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Dr. Hilary McBride
Women are saying things in, in the research data like, I thought I was going to be this used up, dried up, useless, decaying, nearly dead woman based on how I was portrayed in the media, based on how people were talking about menopause and perimenopause. And I feel more vibrant than I've ever felt. I feel more connected to myself. I feel more empowered. I care less about what people think than I've ever cared, and I feel more passionate about the things that make me feel alive. And there's all of these, like, existential things in there too. Like, okay, I'm aware that I'm in the second half of life, which puts me in a conversation around aging and death that I wasn't aware of previously. But I'm still young enough that I feel like I can do something about the life that I'm in. It's like that really tender, important death awareness, age awareness thing that can sometimes catalyze us into living a life that we really want. And it was actually going through perimenopause and entering menopause and being postmenopausal that women said initiated for them the sense of a renewed experience of themselves.
Dr. Mary Claire Haver
The views and opinions expressed on Unpause 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. Today's conversation is a different kind of menopause episode because, yes, we're going to talk about perimenopause and the menopausal transition, but we're not starting with a list of symptoms and a prescription pad. We're starting with the whole person, body, brain, story, culture, and the social scripts we've all been handed about what it means to age as a woman. My guest is Dr. Hilary McBride. She's a psychologist, researcher, author, whose research focuses on women's lived experience of embodiment across the lifespan, and especially what happens in perimenopause and menopause during this critical biopsychosocial transition. She brings a feminist feminological lens to the work, which means she's looking at the intersection of biology and culture, how our bodies change and how the way we talk about those changes can literally shape what we feel, right down to measurable health outcomes. And I want to name something up front. There's been pushback to Hillary's work from people who assume that unless you're older, you don't get to speak about menopause. I completely disagree if we wait until women are suffering and confused to start educating them, we've already failed. Younger women need to be part of this dialogue. Clinicians need to be part of this dialogue. Partners and families need to be part of this dialogue because knowledge changes outcomes. Silence does not. In this episode, we are going to talk about the idea that menopause is not a wasteland. It is not a graveyard. It's not a punchline. It's a portal, and how stepping through that portal can be a difficult and powerful experience. At the same time, we'll also explore finding freedom from the roles that no longer fit, liberation from the male gaze and self objectification, and the possibility of becoming more of who you are, not less. We'll also talk about something I believe is one of the most underused health interventions for women in connection women doing this alongside other women, sharing stories, asking questions, laughing, and realizing they're not alone. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
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Dr. Hilary McBride
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Dr. Mary Claire Haver
So Dr. McBride, welcome to Unpaused.
Dr. Hilary McBride
Thank you for having me.
Dr. Mary Claire Haver
You traveled right from Canada to come down to Los Angeles for filming. Thank you so much for doing this. I think your voice is so important.
Dr. Hilary McBride
Thank you.
Dr. Mary Claire Haver
Tell our listeners a little bit about yourself.
Dr. Hilary McBride
Where are you from?
Dr. Mary Claire Haver
Where'd you grow up? How'd you end up getting a PhD?
Dr. Hilary McBride
Yeah, that's right. Yeah. So I'm from just outside of Vancouver and grew up in Vancouver. And really this is like, I like to say that having a PhD in psychology is kind of my third career option. I kind of fell into this. Yeah. Like we were talking previously about the meandering path that we take. And I was a professional violinist and then wanted to get into midwifery school and did not get into midwifery school. And so I went to GR school and counseling psych. And I remember feeling like, oh, I think I understood why I wanted to be a midwife. I feel like there's something about midwifing the mind or the school that feels like really important to me in my work. And really like so much of my, my clinical work, so much of my research has been shaped by the big questions inside of my own life. Like, what does it mean to be human? Why is it so difficult to be a body? What does the culture say about who we are as Women in a way that sometimes makes our life a lot harder than it needs to be and adds a lot more complexity to things. And it was really early on in my research career that a supervisor of mine asked me about something that I was afraid of as like, I was really having a hard time figuring out what I wanted my program of research to be. And she was like, well, tell me what feels scary for you. And the thing that kind of struck at my core from the get go was I'm going to have a daughter one day who's going to hate her body as much as I do. And that set me off on this course of understanding. How do we relate to our bodies as women? What can we do about it? What, what are the places where things get kind of tricky and sticky? And is there an opportunity for this to go differently? Can we give something to the next generation so that they don't hurt the way that we do? And so now I have a practice. I teach, I research and do things like this.
Dr. Mary Claire Haver
Yeah, yeah.
Dr. Hilary McBride
You have a book?
Dr. Mary Claire Haver
Several. Yeah. Yeah.
