Podcast Summary: Better! with Dr. Stephanie
Episode: Energy, Effort, Purpose & Pleasure in Perimenopause with Dr. Diana Hill
Date: September 22, 2025
Host: Dr. Stephanie Estima | Guest: Dr. Diana Hill, Clinical Psychologist & Author

Episode Overview

This episode dives deep into the emotional, psychological, and physiological transformations women experience during perimenopause and menopause. Dr. Stephanie and Dr. Diana Hill discuss why aging need not be hopeless, and how to approach it as a period of growth, vitality, and joy. The conversation explores grief, burnout, energy management, creativity, pleasure, and the concepts of “genius energy” and “wise effort.” Dr. Hill draws from both clinical experience and her new book, Wise Effort, sharing actionable strategies for embracing change, aligning actions with values, and living more authentically and energetically as women enter midlife.

Key Discussion Points & Insights

1. Reframing Effort and Burnout in Midlife

• The Problem with Over-Efforting
  • Many women associate worth with working hard, multitasking, and perfection, but this often leads to overexertion and disconnection from what really matters.

    “Working harder is actually the problem for women. It's not the solution…working wiser, not harder.” – Dr. Diana Hill (05:13)

  • This over-efforting is ingrained from childhood through praise and societal expectations (07:05).
• Where Our Genius Goes Astray
  • Our greatest strengths (“genius energy”) can become sources of stuckness and burnout if overused or misaligned with our values (10:18).
  • Dr. Hill gives the example of going overboard with elaborate birthday parties to try to gain approval, leading to less connection rather than more (07:05).

2. Identifying and Honoring Personal Genius

• How to Discover Your Genius
  • Look for repeating themes: what you were “too much of” as a child can be clues.
  • Ask trusted friends/family, “What do you notice about me that makes me me?” (12:49)
  • Psychometric tools like the VIA character strengths assessment may also help (12:17).
  • There’s a parallel between adolescence and perimenopause: both involve re-examining identity and core strengths (13:49).

    “A question you asked yourself when you were 13, maybe you're asking yourself again at 43: What makes me me?” – Dr. Diana Hill (13:49)

3. Burnout and Its Roots in Perimenopause

• Three Main Drivers of Burnout in Women
  1. Exhaustion—physical/mental fatigue
  2. Performance Decline/Perception of Decline
  3. Detachment—emotional distancing from things/people that matter (19:03)
• Psychological Contributors
  • Internal stories: self-criticism, negative future thinking
  • Avoidance of discomfort instead of processing it
  • Resistance to change (“rope burn”): suffering is proportional to how tightly we cling to things staying the same (18:52, 19:03)

    “The more you try to keep things the same, the more you will suffer...the more rope burn you are going to acquire.” – Dr. Stephanie (00:28)

4. Grief as Part of Midlife Transition

• Types of Grief
  • Not only related to death but also changes in roles, parenting, relationships, or unfulfilled expectations (22:17).
  • Citing Francis Weller's “five gates of grief,” Dr. Hill explains that loss is constant, and we must learn to become “apprentices to grief” (26:44).

    “Everything you love, you will lose.” – Francis Weller, as cited by Dr. Hill (26:44)

  • The power of presence: staying grounded in the moment is the most healing approach (27:41)

    “We're grieving because we love something, and then you can land in the love.” – Dr. Hill (29:00)

5. Processing Difficult Emotions: Practical Steps

• Stepwise Approach
  1. Find the emotion in your body—locate sensations, not stories (32:29)
  2. Make space for it—breathe around the sensations, don’t try to “solve” (32:38)
  3. Name the emotion—reduces intensity and gives you perspective (32:42)
  4. Ask 'Why are you here?'—behind every feeling is a value or need; this leads to action (32:42)

  “Behind every strong feeling is a strong value.” – Dr. Hill (34:16)

• Movement and Emotion
  • Moving your body (walks, gentle movement) can help metabolize many emotions, especially anxiety or depression (36:00–37:55)
  • For rage/anger, sometimes slowing down and not acting physically is safer and more effective (37:54)

6. From Small Self to Wise Self

• Cultivating the 'Wise Woman' Archetype
  • Imagining and embodying a future, compassionate version of yourself (or drawing from admired figures) can help steer decisions and reactions (42:04).
  • Compassion-based approaches can be a powerful tool (43:14)

    “You are like a tuning fork...whoever it is, whatever energy it is that you pick up on, that's the thing you want—you can be that.” – Dr. Hill (43:15)

