Menopause Is a Portal: Reclaiming the Body, the Story, and the Second Half with Dr. Hillary McBride

22:50Dr. Mary Claire Haver:You know, like just move through it. Just go, you know, and it's going to pass. And it's almost like I've learned to CBT it. Right, exactly. That's a big part of it. Yeah. How can I interpret what's happening? So the research from stress mindset theory is particularly relevant to our bodies because if what we say is, oh my gosh, this is my body giving me the energy to do something I care about. That's your heart clapping for you or something? Yes, right? Like this is our body saying, hey, I'm giving you the energy to do something really matters. That if when you feel nervous, you say, thanks for telling me that matters body.

23:25Like, yes, my heart clapping for me. It moves the indicators or it moves the metrics from being more predictive of death. Like when people are experiencing stress, they're less likely to experience the negative health outcomes of stress if they're interpreting the stress as this is my body helping me.

23:45Dr. Mary Claire Haver:Wow. So there's stress mindset theory. There's anti-fragility theory. These are, you know, ideas that say when we have things that are hard in our life, it's actually that the absence of those things isn't what makes a good life. It's how we are in relationship with the things that are hard. And this is like the truth about perimenopause. is that it's a developmental transition, just like any other developmental transition. And in order to negotiate moving through it into what comes next. And like for our listeners, developmental transition is things like adolescence. Exactly. Madressence, adolescence, your first big career, finishing school, aging, empty nesting, right?

24:23All of the big things that shape the course of your life and how it feels to be you. That part of a developmental transition is a little bit of a crisis and not like a, oh my gosh, I have to call 911 crisis, but the tension inside between, wait, who was I and who am I going to be? And what do I have to leave behind? And what am I getting? And the wrestling of the letting go and the stepping into and the feeling ourselves be changed, that challenge is actually part of accumulating the skills that we need to face what comes next. And so it's through the challenge. It's through a little bit of like the conflict inside and outside that we rise to the occasion and become more of ourselves.

25:02Dr. Mary Claire Haver:In your dissertation, you talk about menopause as like a found freedom. And I see that with my patients, like once they're through the fire of it, you know, but what are they, what do you find that they're freeing themselves from? So there's just a few different tiers of what the data says. There's obviously the physical things like, oh, I'm free of menstruation. It's going to change my sex life. What I wear. I'm, I had a woman in one of my data sets say, I'm wearing white pants again. Like this feels great for me. It's a whole new wardrobe that's opened up. So freedom to make choices around my body, freedom around my sexuality in some ways, maybe freedom from this - Pregnancy worry.

25:38Right, exactly.

25:39Dr. Mary Claire Haver:Yeah, especially if your periods were bothersome. Yeah. And then we have the psychosocial pieces. And maybe we could say the psychological relational, like, oh, I'm caring less about what other people think. Oh, I'm feeling like I'm more connected to what I know instead of filtering everything through who I'm supposed to be. But then we start to see this broader societal kind of freedom, which is that I'm starting to feel free from the game I didn't even know I was playing. Okay, so what is the game? You're supposed to be this to be a woman. Your body has to look this way. These are the ways that you're socially valuable.

26:15And as you get further and further from those things, there can be some conflict and some tension inside, especially if that was the way that we knew that we were good, how you showed up in the world. Yeah. But the truth is that we know what's going to win. Like aging is going to win. Our body slipping further and further away from that very narrow story is going to be what wins. And there's a liberation in that. Realizing I never chose to be part of those stories that were harming me, but now I get to be free from them and I get to do life on my terms.

26:47Dr. Mary Claire Haver:You've talked about how women who are actually doing well can feel socially silenced. Like they're not given permission to talk about this. I see less of that. I see women kicking that door down anyway, but why do you think that is? I'm so glad that that's the case. We need more of that. At least on my social media page. Yes. Yeah. Right. It's important that there are spaces for us to talk about doing well. And I can talk about that in a moment. But in my research data, what I found is that women were saying, if I'm doing well, it feels threatening to the relationships around me. And it feels like there isn't enough relational space for me to be connected to the people that I love who are struggling if I'm doing well.

27:30And this principle of I'm going to self-silence around my thriving, my well-being, my flourishing, I have seen in research about matrescence. I've seen in research about puberty.

27:42Dr. Mary Claire Haver:Explain what matrescence is for our listeners. Matrescence is primarily the first three years of the transition into motherhood. And so that experience, the word, think about it like adolescence, right? This like huge time of developmental, again, developmental transition as women are becoming mothers and the neurological, hormonal, relational, social, psychological, complete disorganization and reorganization as you're kind of moving into this new way of seeing the world. I saw that in my research around madtressants. I saw that as young women who loved their bodies were trying to negotiate social relationships.

