May 16, 2025 • 43 mins
How do hormonal changes during menopause affect your mental health? This question has remained largely unaddressed in conventional healthcare, leaving countless women struggling to understand why they suddenly feel like strangers in their own minds and bodies.
Psychotherapist Kim Crispeno joins us to shed light on this critical intersection. As co-founder of the Aftermath Agency, Kim's approach to mental health during menopause emerged from her own personal journey and professional expertise. She explains how hormonal fluctuations directly impact brain function, triggering everything from brain fog and memory issues to anxiety, depression, and irritability that can strain relationships and diminish quality of life.
The conversation takes a fascinating turn as Kim introduces the concept of shame in menopause. What if our changing bodies become the "dysregulating other" that triggers profound discomfort as our previously reliable cognitive functions seem to betray us? This perspective helps explain why competent, high-functioning women suddenly feel destabilized during this transition.
Kim offers practical strategies for navigating these challenges, emphasizing the power of community, self-awareness, and reframing menopause as a doorway rather than just a loss. Her advice to simply "notice" what's happening without judgment provides a gentle first step toward self-compassion. She even writes "permission slips" for clients – tangible reminders that it's okay to prioritize their needs during this transition.
Whether you're experiencing perimenopause symptoms without realizing their source, fully immersed in the menopause journey, or supporting someone who is, this episode provides valuable insights for approaching this significant life transition with greater awareness and self-compassion. Kim's parting wisdom to be "kind and curious" with ourselves may be the most powerful tool for transforming how we experience menopause.
Kim’s contact info: https://www.theaftermathagency.com/
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MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
April Haberman (00:00):
Welcome to the MiDOViA Menopause Podcast, your
trusted source for informationabout menopause and midlife.
Join us each episode, as wehave great conversations with
great people.
Tune in and enjoy the show.
Hey everyone, welcome to theshow.
Today we have Kim Crispeno,with the Aftermath Agency, with
(00:23):
us.
We're super excited about thisconversation because we know Kim
professionally, but we alsoknow her personally and she's
our neighbor, so we're all inthe same neighborhood.
We've known each other foryears, but professionally we
have high regard and respect forKim and what she does.
So I'm going to dive right inand, kim, have you hop in here
(00:47):
and introduce yourself.
Tell us a little bit aboutyourself, what you do and why
maybe you started the AftermathAgency.
Kim Hart (00:56):
Great Well, thank you both for having me.
It's fun to be in aprofessional context with the
two of you.
April Haberman (01:03):
Yeah, for sure.
Kim Hart (01:04):
So I, as you mentioned , I'm a psychotherapist with the
Aftermath Agency, which Ico-founded and that we
co-founded.
It's a group of licensed andcertified professionals who
focus on well-being from anumber of different angles,
because we believe that healthand wholeness and well-being
from a number of differentangles, because we believe that
(01:26):
health and wholeness andwell-being you don't just
approach from one angle, youhave to hit it from a lot of
different angles.
So that's kind of where I amright now.
I also the reason we startedAftermath.
It actually begins with story,with my family's story.
(01:47):
I have a child who had somesignificant mental health issues
that manifested themselves whenthey were a preteen, a teen,
and that led us on a journeythat we probably weren't very
(02:09):
well equipped for.
But both my partner and Iconsider ourselves to be, you
know, high functioning,resourceful, educated, and it
was a full time job for both ofus, trying to manage care and
figure out what would help.
And then it launched us into.
(02:30):
Basically, that child was adetonator in our family for
everything in our system thatneeded to be looked at and
examined and healed needed to belooked at and examined and
(02:51):
healed.
And out of that we, because wehad financial resources that we
could use, so grateful for that.
But there were some uniquecircumstances in our situation
that allowed us to access somestate funding.
That was huge.
To access some state funding,that was huge.
But we realized not everyonegets this kind of care or cannot
, can't even figure out how tofind this kind of care, excuse
(03:12):
me.
So we thought, could we providesomething that offers more
wraparound care, resourcing,help for people who are in
situations where it's kind ofoverwhelming?
So that's kind of the visionbehind it.
Yeah, it's so inspiring.
(03:32):
I mean, there's so manyfamilies that are faced with
those things and are not surewhat to do, and, especially as
the mama, it just tears youapart when you can't find the
resources for your child.
So I love that you took thatand said let's help others,
because it was such a journey oflearning and navigation.
(03:55):
So that's so inspiring, kim.
Thank you for sharing thatstory, because I think that
really sets the stage for theconversation.
Kim Crispeno (04:06):
Yeah, well, you're welcome.
April Haberman (04:08):
And you see so many people through the
Aftermath Agency.
We've been fortunate enough tosee your space and it's
beautiful, and we just hadTricia, your co-founder, on the
podcast as well recently.
But I know you also have a lotof women that are in midlife
(04:30):
that are coming through yourpractice in one way or the other
, and I'm curious because it isMental Health Awareness Month
and that's why I wanted to haveyou on the podcast to
specifically address midlife andmenopause and mental health.
How do you think that menopauseinfluences mental health among
(04:54):
midlife women?
What are you seeing in yourpractice?
What are you hearing?
Tell us a little bit more.
Kim Crispeno (05:01):
That's a large question.
April Haberman (05:02):
It is A loaded question.
How long do you want to unpackthat yeah?
Kim Hart (05:07):
well as, as you both are well aware of, hormones
don't just control our bodies.
They shape our mental andemotional worlds and, um, they
have a profound effect on ourmental health because they
directly affect and influenceour brain function and
(05:29):
menopausal women, partly becausethey are coming in and they are
(05:51):
raw, they are honest, they arefeeling vulnerable and most of
them are like just open, likewhat can, how can, can you help
me?
You know I need some help.
Some of them are like just open, like what can, how can, can
you help me?
Um, you know I need some help.
Some of them are pissed off.
I think, uh, that feels to melike that's a little bit later
(06:14):
in the stage.
This doesn't always show upinitially in perimenopause.
Um, because I think often whatI'm noticing in perimenopause,
women are coming in and theyhave these symptoms that they're
they think they're mentalhealth symptoms and they are,
but they're very connected towhat's going on in their
physical bodies and they haven'tyet made that connection Right.
(06:36):
I think back to when I wentinto perimenopause and I, I
think I didn't know I was in itand, um, and I remember I don't
know what your both of yourexperience was, but I think the
(06:57):
initial symptom for me is Istarted dropping all the nouns.
I could not for the life of meremember names, proper nouns,
other kinds of nouns, and solike my conversations were just
a hot mess and my kids were likemom, you know, do you have some
(07:20):
early onset?
I was actually a little bitscared about that.
Yeah sure, alzheimer's in myfamily, and I didn't initially
make the connection to hormones.
What was going on in my body.
I just thought what is going onI must you know.
So that was my experience.
(07:42):
I'm curious about the two ofyou, like when you kind of
noticed.
April Haberman (07:46):
Well, kim, you, you go, cause you've had.
You had the brain fog too.
Kim Hart (07:51):
Yeah, brain fog, sleeplessness, uh, anxiety, um,
uh, incessant, incessant worry,um, yeah, those and.
And the brain fog for me was Idon't have a problem talking, I
talk.
And the brain fog for me was Idon't have a problem talking, I
could talk all day long, just me, to everyone, by myself, and I
didn't want to open up my mouthbecause I couldn't remember the
(08:12):
words and I felt stupid all of asudden because I couldn't.
I like the nouns, that's likeyou couldn't remember what it is
that you're saying.
