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Compassion in a T-Shirt
Menopause and Mental Health: How Self-Compassion Builds Resilience | Lydia Brown
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- [00:01]
A
Menopause is one of the most significant transitions in a woman's life and yet it's often ignored, misunderstood, or reduced to a few stereotypes about hormones and hot flushes. But for many women, menopause is not just biological, it's psychological. It touches identity, work, relationships and well being. Hi, I'm Dr. Stan Steindlie and welcome to Compassion in a T shirt. Today I'm joined by Dr. Lydia Brown, Senior Lecturer in the School of Psychological Sciences at the University of Melbourne. Lydia completed her PhD on self compassion and menopause, has undertaken postdoctoral training in healthy ageing and works clinically in women's mental health in the second half of life. In this episode we explore what menopause really is, why it can be such a challenging life transition, and what Lydia's research shows about self compassion as a source of resilience. We talk about sleep, mood, workplace pressures, blocks to self compassion, and how this work connects to positive aging more broadly. It's a thoughtful and practical conversation about navigating change with wisdom and kindness. And so I bring you Dr. Lydia Brown. Doctor Lydia Brown, welcome to Compassion in a T shirt.
- [01:30]
B
Thanks for having me, Stan.
- [01:32]
A
I'm coming to this conversation curious, but sort of relatively naive, I guess, about menopause. I can't of course, have direct experience of it, but it's very much a part of the lives of women around me, women I love and care about and that sort of thing. And so I want to sort of be something of a male ally in all of this. And so I wondered if we could start for people like me or for everyone really. But yeah, what is menopause and why is it such an important and often challenging life transition?
- [02:09]
B
Yeah. So menopause really is a day in a woman's life. The exact menopause technically is sort of the first day of your very last menstrual cycle. So anybody born with ovaries and a uterus will go through menopause if they are lucky enough to grow old and to reach that time. Not grow old though. So menopause normally happens on average about age 51. And there's a lead up to that day of your last period where you have irregular cycles. So that's called the menopause transition or perimenopause. So that normally lasts about four years. So you've got four years leading up to menopause where you've got irregular menstrual cycles. But the time frame of this menopausal sort of phase of irregular cycles and then going into the time when you no longer have cycles varies a lot. So it can last up to 10 years for some women. And it can also happen earlier or later. So about 10% or so of people might go through this sort of before age 45, for example. So it tends to happen in midlife and it affects, it's a universal phenomenon for women and some gender diverse people and it is a big deal. But it's often, you know, traditionally there's been a big neglect of menopause science and women haven't really had a lot of open conversations about menopause. They've sort of had to suffer in silence a bit. And there's not been a lot of medical sort of research or clinical practice focus on menopause. And only now in the past few years we've been shining more of a light on this major transition. And as you say, it can be, I mean, it's a very significant hormonal transition in a woman's life. Just like adolescence is. Major hormonal changes over a long period of time. Same with menopause. So your estrogen levels are going sort of up and down, there's more volatility. And then gradually, as your menstrual cycles sort of become further and further apart, estrogen levels start to drop. And post menopause they continue to drop. Progesterone changes and these hormonal changes have a big impact on the biology of women. And menopause can cause a lot of different types of symptoms. The hallmark symptom and the most common symptom is the hot flush. But there can also be sleep changes, dry vagina. It can impact mood for some women and cause a whole host of different symptoms. So it's a pretty big deal, I would say, for women.
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A
Yeah. Yes. It's amazing. The variability of it is something that I have kind of observed too amongst the different people. I know that when it happens and how long it might happen and the variation in different levels of symptoms that go along with it as well, like there just seems to be a lot of, a lot of variation there, which makes it hard, I imagine, because people can feel like they're kind of coping with it a bit alone almost, you know, or they're just sort of different from a lot of their friends.
- [05:31]
B
It's like, it seems like women's bodies all respond a little bit differently to those hormonal changes. And I guess this is why women have traditionally been excluded from medical trials or even my studies. Traditionally they've decided, no, women's hormones are too complex. There's Too much variability. So we'll exclude them from medical research because it is complicated and it can be quite nuanced. Just in the same way that for younger women, hormonal changes with their menstrual cycle, same can be nuanced. Sometimes those changes might impact your mood, other times they don't. So there's so many factors involved and that's what makes menopause a really exciting area to research. But also it helps explains why there can be confusion, because I think it genuinely is a little bit complicated in terms of an area of women's health.
- [06:22]
A
And you mentioned the lack of research. Can you sort of tell us the history there of the HRT research? That it sort of was happening and then some decades ago it kind of went dark. There were risk factors identified and we're not really sure whether that was quite accurate. But anyway, it all went very quiet for a number of decades. What's the history there with all that?