Dr. Hilary McBride
So the one that I'm probably most well known for is the wisdom of your body. And I'm working on other things all the time, but really the work around embodiment, my first book, Mothers, daughters and body Image, was really about this, this research that I'd done. How do we as women pass messages between us about bodies? And is there something that we can shift in the conversations we're having to give ourselves a better chance to be at ease than at home in ourselves?
Dr. Mary Claire Haver
So your work pushes back on medicalized, patriarchal and androcentric framing of menopause. First of all, what are all those words mean for the audience? And what do you, what do you mean by this? What does this mean when a woman thinks of how she feels in her body?
Dr. Hilary McBride
Yeah. So this is like, those are all just fancy academic ways of saying that. The, the story we've been handed about midlife bodies, particularly perimenopausal and menopausal bodies, are shaped by a male dominated pathology driven conversation.
Dr. Mary Claire Haver
Their entire medical field is shaped by the same thing.
Dr. Hilary McBride
Exactly right. And this is like when I'm doing academic research on what does it mean to be a woman at midlife? What does it mean to be a woman who's negotiating a changing body? What does it mean to be experiencing perimenopau and menopause? Women's voices have been nowhere to be found. I mean, if you're really digging, every once in a while you can find something. But to look at pushing back on that, we have to look from a different angle. And that angle is from women's lived experiences. What are women themselves saying about what this feels like? And it turns out that when you ask women, what is it like to be perimenopausal, what is it like to be postmenopausal? What's happening for you? They say very different things than we read in the empirical literature about menopause and perimenopause. Menopause.
Dr. Mary Claire Haver
So give me some examples.
Dr. Hilary McBride
Well, we can think about the pre. Like, predominantly. What if you survey the research literature from not just a biopsychosocial perspective, but purely from a psychological perspective. What you're seeing is conversations about symptoms, conversations about women saying, not even women saying, but people talking about women's experiences. And when you're asking women what's going on for you, they're saying things like, I'm having a really hard time and I'm also feeling more connected to myself. Or they're saying things like, what is happening? And also I feel like I actually kind of know who I am for the first time in my life.
Dr. Mary Claire Haver
I'm seeing the exact same thing. Yes. Like, I don't like the way I feel, but I am loving the way
Dr. Hilary McBride
I'm thinking or some combination of, like, contrasting ideas. Like maybe what is happening to me? I don't. I don't know something. And also I know something like this. These tensions. We see a lot of these tensions. And what I'm seeing in my research literature, the. The review of the literature as well as the research that I'm doing and the patients that I'm working with, women are saying, I feel more connected to myself and more free and more empowered than I've ever felt. And not always and not consistently and not about everything. But that's definitely not represented in the research literature as a whole. Like, we're just not hearing women's voices when we're talking about perimenopause from this kind of top down, very medicalized, male centric perspective.
Dr. Mary Claire Haver
Right. Where I think that conversation is happening, good or bad, is on social media and now at the water cooler.
Dr. Hilary McBride
The water cooler.
Dr. Mary Claire Haver
Right.
Dr. Hilary McBride
I was gonna say, like, women have been gathering in circles to talk about life transitions since time immemorial. I mean, that's been one of our primary foundational ways as a species of making sense of change. And so when women have had conversations in groups, they've been able to navigate really difficult things together. And the fabric of society is shifting a little bit. A lot of those conversations are moving digitally and yet still when women have their book clubs or when they have their wine clubs, or when they're going on vacation or they're talking at work together, they're having conversations that we're not capturing in research necessarily or in medicine and the way that they're represented in women's lives.
Dr. Mary Claire Haver
What do you feel like mainstream medicine, modern medicine is getting wrong? I have very strong ideas about this. I mean, I can tell you what I was taught. But what do you see collectively?
Dr. Hilary McBride
Yes, well, of course there's like all of the getting wrong about the data. We know that there has been a lot of bungling of data in a way that has just disenfranchised women and disempowered them and made them feel scared of interventions and, you know, things like that. But, but what they're also getting wrong is that there's. There's this really important critical developmental opportunity that's happening here at midlife, where women are getting an, an opening to do things differently, to reclaim, to feel power, to feel like instead of their body being viewed as this, a used up male body, which I think. When was the last time that that was talked about in the medical literature? In the 80s or 70s, like that that was actually used as some sort of like.