And that happens occasionallynow, but nothing like what it
was, and it was sort of an outof body experience really, just
to try and manage myself and mybrain during that time.
(08:32):
I'm still dealing with thesleeplessness and the anxiety
and those kinds of things, butbecause I've gotten help, it's
so much better and manageable.
But yeah, it was a.
It was a scary couple of monthsas I was trying to figure it
all out.
April Haberman (08:47):
Yeah, it's so interesting to hear everybody's
story too.
Right it's, for I went throughearly menopause, kim.
I don't know if you know thator not.
I don't know if I shared thatwith you, but you know it was.
It was extremely frustratingbecause healthcare professionals
don't necessarily look at thatas menopause, perimenopause
(09:10):
right, you're too early for that, so we're not looking at that.
No one was really looking forthat.
So I was really at a loss but alittle bit of brain fog.
But I had heavy flooding,bleeding I call it crime scene
bleeding.
Couldn't leave the house youknow gym in the middle of the
night.
My husband, we were like whatyou have to help me, right, I
think I'm dying in the bathroomhere.
(09:31):
And fortunately I had aflexible working environment so
I didn't have to show up in theoffice.
But I had anxiety, I haddepression, I was irritable.
I had depression, I wasirritable.
I look back on that now inhindsight and think you know a
(09:57):
lot of the, a lot of thechallenges and just anger that I
had in even in my marriage andfrustration with the kids was
menopause and I didn't realizeit at the time until I started
hormone therapy.
And for me that was a goodchoice because I reached early
menopause and for long termhealth I wanted that choice.
But you know divorce rates arehigh in individuals between 40
and 60.
(10:18):
And that very well could havebeen where I ended up, so that
anxiety, the irritability, thedepression is real.
And I was on antidepressants.
You know that the doctor saidhere you go, take Lexapro, let
me know if you feel better in acouple of months.
So I'm wondering, you know, aswe're kind of shifting back into
(10:42):
that mental health conversation, do you see that where midlife
women are coming to you nothaving the information from
their healthcare practitioners,and are they coming to you in
more of a state of desperation?
How do they get to you and whatare you hearing when they
(11:04):
arrive at your doorstep?
Kim Crispeno (11:09):
A lot of women come because they are
experiencing the mental healthimpacts of perimenopause
menopause and they haven't yetfully connected the dots to
physical health.
And so if you have a goodmental health practitioner, they
(11:31):
should always be ruling out aphysical source of what's going
on in your body.
So when I'm working with anywoman 30s onward or actually
anybody but they're coming inand they're presenting all these
different symptoms, I am alwayssaying, hey, we need.
(11:55):
Are you working with someone onyour physical symptoms?
Have you had blood work done?
Have you been looking at thesethings?
Because it goes hand in hand.
There still is the mental healthaspect that we can I can help
with, but I always see that weneed the physical care and I do
find a lot of women strugglingto find competent care, care
(12:19):
that where they are notdismissed with what they're
feeling, where it's not all intheir head, where there's a lot
of women have had trouble, andone of the things that again,
we're trying to do at Aftermathis create a robust database of
resources, of people that wetrust, that we can send people
(12:40):
to, and we have a resourcespecialist.
Her name is Meredith, she'swonderful and she's available
free to the community to helpyou resource if you need it, and
we're like working with thoserelationships.
Who are the people that aregoing to take you seriously when
you walk into?
Kim Hart (12:59):
the office.
Kim Crispeno (13:00):
That is so important, I think, in all
aspects, for women in particular.
In a lot of our experiencewe've been invalidated, we've
been told, oh no big deal, youshould be able to figure this
out.
And we tell ourselves that too.
We dismiss our own experiencereadily, experience readily.
(13:28):
And so a lot of women come inand they don't even.
Oftentimes they're likethinking they're crazy or it's.
You know they're.
They're just looking forsomebody who will to get their
experience to, who will takethem seriously yeah.
Kim Hart (13:43):
Yeah, it's, it's a thing we hear all the time and
we talk about.
It's okay to divorce yourdoctor to find a good doctor.
It's okay to go get you know,get your team together so that
you have your therapist and youhave your support system around
this for so when the when thishappens to you, you know, you
can imagine that you probablyget the same thing, but we get
(14:04):
everyone's stories because theyknow it's a safe place to be
able to talk about it.
Have you identified anyspecific patterns or triggers
that happen for women thatexacerbate these mental health
symptoms during menopause?
Kim Crispeno (14:21):
I would think that there are a few.
If a woman has a pre-existingcondition, if she's already
struggled with anxiety ordepression or even paranoia or
things like that if there's aprevious condition that's being
(14:42):
treated, then oftentimes that isworse, it gets much worse, and
there's an interesting study outof that was published in, I
think, cambridge UniversityPress in 2023, where and you, I
know you all know this, but thatif you have a pre-existing
(15:04):
condition, usually it gets worse.
That's connected to hormones.
It gets worse during menopauseand the treatments that may have
been managing it don't manageit in the same way anymore and
you need to make adjustments.
So that's one thing I would say.
Another pattern is if there'san escalation and stress in any
(15:28):
part of a woman's life, thatalso exacerbates things.
If a person has a lot of traumaand this is where I don't know
if you, um, our listeners arefamiliar with a window of
tolerance probably they areunpack that a little bit.
April Haberman (15:53):
I'm not sure that everyone knows what that is
yeah, okay.
Kim Crispeno (15:56):
So a tolerance is basically a concept in
psychology and neuroscience thatdescribes the optimum or
optimal zone of arousal where aperson can function most
effectively.
So when you're in that optimalwindow, you can think clearly,
(16:19):
you can feel and process youremotions without overwhelm, you
can respond rather than react tostress and you can engage
socially and make decisions.
So when people have trauma or alot of stress, whether it's
(16:39):
chronic or acute, or if they'reexcuse me if they're feeling bad
in their bodies, whateveroftentimes our window of
tolerance is small.
Kim Hart (16:48):
Right.
Kim Crispeno (16:49):
And so anything can push us to the edges or
outside of that.
And when we get to the edges ofit or outside of it, then we
find ourselves in a couple ofstates ourselves, in a couple of
states, so hyper arousal, whichwould be fight excuse me, fight
or flee, you know or a hypoarousal state where we kind of
(17:16):
shut down, we're overwhelmed,all of those things.
So that's, you know.
I think most of us are familiarwith that.
And so what happens is like intherapy I am working with to
(17:37):
help a person identify whattheir window of tolerance
currently is and what's going tohelp them stay in that, so what
tools, techniques, things canhelp them stay in there and what
they need to pay attention to.
And then, but also in thetherapeutic space, I'm actually
working to try to expand theirwindow of tolerance.
But that, I think, has to bedone carefully, right?
(18:03):
We're working to increase ourability to tolerate distress and
it really helps if we have aperson who's regulated, who's
helping us do that.
So I don't always try to get myclients to do that on their own
outside.
I want them to stay in theirwindow as much as possible on
their own and then in spacewhere I can help them work to
(18:25):
increase it.
So those are some of the thingsthat I think I'm seeing when
women come in that are patternsor triggers.
Kim Hart (18:35):
We get a lot of questions about you know, how
much should I suffer before I goand get help?
Like we're always saying, thereis no need for suffering here,
like suffering is an optionalthing.
What strategies do you helpwomen have to better understand
and articulate how these mentalhealth experiences are affecting
(18:58):
them during menopause and andyou know from the suffering
point of view, when do you, youknow, when do you put up your
hands and say I can't?