- [06:48]
B
So hormonal therapy started to become popular back in the 1950s and this, at the time was very exciting because women really did have to sort of suffer in silence. There was not really any treatments for, say, hot flushes. And so the sort of emergence of hormone therapy in the mid 20th century was. There's a lot of energy and excitement around that. And with the Women's Health Initiative, though, in 2001, this is when that large randomised control trial was stopped because of concerns about possible risks, health risks, especially breast cancer around that time. And there was shock waves throughout the world and doctors, many felt really too, too fearful to prescribe hrt. And so many women then had to kind of endure menopausal symptoms without doctors feeling confident to sort of offer any effective treatments. And so this has been sort of, I wouldn't say debunked, because the Women's Health Initiative actually has a great deal of very important research that we still rely on today. But there were kind of flaws in the analysis and the communication method. And so now we know that HRT can be very effective and helpful and appropriate treatment for many women. Not all women, though, and also not all women need treatment. But again, this is sort of one of the reasons why we've not had a lot of research in the past 20 years into menopause. And now that is starting to improve and change.
- [08:24]
A
It's such a good thing that it's. That not only the research, but just the public conversation around these topics, it just seems so important to create a sense of just that common humanity and that shared experience that women Kind of go through. There's often this focus on the hormones and the physical symptoms. And HRT can often be a really powerful, essential part of treatment. But from your perspective, what might, what can we miss maybe sometimes when we don't also attend to the psychological side of the experience?
- [09:01]
B
Well, let's say that hrt, you know, it's not essential for everybody and menopause isn't a medical condition. And sometimes it can be really helpful. But I guess with that lack of research sometimes then there have been sort of messages that it's sort of a curable fix all or that somehow, oh, aging women need estrogen to kind of keep them young or improve their skin. And there's not great sort of research to say that it is some panacea or that it's needed for everybody. And the menopause transition as it comes at a time of life that is very complex and busy for a lot of women. So not only are there these hormone changes, but it's a time when women have often a lot of, a lot to give, perhaps seniority at work or life experience. So people do gain wisdom with age and you have more to offer just through years lived on the planet. And also you may have complexities, aging parents caring for younger grown children as well. You may be going through a divorce or have had a health scare or perhaps people you know have had serious health conditions or you've experienced a loss or death and somebody close to you. So there's so much more than hormones and all of these factors combined can really interact to really have quite a profound impact. And I'm not really a Jungian therapist, but Carl Jung talks about midlife as a sort of time where there's a shift in focus. So as you grow as a young adult, it's about sort of gaining experience. Looking outward. Perhaps you grow a family, get a house or don't do those things. But around midlife there can be the shift inwards where you think, well, who am I and what do I want and what matters most in the world? This process of individuation, I think he called it. But this kind of shift inwards, which I think is really interesting. And I think menopause for women, where their bodies are changing or they might have these physical symptoms or mental health symptoms, it's sort of like demanding attention. It's saying, hey, you focus so much on the outside world and on other people and I'm driving this life forward. But what about me? Like I need some attention too. And so we can sort of use this as a bit of a gateway to think about ourselves a bit more deeply.
- [11:51]
A
Yes. As you listed, the many and varied things that are happening in midlife, I certainly could relate to a number of those, to be honest. We end up a little bit sandwiched or I can't remember what the term is that people say, but you have the, and again, it varies for people and their experiences can be different, but you might have the aging parent as well as the growing children and you might even have grandchildren potentially, but then you're still wanting to work and contribute to work. You've got this kind of growing sort of wisdom and experience that you'd kind of like to share. And grief starts to come in more too. Things start to change or losses start to accumulate. I mean, there's, there's a lot, a lot going on and, and menopause, you know, coming into, in amongst all of that. Yes, it's interesting in some ways it's a, an extra demand or stressor or something like that. But in some ways it's a signal too, as you say, it's a signal to perhaps turn inwards and, and kind of have you start to consider things, you know, about yourself and your identity and where you're heading. And in fact, your research really centers on, or some of the research centers on self compassion in the context, I guess, of, of menopause. So I guess it's, it's all of that. But, but what, what is it that drew you to, to self compassion as being a worthy thing to investigate in this, this time of life?