28:17This has shown up in pretty much every single study that I've done asking women, how do you feel about your bodies? What's going right? How are you doing well? Looking kind of at how we protect positive relationships with bodies, women will say, if I tell the truth about doing well, I feel excluded from relationships. and this principle was first talked about by Mimi Nixcher in the early 1990s, late 1990s, and she coined the term fat talk. And the idea with fat talk, this is like a really interesting principle. Fat talk is not necessarily even about fat, but as an anthropological term, what she said is that it's part of the social contract around connection and social bonding to talk poorly about your body and about yourself.

29:03And if you don't do that, you're seen as arrogant, detached from reality, and women report reliably, I don't get to stay connected to the people that I love. There's no room in our conversations for me to be doing well. And so what happens as women don't share about doing well is it contributes to this story that's really one-sided when actually what women are saying kind of in their private thoughts might be really different than what they're saying on social media or even to their friends in that our experiences of being a body can include so much more than we're ever allowed to talk about and can include maybe this is feeling good or maybe this is not feeling good but there are social contracts that we've entered into that we don't even know we've entered into that restrict us from talking about what it's really like to be us including doing positive including the positive yeah i am recognizing patterns in my

29:59Dr. Mary Claire Haver:own friend groups through the years you know where we you kept quiet about the good things because you were connected by the the meaningful complaining you know and you know oh yeah me too and you celebrated the big high points but just that every day i'm actually doing great you know wasn't what bonded us together. Okay. But this is where like the psychologist in me, when I move into the clinician, as opposed to the researcher, here's women talk about this every day in my practice. Like when I'm working with women in clinic, it's not just about, I can't talk about those things, but like what actually happens in the dynamics.

30:40Let's just say we're sitting down at coffee and I say, how are you doing? What's going on? This is really, really hard for me. What's going to happen in our connection if you say, and I'm actually really doing well about that thing, or like that thing is going well for me, how do we negotiate that as a friend, like as a dyad? How do our friend groups hold the space for complexity? And so our ability to hold complexity, to emotionally regulate, our ability to be able to say your experience can be different than mine and we could still be connected. Our ability to talk, I think in more broad terms as a society about the spectrum of experiences and one not excluding the other, that actually comes down to the mechanics of the conversations that we have with the person over coffee and our ability to say, oh, hey, I just, I know you had a miscarriage and I know it's really painful for you.

31:35And I wanted you to know that I'm expecting, and I know that might be hard and I really trust that you can be with me and my joy and we can hold both together. Or I know this treatment has not worked for you and it feels hard to say, but it's really worked for me and I felt nervous to tell you that, but I actually want you on my team and I want our friendship to be able to hold all of it. And those conversations are hard to - Like you're giving me palpitations right now. Do you want to say more?

32:03Dr. Mary Claire Haver:Imagining having that conversation, I'm like - Yeah. We need better skills. We need better skills for women to be able to do well and stay connected to each other. So in your work, there's this theme that menopause is not losing who you are, but it is becoming more of who you are. Yeah. How does that show up in this big identity shift? Well, one thing that I found really novel in findings from one of my studies is that women described that on the other side of menopause, that there was a new role that they were taking on. And in one sense, I'm like, oh, that feels like such an important novel finding.

32:40But when I step back, I think, duh, women have been saying that forever. And we just have these archetypes that maybe, you know, maybe feel a little bit outdated in the language, like the crone or the elder or the queen, like these social stories. But women are saying, I'm stepping into something. And although I've been told that this stage of my life is all about loss, what I'm finding is that there is a new role that I have. I feel like I have a new role, not just in society or for my community, but also in terms of, you know, I know some things and I have some things that I need to share. And I have some creative expression inside of me that still is wanting to come out.

33:21And I have a passion and I have the time for it and I have the energy for it. and I was told that this season in my life is all about decay and yet I I'm doing something important in the world so when I think about 30 year old Mary Claire who was a resident and like

33:37Dr. Mary Claire Haver:up to her neck and you know trying desperately to be pregnant and took a couple years but we finally got there but when she thought about 60 year old Mary Claire and what that would be it would be a great my grandmother at 60 had gray hair and look she looked exactly the same from 60 to 90 in my little brain, you know, but it would be slowed down retirement, you know, grandma, like if she would have seen me at 57, you know, who's not going to be stopped. Well, God, you know, God willing, not stopping at 60 and still building and creating and starting companies and pivoting and changing her career, you know, to another direction.