You know, from the sufferingpoint of view, when do you, you
know, when do you put up yourhands and say I can't?
You know I can't do thisanymore.
April Haberman (19:09):
How much is too much?
Yeah, we hear oh, it's not thatbad, you don't have to suffer.
Kim Crispeno (19:15):
Yeah.
April Haberman (19:15):
Great Thanks for bringing that up.
Kim Crispeno (19:24):
Yeah, I, sooner that we can get intervention and
help, the, I think the less wewill suffer, right, and so one
of the misconceptions that I seecoming up with women is that we
can figure this out on our own.
Kim Hart (19:40):
I'm smart.
I've been able to do thingsbefore.
I have figured things out upuntil this point.
Kim Crispeno (19:45):
This is a thing that I can just put down I don't
need help.
Kim Hart (19:47):
Yeah, I'm smart, I've been able to do things before.
Kim Crispeno (19:49):
I have figured things out up until this point.
This is a thing that I'm I can,just I don't need help.
Yeah, I'm good, right, rightand and I don't need help.
Or there is, I think, anotherlevel of um.
This is where I think shamepops into the picture that we
feel like there's somethingwe're doing wrong.
And so kind of like, as women,we dig in our darn heels and
we're like I am gonna figurethis out, because you know,
(20:11):
there's something wrong with methat I can't figure it out, and
so we do stay in that state ofnot asking for help longer.
So I think I would like to saya little more about shame,
because I've been thinking aboutthat in relation to this
conversation, and, uh, reneebrown, as we know, did a lot to,
(20:33):
I think, help people understandthe difference between guilt
and shame.
Guilt I did something wrong orbad.
Shame says I am wrong or I ambad, and I think that's helpful
for common understanding.
But there's a woman, patriciaDeYoung, and she wrote a
(20:55):
wonderful book on shame calledUnderstanding Chronic Shame, and
her definition I'm like.
So she talks about shame asalways being relational, so
shame is one of those thingsthat we experience in relation
to someone else, so it triggersa feeling.
(21:18):
Something triggers a feeling ofI am, something is wrong, and
it's usually me.
Um, and her definition, though,is really interesting.
April Haberman (21:28):
She says um, shame is the felt sense of a
disintegrating self inconnection to a dysregulating
other wow, that's okay oh, Iknow you got to tear that apart,
I think say it again and maybelike let's, let's give, let's
(21:50):
unpack that a little bit.
Kim Hart (21:51):
So first of, all.
Kim Crispeno (21:52):
So she says shame first of all.
The first part it's a feltsense.
So it may not be true, but it'swhat we're feeling right it's a
felt sense that we aredisintegrating.
We have a disintegrating self.
Something you know is is is iskind of, yeah, disintegrating in
(22:14):
us, like we're breaking down.
April Haberman (22:16):
I mean, are we?
Is this your self-esteem?
This is?
Kim Crispeno (22:20):
right, yeah, but it's in the um in relation to or
in the presence of adysregulating other.
Kim Hart (22:27):
So that's somebody else that's causing this, for it
happened to you or somethingelse.
Kim Crispeno (22:33):
Yes, and so, for you know, like a lot of times,
like if you're oftentimes shamedget its hold on us in childhood
.
Gets its hold on us inchildhood.
So we experienced a lack ofattunement from a primary
caregiver who doesn't read whatwe need, and so, you know, in
(22:56):
our young brains we can't sortthings out.
So we begin to think, oh,something's wrong with me.
Yeah, so, but what?
My question around this, why Iwanted to bring this up, is what
if in menopause and this is I'mtaking this loosely but what if
in menopause, the dysregulatingother is ourselves?
April Haberman (23:22):
Yeah, that is a good question yeah, that is a
good question.
Kim Crispeno (23:30):
And so, in relation as ourselves, are
dysregulated in our bodies andare all of the things because of
what's happening chemically inour bodies and then we
experience a sense ofdisintegration I can that Like.
Kim Hart (23:44):
If you take my brain fog example, I was.
I was ashamed that I couldn'tcome up with the right words and
I didn't want to talk because Ifelt like I would appear as not
smart or not together orwhatever.
So I can see that shame reallycame in for me in that me in
that case.
Kim Crispeno (24:05):
Yeah, and so what if we could reframe menopause?
And you know, think about it asoh myself is going to be
dysregulated in this time Right,and we can begin to understand
that and see menopause as adoorway into understanding more
(24:29):
A our own patterns ofdisintegration and then what is
needed for integration.
And unfortunately, women havethis much harder, in my opinion,
than men, because we have allthis stuff going on in our
bodies.
And um, I just wish you knowhow they have those um period
(24:52):
pain simulators that they attachto men.
April Haberman (24:55):
Oh, we do have a um hot flash simulator.
Kim Crispeno (24:59):
Oh, you do.
April Haberman (25:00):
Okay, I was hoping, but but there is one um,
there's a mental vest that um,that you can, you can put on and
simulate hot flashes, but umbut what about the other
symptoms, all the others?
I like that.
Kim Crispeno (25:15):
That's just one right One there's 34 things that
are like all happening at thesame time for us and this like
yeah, sure, the hot flashes aremiserable, but they are flashes.
They're over fairly quickly.
They may come a lot dependingon how well, how much estrogen
(25:38):
we've got going on in our system.
April Haberman (25:41):
Right, kim, I love this conversation about
shame and menopause andreframing it and menopause being
the doorway, and I'm reallythinking about you know what,
your thoughts and brain fog andbeing.
We're used to functioning at ahigh level and what's wrong with
(26:09):
me and it's my fault.
I think there also is shamethat can come with the need to
talk to someone, the I don'tneed to see a therapist, I don't
need to see a therapist, Idon't need to see a mental
health specialist, because thensomething is wrong with me,
right?
(26:29):
Then I'm labeling myself andI've attached this label when in
reality we know that seekingthe help that we need is so
beneficial in so many ways.
But I love the idea of lookingat it as a doorway.
Right, just walk through thedoor, open the door, crack the
door and see what's on the otherside, see what's inside.
(26:55):
For you and I often picturedoorways myself I'm a very
visual person, as Kim knows.
I have to stop and I have tovisualize things.
But for me, in that midlifestage, when I went through
menopause and it was awful Ifelt like I was closing one door
and I was standing in an emptyhallway and it was dark and
(27:19):
there were a couple of otherdoors that were cracked open,
but I was afraid to go throughthem and I so I stood in the
middle, right.
I stood in this blank, darkspace for a long time before I
had the courage to go throughone of the other cracked doors.
And it's that transition that Ithink is the hardest sometimes
(27:41):
because it is there is shameassociated with it, right, so we
can look back and we might haveshame from our childhood that
we're trying to maybe shut thatdoor and we're trying to move
forward, but there's shame inseeking help and we're lost.
And that's what I think is thesaddest for me in this whole
conversation and what we do withwomen in menopause, because it
(28:04):
can be liberating and sometimesthere's hard work that needs to
be done.
Oftentimes there's hard workthat needs to be done, but it
can be liberating and freeingand beautiful on the other side.
So, in that context, what wouldyou say to someone if they are
in that place and not quiteready to make the next step, or
(28:28):
they're carrying shame with them?
How do we encourage ourlisteners to take that next step
to seek the help that they need?
Kim Crispeno (28:38):
So I'm curious, what helped you move forward,
what helped you go into anotherdoorway?
April Haberman (28:43):
if you can think of that, yeah, that's actually
a really good question.