- [13:25]
B
Well, I thought I, I don't normally share the big, the bigger backstory. Compassion. Your, your podcast is on compassion. And so I thought I'd start there and then move to self compassion. So compassion is really for my family. So before had a brother who died in a car crash and I never met him and I never sort of suffered the direct grief from that. But growing up, it was never overt. We didn't feel like I at all lived in a sort of traumatic sort of set of circumstances. But there were these, these hints of that, this undercurrent sometimes that my parents and my older brother had been. Been through a lot, just a little conversation here or there. And so this idea of kind of suffering, but not getting weighed down by the suffering, feeling like, oh no, this is, this is a tragedy. I mean losing a child is always a tragedy. But I think from my viewpoint as this child who was entering those set of circumstances, I never thought about it logically, but it's kind of like, okay, there's suffering in the world and each human being experiences it in different flavors, different ways. But we can make it. We can sort of become. Let that get us down and feel the weight of suffering. Or we all. We can sort of use suffering as a bit of a gateway to lean in, be curious and think, well, how can I live a meaningful and happy life despite all the imperfections of life? This is kind of feeling and seeing suffering and leaning in. And women, as it turns out, can be very compassionate like that, very able to see suffering in the world and sort of leaning in and having this wish to help, this wish to care, wish to kind of ameliorate other people's difficulties. This is compassion. But self compassion, for women at least, can be harder. So later on, when I sort of graduated from uni, I did a bit of a career change, sort of gave up a scholarship in politics to spend time at a Buddhist monastery and was interested in compassion, perhaps due to this life history, but hadn't learned about self compassion yet. And I'd be there sort of trying to meditate and be really rigorous about that and meditate all day long and have this quite sort of Western mentality of striving that sort of came into the meditation. And I think really self compassion, at least in that meditation practice for me, was kind of the one missing ingredient, really. And in part it was through conversations with midlife women who tend to be a big meditator group, a very sort of cohort of the population that are very likely to meditate compared to other. I think the most common meditator is a midlife woman. And so, yes, so the missing ingredient of self compassion. And I heard about that in a Western context, I think, really through like a Western sort of meditation teacher who'd brought that up. And I thought, oh, my God, yes, this is what. This is what I need. I'm not compassionate towards myself. And speaking to other sort of midlife women who. Who I tended to hang out with as a young adult quite a bit because of the meditation, shared interest, they would say that too. And that's what the research says, that women are good at, being kind to others. They have sort of high compassion for others, but they have on average, slightly lower compassion for themselves than men. So they struggle with this kind of bending of the energy of compassion, which is this wish to heal, this wish to care for suffering. It's difficult to do that to yourself. So it really was very, very personally meaningful for me and I think so relevant to the midlife context. And for women, which I'm sure we'll talk more about as we go along.
- [17:25]
A
Yeah, well, thank you for, for sharing that story and the sort of, the, the, the arc of experience there as it, as it sort of happened for you. And it is such a curious phenomenon, isn't it, that, that women can be so compassionate towards others and yet find self compassion hard. I guess there are sort of socializing kind of factors in that, that that's how they might be brought up or what's expected of them or, you know, those sorts of things. Perhaps there are other fears, blocks and resistances there. What's your hunch about the blocks really for women? What comes up for them?
- [18:08]
B
That's a huge topic. And I think also across genders, you know, we're even young children are not really taught about being kind to themselves. Maybe that's changing now, but it's for any adult. So if you speak to any adult, self compassion really only entered the scientific discourse to my knowledge, sort of mainstream. Lisa, I'm more trained in the Kristen Neff sort of sort of approach to self compassion and her first paper was published in 2002. So really self compassion is a foreign concept to the West. We're taught how to be kind to others, we're taught to be thoughtful about others, but we're not really taught to be kind to ourselves. And I think that's for men and women included. But then I guess, you know, as women grow up there, perhaps there's even more pressure. I'll be a good girl or you know, share. And both genders have that. But the good girl thing has this kind of weight to it, I guess, or this bit of connotation and just this sort of expectation that you care. And so it's. So we might have a natural sort of leaning towards empathy and then our culture also kind of intensifies that. So we flex our muscles for care, but then we don't have many opportunities to kind of flex those muscles for self care because we haven't really been taught how.
- [19:39]
A
Yeah, there might be partly a discomfort about it, you know, worrying about being selfish sort of thing, you know, and. But there might also just be a block there, you know, just not quite sure what it even means to be self compassionate, you know, just having been so focused on looking after others. It's sort of an unfamiliar concept that we might try to introduce.
