Exploring the stories and narratives around menopause with Richmond (The Pain Coach)
Stories
Life is largely made up with stories. We are not born with them, instead gathering them as we grow and form an identity. Part of that identity hinges on our sense of gender. Much has been written about this subject. Suffice to say here is that as a result of being male or female, we live different stories that are thrust upon us, imprinted by parents, society and the media. Rightly or wrongly.
We take these stories forwards and they become our beliefs about the world. We can then of course, pass them on in the same way. They are very convincing, shaping our worlds and experiences and relationships and lives. But, and here’s the thing, we can change the story.
On being asked to share some thoughts on menopause, they are largely based upon the stories I have been told by the many women I have seen in the clinic blended with healthcare education. They describe what they feel in their bodies and their emotional states: the qualities of the experiences and the impact.
The bottom line is that the experience of menopause is often one of suffering. Not only from the symptoms but also the powerlessness that some perceive until they gain an understanding of what is really happening and what they can do. This can change everything. At the heart of this is always a person. This is the key point that I will return to.
Perceptions and expectations
Most women I see have come because they have aches and pains. Pain is complex and involves many body systems as it is a whole person perception: it is the person who feels pain, not the body part. Hormones play a role, oestrogen in particular. But this is not in isolation to how the endocrine system works together with the autonomic nervous system, the endocannabinoid system and other body systems.
All systems are overseen by the brain, which is making its best guess about the causes of the sensory information it receives in its dark cave. Past experience (priors) frames the prediction that can be updated, given certain circumstances and movements, by the incoming sensory data. In fact, this could be at the heart of getting better by making better predictions
Expectations and attention both play a significant role in what we experience. We see the world we expect to see, based upon what we know. Much of what we know, ‘the rules’, we don’t have conscious access to, yet it fundamentally shapes our perceptions. Pain for example, is influenced hugely by what we expect to feel and where our attention lies. This is far more important to consider than the tissue state, which is poorly related to the pain. Pain and injury are not well matched.
Whilst this is more complex than the over-simplified ‘pain = injury’ model (and vice versa), there are far more opportunities as a result. And therefore, great hope for people suffering. Understanding pain as a perception that is being shaped by a range of modifiable factors allows us to tap into human capacity for growth and development.
The word change is often used. Yet this can imply changing the person, which we are not seeking to achieve. Instead, a change of experience and perception of the world by focusing on and building wellness. This is our major buffer to life’s inevitable ups and downs.
The whole person
I am not an expert in menopause. Fortunately, there are an increasing number of people offering effective ways forward. They are usually grounded in compassion, an essential ingredient for healthcare in my opinion.
As with persistent pain, understanding is the key start point. What is happening and why? What are my needs? How can I best meet them? What can I do? What help do I need? These are all useful questions to ask and have answered.
I stated before that it is the person who suffers, not the body part. It is a person who experiences the symptoms of the menopause and pain – the whole person. Hence the person’s lifestyle, their attitudes, their past experiences, their outlook, their belief in themselves to make an impact, their faith in their body to change state and more, is much more indicative of the trajectory that they are on. Or the story they are living out.
But is this the one they want? If not, we work at changing the story. What is your ideal future? What are you working towards?
People around
We are influenced by those around us. Choosing our circle of influence is important, as we make allowances for, and set our standards according to theirs.
What do people close-by say to you about your experiences? Do they make light or fun? Does that help you or instead cause you to bury your feelings deep inside?
Have you got someone to talk to who can hold the space and listen? What difference does that make? Have you noticed a difference between the attitudes of men and women?
Of course, each person will have their own encounters.
Meeting needs
Our behaviours are attempts to meet our needs. This includes what we do and say.
The sensations in our body and the emotions that we feel are guides. They are telling us something about our needs. This may not be convenient or pleasant, but it is necessary. Without such feelings, we would not know that there is a need to be met.
On building an understanding of what the need is likely to be, and then how to meet it, there is a change based on growth. This can be shared, contributing to someone else’s quality of life, and that of the sharer. One of our basic skills of being well is to share and contribute.
This is why the communities that have been created are a source of support and encouragement, if used in a positive way. That is, towards something better. The many meme posts that highlight the negative side only fuel those feelings, much like office gossip. The art of communicating is so impacting. The person you communicate with the most, is you.
So, what do you tell yourself? What is your story? What are you working towards as an ideal self?
You choose.
About Richmond (The Pain Coach)
I am a physiotherapist specialising in helping people understand and overcome their persistent pain so that they can lead fulfilling lives.
Over the past 10 years I have been pioneering Pain Coaching (PC). PC is a way to guide and encourage people to reach their potential to improve their lives. They can do this by focusing on their strengths, using practical tools and employing the habits of peak performers as they move towards their picture(s) of success.
I have worked in healthcare for over 27 years. My primary focus has been on the person, their needs and how they can best meet them. I learned this early on when training to be a nurse, and this philosophy continues to be at the heart of what I do.
Outside of sessions with people, I am to be found reading, writing and listening, so as to continue the journey of understanding human beings. This is the way I think that I can help.
Then I run. For long distances. It keeps me fit but also allows me to explore my own experiences and my mind whilst bathing in nature.
I am married with four kids. They inspire me.
Finally, I am grateful for the opportunity to do what I do with the people who come along for guidance, my family, friends and the capacity to run.