For me it was the tribe, kim,you talk about this a lot.
Build your tribe, build yourcommunity around you.
It was the friends, it was theencouragement that I had there,
the, you know, the spiritualsupport from my, my besties, and
(29:07):
really a lot of introspection,which I think can be scary as
well.
So I mean I journal every day,I put my thoughts down on paper,
I go for long walks and that'smy, you know my time to think
and unpack and I'm not afraid ofthat self self reflection and
work.
But I'm not sure that everybodyknows how to do that.
(29:30):
Right, we have, if you haven'tpracticed that for years, even
that's foreign looking at ablank piece of paper and like
what do you mean you journal,what do you mean you unpack that
?
So I had a support network andI I to self-reflection, but I
don't know that everybody hasthat.
Kim Crispeno (29:50):
Right, yeah, no, that's helpful and I think you
articulated a couple importantthings in there, so I do
actually really like the ideathat menopause has the word
pause in it.
Yeah, the word pause in it.
(30:11):
Yeah, because I think menopauseis an invitation both to pause
and to move, and at differentparts in different times in that
story and in that journey we'rewe're doing different things,
right?
And so you're describing amoment of pause where you know,
like you are like in this blankspace and I think, along with
shame, there's grief sometimes.
That attends to.
(30:32):
That comes with menopause, evenif we're not necessary.
I mean, I was never sorry tolet go of that period.
I'll tell you that one rightnow.
See you later, go right aheadand leave.
But there's also this sense of,oh, I'm getting older, I'm aging
(30:55):
, my body is changing.
There are certain things nowthat are inaccessible to me
forever, and not that Inecessarily wanted them, but so
there's grief there.
And so I do think that in thatpause it is important to stop
and notice what is there, stopand be able to, you know, attend
(31:19):
to what is there.
But what you said that I thinkis so crucial is a lot of women
do not know how to do that wellon their own, because we've been
so freaking busy doingeverything in our lives to keep
everybody else going and to helpeverybody else along and to
slow down and attend toourselves.
(31:41):
It's just something we don'thave a lot of practice at.
April Haberman (31:43):
Yeah.
Kim Crispeno (31:44):
So that's where community is really important.
That's where starting to buildsome supports, um and the women
I uh feel most concerned aboutthat come into my space are the
ones that really lack support.
yeah, um, because, and so that'sone of the things we do part of
(32:07):
my like at least, mentaltreatment plan is how can we
build support?
How can we um help this personfind connection, find community,
find validation, like so theyrealize they're not alone, yeah,
in this journey.
And then at some point it Ithink women want to move, um.
(32:30):
Yes, they don't want to staystanding still too long, which
is it's good, because I thinkour bodies are designed to move
us into new things, to newplaces.
And I love um eric erickson.
The stage that he has apsychosocial development here is
um generativity versusstagnation.
(32:51):
So that's this age range thatyou're in and that's the stage
that's most associated with thisstage, like 40 to 65 or
something like that.
And it, you know, that's theinvitation in actually menopause
and we can get stuck in thosethat stagnation place.
But if there are others aroundus supporting, at some point
(33:13):
we're going to say wait, wait,wait, wait.
I want to be generative, I wantto move into this next season
with um.
I want to move into this nextseason with taking, letting,
like all of that I mean all ofthat stuff burn away, those hot
flashes, let them burn away allof the stuff that no longer
serves me and move into a newseason with, you know, some
(33:37):
generativity, with somecreativity, with some curiosity.
April Haberman (33:41):
What's next?
Kim Hart (33:42):
yeah, it's interesting because we, uh, we have a
friend, a doctor, who talksabout asking our patients what
do you want?
And most of the time at thispoint in your life, it doesn't.
It hasn't mattered what youwanted because, you had to raise
kids and do a job and, you know, take care of whatever the
(34:04):
things you needed to do.
And all of a sudden you're atthis inflection point where
you're like, okay, maybe I getto choose what I want to do next
.
And that can be scary forpeople who've never had to do
that before or don't even knowhow to do that before.
How do you, you know, how doyou approach this with mental
health and menopause, with womenwho are, you know, at this, you
(34:28):
know hallway or fork in theroad or whatever it is that
you're facing from what's nextfor you.
Kim Crispeno (34:38):
Yeah, I noticed that Tricia Wilkerson in her
podcast she said this, but thisis my favorite word actually
with clients.
If you work with me, you willhear me say this again and again
, and it's notice.
Yeah that hallway.
(35:03):
I just invite them to startnoticing.
Start noticing, and they don'thave to do anything about what
they notice.
I am just saying notice, isthere anything that you're like?
You have a flicker?
Oh, that sounds kind ofinteresting.
Oh, no, I don't want to go tothat social gathering.
Mm, hmm, you know, juststarting to notice those things,
(35:24):
and then the next step is tostart acting on those noticings.
You can stay in the noticingfor a while but then say, okay,
so I don't want to go to thatsocial gathering because I
actually feel like crap, socialgathering, because I actually
(35:47):
feel like crap.
Then you have to decide to notgo.
And another thing I'm reallygood at doing with therapy is I
have a little post-it.
You know some post-its and Iwill write permission slips for
these women.
You do not have to go to thesocial gathering, you know,
because, again, we aren't sogood at giving other people
permission to not do things.
We learned how to do that forourselves, yeah, and it's just
(36:11):
really helpful to have a littlepiece of paper, and I sometimes
do that for myself.
I bring myself littlepermissions.
It helps.
April Haberman (36:20):
I love that.
I feel like I could put that onmy bathroom mirror, like you
have permission to yeah.
Kim Hart (36:29):
Yeah, I often say to people when I'm coaching, when
they're like I don't know, I'mlike well, pretend you do know,
let's just pretend for a minute.
You know what door you'd gothrough.
Why don't you go be curiousabout that Right?
Kim Crispeno (36:43):
Yeah, yeah, it's kind of like a miracle question.
It's a miracle question whichis like if everything could do
whatever you want, have whateveryou want you know, everything
would go away, but what?
What's left, like what you know, and if people can, yeah, it is
, um, yeah, fun to to do that.
Kim Hart (37:02):
It's a gift to yourself that you haven't
figured out how to do you giveor get before, and so it's a
little scary, but also it's alittle exhilarating once you
figure out that.
Oh, you can notice you can dosomething different.
April Haberman (37:16):
Yeah, it's freeing yeah, for sure well, kim
.
I'm just wondering, as we beginto wrap up the conversation
what, what changes would youlike to see?
I'm sure you have many, associety addresses the
intersection of menopause andmental health.
What, what would you like tosee?
Kim Crispeno (37:38):
Well, I'm seeing it with the two of you and what
you are doing to educate womenand workplaces and men and all
the you know, all the peopleabout what's going on.
I definitely see that that isso needed.
The more that we talk aboutthis, the more that we see
(38:01):
creative ways to go forward.
I'd love to see more researchmore funding for women's mental
and physical health.
I mean, I don't know, there'sthat book Invisible Women.
I can't remember who it's by,but it's just atrocious in terms
of the lack of funding forwomen's health studies and
(38:28):
things like that.
So I'd love to see more of that.
I'd love to see us enter intomore of a playful space around
like this idea of seasons andtransitions and normalizing that
we actually change is a goodthing and that sometimes it
(38:49):
sucks how it happens and it'snot.
There's uncomfortable thingsthat happen, but if we can
reframe change as being, yes, itcan be scary, but there's an
invitation always, I think,embedded in change.