- [20:05]
B
I know, like there can be so many blocks. So part of it is just the, like the lack of education around it or even thinking about it, but a nice kind of Little trick is just a simple thing like, well, what would you say to a friend? And then, oh, well, I, you know, I couldn't find my keys and I was running late and I was letting everybody down and I was so frustrated because I just felt like I just shouldn't have done that. Or would you say to a friend and then that just little question can just help with the language of self compassion a bit? Oh, well, how can I, what can I say to myself in that, in that moment? Or if you say something a bit awkward in a, in a social setting and then you beat yourself up about it, it's like, well, what would I say to a friend? So I love that little question to kind of help. But women will have a lot of sort of reasons and as you mentioned about selfishness, so yeah, like, isn't it selfish to carve out time for myself or to kind of prioritize my own needs? I don't, I want to give back. I want to, I want to, I want to focus on other people. That, that, that, that's a meaningful life. Sometimes people will kind of say, I don't want to be selfish. But we know that self compassion is very different from being selfish because self compassion is including your own needs on an equal playing field to other people. So really treating yourself very equally to how you might treat others. Whereas selfish is putting your own needs above others. So there's a bit of hierarchy there. Whereas self compassion has this ingredient of common humanity where you literally value yourself no more or no less than any other being on the planet. Planet.
- [22:00]
A
Yes. I often think about Chris Skermer saying to me at a, at an MSC retreat that it really. Self compassion is really just widening your circle of compassion to include yourself sort of a thing. And that helped me a lot too to, to sort of see it that way. You know, where we, our compassion is for other living beings and we're a living being and so, you know, we're part of that circle almost. And, and sometimes it's, it's trying to find a way to just help people conceptualize it such that it's not, it's not threatening or it's not kind of unfamiliar or uncomfortable, but it sort of helps to make sense.
- [22:37]
B
Oh, sorry. Sorry I interrupted.
- [22:39]
A
That's okay.
- [22:41]
B
I was just gonna say it can feel so foreign and so threatening though sometimes for people, self compassion, it can just feel like you're out of your depth sometimes if you're thinking, well, I've also motivated myself through harsh inner critic. That's another barrier we could talk more about. That's a common barrier. And if you're like oh my God, I like. It can feel overwhelming sometimes for some, for some clients or for some people to think about actually genuinely being compassionate to themselves emotionally. Not just thoughts, but that sort of like a deeper kind of level of also emotions of oh well, I've beaten myself up for a long time. I don't know how I, who I'd be or how I'd feel if I was kind to myself.
- [23:29]
A
Yeah, we can be so up against the self criticism and the way that that's just always been part of what we have, have thought has motivated us, you know, or you know, that we. Is there in women who perhaps are experiencing perimenopause or sort of arrive at menopause, are there particular factors that make self compassion harder there? For example, the fact that it's been for some time kind of an unspoken experience, you know, that there's almost a sense of well, I just need to put up with it or soldier on. But is there specific blocks there for those situations?
- [24:15]
B
I think that yeah, I'll get to a block for women, but also a block is that it could at worst be a bit gaslighting and feed exactly what you're talking about of the fact that women have sort of often been told by doctors, there's nothing I can do for you. I don't know what to prescribe or I have nothing to prescribe. I don't, haven't really been trained in menopause. I'll refer you to a, to a specialist clinic but then the wait list is really long. And so it were self compassion could kind of be more like look, this is on you. You should, you should kind of figure this out by yourself. That's definitely not what I mean when I say self compassion. So really I think the first step is kind of getting the practical thing though. But first step when it comes to self compassion and menopause is to look outwardly. So yes, as an individual we have, we have a responsibility in our role to build self compassion within ourself. But when it comes to menopause, start by looking at the supports around you and to see if they're adequate or not as a starting point. So like do you have a good doctor that, that feels sort of competent and is able to listen, understand and listen to your experiences and support you adequately? Do you feel like you've got a voice to talk through what you're going through when it comes to menopause with friends or family? So Looking outwardly I think first, but then not stopping there and then also looking inwards and thinking, okay, well during this time of my life that could be tumultuous or could be just really busy. It could be a very exciting time when you've got more seniority at work. You've got a lot going on. But thinking, okay, well how can I cultivate self compassion which we know doesn't come naturally to most women and I think it's a really exciting journey.
- [26:17]
A
That's such a helpful little piece of nuance there that you mentioned about. Sometimes self compassion can feel like, you know, oh, what? So I have to just keep doing it all by myself sort of a thing. And it can actually feel very disheartening if it gets sort of, you know, sort of delivered in that sort of a way to a person or the person interprets it in that sort of a way. So the idea of also opening up to receiving compassion and having those social supports and talking to others and communicating perhaps with other women and so on is, is such an important kind of first, first step because like I think based on your findings and so on, I mean self compassion helps, it helps with coping and it helps with coping with some of the physical challenges of, of men of perimenopause or menopause as much as, you know, psychologically. So tell us a bit about, yeah, the findings there and how self compassion can help.