34:14I think she would have been exhausted for one. Right.

34:18Dr. Mary Claire Haver:But but shocked. But I mean, And I really think that menopause gave me that power. You talk about a new role. What I'm seeing, and tell me if you're seeing this in your research, it's also a culling, a pruning, a trimming. Like suddenly all the little things you were trying to manage and the balls you were balancing, you're dropped. And no shame. Drop in those balls because you're going to focus on these balls. Yes, exactly. And that's part of the clarity and the self-knowing and the intuition that women are reporting. I don't have time for this anymore. That was somebody else's goal for my life.

34:47That was me doing that because I thought I had to, to be good. But I'm not concerned about keeping everybody happy anymore. I'm concerned about living a life that feels authentic, that feels empowered, that feels embodied. And it means not doing any of that stuff anymore. And maybe going hard on this or saying no to all of these other things. We're really letting myself live into this dream that I never got to live. People going back to school, people starting new careers, right? Businesses, right?

35:13Dr. Mary Claire Haver:There's just some data that came out looking at the biggest percentage of the population that is starting a business are women of my age. Yes. It makes so much sense to me. Like you've got time. You've got energy. You're clear on who you want to be. You're clear that life will not last forever. And it's really important to make something meaningful with the time you have left. I love that.

35:41Dr. Mary Claire Haver:your research mentioned that anticipating so like the premonition of a difficult menopause can help predict the kind of symptoms women experience yeah talk about that in the empirical literature there is some really i think fascinating findings if we can hold them lightly and with like, you know, some cautious interpretation around it show us what actually just makes sense on an intuitive level. If you're scared of something and then you experience that thing you're scared of, it would make sense that it would feel scary for you. But there's like that level of common sense to this. Let's just say women have been told your body is going to hurt more.

36:18You're going to lose social value. You're going to have less viability in the labor market. Your sex life is going to suffer and all of that is going to make you irrelevant and, you know, lose your value, it would make sense that as women are experiencing the transition that that would feel really scary for them. And that things like psychological symptoms are going to increase, social symptoms are going to increase. What is surprising is that women who, this was a study from 2003 in particular, Bush and colleagues, they found that women who have negative anticipations of menopause are more likely to experience sleep disturbances, joint pain.

36:53And without blaming women. Like I think it's very easy. Right. Because like there's a few out there going,

36:59Dr. Mary Claire Haver:oh no, it's all on her head. Yeah. Yeah. What we can say is that we have been under supported with how to navigate the transition and that when women are not doing well, very rarely is that a woman's problem alone. That is a social problem. That is a systems problem. That is a lack of resources problem. The women have been navigating perimenopause and menopause since the beginning of time, what's making it so hard is that there is so much that we have been taught to be afraid of without the support around how to deal with it and without the connections around feeling like, oh, this is actually part of what to expect and this is normal and this is not normal and here's what you can do to support yourself.

37:41Dr. Mary Claire Haver:So the conversation around menopause and perimenopause, mostly menopause, has really exploded in the last three years. So in your research, are you seeing now that we have at least there's better education there's better awareness women are talking about this openly are you seeing better outcomes at the end now that we're starting to get some systems in place and the you know the medication and the training part will catch up we're far behind there yeah what are you seeing like today so if you think about that question and ask what do we mean by outcomes we can say yes like there are some women who are suffering less in certain ways, like the things that they were going to seek their doctor for support with.

38:21Okay, they're getting some treatment for it. Sometimes it works, sometimes it doesn't. They are having conversations. But where the conversation still needs to go is what does it feel like to be you? And what do you want to do with this time in your life? And thinking about outcomes, not just in terms of managing pathology, but outcomes in terms of flourishing and well-being and women feeling like they get to drive their life. I think we have a lot further to go in that conversation because we've been there's been such an absence of dialogue about menopause and perimenopause you talk about three buckets oh yes yeah the discourses yeah so what how is that conversation going the discourse around menopause and perimenopause is a way of understanding the different kinds of filters that were given on an experience and those filters actually shape what it feels like to be us so an example of that like the i'm going to paraphrase some of the the discourses.

39:14One of them is your body is a problem. And if your body is a problem, well, one, who's saying that and who benefits from that statement? And also, how does that make a woman feel? But if that is also something that we've been told our whole life, we might not even realize that that's a specific framework and you could see it differently than that. And then we have the, this is really hard, but I'm going to liberate myself. I'm going to come to my own rescue kind of discourse, which is like, take charge of your health, right? You can be empowered to do something different. There's still a risk and a problem here.