Kim Hart (39:06):
Yes, for sure, just a whole other podcast.
April Haberman (39:09):
Yeah, oh yeah yeah, it'd be a good one, though
, so we'll come back to that one, kim.
Yeah yeah, those are all good,kim, and we completely agree
with you on all three of those,especially that research piece.
We need that Again could be awhole other podcast as we unpack
that.
But before we let you go, wehave our last question that we
(39:32):
ask everyone what is the bestpiece of advice that you've ever
received or given?
Kim Crispeno (39:40):
That's a hard one and I'm going to answer it in a
kind of menopausal way.
Um, in the sense that itdepends.
It depends on the on the day,or the mood, or what's going on
in terms of what is the advice Imost needed to hear.
But I think consistently andthis is so is so silly and so
(40:03):
simple, but it is something Ireturned to again and again and
it was my own therapist whobasically just kind of drilled
into me to can you be kind andcurious to yourself and about
your experience?
And kind and curious and I cando that for other people, but I
(40:26):
have always struggled aroundthat for myself, and even last
night I had an experience.
I was at a social event and Iwent into a complete shame
spiral and I'm still like thismorning, like in that place, but
I've like been like oh, can Ibe kind to myself about this?
(40:49):
Can I be kind and curiousaround why?
This was why I went into thespiral?
Well, it triggered that, and sothat's, I think, where I come
back to a lot.
Is that kind and curious aboutmyself?
Kim Hart (41:05):
yeah to myself that's such a good thing to do for
yourself too.
April Haberman (41:09):
We don't do that very well no, but it's good,
kind and curious and that, Ithink, really applies to women
in menopause.
Kim Crispeno (41:17):
I mean, like, can you be kind to yourself, what
does that look like?
And in this moment?
Kim Hart (41:27):
And then can you be curious, yeah that feels
emotional to me a little bit.
I'm honest, right, can you bekind to yourself?
You know, I don't know if we,if we think about what that
would mean.
So I appreciate you bringingthat up because I think that's a
little like thing we shouldjust keep in our head in those
(41:48):
moments Like, okay, what wouldthis be like if I was being kind
, kind, kind, kind.
We know how to be kind, justnot to ourselves, not to
ourselves.
Oh well, kim, what a greatpleasure to have you on.
We wanted to do this for a longtime.
We think the world of you,obviously, but the work that
you're doing is so important.
(42:10):
And thank you for creatingcommunity, for helping people
find their truth, for supportingpeople through trauma big T,
little t trauma, because thoseare hard things to get through.
So where can people find you?
Kim Crispeno (42:26):
They can find us at the aftermath agencycom.
We're on Instagram, we're alsoon LinkedIn, so they can find us
that way.
Perfect.
April Haberman (42:38):
We'll put all of that in the show notes.
Thank you again for your timetoday in this rainy Friday,
seattle weather, and until wemeet again, everyone go find joy
in the journey.
Thanks, kim, thanks Bye.
Thank you for listening to theMedovia menopause podcast.
(42:59):
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
episode with a friend.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
Welcome to the MiDOViA Menopause Podcast, your
trusted source for informationabout menopause and midlife.
Join us each episode, as wehave great conversations with
great people.
Tune in and enjoy the show.
Hey everyone, welcome to theshow.
Today we have Kim Crispeno,with the Aftermath Agency, with
(00:23):
us.
We're super excited about thisconversation because we know Kim
professionally, but we alsoknow her personally and she's
our neighbor, so we're all inthe same neighborhood.
We've known each other foryears, but professionally we
have high regard and respect forKim and what she does.
So I'm going to dive right inand, kim, have you hop in here
(00:47):
and introduce yourself.
Tell us a little bit aboutyourself, what you do and why
maybe you started the AftermathAgency.
Kim Hart (00:56):
Great Well, thank you both for having me.
It's fun to be in aprofessional context with the
two of you.
April Haberman (01:03):
Yeah, for sure.
Kim Hart (01:04):
So I, as you mentioned , I'm a psychotherapist with the
Aftermath Agency, which Ico-founded and that we
co-founded.
It's a group of licensed andcertified professionals who
focus on well-being from anumber of different angles,
because we believe that healthand wholeness and well-being
from a number of differentangles, because we believe that
(01:26):
health and wholeness andwell-being you don't just
approach from one angle, youhave to hit it from a lot of
different angles.
So that's kind of where I amright now.
I also the reason we startedAftermath.
It actually begins with story,with my family's story.
(01:47):
I have a child who had somesignificant mental health issues
that manifested themselves whenthey were a preteen, a teen,
and that led us on a journeythat we probably weren't very
(02:09):
well equipped for.
But both my partner and Iconsider ourselves to be, you
know, high functioning,resourceful, educated, and it
was a full time job for both ofus, trying to manage care and
figure out what would help.
And then it launched us into.
(02:30):
Basically, that child was adetonator in our family for
everything in our system thatneeded to be looked at and
examined and healed needed to belooked at and examined and
(02:51):
healed.
And out of that we, because wehad financial resources that we
could use, so grateful for that.
But there were some uniquecircumstances in our situation
that allowed us to access somestate funding.
That was huge.
To access some state funding,that was huge.
But we realized not everyonegets this kind of care or cannot
, can't even figure out how tofind this kind of care, excuse
(03:12):
me.
So we thought, could we providesomething that offers more
wraparound care, resourcing,help for people who are in
situations where it's kind ofoverwhelming?
So that's kind of the visionbehind it.
Yeah, it's so inspiring.
(03:32):
I mean, there's so manyfamilies that are faced with
those things and are not surewhat to do, and, especially as
the mama, it just tears youapart when you can't find the
resources for your child.
So I love that you took thatand said let's help others,
because it was such a journey oflearning and navigation.
(03:55):
So that's so inspiring, kim.
Thank you for sharing thatstory, because I think that
really sets the stage for theconversation.
Kim Crispeno (04:06):
Yeah, well, you're welcome.
April Haberman (04:08):
And you see so many people through the
Aftermath Agency.
We've been fortunate enough tosee your space and it's
beautiful, and we just hadTricia, your co-founder, on the
podcast as well recently.
But I know you also have a lotof women that are in midlife
(04:30):
that are coming through yourpractice in one way or the other
, and I'm curious because it isMental Health Awareness Month
and that's why I wanted to haveyou on the podcast to
specifically address midlife andmenopause and mental health.
How do you think that menopauseinfluences mental health among
(04:54):
midlife women?
What are you seeing in yourpractice?
What are you hearing?
Tell us a little bit more.
Kim Crispeno (05:01):
That's a large question.
April Haberman (05:02):
It is A loaded question.
How long do you want to unpackthat yeah?
Kim Hart (05:07):
well as, as you both are well aware of, hormones
don't just control our bodies.
They shape our mental andemotional worlds and, um, they
have a profound effect on ourmental health because they
directly affect and influenceour brain function and
(05:29):
menopausal women, partly becausethey are coming in and they are
(05:51):
raw, they are honest, they arefeeling vulnerable and most of
them are like just open, likewhat can, how can, can you help
me?
You know I need some help.
Some of them are like just open, like what can, how can, can
you help me?
Um, you know I need some help.
Some of them are pissed off.
I think, uh, that feels to melike that's a little bit later
(06:14):
in the stage.
This doesn't always show upinitially in perimenopause.
Um, because I think often whatI'm noticing in perimenopause,
women are coming in and theyhave these symptoms that they're
they think they're mentalhealth symptoms and they are,
but they're very connected towhat's going on in their
physical bodies and they haven'tyet made that connection Right.