Dr. Mary Claire Haver
So yeah, there's. There was very few books on menopause, so like focusing on that and in popular culture. But there was one and it was written by a male physician with no data and just kind of on his gestalt. And he basically, it was a very pro estrogen book when estrogen was being commercialized as a treatment for menopause. But it was really framed as a get your wife back book, like husbands like format. Get your wives on estrogen and you will get her functioning. You know, sex life, vagina, like all the things she's meant to do. And then I'll tell you a story. Sure. My mother, I remember I was in, in junior high, I was probably 13, 14. And she was. Now I know she was perimenopausal. If I do the math right. She'd had a hysterectomy. So but I, you know, the age was right. She was in her mid-40s and she had this pill bottle in the bathroom. And that was her like her medicine, like when things were tough or she was stressed out. Go get my. I need my pills. My medicine, my medicine. And I remember they were called butasol B U T I S O L and you get the beauty salt, get the besol Ah, I need it to calm me down. Like. Okay. And later in medical school when I was learning pharmacology, I, I learned that this is a sedative that we use to treat seizures in some patients. My mom was being sedated through her perimenopause. So I started looking at the advertisements of back then and there was a collection of drugs similar to Butasol, and some of them even combine estrogen with. Oh, wow, a sedative.
Dr. Hilary McBride
Right, of course.
Dr. Mary Claire Haver
And the pictures in the images were of women wearing aprons, holding cookies, or like cooking breakfast. And I was like, get your, get your wife back. I mean, these were national magazine.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
In the 60s and 70s articles. I mean, you know, advertisements for, for these pharmaceutical products that were sedating and giving estrogen back, which probably was helpful. They needed to give progesterone too, because of the endometrial cancer. But that's a whole nother discussion. When we talk about where we came from and what set up how we look at women and how they age and what their roles and responsibilities are. And if she can't do these things, she is not a woman. It's mind blowing to me. And that was my own mother.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
Who was heavily sedated through her own perimenopause.
Dr. Hilary McBride
Yeah. It says so much about the level of social control around keeping women in this particularly subservient role and how our, our systems, which like I think it's important to name even healthcare, can very easily get co opted into the patriarchal misogynistic message at times. Like we might want to think of medicine as objective. And yet there's agendas. Right. That's a perfect example. People being medicated in such a way that reinforces and keeps them constrained in this restrictive gender role.
Dr. Mary Claire Haver
Unbelievable.
Dr. Hilary McBride
Yeah, it's. No, no. Good.
Dr. Mary Claire Haver
Well, talk to me about the portal and what you discovered. So when you went into this research.
Dr. Hilary McBride
Yes.
Dr. Mary Claire Haver
You're young, you know, you. I'm assuming you have a ways to go before this. This, you know, hormonal transition will cross your path. One. What made you. Why did you want to study this?
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
Okay, so because it's a blip on the radar of all medical research. Like perimenopause isn't even. I mean, when we look at the number of articles, it's like 1,2 million for pregnancy, 98 now or 99,000 now for menopause. And it's getting better. And there were about 8,000 for perimenopause. Like you're starting from scratch. Did you get Pushback from your thesis advisor?
Dr. Hilary McBride
No, actually, she was the one who suggested it. So, of course, like, the older woman who's like, here, listen, if you want to be researching women's relationships to their bodies and speaking to something that hasn't been looked at, go talk to older women, women who are older than you, about what perimenopause was like for them. And what you're going to find is that what they're actually saying isn't represented in the research literature. So I was thinking at that time, like, okay, this is, what kind of wild goose chase are you sending me on? And this feels so irrelevant. And at that point, I was my late twenties that I was doing my doctoral work, and I trusted her. She was huge name in the. In the research around women's sexuality across the lifespan. And I knew her voice and her leadership was important. But I remember thinking, like, this feels really irrelevant to me. And then as I was listening to women who were saying all sorts of things, what the, you know, the feminist research in me, researcher in me, started realizing women's voices have not been captured. Women's lived experience has been missed in the conversation about all of this.
Dr. Mary Claire Haver
That's what I find too.
Dr. Hilary McBride
Yes.
Dr. Mary Claire Haver
And that once women were given permission or felt agency to be able to talk about their lived experience, the whole conversation exploded.
Dr. Hilary McBride
It blows up. And there's all of these things that women are saying that aren't being captured in research literature. And of course, that's all about, like, what questions are you asking and who's asking and who's measuring? How are you measuring? Exactly. But the other piece that was so fascinating to me about this all was as I started to understand the whole experience of perimenopause and it being 10 to 15 years of a change. So, yes, you know, the mean age of. Of having that actual day of, you know, cessation of period after one year is 51 for women in Canada. I think it's similar in the same. Yeah. And I remember thinking, okay, if I'm, you know, the last period that I have is when I'm 50 and 10 to 15 years before that, that means that women who are 35 need to be having these conversations. And it is not something that is way off in the distant future. That was right around the corner for me. And now, obviously, I'm in my late 30s. And so these are conversations that feel a lot more relevant to me because I'm in that window. And so I'm looking at, like, what's happening to my body and how do what I know. How does what I know empower me to, to feel like I can be more proactive about things? But it was listening to older women
Dr. Mary Claire Haver
tell me, were they through or, or were they actively in the middle of it? You were just all ages.