39:47And what we see for women is that there's a little bit more agency to that, but the underlying tone of that often is still, this is like something bad is happening here.

39:56Dr. Mary Claire Haver:I need to fix something that's broken. Yeah. And then there's the emancipation dialogue or discourse, which is a filter that's put on all of this where perhaps we're invited or encouraged to see what do I get to be free from here? If this is not just about the ending of something, but about the beginning. Or if I get to, like you said, like if I get to chuck things and not just chuck tasks or jobs, but also ideas about bodies, or I get to chuck stories about myself that no longer serve me, there's an opportunity instead of seeing this whole thing as a problem, seeing this as part of the way that my body is joining with me in towards my liberation.

40:35Dr. Mary Claire Haver:And what is the point of all this? Like, is it that women overall are happier or they live longer? Like, like, where does this go? Yeah. Yeah. Well, is there, is there a problem we're trying to fix overall? With, with what? Well, the way that women think about their bodies, think about menopause and how they transition. What I was seeing was silence in the medical world. Like, well, there's nothing we can really do for it. And she's probably a little bit crazy. So just cut her on the knee and get her going. But when I saw the New York Times article from Susan Dominus that really kind of ignited the conversation around, hey, but it still feels like, are we trying to fix something that's broken?

41:18We're women not happy. I think the point of all of this is that we get to enjoy our lives. I want to enjoy my life. And what I know that people want, in addition to having a sense of meaning and feeling like their body is safe and like their relationships are refilling. It's like when we get to the end that we get to look back and say, I lived well and it felt really good to be me and I got to live the way that I wanted to. And it's really hard to do that when it feels like the conversations about how to have agency in your life are gatekept from you or the pathways or the opportunities that can catalyze this deep personal change and growth are characterized as a problem.

41:59Dr. Mary Claire Haver:Yeah. It's really hard to lean in. Like there's even some women who will say, you know, I'm not really struggling with, you know, symptoms of menopause. It feels like, whoa, all of a sudden I'm here and I didn't even know that the transition happened. I'm like, okay, I was ready for this bit. You know, I was bracing for this big thing. But even they will say, but I didn't get to participate in it because I didn't know what was happening. And I want to know what's happening so that I can join in, like, constructing my life, having agency, feeling like I got to be the author of my story. And it's really hard to do that when men are holding the pen, when medicine is holding the pen, when society and patriarchy are writing the rules.

42:40Exactly. And writing the scripts. That's it.

42:43Dr. Mary Claire Haver:And, you know, how women are showing up in TV and media. I think we're getting better. There's a debate about that. Yep. You know, I think women's stories are becoming more representative. Yes. We talked before about the CBC had done small achievable goals. Right, yeah. The BBC has done Riot Women. Yeah. And I'm seeing Reese Witherspoon and her work, you know, elevating women's stories as women as a central character who's not looking for a man to savor. Yeah. Or even I'm thinking about Kate Winslet, who said very publicly, this is what an aging woman's face looks like. This is actually it. You might not see it very often, but here it is, right?

43:22Like we're having this like more. You're right.

43:24Dr. Mary Claire Haver:There is a little bit more room to have some of these conversations. So myself, my patients, people I see have spent decades, their body is this object they have to control. When I tell you, thin was always the goal. How you looked. I was exercising to look a certain way for a certain gaze. I was eating to maintain a certain weight so I would look a certain way. And even medicine reinforced that. If you weigh X and you're on this scale, regardless of how much muscle or how much my bones weighed or where the fat was deposited, you know, you were healthy. There's a lot of undoing to be done here.

44:07Dr. Mary Claire Haver:So what changes, you know, when their body rebels and they can no longer, because I see it every day, they can no longer maintain this. It is physically impossible. This is a predictable biological consequence. Yes. Of menopause is your body composition will change and women are not okay with it. There's a lot of grief to be had. And I mean that in a couple ways, like the grief of losing a body that we thought we could keep forever. And we were told was our way to be loved and valuable that, that actually deserves grief. If you were holding onto an ideal and everybody in your life and the systems around you was reinforcing, that was important.