(06:36):
I think back to when I wentinto perimenopause and I, I
think I didn't know I was in itand, um, and I remember I don't
know what your both of yourexperience was, but I think the
(06:57):
initial symptom for me is Istarted dropping all the nouns.
I could not for the life of meremember names, proper nouns,
other kinds of nouns, and solike my conversations were just
a hot mess and my kids were likemom, you know, do you have some
(07:20):
early onset?
I was actually a little bitscared about that.
Yeah sure, alzheimer's in myfamily, and I didn't initially
make the connection to hormones.
What was going on in my body.
I just thought what is going onI must you know.
So that was my experience.
(07:42):
I'm curious about the two ofyou, like when you kind of
noticed.
April Haberman (07:46):
Well, kim, you, you go, cause you've had.
You had the brain fog too.
Kim Hart (07:51):
Yeah, brain fog, sleeplessness, uh, anxiety, um,
uh, incessant, incessant worry,um, yeah, those and.
And the brain fog for me was Idon't have a problem talking, I
talk.
And the brain fog for me was Idon't have a problem talking, I
could talk all day long, just me, to everyone, by myself, and I
didn't want to open up my mouthbecause I couldn't remember the
(08:12):
words and I felt stupid all of asudden because I couldn't.
I like the nouns, that's likeyou couldn't remember what it is
that you're saying.
And that happens occasionallynow, but nothing like what it
was, and it was sort of an outof body experience really, just
to try and manage myself and mybrain during that time.
(08:32):
I'm still dealing with thesleeplessness and the anxiety
and those kinds of things, butbecause I've gotten help, it's
so much better and manageable.
But yeah, it was a.
It was a scary couple of monthsas I was trying to figure it
all out.
April Haberman (08:47):
Yeah, it's so interesting to hear everybody's
story too.
Right it's, for I went throughearly menopause, kim.
I don't know if you know thator not.
I don't know if I shared thatwith you, but you know it was.
It was extremely frustratingbecause healthcare professionals
don't necessarily look at thatas menopause, perimenopause
(09:10):
right, you're too early for that, so we're not looking at that.
No one was really looking forthat.
So I was really at a loss but alittle bit of brain fog.
But I had heavy flooding,bleeding I call it crime scene
bleeding.
Couldn't leave the house youknow gym in the middle of the
night.
My husband, we were like whatyou have to help me, right, I
think I'm dying in the bathroomhere.
(09:31):
And fortunately I had aflexible working environment so
I didn't have to show up in theoffice.
But I had anxiety, I haddepression, I was irritable.
I had depression, I wasirritable.
I look back on that now inhindsight and think you know a
(09:57):
lot of the, a lot of thechallenges and just anger that I
had in even in my marriage andfrustration with the kids was
menopause and I didn't realizeit at the time until I started
hormone therapy.
And for me that was a goodchoice because I reached early
menopause and for long termhealth I wanted that choice.
But you know divorce rates arehigh in individuals between 40
and 60.
(10:18):
And that very well could havebeen where I ended up, so that
anxiety, the irritability, thedepression is real.
And I was on antidepressants.
You know that the doctor saidhere you go, take Lexapro, let
me know if you feel better in acouple of months.
So I'm wondering, you know, aswe're kind of shifting back into
(10:42):
that mental health conversation, do you see that where midlife
women are coming to you nothaving the information from
their healthcare practitioners,and are they coming to you in
more of a state of desperation?
How do they get to you and whatare you hearing when they
(11:04):
arrive at your doorstep?
Kim Crispeno (11:09):
A lot of women come because they are
experiencing the mental healthimpacts of perimenopause
menopause and they haven't yetfully connected the dots to
physical health.
And so if you have a goodmental health practitioner, they
(11:31):
should always be ruling out aphysical source of what's going
on in your body.
So when I'm working with anywoman 30s onward or actually
anybody but they're coming inand they're presenting all these
different symptoms, I am alwayssaying, hey, we need.
(11:55):
Are you working with someone onyour physical symptoms?
Have you had blood work done?
Have you been looking at thesethings?
Because it goes hand in hand.
There still is the mental healthaspect that we can I can help
with, but I always see that weneed the physical care and I do
find a lot of women strugglingto find competent care, care
(12:19):
that where they are notdismissed with what they're
feeling, where it's not all intheir head, where there's a lot
of women have had trouble, andone of the things that again,
we're trying to do at Aftermathis create a robust database of
resources, of people that wetrust, that we can send people
(12:40):
to, and we have a resourcespecialist.
Her name is Meredith, she'swonderful and she's available
free to the community to helpyou resource if you need it, and
we're like working with thoserelationships.
Who are the people that aregoing to take you seriously when
you walk into?
Kim Hart (12:59):
the office.
Kim Crispeno (13:00):
That is so important, I think, in all
aspects, for women in particular.
In a lot of our experiencewe've been invalidated, we've
been told, oh no big deal, youshould be able to figure this
out.
And we tell ourselves that too.
We dismiss our own experiencereadily, experience readily.
(13:28):
And so a lot of women come inand they don't even.
Oftentimes they're likethinking they're crazy or it's.
You know they're.
They're just looking forsomebody who will to get their
experience to, who will takethem seriously yeah.
Kim Hart (13:43):
Yeah, it's, it's a thing we hear all the time and
we talk about.
It's okay to divorce yourdoctor to find a good doctor.
It's okay to go get you know,get your team together so that
you have your therapist and youhave your support system around
this for so when the when thishappens to you, you know, you
can imagine that you probablyget the same thing, but we get
(14:04):
everyone's stories because theyknow it's a safe place to be
able to talk about it.
Have you identified anyspecific patterns or triggers
that happen for women thatexacerbate these mental health
symptoms during menopause?
Kim Crispeno (14:21):
I would think that there are a few.
If a woman has a pre-existingcondition, if she's already
struggled with anxiety ordepression or even paranoia or
things like that if there's aprevious condition that's being
(14:42):
treated, then oftentimes that isworse, it gets much worse, and
there's an interesting study outof that was published in, I
think, cambridge UniversityPress in 2023, where and you, I
know you all know this, but thatif you have a pre-existing
(15:04):
condition, usually it gets worse.
That's connected to hormones.
It gets worse during menopauseand the treatments that may have
been managing it don't manageit in the same way anymore and
you need to make adjustments.
So that's one thing I would say.
Another pattern is if there'san escalation and stress in any
(15:28):
part of a woman's life, thatalso exacerbates things.
If a person has a lot of traumaand this is where I don't know
if you, um, our listeners arefamiliar with a window of
tolerance probably they areunpack that a little bit.
April Haberman (15:53):
I'm not sure that everyone knows what that is
yeah, okay.
Kim Crispeno (15:56):
So a tolerance is basically a concept in
psychology and neuroscience thatdescribes the optimum or
optimal zone of arousal where aperson can function most
effectively.
So when you're in that optimalwindow, you can think clearly,
(16:19):
you can feel and process youremotions without overwhelm, you
can respond rather than react tostress and you can engage
socially and make decisions.
So when people have trauma or alot of stress, whether it's
(16:39):
chronic or acute, or if they'reexcuse me if they're feeling bad
in their bodies, whateveroftentimes our window of
tolerance is small.
Kim Hart (16:48):
Right.
Kim Crispeno (16:49):
And so anything can push us to the edges or
outside of that.