Dr. Hilary McBride
No. So what? Well, the piece that feels like salient in terms of why I researched this was I had an older woman say, you need to be thinking about this. And then what we decided to look at is women who had just completed menopause, we're now like newly postmenopausal, and we're reflecting back on their experience of the menopausal transition. Okay. And of course, I'd asked other groups of women before in, in other research studies I'd done about how do women feel about their changing bodies, but had kind of more broadly included women who were negotiating all sorts of changes and whatnot. But it was, it was fascinating to hear the kinds of things that were nowhere to be found in research as,
Dr. Mary Claire Haver
like, I'm like on the end of my seat.
Dr. Hilary McBride
Yes, you're. Well, you're talking about this. You mentioned the portal. So women are saying things in, in the research data like, I thought I was going to be this used up, dried up, useless, decaying, nearly dead woman based on how I was portrayed in the media, based on how people were talking about menopause and perimenopause. And I feel more vibrant than I've ever felt. I feel more connected to myself. I feel more empowered. I care less about what people think than I've ever cared, and I feel more passionate about the things that make me feel alive. And there's all of these like, existential things in there too. Like, okay, I'm aware that I'm in the second half of life, which puts me in a conversation around aging and death that I wasn't aware of previously. But I'm still young enough that I feel like I can do something about the life that I'm in. It's like that really tender, important death awareness, age awareness thing that can sometimes catalyze us into living a life that we really want. And it was actually going through perimenopause and entering menopause and being postmenopausal that women said initiated for them this sense of a renewed experience of themselves. In fact, I had women say in one of my studies, everything up until now felt like a dress rehearsal. Everything up until now felt like I was getting ready and now I actually get to live the life that I'm meant to live.
Dr. Mary Claire Haver
Our patients say very Similar things. A lot of them didn't have many symptoms of menopause, but they're like, hey, I feel like I'm at a really critical inflection point for how am I gonna live the 30 years? And they're feeling good about who they are and, but they, they want, they want help with the health end of it to make sure they're, they're optimizing their nutrition and their movement and all the things. Because it's very confusing on social media. But when we look at sex based differences for longevity and I think women in general, not all, of course, have a very different goal than, than what I see on social media with, with the men who are in charge of
Dr. Hilary McBride
this space are talking about. Interesting.
Dr. Mary Claire Haver
Women are looking at being more of a benefactor and don't want to be a burden. And the conversations they say that their husbands are or their partners are having if they're male is they don't care about that. Like, you're gonna just have to take care of me when I get old, you know, that's just part of the, you know, signing up to be hitched to me for the next 30 years. And they're not worried about that part because, well, that's just gonna happen, you know, but like women are like acutely aware of that. I can change this trajectory. Especially if their moms, you know, had a difficult aging process.
Dr. Hilary McBride
Right. And haven't women done that forever? Like, there's something about, I think the, the unique experience of being a woman in this world and that there is something around. I'm going to connect with other people, I'm going to get information, I'm going to fight for the things that are mine. I'm going to join together with other people who have a similar experience. And I want to live a good life and I want to do it with the people that I love. And there's just something that I hear over and over again in my research that women don't experience by and large the same kind of social isolation that men do. And that there's something about the community element of women empowering each other that feels like it's a really untapped resource at this particular time in life. Like thinking about this really big change. But what we know is that when women do well, that they give that information away, that everybody in their system benefits. That there's something about. If I learn this information and feel, feel empowered myself, you better believe everybody in that woman's book club, everybody in the water cooler line, everybody on the text thread, is going to hear about what worked. And we all get to benefit. When people who are close to us, women in particular, learn things about health
Dr. Mary Claire Haver
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Dr. Hilary McBride
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Dr. Mary Claire Haver
You've been really clear that this transition doesn't have to be easy to be powerful. What did you mean by that?
Dr. Hilary McBride
Well, that actually comes from the data itself. Women are saying it's actually part of the challenge of this, that connected me to my sense of knowing. The. The. The felt sense of having accomplished something and coming through on the other side and feeling empowered. And that's something that's really replicable across, you know, different domains of developmental psychology. We see things like stress mindset theory or anti fragility or.
Dr. Mary Claire Haver
What is that?
Dr. Hilary McBride
Oh, yes, okay. Oh, yes, please teach me. Okay. So the idea in some of these. These concepts, like stress mindset theory is a really fascinating piece of data that shows, like, very well replicated in the empirical literature, that it's actually not stress itself isn't bad. It's how you are in relationship with the stress. Okay, yes, we're gonna have stress. Yes, exactly. So a good example of this would be, okay, let's just say you're about to go do something that you feel really nervous about. And when you experience the nervousness, what do you say to yourself about that?