44:46And we bought in to be able to To actually let that go requires feeling the pain of it. In terms of affective neuroscience, the role of grief and the function of it is to allow something to be released. We can't move on to something new unless we feel the pain of letting go of the old thing. So we need to grieve, but we also need to grieve that that was normal. Those stories were reinforced and all they did was keep us from our power and our ability to enjoy our lives and feel pleasure and a sense of agency. I was going to say like to have a really good meal and enjoy the pleasure of it or to have like I'm thinking about even having an erotic experience or having a sexual encounter which isn't filtered through the angle of how is my appearance being perceived but oh my god this feels good like the different way we show up in our bodies when this feels good is what's driving us instead of, okay, I'm going to lose my appearance value if I don't make these choices.

45:46It's a really important thing to be able to grieve. But this is where the embodiment literature comes in here. And embodiment, when we're looking at it from a psychological and philosophical perspective, is about what does it mean to be me in my own skin? And what does it feel like to be a body? And how does the world around us shape what it feels like to be me in my body. And there's a whole subsection of research literature about positive embodiment, which reminds us that our body has always been so much more than an object. And so when we're navigating this change of an aging midlife body, a body that's now through menopause or is in perimenopause, all of a sudden, yes, there can be the grief and the loss and the struggle and the tension and the conflict.

46:30And we can spend lots more time talking about that. But there's also this whole other way of relating to our body that opens up, which is to see our body as this place that holds all the memories of what we've been through, that holds like strength and power. If I'm not thinking about being thin, maybe I can actually get to be strong, right? And maybe the strong in my body isn't just something that shifts my muscle mass, but changes the way that I see the world and gives me a sense of like a fortified and embodied power that I carry into every conversation. This like the conversation about embodiment suggests that mind and body are not so separate.

47:10And every time our body is changing, that it's shaping what it feels like to be us and on our mind and the way that we think about things.

47:15Dr. Mary Claire Haver:You talk about that we can't really separate the menopause experience from fertility, relationships, social support, stress, trauma, all the things. But what are modifiers? Like, how do you think? So here's a woman listening to this today. And she's like, give me five things. Yes. Like, what are my five things? How can I modify this? So you're probably going to answer that question really differently than I would based on your disciplines. Yeah. But when I'm thinking about, okay, not just symptom management, but the developmental arc, like who am I becoming? You're giving women permission to think about this.

47:51Do you understand that?

47:52Dr. Mary Claire Haver:Like we've always framed ourselves, at least I have, as how am I serving? Yeah. Right. It is my job to make the world better, not to make me better. It's so time for that to shift. And what we know, like it's just what we know that we know that we know in feminist scholarship is that when women are connected to their power, everybody does better. Like that old myth that we were told that it's going to make you selfish. No, guess what happens to women who are self-assured and confident. They give information away. They contribute to their communities. They model healthy integration of a self. They give a different story to younger women saying that this is something that's available for you now.

48:31You don't have to wait. Like here, this is what's coming. This is what's possible. And it completely changes the experience of anticipating and experiencing menopause if you know that what's on the other side of it is this deeply empowered, self-connected, sovereign place. So we know that there are lots of things that shape, that predict if this is going to go well for you. Or is that kind of

48:55Dr. Mary Claire Haver:what you're asking? Like, how do we help women do better? Or is that? So someone's struggling with her body image. Oh, it's for her body image. Yes. Okay. I think we need to kind of forget the body image conversation. We've way over indexed on image. And this is like something, you know, this is like maybe a little bit of a new idea for some people, but our body is actually not just the image that we have of it, right? Our body is not just the mental story we tell about how we appear. What is it? Our body is that feeling you get when you see the person you love. Our body is the memory of being a kid and running off the end of the dock and jumping into the water.

49:33Our body is the experience of looking down and seeing the scar from the time that thing happened. You're like, oh yeah, that really happened. Our body is that felt sense of knowing, don't get into the cab. Our body is the intuition and wisdom. It's not right. I need to go this direction. Our body is cognition. Our body is memory. Our body is intuition. Our body is emotion. Our body is pleasure. Our body is expansion. You can even go into embodiment and talk about embodiment and And our bodies really is being the pathway of connection to all things. Like everything that's alive is breathing. And so there is a huge territory here around seeing our aging bodies as replicating nature in a way that moves us into a spiritual conversation.

50:18Like, oh my gosh, my body is growing rings, kind of like a tree is. I am expanding. Or like everything in age decays and softens. Everything.

50:30Dr. Mary Claire Haver:Do men have this? Is this just a female thing? I don't see my husband lamenting too much. About body image? A little bit. Yeah. He lost his hair at 25. Yeah. A long time ago, he's bald. And that was hard for him. Yeah. But, you know, we're past that. But he just is going with it. And it doesn't shape who he is or many of his decisions. Men have historically been kind of inoculated from some of the same stressors and pressures around image. I would say that like they're increasing and that as social media is increasing and access to resources that can shift appearance are increasing, that men are more likely to have some struggles than they have.