- [27:20]
B
Yeah, so we know that self compassion is quite a powerful predictor of well being across the lifespan, but especially in the context of menopause. So some of my earlier work from my Ph.D. i graduated back in 2015, so about a decade ago now. But we're looking at the possible role of self compassion and support and potentially supporting women going through hot flushes. So those that's the most sort of burdensome, impactful symptom on average. Women have a lot of different symptoms but people say that the hot flushes because if you wake up multiple times a night sweating or that's really impactful and during the day as well. So we were especially looking at hot flashes to see well is self compassion relevant? And so it was a survey based study looking at women living in Victoria and New South Wales, about over 500 women. And we found that women high on self compassion for any given level of hot flashes, so say they had a lot of hot flashes, maybe 10 per day. A woman with high self compassion was able to kind of navigate those symptoms and manage them with less impact to daily life and mood. Whereas women quite low on self Compassion would be much more impacted by those symptoms, so more likely to have a lot of sequelae from the hot flushes and more likely to be at risk of depression. So it looks like the data is showing that self compassion is a bit of a buffer that can help women manage some of the symptoms of menopause, such as a hot flash.
- [29:10]
A
By the way, you were quite an early adopter and if you finished your PhD in 2015, I think Krista Neff published her book self compassion in 2011 or something was it? And I mean, I know her initial paper was 2002 or 2003 and so that's really amazing that you were producing this data and these findings so early on. But yeah, there's this very. It's fascinating really, isn't it, that self compassion seems to be more powerful in predicting wellbeing than perhaps the severity of those difficult or challenging symptoms.
- [29:52]
B
Yeah, that's right. So some of our other work shows that self compassion can sort of be a stronger predictor of well being or depressive symptoms than say menopausal symptoms. But again, I would, I would hate to sort of dismiss the impact and burden of menopause. Rather, I think this is more shining a light on, wow, self compassion feels really relevant and it's interesting from a, from a scientific perspective because of, you know, I really think that self compassion can obviously be used sort of alongside other treatments like hormone replacement therapy, but sometimes how you design trials you have to say, oh well, you can't take any other medication, otherwise it's not a good quality trial and you just have to do self compassion. But I kind of think, well no, but, but the whole point of self compassion is that it can be an effective treatment but alongside other approaches. I love the flexibility of self compassion and how it can be used alongside other things as well.
- [30:53]
A
I wonder whether self compassion has been looked at in terms of sort of adherence, for want of a better word with treatment because sometimes that can be challenging too. You know, having to put the stuff on every night and remember to do it and do it at the right time and you know, sort of the burden of treatment itself can sometimes be really difficult. And I wonder whether self compassion might enhance treatment outcome a bit in that way too. You know, the compassionate part of ourselves is just kind of jollying ourselves along with all of that and trying to kind of, you know, with, with strength and, and, and courage and that sort of thing, just keeping us going with, with some of the treatments as much as coping with, and, and you know, kind of the Actual symptoms itself.
- [31:45]
B
Yeah, it's like kind of a little microactive self care every day. Be it to you know, to take a medication or a physicality of sort of of the process of taking medication and sort of stopping and thinking okay, this is an act of self care and to kind of the way that you do it. And kind of the meaning behind that act can be relevant too. Or if you have to find time in your schedule to book an appointment to maybe see, you know, not necessarily menopause but related but well, for example, you know, aches and pains can sometimes be be related to hormone changes as well of menopause.
- [32:24]
A
So.
- [32:24]
B
Well, you know what, I'm actually going to carve out an appoint time to see a physio and to talk talk that through.
- [32:31]
A
So.
- [32:33]
B
Yeah. Connecting different types of treatments with this kind of mindset of self compassion. And you might say, oh no, but I already took sick leave to take my daughter to the dentist yesterday and now I need to see the physio. But, but again to kind of like anchor back to, to kind of a mindset and to prioritize self compassion in action can be really valuable.
- [32:59]
A
Yes. I think I've heard Krista Neff sort of say self compassion is sort of in, in the service of health and well being really. And that sometimes that means doing some hard yards in, in the service of health and well being in the end. And, and that hence it, it does take a lot of, a lot of that strength and so on to persist and do the stuff that might not feel so good in the immediate moment but is good for us and good for our health and well being or something like that.
- [33:32]
B
Yeah. And just I know that you're a therapist too, but I think I like to also pair it back to cognitive behavior therapy. And I know a lot of compassion therapists will say oh, we don't like CBT or whatever, but I as a bit of a CBT therapist that's also how we train our students at Melbourne Uni. And I feel that self compassion just aligns really beautifully with like a CBT model looking at how we can sort of modify thoughts, modify behaviors, modify the environment and our physiology and our emotions through kind of a mechanism or the language of self compassion. So I really see it as being in harmony with like CBT as well.