And when we get to the edges ofit or outside of it, then we
find ourselves in a couple ofstates ourselves, in a couple of
states, so hyper arousal, whichwould be fight excuse me, fight
or flee, you know or a hypoarousal state where we kind of
(17:16):
shut down, we're overwhelmed,all of those things.
So that's, you know.
I think most of us are familiarwith that.
And so what happens is like intherapy I am working with to
(17:37):
help a person identify whattheir window of tolerance
currently is and what's going tohelp them stay in that, so what
tools, techniques, things canhelp them stay in there and what
they need to pay attention to.
And then, but also in thetherapeutic space, I'm actually
working to try to expand theirwindow of tolerance.
But that, I think, has to bedone carefully, right?
(18:03):
We're working to increase ourability to tolerate distress and
it really helps if we have aperson who's regulated, who's
helping us do that.
So I don't always try to get myclients to do that on their own
outside.
I want them to stay in theirwindow as much as possible on
their own and then in spacewhere I can help them work to
(18:25):
increase it.
So those are some of the thingsthat I think I'm seeing when
women come in that are patternsor triggers.
Kim Hart (18:35):
We get a lot of questions about you know, how
much should I suffer before I goand get help?
Like we're always saying, thereis no need for suffering here,
like suffering is an optionalthing.
What strategies do you helpwomen have to better understand
and articulate how these mentalhealth experiences are affecting
(18:58):
them during menopause and andyou know from the suffering
point of view, when do you, youknow, when do you put up your
hands and say I can't?
You know, from the sufferingpoint of view, when do you, you
know, when do you put up yourhands and say I can't?
You know I can't do thisanymore.
April Haberman (19:09):
How much is too much?
Yeah, we hear oh, it's not thatbad, you don't have to suffer.
Kim Crispeno (19:15):
Yeah.
April Haberman (19:15):
Great Thanks for bringing that up.
Kim Crispeno (19:24):
Yeah, I, sooner that we can get intervention and
help, the, I think the less wewill suffer, right, and so one
of the misconceptions that I seecoming up with women is that we
can figure this out on our own.
Kim Hart (19:40):
I'm smart.
I've been able to do thingsbefore.
I have figured things out upuntil this point.
Kim Crispeno (19:45):
This is a thing that I can just put down I don't
need help.
Kim Hart (19:47):
Yeah, I'm smart, I've been able to do things before.
Kim Crispeno (19:49):
I have figured things out up until this point.
This is a thing that I'm I can,just I don't need help.
Yeah, I'm good, right, rightand and I don't need help.
Or there is, I think, anotherlevel of um.
This is where I think shamepops into the picture that we
feel like there's somethingwe're doing wrong.
And so kind of like, as women,we dig in our darn heels and
we're like I am gonna figurethis out, because you know,
(20:11):
there's something wrong with methat I can't figure it out, and
so we do stay in that state ofnot asking for help longer.
So I think I would like to saya little more about shame,
because I've been thinking aboutthat in relation to this
conversation, and, uh, reneebrown, as we know, did a lot to,
(20:33):
I think, help people understandthe difference between guilt
and shame.
Guilt I did something wrong orbad.
Shame says I am wrong or I ambad, and I think that's helpful
for common understanding.
But there's a woman, patriciaDeYoung, and she wrote a
(20:55):
wonderful book on shame calledUnderstanding Chronic Shame, and
her definition I'm like.
So she talks about shame asalways being relational, so
shame is one of those thingsthat we experience in relation
to someone else, so it triggersa feeling.
(21:18):
Something triggers a feeling ofI am, something is wrong, and
it's usually me.
Um, and her definition, though,is really interesting.
April Haberman (21:28):
She says um, shame is the felt sense of a
disintegrating self inconnection to a dysregulating
other wow, that's okay oh, Iknow you got to tear that apart,
I think say it again and maybelike let's, let's give, let's
(21:50):
unpack that a little bit.
Kim Hart (21:51):
So first of, all.
Kim Crispeno (21:52):
So she says shame first of all.
The first part it's a feltsense.
So it may not be true, but it'swhat we're feeling right it's a
felt sense that we aredisintegrating.
We have a disintegrating self.
Something you know is is is iskind of, yeah, disintegrating in
(22:14):
us, like we're breaking down.
April Haberman (22:16):
I mean, are we?
Is this your self-esteem?
This is?
Kim Crispeno (22:20):
right, yeah, but it's in the um in relation to or
in the presence of adysregulating other.
Kim Hart (22:27):
So that's somebody else that's causing this, for it
happened to you or somethingelse.
Kim Crispeno (22:33):
Yes, and so, for you know, like a lot of times,
like if you're oftentimes shamedget its hold on us in childhood
.
Gets its hold on us inchildhood.
So we experienced a lack ofattunement from a primary
caregiver who doesn't read whatwe need, and so, you know, in
(22:56):
our young brains we can't sortthings out.
So we begin to think, oh,something's wrong with me.
Yeah, so, but what?
My question around this, why Iwanted to bring this up, is what
if in menopause and this is I'mtaking this loosely but what if
in menopause, the dysregulatingother is ourselves?
April Haberman (23:22):
Yeah, that is a good question yeah, that is a
good question.
Kim Crispeno (23:30):
And so, in relation as ourselves, are
dysregulated in our bodies andare all of the things because of
what's happening chemically inour bodies and then we
experience a sense ofdisintegration I can that Like.
Kim Hart (23:44):
If you take my brain fog example, I was.
I was ashamed that I couldn'tcome up with the right words and
I didn't want to talk because Ifelt like I would appear as not
smart or not together orwhatever.
So I can see that shame reallycame in for me in that me in
that case.
Kim Crispeno (24:05):
Yeah, and so what if we could reframe menopause?
And you know, think about it asoh myself is going to be
dysregulated in this time Right,and we can begin to understand
that and see menopause as adoorway into understanding more
(24:29):
A our own patterns ofdisintegration and then what is
needed for integration.
And unfortunately, women havethis much harder, in my opinion,
than men, because we have allthis stuff going on in our
bodies.
And um, I just wish you knowhow they have those um period
(24:52):
pain simulators that they attachto men.
April Haberman (24:55):
Oh, we do have a um hot flash simulator.
Kim Crispeno (24:59):
Oh, you do.
April Haberman (25:00):
Okay, I was hoping, but but there is one um,
there's a mental vest that um,that you can, you can put on and
simulate hot flashes, but umbut what about the other
symptoms, all the others?
I like that.
Kim Crispeno (25:15):
That's just one right One there's 34 things that
are like all happening at thesame time for us and this like
yeah, sure, the hot flashes aremiserable, but they are flashes.
They're over fairly quickly.
They may come a lot dependingon how well, how much estrogen
(25:38):
we've got going on in our system.
April Haberman (25:41):
Right, kim, I love this conversation about
shame and menopause andreframing it and menopause being
the doorway, and I'm reallythinking about you know what,
your thoughts and brain fog andbeing.
We're used to functioning at ahigh level and what's wrong with
(26:09):
me and it's my fault.
I think there also is shamethat can come with the need to
talk to someone, the I don'tneed to see a therapist, I don't
need to see a therapist, Idon't need to see a mental
health specialist, because thensomething is wrong with me,
right?
(26:29):
Then I'm labeling myself andI've attached this label when in
reality we know that seekingthe help that we need is so
beneficial in so many ways.
But I love the idea of lookingat it as a doorway.
Right, just walk through thedoor, open the door, crack the
door and see what's on the otherside, see what's inside.
(26:55):
For you and I often picturedoorways myself I'm a very
visual person, as Kim knows.