51:10But the truth is that this has really been a misogynistic patriarchal conversation that to entrap women in the conversation about their body being the only thing that matters about them and a thing that they have to control. Otherwise, they're going to lose any access to social power that they have. Like that's a gendered narrative. And so women post-menopausal are getting free from that because that story, when we look at what the research literature says about where that starts, it starts, yes, in childhood, but really around puberty. when you start menstruating and your body becomes sexualized, all of a sudden the gaze is on you and you leave inhabiting your body from an inside place to observing your body and objectifying yourself on an outside, from an outside place.

52:00Dr. Mary Claire Haver:Do you think that's starting younger and younger now with the access to social media that the kids have? Yeah, I think it's starting younger and it's feeling more insidious and normalized and the world is really changing. And I think parents have to have a lot more skills at their disposal and information around protecting their children from the stuff that's out there. Because what we're seeing is kids are requesting plastic surgery earlier and earlier, that their efforts in order to change their appearance are increasing earlier. Instead of letting kids be kids and have the freedom from that, like that's gonna come at us.

52:34It's gonna come at us in the world that we're in, but can we protect our kids from being exposed to that? That they're harmful ideas that are connected to anxiety and depression and eating disorders and all sorts of self-harming behaviors. It's really important that we gatekeep, I think, social media for kids and their exposure to those ideas and then give them tools to critically think about what they see when they see it. Talk to me about connection and health outcomes. So this is like something that has been so unexpected in the research that I've done, which is that women do better all around when they're connected to each other.

53:11And what has been shocking about this, like I just ran, I've been running group therapy for perimenopausal women for years. And we just did this particular condition where we were doing pre-post measures and really, really looking at what are your symptoms coming in? What are your symptoms going out? As well as other indicators of health, like how's your access to your emotions and your emotion regulation? What's your level of social connection? What's your sense of meaning in life? And what we found is that women's, not only their symptoms of perimenopause decreased, but their distress about their existing symptoms decreased when they were connected to another group of women and actually processing through the transition.

53:50and they're talking about it. Like they're not just talking about, you know, whatever else is going on, what shows they're watching. We were there intentionally to say, what's happening in your life? How is this feeling? What's concerning you? What is it like to be you? What kind of stuff are you wrestling with? That at the end of the 12 week program, as I mentioned, women's symptoms decreased, but their distress about their symptoms also decreased. And that's a really interesting thing to note too, that you could have symptoms and perimenopause and not be distressed by them. Right. That you they could be present.

54:21But instead of feeling like it's coming with all of this shame or anxiety, like, oh, I know what's going on. I have some acceptance over it. I have some ways of being with it. I have some strategies for it that that all of that came from women talking to each other.

54:35Dr. Mary Claire Haver:So one of the reasons I wrote the new perimenopause was that women said over and over again, you know, when we did the postmortem, you know, for my postmenopausal patients, I wish I would have known more so that I wasn't blindsided because that just made it worse. you know and i can just now that i understand so much more about inflammation and cytokines and you know anxiety that you know i remember brooke shills getting her period on the blue lagoon right i'm old okay so i'm dating myself but and it was this like she thought she was dying you know because no one had taught her what menstruation was and here she is on this desert island running around with this kid and she literally was petrified and like i started my period surrounded by my friends who were cheering me on and they had all the stuff ready.

55:22Dr. Mary Claire Haver:And I was like one of the last ones. And I was like, thank God, finally, you know, and like how different, it just struck me how different and like what that would have done to my cortisol, cortisol levels and my stress had I not had all of that preparation and information ready to go and that this is normal. And yeah, I might have cramps or might be really heavy, you know, but we have ways to deal with that. So it's not scary. It also speaks to the importance of intergenerational dialogue. Like when we were not talking to women who are older and younger than us, everybody loses out. There is something so important about having those friends who went through it or the cool mom you can ask the questions to or your friend's auntie who's like, hey, this is what's coming for you.

56:03You can ask me any questions. I got you. Or the way that mothers use that as part of a transition to motherhood to be able to say, okay, who's got the stuff? What did you do? How do we do this?