- [34:18]
A
I think most compassion focused therapists would, would wholeheartedly agree with that too. I, I know Paul Gilbert was certainly a, a big CBT er originally and, and sort of with depression especially and he felt that self compassion was a Way to, or compassionate was a way to create a warmth and a care and you know, kindness in the cognitive work that we might be doing, you know, so that where, when the cognitive challenging comes across with a compassionate tone, I suppose as well. Yeah, so yeah.
- [34:53]
B
Beautiful, wasn't it?
- [34:55]
A
Yes. Yeah, incredibly, incredibly helpful because I was, I was going to ask what you felt the mechanism was there and I suppose by the sounds of it, you might formulate self compassion's contribution from the cognitive point of view, but perhaps from that behavioral action point of view as well. But maybe there's something there in the feeling or the tone. Would you, would you sort of say more there about, you know, kind of like the mechanisms of the effect of self compassion?
- [35:24]
B
Oh, that's a good question. I've not like done it specific study myself, but seeing we're talking about cbt, I was just teaching this to students the other day. First year master students are starting their journey to become therapists. And we're talking about the five part model of CBT which is a very foundational part of cognitive behavior therapy. That any kind of suffering is due to the interaction and acknowledging the interconnectedness between your environment, your thoughts, your emotions, your behavioral choices and your biology. Did I say that? Physiology. And so I think that self compassion can sort of actually help for all of those five parts. So you might choose to sort of focus on self compassionate behaviors, which is not indulging behaviors. You might think, well, what do I really need to prioritize behaviorally in my life right now? Or it might be around thoughts of well, my goodness, my inner dialogue is so harsh and so hurtful and I wouldn't even talk to an enemy the way that I talk to myself. And so in that case it's intervening at the level of thought and like, how can I, how can I be kinder to myself? You might even sort of use thought monitoring for example. But with that lens of self compassion or even I think direct emotion, perhaps more so than what CBT focuses on. But like just sometimes we, we can hold like pain in our, in our body or have this kind of emotion in our body. And this can be kind of quite a powerful aspect of self compassion is, oh my God, I feel my own health. Physical emotion or suffering or trauma from the past. And to kind of see that with mindfulness can be really hard. But then by seeing it, it's like turning on a light. And then you can bring all this kind of healing balm of compassion towards that which is not cognitive per se. It's more Sort of linked to the body and also emotions directly. So I think the sort of various mechanisms to which self compassion can be helpful.
- [37:40]
A
Yeah, lovely, lovely. It was a bit of a sort of an unexpected question for you. But yes, that, that, that answer seems very good. It's. There's multiple ways in actually, which is, which is very helpful. I mentioned to my partner that I was having this conversation with you and asked her whether she had any questions for you and she raised the idea that. And you've alluded to it actually, now that I think about it. But this idea that many women are going through perimenopause or many menopause while still working and still wanting to perform well and progress in their careers maybe, or. Yeah, and certainly just be taken seriously still by colleagues and the leaders and that sort of thing. And at the same time some of the symptoms of menopause can really make work much harder or feel much harder or you know, there's sort of compared to non menopausal people in the organization, you know, there's a lot you're trying to kind of cope with and get through. And I guess, yeah, what from your perspective, how can women navigate menopause in the workplace? Still having aspirations, but also how to maybe even communicate about what they're going through. Not in a way that sort of jokes about it or minimizes it with humor necessarily. Although there maybe there is a role for, for some humor there too. But, but yeah, communicated in a way that, that helps them sort of navigate all that stuff in the workplace.