7. Aging, Self-Acceptance & the 'Sunset' Metaphor

• Letting Go of Attachments
  • Fighting changes in appearance/body will cause suffering (“rope burn”); appreciation and love for the present moment can ease the journey (47:49)
  • The 'sunset' metaphor: appreciate each stage as a unique and beautiful phase, knowing it will change (47:49)
• Investing in Life-Affirming Values
  • Focus on friendships, creativity, or other values-based practices rather than holding onto youthful ideals (50:57)

8. Reclaiming Pleasure and Creativity

• The Physiology of Joy
  • Even under stress, focusing on pleasure (big or small) improves mitochondrial function and energy (51:44)
  • Simple routines (e.g., special morning coffee, flowers, silence) can set the tone for the day (55:27)

    “It's not only about us. It's also the transmission of energy…when you experience more joy…you give off a different energetic vibe.” – Dr. Hill (55:27)

• Creativity as Energy
  • Don't relegate creativity to an afterthought; reclaim it in daily life through small acts or artistic pursuits (56:43)
  • Dr. Hill shares a practical poetry exercise: pick a word (feeling) and an object, and write a few lines starting with “Today my ___ is…” (56:43–59:46)

9. Energy Audit & Wise Effort: Daily Action Items

• Four Pillars of Wise Effort (69:06)
  1. Whole Body Yes/No: Tune in to bodily wisdom regarding decisions/commitments (69:20)
  2. Genius Strengths: Use what comes naturally and energizes you
  3. Values Clarification: Ask, “What’s important to me in this moment?” Are actions reflecting those values?
  4. Impact on Others: Consider the “we” beyond just the “me”—how does your energy affect the collective?

When these pillars are integrated, women report increased energy, alignment, and sense of contribution regardless of age-related changes or challenges.

"When you are doing that throughout your day, then you will start to feel a little bit more energy, a little bit more aligned, a little bit more like you're contributing the best parts of you." – Dr. Hill (71:40)

Notable Quotes & Memorable Moments

• "The more you try to keep things the same, the more you will suffer...the more rope burn you are going to acquire." – Dr. Stephanie (00:28)
• "It's not just even smart, it's wisdom, which I believe grows with us, can grow with us as we age." – Dr. Hill (05:49)
• "Behind every strong feeling is a strong value." – Dr. Hill (34:16)
• "Everything you love, you will lose." (Francis Weller, cited by Dr. Hill) – (26:44)
• "There is something to appreciate [in any moment], and that can shift our energy." – Dr. Hill (51:44)
• "When you're holding on to things that are changing, it will make you feel more pain over time." – Dr. Hill (49:45)
• "It's not all hopelessness as we age…women in their 60s and 70s are happier…there’s a happiness incline in the 50s, 60s, and 70s because we’re moving into that expansive wise self." – Dr. Hill (38:49)
• "You are a tuning fork…you can be that [embodied wisdom]." – Dr. Hill (43:14)

Important Timestamps

• Core disruptive idea: Working harder is the problem, not the solution (05:13)
• Unraveling beliefs about overwork, worth, and feminine identity (07:05)
• Spotting your genius and managing “shadow sides” of your strengths (10:18)
• Perimenopause as a second adolescence – reclaiming identity (13:49)
• Drivers of burnout and 'rope burn' imagery (18:52–19:03)
• Types of grief beyond bereavement – adapting to loss and change (26:44–30:47)
• Sitting with emotions: Body-based, stepwise processing (32:11–34:16)
• Movement and emotion (when to activate, when to slow down) (36:00–38:49)
• From small self to wise self/archetype; drawing on inner wisdom (42:04–44:23)
• Letting go of attachment, sunset metaphor for self-image (47:49–50:57)
• Pleasure as daily practice and energy manifestation (51:44–55:27)
• Practical poetry as creative wisdom exercise (59:08–59:46)
• Energy audit: Four wise effort questions (69:06–71:40)

Actionable Takeaways

• Notice where you are over-efforting and explore working “wiser, not harder.”
• Identify and honor your personal “genius”—what comes most naturally and energizes you.
• Allow yourself to grieve losses and changes; do not judge or rush the emotional process.
• Practice sitting with your emotions—locate, breathe, name, and process them.
• Cultivate a “wise self” alter ego for situations requiring compassion and clarity.
• Appreciate your current self, body, and phase; fight less, savor more.
• Consciously introduce small pleasures and creativity into your routines.
• Use daily energy audits: check for alignment with body, genius, values, and positive impact.

Resource Links

• Dr. Diana Hill: wiseeffort.com & Wise Effort book
• Dr. Stephanie Estima: Podcast archives, Instagram @dr.stephanie

For anyone journeying through perimenopause or simply wanting to reclaim more energy, meaning, and pleasure in midlife, this conversation provides both motivation and practical, science-informed strategies to do so—from the inside out.