56:14Dr. Mary Claire Haver:How do we navigate this? Yeah. And I'm sure you probably even had that when you were going to medical school, like talking to other people. Like, how did you cope? It was cool because we had like big brothers and big sisters who we were assigned to. And thank God, mine were incredible mentors. And they saved like the old tests and they had like a care package and, you know, kind of like shepherded me for all the scary parts. No, it was incredible. We need those conversations. And yes, there are lots of other things that help women do well in perimenopause. But it seems that that is one of the things that mitigates the fact that there still isn't access to information for so many women.

56:51that if you were talking to a friend, but she's got information or she's read a book or she's tried something, that when we are connected to other people, we get exposure to different ideas, different pathways. Even someone saying, hey, here's how I got through something hard, all of a sudden creates the possibility in us, maybe that could work for me too. So you did therapy with psychedelics

57:13Dr. Mary Claire Haver:and were they legal? How did that go for you? So in the context of a medical clinic, We have a physician prescribed and administered and is tracking all of the data to make sure that everybody's healthy and they're screened appropriately. But we're using the psychedelic in conjunction with group therapy. And the idea is that women are supporting each other to process through what is this season of life like. But then the psychedelic condition is giving them a chance to disorganize and reorganize some of the deeply held beliefs about themselves. to look at things from the past, but without the same kind of fear and to begin to hold new ideas about themselves.

57:49How long does this take? Yeah. So this was a 12 week program. Well, like,

57:53Dr. Mary Claire Haver:I'm just so curious about psychedelics and I'm sure people listening are, how long does the medication last? How long are they in the room? Are they laying down? Are they sitting up? Are they like, please? I'm like, cause I'm envisioning a room full of people laying with some, someone doing music or they're all just talking. No, no, no. So the dose, the dose depends on the person. There's also like a length of medication that depends on which medication you're using in the context of what we're doing here. The medicine lasts about 90 minutes to two hours, but we're in, in a group context where everybody is in the room having their experience at the exact same time.

58:30And it's a really powerful thing of, you know, you're in the middle of your, your psychedelic trip and somebody is in the corner who you've been journeying with and they're, you know, they're over there and they're weeping or this person's over here laughing. And all of a sudden it feels like, whoa, it's kind of shifts and impacts my experience. It's a really powerful, really powerful way to do the work together. Amazing.

58:50Dr. Mary Claire Haver:You've talked about reorganizing body scripts. What is a body script? I think I know what it is, but please educate me and my listeners. Yeah. We just have stories that have been handed to us really since the get-go and we often pass them down intergenerationally. But a lot of them are like, you know, your body needs to be thin in order to be good or young or fertile or pain-free, or your body needs to look like this, or you need to have this kind of shape to this body part. Or how about things like your body's bad, right? Your body's inherently bad and dangerous and you need to control it, right?

59:24There's a lot of religious trauma in that. Your body is a temptation. Yes, exactly. It's going to lead someone astray, but also wield your body appropriately because it's how you get power. I mean, there's a lot of stories that are embedded at the implicit level in our culture and also things that we might've been told, like suck in your stomach or like watch your posture or don't. That was not about you. That was about, you know, what we say. I tell it to myself all the time.

59:48Dr. Mary Claire Haver:Well, can you help women rewrite that script? Yeah. Is that what you do in therapy? Yeah. I mean, therapy is really important, but also consciousness raising. Like, what are the scripts? Like before we even start to rewrite them, And what are the scripts that we've been told? Do you feel like we're our own? This is all internal because I've seen the, oh, it was a commercial or something, but it was an experiment. And then a woman would describe herself. And then a stranger would like view her photo or image and then describe them. And it was so different. She focused on what she felt was negative.

1:00:18Dr. Mary Claire Haver:And the stranger who didn't even know her told, God, your hair is so beautiful and bouncy and curly and you have these big blue eyes. And it was just such a mind altering for me, you know, to watch this experiment because we are so self negative. Yeah. And we loop on a lot of the same things around our bodies. It's really when you think about it, it's actually really hard to have a new and novel thought about your body that's positive because we have so much rehearsal. We've just been practicing many of us since we were young. This is how to see my body. and sometimes it's a cultural shift that changes and we get exposed to a new idea from the outside sometimes it's a physiological shift all of a sudden you lose movement or mobility maybe you lose access to a certain athlete patients really struggle yeah and they lose their their ability to function at what was their peak right or there's pain all of a sudden you have pain and you never had pain and you're not able to do the things that you were able to do to be able to reorganize our scripts, sometimes that happens because of unexpected things, you know, like loss or illness or aging or whatnot.