- [39:19]
B
That's a great question. And I was doing a, like a webinar for World Food program, so really important workers from around the world. And somebody was sort of saying look, I feel so impacted by my experience of menopause. It's been really hard of me that I kind of don't want to work anymore. And my God, that's heartbreaking because these are people that we absolutely need in society more than ever. And also a kind of like feminine wisdom doesn't matter what sort of biological sex you have. But this kind of kind of feminine wisdom is absolutely what the world needs right now. And we need aging women and older women to kind of guide our planet. And. But sometimes people can feel really rattled by menopause to the point they might consider quitting their job. Not all women, but, but some women can. And there's really interesting data from. I think it's uq. I have to get back to you. But I saw some data presented that was talking about the more senior role you have, the more impacted you feel. You report that menopause has had on your career. So this kind of intersecting factors thing, that if you're going through menopause plus a really big career, you can feel impacted by menopause. So it's a big deal. Definitely. I mean, definitely. Really, I don't want to be biased and say, we, the world needs you. Don't quit your job, because if quitting your job's right for you, you know, but just pause and take, take time to really think something big like that through. And also part of this is that menopause has been in the background, and so it's not been adequately addressed. Your own needs have not been addressed, and society is trying to catch up now, so we have to be perhaps a little patient with society and kind of think, okay, well, how can I. How can I manage at work? So lots of answers to that question. But just to shine a light on the brain fog symptom, because women talk a lot about brain fog or like little memory lapses or perhaps talking in a meeting and losing your train of thought and feeling really impacted in terms of confidence from brain fog. So what we know about the cognition, cognitive changes measured objectively from sort of neuropsychological tests is that there can be temporary small changes in cognition. On average, there's like a big study based in the United States, a swan study, that longitudinally tracks, but they're quite, quite mild still within the normal range. And an example, like another study found that because women tend to have a little bit better cognition than men, I believe, although we could check that with a neuroscientist. But I know in this one study, they found that at midlife women lost that cognitive advantage. So they. So you couldn't see the difference between genders during perimenopause. And so women can say, oh, well, I'm impacted by menopause. But also, you know, men are impacted too, in terms of, you know, and to not worry, we take brain fog seriously, but know that from the science of cognition, cognition doesn't tend to go plummet through the four any changes are mild and temporary. And it's fine to lose your word in a meeting. That's got no bearing on your intelligence or what you have to offer. And so the more that we can have those conversations at work, so that our work communities are aware that brain fog is, for example, a common experience. But that doesn't mean that somehow your seniority is being compromised and having those open conversations with, from the top down, like from From, From. For managers to be educated around menopause. My workplace, University of Melbourne, has just introduced menopause leave, actually, so that women are able to have additional time for healthcare management if needed, or for time off if needed, or flexible work. So looking at policies to support women, because it's a transition that has a beginning, a middle and an end, and you kind of come out the other side of menopause being in a phase of life where you've got so much to offer and that some of the happiest years of your life after menopause, happiness levels are at their peak. So there's so much to look forward to and so to kind of ride the journey a bit without feeling like you have to give up or that it's all downhill from here, because it's absolutely not. It tends to be uphill.
- [44:35]
A
That is good news, that last little piece there. Some women might find that their experience of it is so overwhelming that they take a career break or they sort of leave work or something. And that can sometimes be a legitimate choice. Well, it is a legitimate choice. You're also suggesting that it's a moment to stop and reflect a little bit too, and just sort of pause and understand some of the facts of the matter. Becoming informed about, for example, like you were saying, brain fog and what that might actually mean for the person. And I suspect that, you know, brain fog and hot flashes at night and sleeplessness and they all sort of start to add together a little bit in a cumulative way, I suppose. But being really well informed about all of that and what it actually means, there might be some systemic organizational changes that hopefully society will catch up on for us because women do have so much to continue offering. And not least in the feminine wisdom, which is a different contribution, maybe that can be there in the workplace. And then maybe this self compassion piece, you know, is. Is potentially integral as well, because we know that self compassion can help to buffer some of those really difficult and uncomfortable symptoms. And so bringing self compassion into that workplace dilemma, you know, might be really important too.
- [46:14]
B
Yeah, absolutely. That's a great summary. It's. It's such a big topic, but that's a great summary.
- [46:20]
A
It's a massive topic. You're also very interested in self compassion, self compassion and positive aging more generally. And you have a chapter, I think, in the Handbook of Self Compassion that was edited by Kristin Neff. You sort of zoom out a bit beyond the. The menopause to the. The broader experience of, of growing older. I mean, this is probably a whole. Another conversation that we, we could actually have. But what, what role does self compassion seem to play in just helping people adapt to changes related to aging generally and still living well and staying connected and all of that?
- [47:01]
B
Well, I think a really interesting finding that I thought was very cool is that it seems like self compassion becomes a more powerful predictor of, of well being as we age. And I feel it's because there's just more opportunities for self compassion because life is more complex and the challenges that we face are more complex and sometimes heavy and sometimes multi layered. And so as a therapist you might see that in terms of a younger adult might present with this significant mental health issue. The frame sometimes is complex, but on average it's more can be simpler than at midlife. If somebody sees a therapist, there'll be potentially 10 different reasons that's brought them to therapy. Their aging mum, but also their workplace and then also their menopausal symptoms. You know, there's so many more sort of complexities that happen as we age and then maybe physical changes or a health scare or we may have to face our own mortality or the loss of a loved one. So life gets, you could say more difficult. But there's kind of also this cool paradox that I alluded to before around it's a paradox because you'd think that we would all become very depressed as we age because of this. But Laura Carstenson, professor from Stanford, talks about this paradox of aging where everybody tends to get a little bit happier because we're able to let go of the small stuff. We don't sweat the small stuff. We know what makes us happy and we prioritize that. So it's a very cool space ageing. And generally I think for a psychologist there's no better sort of place to explore than aging and self compassion. Given that we know it becomes more important to our well being as we age. Think well, how could, how can I make my own later years with, with warmth and with kindness if I'm faced with losses or physical changes? How, how can I be compassionate towards myself through that and adjust my life rather than resist or kind of fight change? So yeah, it's kind of a bigger topic, but I think it's such an interesting area of how we can grow in self compassion as we age.
