Menopause as a psychic change: Dr Margarita Tareyn on the body, femininity and the new stage of life
Menopause is not merely a biological change. It affects the way a woman experiences her body, her age, her sexuality, her relationships and her own identity. Dr Margarita Tareyn examines this period beyond the stereotypes of “emotional instability” – as a significant psychic transition that may be linked to loss and anxiety, but can also mobilise a new creative and vital potential.
Dr Margarita Tareyn holds a doctorate in clinical psychology in the field of analytical psychosomatics of oncological diseases and is part of the team of the Institute of Medical Psychology, Psycho-Oncology and Psychosomatics. She trained in psychotherapy, psychoanalysis and analytical psychosomatics in Bulgaria and Paris. She works and teaches in the field of psychotherapy and analytical psychosomatics in oncological, autoimmune and other diseases.
The interview was originally published in EVA magazine in connection with Dr Tareyn's participation in the Meno Positivity discussion panel, dedicated to the different stages that women go through during perimenopause and postmenopause.
Dr Tareyn, are there frameworks imposed by society that women in menopause have to live with?
In contemporary society, the frameworks of middle age are much more flexible. We now see more and more mature women whose age escapes us, who live very fully and actively, in no way inferior to young women, or men! I suppose the advances of medicine also play a role in this – the possibilities for extending life, maintaining it in good quality, and hence rejuvenation. And women, fortunately, are beginning to take advantage of this, as well as of the change in culture.
Is it true that during menopause absolutely everything can change: social role, status, career, social circle?
If you mean change in a negative sense, then I would say – only if the woman allows it. If for some reason she lets menopause become a reason to withdraw from life, perhaps yes, then this can happen.
A person creates a very large part of their reality through how they perceive it and react to it. What matters is not only what happens to us, but how we interpret it and how we respond to it. This is a choice for each person, entirely in their own hands.
Can changes in the female psyche be avoided?
I think the belief that menopause is inevitably linked to negative emotional consequences is exaggerated and somewhat risky, like any prejudice.
Yes, deep within herself, a woman is inevitably marked by this moment. Just as the onset of menstruation marks the young girl, so its end marks the mature woman. The self-image changes.
The problem is that menopause symbolises ageing, transience. Even though menopause and ageing are not the same thing. Because the body is always both a psychic body and never merely a biological one.
But the human psyche works with symbols and meanings. Menopause represents a form of loss and is linked to fantasies and ideas about this period of life, built up from the social context and from the example of other women.
With its onset, in her mind the woman moves forward one generation. This changes the way she thinks about herself, perceives her body and her feminine role.
Menopause, as a sign of the transition to another stage of life, also leads to reckonings. In this sense it is a serious psychic shock, which, however, can set in motion a very creative potential, by mobilising the impulses of life in response to the intimation of ageing and transience.
“The body is always both a psychic body and never merely a biological one.”
Women in menopause share that they often forget words and their memory fails them. When should this cause concern or heighten our attention?
Often, seemingly serious cognitive impairments may be due to tension, exhaustion, low mood and other causes of a purely psychic nature.
The picture of the conditions that may be cause for concern is much more complex, involving other faculties as well, and a progressive deepening of the complaints.
In these cases, memory disturbances are not affected by the relief of emotional tension, changes in daily routine and mood, rest, and so on. In such cases, neurological and neuropsychological examinations are necessary.
One of women's fears is that they will no longer experience pleasure in their intimate life. Is this fear justified, and how should we talk with our partner about it?
Every fear, however well-founded it may seem, always contains within it some imaginary element.
Sexuality and the pleasure derived from it, although linked to the biological, are in fact first and foremost psychic phenomena. They depend on the emotional bond, closeness, depth of connection and communication within the couple – in other words, they relate much more to desire than to hormones.
In this sense, the quality of sexuality within the couple before the onset of menopause also matters. The attitude towards intimate life is also linked to body image and self-esteem, which can be shaken by the onset of menopause.