1:01:23So to reorganize our body scripts, again, usually requires us on some level, if we're going to be conscious about it, thinking like, what was I taught and who benefited from that? Where did I learn that? Did that do any good for me? Does it actually lead me to live a life that I want to be living. But as I was saying before, I think that there's a lot about shifting our scripts that actually has to do with experience. So we might have a story in our head that says your body's only good if it looks like this. But then let's just say you have a friend who comes into town and they're like, hey, you want to go kayaking?

1:01:57And you go kayaking, you're not really used to going kayaking, but then you go and you have this experience of feeling like strong and connected to nature and connected to your friend and feeling free. And you're like, I can go anywhere in the water. And that's a new body experience that if you let it integrate into your body story can actually help us push back on the appearance only conversation. So when I said earlier, like, I think we kind of need to drop the body image conversation. I'm just not interested in that as like a really useful avenue to explore. What we see is that if women are less concerned with how they look and are more preoccupied with what makes me feel good.

1:02:36Dr. Mary Claire Haver:See, I worry on trading the look for performance. Right. Yeah. So how far can I hike? How high did I go? I'm constantly like chasing those metrics. Yeah. Okay. Maybe I'm not thin in the way I used to, but I'm going to try to be stronger. Yeah. And it's fun to have a challenge sometime and it's fun to realize like, oh, I can like work on something and improve. But at the end of the day, am I connected to the place of pleasure inside of myself? Do I know how to listen to my body cues? Am I resisting objectification? Do I feel a sense of comfort inside of myself? Do I know that I'm more than an object, that I'm actually like a full human that has a body worth listening and paying attention to?

1:03:18Those metrics or those ways of looking at embodiment tend to be more predictive of a positive relationship with our bodies. Maybe we could forget about trying to even do body positivity or loving our image. Like, I don't know if anybody is actually like, I'm the perfect specimen. like we know that the closer you get to the appearance ideal the more anxious you are about losing it so like the truth is that people who society has said look the best often have to worry a lot about like losing that and so maybe we can just kind of opt out of that conversation in that game and have a conversation about what food do I like to eat and when do I feel free and what is the way that I want to have sex that actually feels the best for me and not is about like performing some sort of story of sexuality that looks like I think it's supposed to look.

1:04:07Can I inhabit myself? And can it be good? And I think perimenopause is an invitation into all of that.

1:04:13Dr. Mary Claire Haver:What makes you hopeful? That we're having these conversations, right? That you and I are here talking cross-discipline, maybe cross-generation, and inviting in conversations that take us past pathology, take us past symptom management into who do I get to become? I think that makes me feel hopeful that women are finally getting access to the thing that has been ours and is our right and has been our right all along, which is I get to shape the life that I want to be in and I get to feel good about it. As we wrap up, what are your top three takeaways for our listeners knowing our demographic is heavily females of 35 to 70-ish?

1:04:53Well, the thing that we've been told about our bodies all along doesn't have to be true and you get to change that. That feels like a big takeaway. Talk to people. Talk to people about what's going well, what's not going well. Make space for a wider story. That feels really important. And I think seeing the challenge not necessarily as a barrier to growth, but actually the pathway through it, that anything that feels like this struggle, there is something for you in it. There is something that can be learned that you get to have and know about yourself on the other side that nobody can take from you.

1:05:27And that's a gift going into whatever comes next. Awesome. Well, Dr. Hilary McBride,

1:05:31Dr. Mary Claire Haver:thank you for joining us on Unpaused. Thank you for having me. You can follow Dr. McBride on Instagram at HilaryLeonaMcBride or through her website, www.HilaryMcBride.com, where you can find more information on her perimenopause therapy groups. Season five of her CBC podcast, Other People's Problems, is out now. Her next book, Embracing Mortality, will be out in early 2027. And her other books, including The Wisdom of Your Body, Mothers, Daughters, and Body Image, and Practices for Embodied Living are all available now. You can find full episodes of Unpaused on YouTube at Dr. Mary Claire. I'd love to hear from you about this topic and anything else that's on your mind.

1:06:14Dr. Mary Claire Haver:You can find me on Instagram at Dr. Mary Claire and get honest, accurate information on health, fitness, and navigating midlife at thepawslife.com. My book, The New Perimenopause, is available for order on Amazon. Please take a moment to follow Unpaused on your favorite podcast app. Following and listening is what pushes this information to more women who need it. So if this podcast has helped you feel seen, understood, or supported, hit follow right now so you never miss an episode. Thank you for being here with me. Let's keep going. Unpaused. Unpaused is presented by Odyssey in conjunction with Pod People.

1:06:52Dr. Mary Claire Haver:I'm your host, Dr. Mary Claire Haver. The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.