Dr. Mary Claire Haver
Gosh, I signed up for this. It's gonna be okay. You've done this before, often before a podcast, right?
Dr. Hilary McBride
Exactly.
Dr. Mary Claire Haver
You know, like, just. You just. Just move through it. Just go, you know, and it's gonna pass. And. And it's almost like I've learned a cbt.
Dr. Hilary McBride
Right, Exactly. That's a big part of it. Yeah. How could I interpret what's happening? So the research from stress mindset theory is particularly, 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 your, like, heart clapping
Dr. Mary Claire Haver
for you or something.
Dr. Hilary McBride
Yes. Right. Like, this is our body saying, hey, I'm giving you the energy to do something really matters. That feel nervous. You say, thanks for telling me that matters. Body like, yes, my heart clapping for me. It moves the indicators or it moves the. 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.
Dr. Mary Claire Haver
Wow.
Dr. Hilary McBride
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.
Dr. Mary Claire Haver
And like, for our listeners, developmental Transition is things like adolescence, like.
Dr. Hilary McBride
Exactly. Mattresscence. Adolescence. Your first big career, finishing school. Aging, empty nesting. Right. All 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 91 1-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. 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. The conflict inside and outside that we rise to the occasion and become more of ourselves.
Dr. 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?
Dr. Hilary McBride
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. Right? Exactly.
Dr. Mary Claire Haver
Yeah. Especially if your periods were bothersome.
Dr. Hilary McBride
Yeah. You know, and then we have the psychosocial pieces, like, 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. And 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.
Dr. Mary Claire Haver
How you showed up in the world safe.
Dr. Hilary McBride
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.
Dr. 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.
Dr. Hilary McBride
Yeah. Why?
Dr. Mary Claire Haver
I, I, I see less of that. Like I see women kicking that door down anyway. But why do you think that.
Dr. Hilary McBride
Yes. I'm so glad that that's the case. Right. We need, we need more of that,
Dr. Mary Claire Haver
at least on my social media page, you know?
Dr. Hilary McBride
Yes. Yeah, right. It's important that there are spaces for us to talk about doing well. And I can, I can talk about that in a moment. But in my research data, what I found is that women were saying, I, 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. And this principle of I'm going to self silence around my, my thriving, my well being, my flourishing. I have seen in research about matrescence. I've seen in research about.
Dr. Mary Claire Haver
Explain what matters for our listeners.
Dr. Hilary McBride
Metrescence is the, primarily the first three years of the transition into motherhood. And so that experience the word, thinking 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 the research in, in my research around Matres. I saw that as young women who loved their bodies were trying to negotiate social relationships. This 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 Nichtur 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. And 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 what, including the positive.
Dr. Mary Claire Haver
I am recognizing patterns in my own friend groups through the years, you know, where we. You kept quiet about the good things because you were connected by the meaningful complaining, you know, and you know, oh yeah, me too. And d d you celebrated the big high points, but just that every day I'm actually doing great, you know, wasn't what bonded us together.
Dr. Hilary McBride
Okay, but this is where, like the psychologist in me, when I move into the clinician, as opposed to the researcher, hears women talk about this, 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. Let'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, 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, as a dyad? How do our friend group 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 and 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, I want you on my team and I want our friendship to be able to hold all of it. It. And those conversations are like, you're giving
Dr. Mary Claire Haver
me palpitations right now. Do you want to say more conversation?
Dr. Hilary McBride
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.
Dr. Mary Claire Haver
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.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
How does that show up in the, this, this big identity shift?
Dr. Hilary McBride
Well, one thing that I found really novel in, in findings from one of my studies is that women describe that on the other side of menopause that there was a new role that we're take that that they were taking on. And in one sense I'm like, oh, that feels like such an important novel finding. But when I step back, I think, duh. When 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 stories, 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 I, 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. And 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.
Dr. Mary Claire Haver
So when I think about 30 year old Mary Claire, who was a resident and like 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 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 for, 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. I think she would have been shot. Well, exhausted for one.
Dr. Hilary McBride
Right.
Dr. Mary Claire Haver
But, but shocked. But I mean, I really think that menopause gave me that power. You know, you talk about a new role, what I'm seeing. And Tommy, 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 dropping those, boss, because you're going to focus on these balls.
Dr. Hilary McBride
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. That 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. Things were really letting myself live into this dream that I never got to live. People going back to school.
Dr. Mary Claire Haver
Right.
Dr. Hilary McBride
People starting careers. Right. Businesses.
Dr. Mary Claire Haver
There's just some data that came out looking at the, the biggest percentage of the population that is starting a businesses are women of my age.
Dr. Hilary McBride
Yes. That 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.
Dr. Mary Claire Haver
I love that.
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Dr. 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.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
Do you wanna talk about that?
