotional style may influence both the incidence of breast cancer and our ability to recover from it. One study, for example, involving 119 women between the ages of twenty and seventy who were referred for breast biopsy because of suspicious breast lumps, looked into the impact of adverse life events on the likelihood of the breast lump being cancerous. Severe crises such as divorce, death of a loved one, or loss of a job in the five years preceding the breast lump did indeed increase the chance of its being cancerous. But, interestingly, the way in which a woman dealt with adversity was also a significant factor in whether she developed cancer. Those who had allowed themselves to experience their grief fully when they confronted devastating losses were three times less likely to suffer from breast cancer than those who hid their emotions behind a brave face or submerged their grief in various forms of activity.2

  Clinical psychologist Lydia Temoshok, Ph.D., shares similar ideas in the book The Type C Connection (Random House, 1992), which she co-authored with Henry Dreher. Drawing on hundreds of case histories, she identifies what she calls the Type C behavior pattern: those who are unfailingly pleasant, self-sacrificing, compliant, and appeasing—and also unable to express their emotions, especially anger. This behavior pattern, Dr. Temoshok discovered, is associated with various cancers, including breast cancer.

  “The most common comment of this kind of cancer patient with breast or gynecological cancer is, ‘I’m not worried about me, I’m only worried about my family,’” notes Dreher. “Those patients with thicker and far more aggressive and life-threatening cancers were more severely self-sacrificing and nonexpressive of their needs and feelings.”3

  Not allowing ourselves to grieve uses up vital energy, depriving us of the resources we need to heal. At times of loss we must go through the painful and difficult process that I refer to as radical surrender: we must surrender to a power and order that is bigger than we are. Call it what you will—God, the universe, whatever—we must allow this power to heal our lives, and this can happen only through the full experiencing of our grief.

  Another study showed that a woman’s feelings about the communication between her and her family, and about the availability of help from her family, affected the function of her immune system and therefore her ability to recover. Women with breast cancer who perceived a lack of social support were found to have immune system depression and a poorer prognosis.4 On the other hand, social support doesn’t have to be from your family to have a positive impact on survival. Studies have shown that breast cancer or other support groups characterized by open and honest sharing of experience are associated with increased longevity and decreased rate of tumor recurrence.5

  MARY: The Ten-Year Plan

  Mary was forty-one when she called Mona Lisa Schulz, M.D., Ph.D., for an intuitive reading. Married to a fiercely competitive businessman who spent more time on the road than he did at home, Mary longed for the day when her husband’s business would finally be self-sustaining enough to allow him to stop traveling so much. She herself had once been a high-powered executive in the computer industry but was now a stay-at-home mom with two children, ages six and nine. As part of the ten-year plan for work, finances, and family that she and her husband had developed, she had left her career in order to devote herself full-time to rearing the two children they had and the two they were planning to have in the time remaining on that plan.

  The problem was, only five years into the plan, Mary was exhausted. As she told Dr. Schulz, she was putting off having a third child until she could get a handle on why she felt so terrible all the time. She wanted to know what her body was trying to tell her through her fatigue. That was why she had scheduled a reading with Mona Lisa.

  The reading Dr. Schulz did on Mary revealed an energy pattern that was like that of “a widow pacing back and forth on a widow’s walk, forever looking out to sea, waiting and pining for her husband to return.” On the basis of what she had read energetically, she told Mary that she, like other women with this pattern of behavior, could have a tendency to form hormonally sensitive densities in her breasts. (Since Dr. Schulz does not make diagnoses during readings, she would never use the term “breast cancer” or even “benign breast lump,” both of which are diagnostic terms.)

  At this point, Mary revealed that she had, in fact, been diagnosed with breast cancer four years earlier. The surgery, chemotherapy, and radiation seemed to have successfully eradicated the cancer, but she still felt completely drained by the experience.

  Dr. Schulz asked Mary what she thought was going on in her life. Mary knew that something was painfully out of balance, but she didn’t know exactly what. She missed her old job and was aware that staying home didn’t suit her temperament, but she felt that she should just learn to make the best of it in the interest of the plan she had agreed to. She was also aware of how much she longed for her husband to share in the raising of their children, but felt she couldn’t voice this longing because it would interfere with his ability to complete his part of the ten-year plan.