- [49:34]
A
Such a curious paradox, isn't it that sometimes as we age we start to accumulate more things that might be difficult, but on the other hand we might also be more self compassionate and happier as well. I mean I certainly noticed turning 50 that I no longer no Longer worried what people thought of me. Well actually that's probably overstating it. There was still some worries there but yeah there's something liberating about getting a little bit older in a way as well. And, and so yeah it's fascinating to, to really think about how, how to bring self compassion and sort of spread the word I suppose, you know, as a. Amongst, amongst our aging population.
- [50:24]
B
Yeah.
- [50:26]
A
To finish on something practical and, and you've actually given us a lot of practical tips and hints already. But what, what's one or two small realistic ways really that women can begin cultivating self compassion during perimenopause or menopause. Just, just kind of maybe starting from wherever they might be with it. All one or two practical things.
- [50:53]
B
So going back to that idea of starting from the outside first and looking out to your supports around you and, and do you have the adequate supports that you need? And they'll never be perfect like our husbands or our partners will never be perfect and even our doctors and also sometimes doctors get a lot of slack in the menopause space and you're not trained. But really that's a broader issue that they haven't been trained. You know, it's not been part of medical so nothing's kind of perfect. But nonetheless we want adequate support. And so it might be going on to the Australian Menopause Society website to say oh what doctors are members and are interested in menopause Working in my area to talk this through if you don't feel you've got that adequate support and thinking well am I able to talk about what I'm going through openly enough, as openly as I need to with my family or friends. Do I would I benefit from seeing a therapist so sort of thinking through these things and tracking how you're going and what supports you have doing a bit of a, a bit of a check, a health check of your supports I guess. But then to go to the inner aspect of self compassion even I like the thinking part is a nice opening is even just a little question of like what do I need right now? So just a little question you can pose to yourself from time to time throughout the day or it could even be in the middle of the night I don't think I mentioned but menopause we know not just because of the hot flashes but also because of hormone changes. Sleep can be impacted and that's the worst because sleep is so important to well being and so you might be up in the middle of the night and you know, sometimes at least I can get into these negative thinking cycles of oh, I wish I could just get back to sleep or I've got a busy day tomorrow and you know, this is really annoying. And then even just a little question like oh, what do I need right now? It just kind of stops that proliferation of thought to kind of think. I, I think I'm just gonna put on my headphones and listen to a podcast or I'm just gonna get out of bed and just sit on the couch for a little bit and just reset the vibe here. Or I'm just gonna rest and feel my body on the bed and not worry that I not be worried about sleeping or not, but just feel that resting, that deep sense of rest of just lying in the bed. But the little question of what do I need right now? Again, it's not a panacea, but it's a nice little trick that I like to use in my life just to kind of start inclining towards self compassion.
- [53:44]
A
Yeah, yeah. Sorry, were you going to say something else?
- [53:50]
B
Sorry, I was just going to say, I mean so many different tips. But also I think Kristin Neff's website is quite helpful as well because she's got all sorts of self compassion exercises and meditations you can listen to. So and I'm sure Stan, that you have resources too, but kind of using resources online can also be a really nice, a nice opportunity too actually.
- [54:16]
A
I might see if you wouldn't mind sending me some of the associations around or other, other points of contact and resources and we can maybe even just include a little, little list of a few of a few things. There's a couple of people I follow on Instagram, for example, who, women who talk about doctors, women doctors who talk about this stuff. So there is much more happening in the public conversation. But yes, I really do love that simple yet profound question like what is it that I really need right now? What is it that would be most helpful for me? And sometimes it's the little, the little gestures of affection towards oneself or kindness towards oneself, something that helps to perhaps soften a little bit that more self criticism side or the worry side or the ruminating side and just allows you to sort of be present with yourself in a way that's kind of gentle and kind and compassionate, I suppose. But. Well, Dr. Lydia Brown, what wonderful research. I'm so impressed that you've been at this for over a decade or longer really since the beginning of your PhD. I hadn't quite calculated that, so that's actually really cool. And so thanks for all the great work you're doing. And thank you for speaking with me on Compassion in a T shirt.
- [55:45]
B
Thank you. It's been great to be here.