Dr. Hilary McBride
In the empirical literature there are 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 that 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, you'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, 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. And without blaming women, like I think it's very easy, right?
Dr. Mary Claire Haver
Because like there's a few out there going oh no, it's all in her head, you know.
Dr. Hilary McBride
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.
Dr. 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.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
What are you seeing like today?
Dr. Hilary McBride
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. Okay, they're getting some treatment for it. Sometimes it works, sometimes it doesn't. They're 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.
Dr. Mary Claire Haver
You talk about three buckets.
Dr. Hilary McBride
Oh, yes, yeah, the discourses.
Dr. Mary Claire Haver
Yeah. So what, how is that conversation going?
Dr. Hilary McBride
The discourse around menopause and perimenopause is a way of understanding the different kinds of filters that we're given on an experience. And those filters actually shape what it feels like to be, to able. So an example of that, like the. I'm going to paraphrase some of the, the discourses. One of them is your body's 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 gonna liberate myself. I'm gonna come to my own rescue kind of discourse, which is like, take. Take charge of your health. Right. You can be empowered to do something different. There's a still. There's still a risk and a problem here. And 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.
Dr. Mary Claire Haver
I need to fix something that's broken. Yeah.
Dr. Hilary McBride
And then there's the emancipation dialogue or discourse, which is a filter that's put on all of this, where. 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. Is. Is joining with me in towards my liberation.
Dr. Mary Claire Haver
And what is the point of all this? Like, is it that women overall are happier or they live longer?
Dr. Hilary McBride
Like.
Dr. Mary Claire Haver
Like, where does this go?
Dr. Hilary McBride
Yeah, yeah.
Dr. Mary Claire Haver
Well, is there. Is there a problem we're trying to fix overall with.
Dr. Hilary McBride
With what?
Dr. Mary Claire Haver
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 pat her on the knee and get her going. But when I saw that the, you know, 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? You know, were women not happy?
Dr. Hilary McBride
I think the point of all of this is that we get to enjoy our lives. Yeah, 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 fulfilling, is 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. The pathways or the opportunities that can catalyze this deep personal change and growth are characterized as a problem. Yeah, it's really hard to lean in. Like, there's. 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. And, 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 it was happening. And I want to know what's happening so that I can join in 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. Writing the rules. Exactly.
Dr. Mary Claire Haver
And writing the scripts. And, you know, how women are showing up in TV and media. I think we're getting better.
Dr. Hilary McBride
There's a debate about that.
Dr. Mary Claire Haver
Yep. You know, I think women's stories are becoming more representative.
Dr. Hilary McBride
Yes.
Dr. Mary Claire Haver
We talked before about the CBC had done small achievable goals. Right.
Dr. Hilary McBride
Yes.
Dr. Mary Claire Haver
The BBC has done riot women. 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 save her. Yeah.
Dr. Hilary McBride
Or even I'm thinking about Kate Winslet, who has 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.
Dr. Mary Claire Haver
Right.
Dr. Hilary McBride
Like, we're having this, like, more. You're right. There is a little bit more room to have some of these conversations.
Dr. Mary Claire Haver
So myself, my patients, you know, people I see have spent, you know, decades, relate. You know, 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 if the. Where the fat was deposited, you know, you were healthy. There's a lot of undoing to be done here. 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 of menopause. Is Your body composition will change, and women are not okay with it.
Dr. Hilary McBride
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 on to an ideal and everybody in your life and the systems around you was reinforcing, that was important and we bought in. To be able to actually let that go requires feeling the pain of it. It's a. In terms of affective neuroscience, the. 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.
Dr. Mary Claire Haver
Enjoy it.
Dr. Hilary McBride
I was gonna say 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 gonna lose. I'm gonna lose my appearance value if I don't make these choices. It'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. 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 and 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' 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, and, you know, 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 that. Yes, 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. And 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.
Dr. 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, what are modifiers? Like, what do you. How do. How do you think? So here's a woman listening to this today, and she's like, give me five things.
Dr. Hilary McBride
Yes.
Dr. Mary Claire Haver
Like, what are, what are my five things? How can I modify this?
Dr. Hilary McBride
So you're probably gonna answer that question really differently than I would based on disciplines. But when I'm thinking about, okay, not just, just symptom management, but the, the developmental arc, like, who am I becoming?
Dr. Mary Claire Haver
You're giving women permission to think about this. Do you understand that? Like, we've always framed ourselves, at least I have, as how am I serving?
Dr. Hilary McBride
Yeah, right.
Dr. Mary Claire Haver
It is my job to make the world better, not to make me better.
Dr. Hilary McBride
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. You 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 many 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 gonna go well for you. Or is that kind of what you're asking? Like, how do we help women do better? Or is that.
