Midlife as a Gateway to Authenticity

Are you a midlife woman who doesn't understand what is happening to your body and your mind?
Have you told your doctor how you’re feeling and were dismissed with medications or hormone replacement therapy?

Do you feel overwhelmed by the volume of information available about managing midlife and peri-menopause?

I am not only a practicing internist but a midlife woman.  I have been helping midlife women for over two decades with their menopausal symptoms and have gained significant personal insight about how little support is currently available for us.

During my forties I noticed my body and energy level change. I began to feel tired and heavy.  I also felt restless and had trouble sleeping through the night.  I looked for answers to these symptoms in my medical books and journal articles. I even went to my gynecologist to understand why I was feeling this way.  All she had for me were prescription drugs and hormone replacement therapy.  She told me that this is peri-menopause and that I have entered this category in midlife.  “It’s downhill from here” she said.  My visit was a huge disappointment.  As a scientist and a problem solver, I was determined to understand why I was having these symptoms and what I could do to restore my sense of health and well-being.

I found a lot written on this subject.  What I read though was theoretical but not practical and it did not address the deeper aspects of what I was looking for.  Why did my soul feel restless?  Why did I feel emotional ‘heaviness’?  Why was my body changing in this way and why were issues resurfacing that I thought were solved?  I was forty-two when I began to feel this way. I was an intelligent and a dynamic woman who had lived a very healthy lifestyle.  I had also created a successful medical practice and on the surface,  appeared to be at the top of my game.  Deep inside, I felt empty and disconnected.  My marriage felt deeply unsupportive and I found myself less able to tolerate the disrespectful ways I was being treated.  It was as if I was not able to compromise myself in order to adapt anymore.   My tolerance for the superficial was receding.  I found myself being more reactive and angry.

What I discovered was that hormonal shifts in my body that were normal during this stage of life brought with them emotional and soul shifts that were offering me an opportunity to take a look at my life from a deeper perspective.  Since I was conditioned to pathologize this, it engendered a deep fear of aging and degeneration. It was anything but.

This time in a woman’s life holds immense transformational power.  When a woman arrives at this gateway, her hormones shift, recalibrating her identity.  She is meant to question who she has pretended to be and move her deep into her soul and her authentic self.  Our society deems this a ‘midlife crisis’.  I like to think of this as the alchemical process of becoming real.   Women need to learn how to take care of themselves through this gateway and beyond.  They need to learn how to use the framework of transformation to connect with their intrinsic power and truth.  At this juncture, women are in need of balance at all levels of their body, mind, emotions and soul.  Many have lived unbalanced lives up to this point, neglecting to take care of ourselves.  As their bodies change they are called to heal their self-neglect.

I would like to offer some simple solutions to support your midlife transformation:

1. Work with a physician who can help you balance your hormones, not replace them.  Bio-identical hormones are much safer alternatives to synthetic ones.  They can quickly restore your feeling of well-being when used correctly in small doses.  Most women are in need only of natural progesterone to balance the estrogen to progesterone ratio.  Taking estrogen in even natural form can aggravate many symptoms of the menopausal transition.  This needs to be customized by your physician to suit your biology and your sense of well-being.  There is no "cookie cutter" way to balance hormones.

2. Acupuncture can make a significant difference in your well-being particularly if you are having a difficult time with menopausal symptoms such as hot flashes and night sweats.

3. Have your thyroid levels checked.  Make sure your physician orders a thyroid panel to give her/him a better understanding of the status of your thyroid as it can become sluggish during midlife.  Make sure you have free T3 levels checked.  These commonly decrease in midlife resulting in weight gain, fatigue and foggy thinking.  Replacing your free T3 and normalizing your TSH to a value between 1 and 2 will make a big difference in your sense of well-being.  Moreover, low free T3 levels have been correlated to an increase in all cause mortality.

4. Clean up your diet.  Change your diet to one that is mostly organic and plant based.  A plant based Mediterranean diet has been shown to significantly lower the risk of heart disease, diabetes and cancer, three of the most common diseases in the U.S. that present in midlife and beyond.

5. Begin taking a therapeutic grade omega-3 supplement and vitamin D.  These will decrease inflammation and strengthen your immune system, reducing the risk of disease.

6. Make aerobic exercise a priority.  At least 20 minutes of exercise, 6 days a week is needed to decrease the impact of physiological stress and restore cardiac health.

7. Incorporate massage therapy, yoga and meditation in your life as ways to heal stress and bring you closer in contact with your authentic self.

8. Work with a psychotherapist to gain a better understanding of your real needs and desires and to dismantle the parts of you that no longer serve your life.  Many feel that they can do this alone and with the help of friends, but it is much more effective and efficient to engage a professional who is objective and can clearly mirror what you need to work on to connect to your authenticity.

9. Make a commitment to be true to yourself and seek for a deeper sense of meaning every day.  Stop compromising your real needs to be liked or accepted.  This is one of the hardest patterns for women to break.  Garner the courage to be true to yourself.  You will earn the respect of many around you.