  Dr. Schulz explained to Mary that all illness is a hologram that contains genetic, environmental, physical, nutritional, emotional, spiritual, and behavioral aspects simultaneously. For Mary, the understanding of that hologram would require her to question the validity of the plan that had locked her and her husband into a way of life that was in fact unsatisfactory to both of them. Her breast cancer had been a signal to her, and the fatigue that had enveloped her ever since then was another signal. Both were persistent indicators of unrecognized and unmet needs. Her task was to articulate her needs first to herself, and then to her husband and family. One of her unmet needs was for the intellectual stimulation
of work outside the home. She had to admit that she was not temperamentally suited to be a stay-at-home mother. Some women would, of course, thrive in such circumstances if, like Mary, they had the economic wherewithal to support that lifestyle. Mary just didn’t happen to be one of them.

  Up until her reading, Mary hadn’t allowed herself to truly feel her level of dissatisfaction with her life. Not realizing that she had a choice, she had fallen into a very common trap for all of us—a trap in which we talk ourselves into putting up with our circumstances because we have been taught that we ought to be able to just grin and bear it, to stuff our emotions and needs and get on with it. Sometimes this is the case, but very often, women have choices that they don’t realize they have. Both Mary and her husband were wedded not just to their plan, but to an outdated view of gender roles: the woman is to be the full-time nurturer, the man the good provider. At first Mary blamed herself for her own unhappiness and inability to “get with the program.” She beat herself up for wanting to get out of the house and thinking it meant that she was not a good mother. She thought she needed to squelch these feelings, not use them to articulate and act on her legitimate needs and desires. Mary’s unhappiness seemed to her to be her own fault, a sign that she was not a good mother—so it was something she thought she needed to fight against, not act on.

  Though the particulars of Mary’s story are unique, the basic dilemma is not. But there’s a way out. Own your feelings—all of them, including the unpleasant ones like anger, guilt, sadness, and resentment. Connect those feelings with the unmet needs they signify. And get professional help if necessary.

  PROGRAM FOR CREATING BREAST HEALTH

  Breast health is achieved through the energetic influence of self-nurturance, releasing resentments, and participating in relationships in which we both give and receive wholeheartedly. As with every other bodily organ system, however, our breasts are also greatly affected by what we eat and by other lifestyle choices. This comprehensive program addresses all these factors and will help you achieve maximum breast health throughout your life.

  ~ BE HONEST ABOUT WHAT YOU’RE FEELING. I highly recommend Marshall Rosenberg’s website on nonviolent communication (www.cnvc.org), on which there is a list of emotions and a list of the needs they signal. Go through your own circumstances and have a trusted friend listen for the unspoken “need” that that emotion is signaling. You’ll be amazed at how freeing this can be.

  Consider the previous story about Mary. Like many women with breast cancer, Mary appeared to be too sweet and nice, despite being in a very difficult situation. She’d say things like “It’s not that bad. It’s okay, I can handle it,” and then two seconds later mention how frustrated she actually was with her situation. Her response reminded me of an episode of the old TV sitcom Golden Girls, in which Blanche was trying to come to grips with her son’s decision to marry a much older woman who was pregnant with his child. When a friend of hers asked her what she planned to do, she replied, “Do what mothers always do. Tell my son I love him and that anything he does is fine with me, then complain like hell to anyone else who will listen.” This pattern, though funny in a sitcom, is exactly what creates disruption in the energy of our fourth emotional center.

  Creating health instead of havoc in your emotional centers requires you to extinguish those “I’m fine” phrases from your vocabulary when they are covering up real and painful emotions that need to be expressed. You may need to work with a therapist to help you learn how to be honest first with yourself and then with your mate or other family members.

  You also need the courage to be honest with yourself about any aspect of your life that you aren’t ready to change. Given our cultural inheritance about our breasts, it is little wonder that women’s fear of breast cancer far overshadows our risk for those things that are more likely to kill us either directly or indirectly, such as heart disease or being battered by a husband or boyfriend. I’ve come to believe that the fear of breast cancer serves to numb us to what we’re really afraid of—being abandoned and left alone while continuing to pine for true love and the improvement of the relationship we’re in. (When my colleague, breast expert Dixie Mills, M.D., read this, she said, “This sentence is so important, I wish there were a way to make it stand out.”) One of my patients, a woman with breast cancer who was also supporting her husband financially and had the means to change her life, finally admitted to me that she continued to stay in her loveless marriage because it felt so much easier for her to die than to risk being the one to be abandoned or left alone first.

  ~ CREATE A LIFE PLAN. You have the power to improve your relationships and love life right now! This process begins with improving your relationship with yourself. Draw up a one-or two-year life plan just for yourself (not for your mate or family members). Spend at least thirty minutes dreaming about how you’d like to fill your time, where you’d like to go, whom you’d like to be with, and so on. When we went over the life plan concept with Mary, she admitted that even the thought of having a third child exhausted her. Gradually she began to come to terms with the fact that the two additional children called for in their infamous ten-year plan might not be right for her. Clearly Mary’s body in general, and her breasts in particular, had been trying to tell her this for a long time.