Dr. Mary Claire Haver
So someone's struggling with her Body image.
Dr. Hilary McBride
Oh, it's for her body image. Yes. Okay, I. I think we need to kind of forget the body image conversation. We've way over indexed on image and in. 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. Our 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 our bodies really as 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. Like, 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.
Dr. Mary Claire Haver
Do men have this? Is this just a female thing? I don't. I don't see my husband lamenting too
Dr. Hilary McBride
much about body image or body image a little bit.
Dr. Mary Claire Haver
He lost his hair at 25.
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
A long time ago. He's bald and that was hard for him. 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.
Dr. Hilary McBride
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 so social media is increasing and access to resources that can. Can shift appearance are increasing that men are more likely to have some struggles than they have. But 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. That's a gendered Narrative. And so women postmenopausal 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.
Dr. Mary Claire Haver
Do you think that's starting younger and younger now with the access to social media that the kids have?
Dr. Hilary McBride
Yeah, I think it's starting younger and it's, it's feeling more insidious and normalized and the world is really changing and it, I think parents have to have, have a, a lot more skills at their disposal and information around protecting their children from, 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 kids be kids and have freedom from that. Like that's going to come at us, it's going to 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.
Dr. Mary Claire Haver
It talk to me about connection and health outcomes.
Dr. Hilary McBride
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. And what has been shocking about this, like I just ran a, 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. 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 decrease, but their distress about their symptoms also decreased. And that's a really interesting thing to note too, that you could have symptoms in perimenopause and not be distressed by them.
Dr. Mary Claire Haver
Right?
Dr. Hilary McBride
That you. They could be present, but 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.
Dr. Mary Claire Haver
So one of the reasons I wrote the new perimenopause was that women said over and over again, you know, when, 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 Shields getting her period on the Blue Lagoon movie, 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 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 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.
Dr. Hilary McBride
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. You 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, like, how do we do this?
Dr. Mary Claire Haver
Or how do we navigate this?
Dr. Hilary McBride
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?
Dr. Mary Claire Haver
It was cool because we had like, big brothers and big sisters.
Dr. Hilary McBride
Okay.
Dr. Mary Claire Haver
Who we were assigned to, and thank God, mine were incredible mentors and they saved like, the old test and they had like, like a care package and, you know, kind of like shepherded me through all the scary parts. No, it was incredible.
Dr. Hilary McBride
We need those conversations. And, and yes, there are lots of other things that help women do well in perimenopause, but it seems that that, that is one of the things that mitigates the fact that there still isn't access to information for so many women, that 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.
Dr. Mary Claire Haver
So you did therapy with psychedelics, and were they legal? How did that go for you?
Dr. Hilary McBride
So in a med, in the context of a medical clinic, we have a physician prescribe and administer 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 what, 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.
Dr. Mary Claire Haver
How long does this take?
Dr. Hilary McBride
Yeah. So this was a 12 week program.
Dr. Mary Claire Haver
Well, like, I'm, 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, like. Because I'm envisioning a room full of people laying with some. Someone doing music or they're all just talking. No, no.
Dr. Hilary McBride
So the dose, the, the, you know, 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, exact same time. And it's a really powerful thing if, 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 kind of shifts and impacts my experience. It's a really powerful, really powerful way to do the work together.
Dr. Mary Claire Haver
Amazing. You've talked about reorganizing body scripts. What is a body science script? Yeah, I think I know what it is, but please educate me and my listeners.
Dr. Hilary McBride
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. There's a lot of religious bodies.
Dr. Mary Claire Haver
A temptation.
Dr. Hilary McBride
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 have 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.
Dr. Mary Claire Haver
I tell it to myself all the time. Well, can you help women rewrite that script?
Dr. Hilary McBride
Yeah.
Dr. Mary Claire Haver
Is that what you do in therapy?
Dr. Hilary McBride
Yeah. I mean, therapy is really important, but also consciousness raising. Like, what are the scripts like before we even start to rewrite them? What are the scripts that we've been told?
Dr. Mary Claire Haver
I feel like we're our own. This is all internal because I. I've seen the. Oh, it was a commercial or something, but it was this. 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 and the stranger who didn't even know her Told your God, your hair is so beautif 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.
Dr. Hilary McBride
And we, we loop on a lot of the same things around our, 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.
Dr. Mary Claire Haver
A lot of athlete patients really struggle with this. Yeah. And they lose their fun, their ability to function at what was their peak.
Dr. Hilary McBride
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. So 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, 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? And you go kayaking. You're not really used to going kayaking. But then you go and you, 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 better. 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, 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.
Dr. Mary Claire Haver
See, I worry I'm trading the look for performance.
Dr. Hilary McBride
Right. Yeah. And there.