I invite you to reframe midlife from a time of crisis to one of transformation.  The best years of your life are yet to come.  Grace them as a seeker with deeper meaning and understanding  so you can experience the power and sacredness of your authentic self and most of all experience a deeper sense of meaning now and for the rest of your life.

The Need to Transform the Existing System of Healthcare

There is a movement underfoot in our country that is provocative and exposing. Our shadow is up and it is unraveling itself in all of our institutions. When I left the medical system at age 36, I did so because the corporate intent that I was expected to enable – sick care, felt ‘unethical’ to me. Sick care was not what I was trained to serve. It was not what my heart and soul went into medicine for. But it was required of me by the medical system to generate profit. I was required to keep people sick in order to keep my job.

Deep inside, I knew I was a problem solver. This is what I loved about Internal Medicine. I wanted to uncover the causes of symptoms and ease suffering by working with people to figure out the causes for their illness and how to tap into it to find solutions with them. If our premise is that life is full of precision, then we should be able to figure out the purpose and meaning behind our symptoms and suffering. Our suffering can also help us become real. It has an alchemical effect on our ego that strips it from being ‘all knowing’ to becoming a student of life.

I love medicine. It excites me and it stimulates my thinking at many levels. As physicians, we need to use our knowledge from a context that serves the vocation of medicine.  We also need to use it responsibly and humanistically. This is what we have lost and must regain in health care today. We must open the currently closed system of medicine while maintaining a high standard-of-care. An open system grows and evolves.  A closed system stays stagnant and is based in fear.  Today’s health care system uses fear to keep patients coming.  Its revenue depends on this.

An open system will of medicine is cost effective and patient centered. Its context examines what is wrong but also “what is right about what is wrong”. When we explore symptoms and illness from this framework, we can heal our patients at causal levels. We can use the pathological model within the larger context of a healing model, seeing pathology as a symptom rather than an end.

This context is transforming medicine and evoking health at The Ommani Center for Integrative Medicine. This is a prototype of an ‘open system’.  This was a way I could make medicine REAL and restore and reclaim its SOUL. Becoming Real is the calling of our time. This is our collective path. This can transform our medical system and restore it to what it was originally intended to be.  This will involve physicians who are open to working from this context and patients who expect it.

Midlife as Alchemy

What is Midlife? What is Menopause? What is at stake?
What is our Conditioned-Self?  What is our Authentic-Self? How do they differ?
In my 22 year history as a physician who has worked with thousands of brave and courageous men and women with stories of wounding, suffering and healing, I can say that I have been able to identify the differences between these selves and the intrinsic power that emerges when one leaves the Conditioned for the Authentic Self.  The Conditioned-self is who you were told you SHOULD BE. The Authentic-Self is WHO YOU ARE.   For the first half of our lives, the Authentic-Self is buried beneath the Conditioned.  In the second half, we must re-emerge Authentic.
There is a powerful shift that occurs in midlife when our physiology and soul intersect at this gateway to make room for the REAL to emerge.  This creates a felt space between the Conditioned and Authentic selves.  The traction of the conditioned one pulls at us, urging us to behave from familiarity based in FEAR.  All the ‘shoulds’ fear us into staying stuck.  Fear is the feeling that adapts us in the first half of our lives.  We adapt to be accepted.  Adaptation conditions us. It creates a shell around our Authentic –self that waits patiently for us to awaken.  We learn to withhold our truth; we say ‘yes’ when we want to say ‘NO’. We over-ride our true feelings to be accepted and loved.  For decades we live this way.  We construct our lives from choices that emerge through our conditioning.  We become part of society’s ‘herd’.   We normalize this identity and close our eyes.
When we turn 40, something changes.  A soft whisper fleets through our body and mind, suddenly with no warning.  Sometimes we don’t really hear it, sometimes we try not to.  It beckons us to awaken, to bring LIGHT to our choices.  It says, ‘Who are you really?’  This frightens us.  If we don’t listen, it moves in deeper, rises stronger – as fire, as density -anxiety, depression –in our bellies, pulling us in.  We begin to sweat, to hot-flash; we awaken at 3 am with minds racing and fear coursing in this unknown place.  In the middle of the dark rises a whisper of comfort, the voice of our Soul pulling us in – to connect, to open, to awaken and deliver us finally to our Voice and our Truth.
If we do not listen, it may call to us as cancer, divorce, tragedy, devastation, that forces us inward to evaluate, deconstruct and  make ourselves new.
All this sorting and sifting, transforming and reinventing – THIS is midlife.
This is menopause.
This is not a sickness or a  deficiency. This is NOT a pathology.
This can NOT be medicated away.
This is HERE to stay and it will offer us the fire of alchemy into which we must step to make ourselves WHOLE.
The voice of the Authentic-Self will rise from ashes of the conditioned one as adaptations fall into the fire to be transformed.  If we willingly lean into this, our voice will emerge – FINALLY- the TRUE voice we will use to heal the world.
We will spread our wings and fly out from this fire into life again with wisdom and an inner eye that can never be closed.

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