  ~ CREATE AN ENERGY BUDGET. Draw up a balance sheet with one column listing the activities that rejuvenate you and the other listing the activities that drain you. Then make a daily expenditure plan that tips the balance in favor of rejuvenation. (If you have young children, for example, I’d suggest that you trade off child care with other mothers or grandmothers in your neighborhood.) Commit to engaging in at least one activity per week that is pleasurable to you—regardless of what your family members think of it. Understand that this is a process, not a destination. It took me four years to tell my husband that I was getting massages every month. Until then, even though I had made them part of my regular schedule, I didn’t have the courage to admit to him that I was actually spending time and money on something so nurturing and pleasurable that didn’t have an immediate, tangible payoff. Now, years later, I enjoy a massage every week, and I cannot even imagine having to run my expenditures by anyone but myself. What a huge revelation!

  ~ MAINTAIN A RELATIONSHIP WITH YOUR OWN CREATIVITY, PLEASURE, AND NEEDS. My colleague Regena Thomashauer, founder of Mama Gena’s School of Womanly Arts, points out that daily doses of pleasure are as life-sustaining for women as vitamin C was for sailors in order to prevent scurvy. She insists that if we fail to consciously bring pleasure into our lives, we are at risk for scurvy of the soul. I completely agree. Don’t allow your creative pleasure to wither or permit your true self to get lost in the daily grind of living. If you’re not working a regular job, consider taking a class or engaging in some other stimulating activity on a regular basis. I’ve found time and again that the very act of having a schedule tends to help us conserve and direct our energies. (I always practiced my harp with much greater focus when I knew I had a performance coming up.) There is no substitute for having some order, discipline, and structure in your daily life. Just be sure that you are creating the structure, not the other way around.

  ~ PERIODICALLY REEVALUATE YOUR GOALS AND PLANS. I do this each year around my birthday, and also during the solstices and equinoxes of the year—times when the creative energies of the earth are maximally available to us. Let go of anything that is clearly obsolete and incompatible with your emerging inner wisdom. Mary told us later that when she asked her husband how his body was responding to their ten-year plan, he told her that his old ulcer had been acting up lately. But he hadn’t wanted to share that with her, because he felt that he needed to show his love and support for his family by remaining a “good provider.” This is an example of how a basically good marriage can change and grow when people are honest with each other—and themselves—about their needs.

  ~ CONCENTRATE LESS ON A DIET THAT AVOIDS FAT AND MORE ON AVOIDING SUGAR AND REFINE
D CARBOHYDRATES. For many years, doctors (including myself) recommended a low-fat, high-fiber diet, especially for women at high risk for breast cancer. Such a diet increases the excretion of excess estrogen, making it less likely that estrogen-sensitive breast tissue will be overstimulated. However, the connection between fat and breast cancer is not as straightforward as previously thought, according to data from the famous Nurses’ Health Study, which included an analysis of the diets of 88,795 women, ages thirty to fifty-five, who had completed detailed questionnaires about their eating habits every four years from 1980 to 1994. This phase of the study focused on fat because it was known that Asian women, who eat a diet much lower in fat than ours, also have a much lower rate of breast cancer. However, breast cancer was found to be no more common among the women in the Nurses’ Health Study who ate a lot of fat than among those who consumed less than 20 percent of their calories in the form of fat. Furthermore, there appeared to be no difference in breast cancer incidence among those who ate saturated fats, or even the infamous trans fats, versus those whose fats were derived mainly from vegetable sources or from fish.

  In response to these surprising results, the study’s lead author, Michelle Holmes, M.D., an instructor of medicine at Harvard, said, “Our research indicates it’s highly unlikely that women who consume a low-fat diet are protected against breast cancer. Equally, it appears that a high-fat diet also poses no increased risk for the disease.”6

  Though I would have been surprised by this study back in the 1980s, I’m not surprised now. Breast cancer is multifactorial, with nutritional, emotional, and genetic aspects. Nutritionally, it’s becoming clear that sugar and refined carbohydrates are a far bigger risk factor for breast cancer than dietary fat content, but unfortunately they weren’t taken into account in this study. Nor were other factors that may help account for the low rate of breast cancer in Asian women. The different micronutrient intake, the high intake of plant hormones such as the isoflavones found in soy, and a lower amount of refined carbohydrates in their diet may all turn out to be factors that lower breast cancer risk.7