Dr. Mary Claire Haver
So how far can I hike? How high did I go? I'm constantly, like, chasing those metrics.
Dr. Hilary McBride
Yeah. Okay, maybe I'm not thin in the way I used to, but I'm going to try to be stronger.
Dr. Mary Claire Haver
Yeah.
Dr. Hilary McBride
And it's fun to have a challenge sometime. And it's fun to realize, like, oh, I can. 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 cue? 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? Those 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 person. 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 like, can I inhabit myself and can it be good? And I think perimenopause is an invitation into all of that. 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 a 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.
Dr. Mary Claire Haver
As we wrap up, what are your top three takeaways for our listeners? Knowing our demographic is heavily females or of 35 to 70ish well, the thing
Dr. Hilary McBride
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, 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 like seeing the challenge not necessarily as a barrier to growth, but actually the pathway through it that anything that feels like this, 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. And that's a gift going into whatever comes Next.
Dr. Mary Claire Haver
Awesome. Well, Dr. Hilary McBride, thank you for joining us on Unpaused.
Dr. Hilary McBride
Thank you for having me.
Dr. Mary Claire Haver
You can follow Dr. McBride on Instagram @Hillaryleannamcbride or through her website, www.hillarymcbride.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 youf Body, Mothers, Daughters, and Body Image and Practices for Embodied Living, are all available now. You can find full episodes of unpaused on YouTube @Dr. MaryClaire. I'd love to hear from you about this topic and anything else that's on your mind. Mind you can find me on Instagram rmaryclaire and get honest, accurate information on health, fitness and navigating midlife@thepauselife.com My book, the New Perimenopause is available for order on Amazon. Please take a moment to follow Unpause 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 Odysee in conjunction with pod people. 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.
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Podcast Summary: unPAUSED with Dr. Mary Claire Haver Episode: Menopause Is a Portal: Reclaiming the Body, the Story, and the Second Half with Dr. Hilary McBride Date: May 26, 2026
In this deeply insightful episode, Dr. Mary Claire Haver sits down with psychologist and researcher Dr. Hilary McBride to reframe the menopause journey—not as a decline or a medicalized problem, but as a powerful developmental portal that can catalyze authenticity, liberation, and deeper self-connection for women. Together they dive into the stories, scripts, and social forces that have shaped how women experience menopause, and explore how sharing stories in community can transform individual and collective well-being.
| Timestamp | Topic/Quote | |:---------:|----------------------------------------------------------------------------------------------------------------| | 00:00 | Dr. McBride on the surprising empowerment and vibrancy post-menopause | | 09:20 | Challenging patriarchal, medicalized narratives about menopause | | 11:07 | Contradictory feelings: struggle + empowerment | | 16:33 | The metaphor of menopause as a portal and why Dr. McBride chose to study it | | 20:14 | Women’s real stories: “I thought I’d be useless… I feel more alive than ever.” | | 21:34 | “Everything up to now felt like a dress rehearsal… now I get to live the life I'm meant to live.” | | 26:44 | Explaining 'stress mindset theory' and growth through challenge | | 29:49 | Found freedom: menstruation, societal stories, and self-objectification | | 31:20 | Social silencing of women who are thriving (fat talk, maintaining connection through complaint) | | 34:56 | The importance of relationships that can hold both joy and struggle | | 38:06 | Post-menopausal identity and stepping into new, empowered archetypes | | 41:43 | Anticipation predicts experience: how belief and story shape symptoms | | 44:10 | Are outcomes improving with more dialogue and education? | | 55:02 | Moving beyond body image to embodiment | | 59:03 | Connection and group therapy leading to decreased symptoms and distress | | 61:46 | Intergenerational learning and the importance of sharing stories | | 65:52 | How therapy and experience can help rewrite internal body scripts | | 70:55 | Dr. McBride’s takeaways for listeners: change the narrative, talk to each other, see struggle as opportunity |
Rewrite the Script
The narratives you've internalized about your body and menopause don’t have to be true—you have the agency to change them.
Connect, Share, and Support Seek out and create spaces where all experiences—good, bad, and complex—can be shared. Community and connection act as powerful medicine.
See the Struggle as the Path The challenge of menopause isn’t just to be endured; it’s a growth opportunity that can catalyze deeper self-knowledge, freedom, and flourishing.
This episode moves the conversation on menopause from one focused on loss and pathology to one rich with potential for transformation, community, and agency. Dr. Hilary McBride and Dr. Haver call women (and their communities) to reclaim their stories and collective power in the second half of life, making room for both grief and joy, challenge and celebration.
For more, follow Dr. Hilary McBride on Instagram @hilaryleannamcbride or visit her website hillarymcbride.com. Check out Dr. Haver’s resources on Instagram @maryclaire and thepauselife.com.
Let’s keep going—unpaused!