This can lead to a feeling of estrangement from one's own body or inadequacy towards the partner, and to withdrawal from sexuality. This is why, at this moment, the woman needs to find reassurance and a point of support for her confidence in her attractiveness in her partner's eyes.
The risk is that she isolates herself in her worries and distances herself from him, thereby preventing him from helping her.
Sharing, open, spontaneous and authentic connection with the partner increase closeness and set the emotional life of the couple in motion. And the couple is a shared creation between two people, which has the potential to change, develop and repair.
As one of the great psychoanalysts said: “The couple and love do not exist. They are created.”
How should relatives and partners behave when a woman is finding the menopause period difficult to bear?
They should show tolerance, patience and understanding towards the fact that they are dealing with something they do not understand.
In difficult moments, they should be able to open a space for sharing, closeness and support, without pretending to know what is happening, but rather trying to truly grasp what the woman beside them needs.
And also to serve as a good, corrective mirror for the unpleasant sensations, the doubts about oneself and the dissatisfaction linked to them – a mirror in which the woman can recognise herself as herself, whole and loved.
Are there self-help techniques for easing the psychological symptoms during menopause?
Many women find it difficult to reach a psychologist. The best technique, in my view, is the honest and self-benevolent making sense of one's feelings and states.
I have always been reserved about techniques, firstly because what helps one person may be completely inapplicable to another, and above all because behind techniques may lie an attempt to cover things up.
If a woman feels irritation, for example, there is a reason for it – there is something that needs to be recognised and probably changed. Using a technique to distract from a frequently recurring unpleasant feeling means ignoring a truth about ourselves that something is telling us.
By expecting that the physiological changes during menopause have a strong influence on a woman's emotional state, we risk pointing to the wrong cause for negative feelings, which may have entirely different sources.
Although subject to certain physiological changes, a person's emotional reactions are never accidental, causeless or random.
Trying to understand what lies behind our experience and what we need when we are not feeling well is, I think, the best way to understand how to help ourselves too.
Is there a way to avoid or keep under control the manifestations of emotional and psychic instability during this period?
Yes – for the woman not to lose interest in herself.
The emotional charge accumulated around the psychic experience of the change brought on by the onset of menopause, which probably lies behind a woman's heightened sensitivity, can be directed towards various constructive directions, such as purposeful care for health, beauty, elegance, self-development, and so on.
Health is not a constant, nor a flawless state determined by one factor or another. It is a form of preserving psychic and bodily balance and comfort.
With greater responsibility towards oneself, this can become a clearly defined goal for a woman.
Is there a difference in how we talk about menopause? Years ago, we used to say the word “menstruation” quietly, as if it were something shameful. The same was later observed for the word “menopause”. How is it today?
Here we are, Vichy is talking about menopause! Even the fact that we are discussing it with you also shows that there is now more freedom. Whether freedom in speaking is also freedom in thinking is another question.
If in the past menopause was a delicate topic for open discussion, as something linked to intimacy, and respectively to a woman's sexuality, today it may rather cause unease due to its analogy with ageing and the decline of active life.
“If sexuality used to be shameful, today what is shameful, for some reason, is not being ‘in shape’.”
Menopause in the office – how can a working woman preserve her self-esteem without being suppressed or fearing “discrimination”?
I think it is unfounded to speak of genuine discrimination in relation to menopause. Menopause is presumed, it is not visible or openly stated.
When we see a woman, we do not think about whether she is in menopause or not. We respond to what comes from her towards us, to what she is and shows.
The human being, and the sense we have of them, is a complex whole that cannot be reduced to individual characteristics. Least of all – to the presence or absence of a menstrual cycle!
If, however, a woman begins to accept menopause as an unpleasant characteristic of her own, with which she identifies, this can lead to what might be called self-stigmatisation, which may in turn be reflected in the attitude of those around her.
But under normal conditions, I could not imagine stigmatisation in itself on this account. If a woman has such a feeling, I think it is good for her to consider whether it is not simply a reflection of her own feelings.
The interview was originally published in EVA magazine.