I have to stop and I have tovisualize things.
But for me, in that midlifestage, when I went through
menopause and it was awful Ifelt like I was closing one door
and I was standing in an emptyhallway and it was dark and
(27:19):
there were a couple of otherdoors that were cracked open,
but I was afraid to go throughthem and I so I stood in the
middle, right.
I stood in this blank, darkspace for a long time before I
had the courage to go throughone of the other cracked doors.
And it's that transition that Ithink is the hardest sometimes
(27:41):
because it is there is shameassociated with it, right, so we
can look back and we might haveshame from our childhood that
we're trying to maybe shut thatdoor and we're trying to move
forward, but there's shame inseeking help and we're lost.
And that's what I think is thesaddest for me in this whole
conversation and what we do withwomen in menopause, because it
(28:04):
can be liberating and sometimesthere's hard work that needs to
be done.
Oftentimes there's hard workthat needs to be done, but it
can be liberating and freeingand beautiful on the other side.
So, in that context, what wouldyou say to someone if they are
in that place and not quiteready to make the next step, or
(28:28):
they're carrying shame with them?
How do we encourage ourlisteners to take that next step
to seek the help that they need?
Kim Crispeno (28:38):
So I'm curious, what helped you move forward,
what helped you go into anotherdoorway?
April Haberman (28:43):
if you can think of that, yeah, that's actually
a really good question.
For me it was the tribe, kim,you talk about this a lot.
Build your tribe, build yourcommunity around you.
It was the friends, it was theencouragement that I had there,
the, you know, the spiritualsupport from my, my besties, and
(29:07):
really a lot of introspection,which I think can be scary as
well.
So I mean I journal every day,I put my thoughts down on paper,
I go for long walks and that'smy, you know my time to think
and unpack and I'm not afraid ofthat self self reflection and
work.
But I'm not sure that everybodyknows how to do that.
(29:30):
Right, we have, if you haven'tpracticed that for years, even
that's foreign looking at ablank piece of paper and like
what do you mean you journal,what do you mean you unpack that
?
So I had a support network andI I to self-reflection, but I
don't know that everybody hasthat.
Kim Crispeno (29:50):
Right, yeah, no, that's helpful and I think you
articulated a couple importantthings in there, so I do
actually really like the ideathat menopause has the word
pause in it.
Yeah, the word pause in it.
(30:11):
Yeah, because I think menopauseis an invitation both to pause
and to move, and at differentparts in different times in that
story and in that journey we'rewe're doing different things,
right?
And so you're describing amoment of pause where you know,
like you are like in this blankspace and I think, along with
shame, there's grief sometimes.
That attends to.
(30:32):
That comes with menopause, evenif we're not necessary.
I mean, I was never sorry tolet go of that period.
I'll tell you that one rightnow.
See you later, go right aheadand leave.
But there's also this sense of,oh, I'm getting older, I'm aging
(30:55):
, my body is changing.
There are certain things nowthat are inaccessible to me
forever, and not that Inecessarily wanted them, but so
there's grief there.
And so I do think that in thatpause it is important to stop
and notice what is there, stopand be able to, you know, attend
(31:19):
to what is there.
But what you said that I thinkis so crucial is a lot of women
do not know how to do that wellon their own, because we've been
so freaking busy doingeverything in our lives to keep
everybody else going and to helpeverybody else along and to
slow down and attend toourselves.
(31:41):
It's just something we don'thave a lot of practice at.
April Haberman (31:43):
Yeah.
Kim Crispeno (31:44):
So that's where community is really important.
That's where starting to buildsome supports, um and the women
I uh feel most concerned aboutthat come into my space are the
ones that really lack support.
yeah, um, because, and so that'sone of the things we do part of
(32:07):
my like at least, mentaltreatment plan is how can we
build support?
How can we um help this personfind connection, find community,
find validation, like so theyrealize they're not alone, yeah,
in this journey.
And then at some point it Ithink women want to move, um.
(32:30):
Yes, they don't want to staystanding still too long, which
is it's good, because I thinkour bodies are designed to move
us into new things, to newplaces.
And I love um eric erickson.
The stage that he has apsychosocial development here is
um generativity versusstagnation.
(32:51):
So that's this age range thatyou're in and that's the stage
that's most associated with thisstage, like 40 to 65 or
something like that.
And it, you know, that's theinvitation in actually menopause
and we can get stuck in thosethat stagnation place.
But if there are others aroundus supporting, at some point
(33:13):
we're going to say wait, wait,wait, wait.
I want to be generative, I wantto move into this next season
with um.
I want to move into this nextseason with taking, letting,
like all of that I mean all ofthat stuff burn away, those hot
flashes, let them burn away allof the stuff that no longer
serves me and move into a newseason with, you know, some
(33:37):
generativity, with somecreativity, with some curiosity.
April Haberman (33:41):
What's next?
Kim Hart (33:42):
yeah, it's interesting because we, uh, we have a
friend, a doctor, who talksabout asking our patients what
do you want?
And most of the time at thispoint in your life, it doesn't.
It hasn't mattered what youwanted because, you had to raise
kids and do a job and, you know, take care of whatever the
(34:04):
things you needed to do.
And all of a sudden you're atthis inflection point where
you're like, okay, maybe I getto choose what I want to do next
.
And that can be scary forpeople who've never had to do
that before or don't even knowhow to do that before.
How do you, you know, how doyou approach this with mental
health and menopause, with womenwho are, you know, at this, you
(34:28):
know hallway or fork in theroad or whatever it is that
you're facing from what's nextfor you.
Kim Crispeno (34:38):
Yeah, I noticed that Tricia Wilkerson in her
podcast she said this, but thisis my favorite word actually
with clients.
If you work with me, you willhear me say this again and again
, and it's notice.
Yeah that hallway.
(35:03):
I just invite them to startnoticing.
Start noticing, and they don'thave to do anything about what
they notice.
I am just saying notice, isthere anything that you're like?
You have a flicker?
Oh, that sounds kind ofinteresting.
Oh, no, I don't want to go tothat social gathering.
Mm, hmm, you know, juststarting to notice those things,
(35:24):
and then the next step is tostart acting on those noticings.
You can stay in the noticingfor a while but then say, okay,
so I don't want to go to thatsocial gathering because I
actually feel like crap, socialgathering, because I actually
(35:47):
feel like crap.
Then you have to decide to notgo.
And another thing I'm reallygood at doing with therapy is I
have a little post-it.
You know some post-its and Iwill write permission slips for
these women.
You do not have to go to thesocial gathering, you know,
because, again, we aren't sogood at giving other people
permission to not do things.
We learned how to do that forourselves, yeah, and it's just
(36:11):
really helpful to have a littlepiece of paper, and I sometimes
do that for myself.
I bring myself littlepermissions.
It helps.
April Haberman (36:20):
I love that.
I feel like I could put that onmy bathroom mirror, like you
have permission to yeah.
Kim Hart (36:29):
Yeah, I often say to people when I'm coaching, when
they're like I don't know, I'mlike well, pretend you do know,
let's just pretend for a minute.
You know what door you'd gothrough.
Why don't you go be curiousabout that Right?
Kim Crispeno (36:43):
Yeah, yeah, it's kind of like a miracle question.
It's a miracle question whichis like if everything could do
whatever you want, have whateveryou want you know, everything
would go away, but what?
What's left, like what you know, and if people can, yeah, it is
, um, yeah, fun to to do that.
Kim Hart (37:02):
It's a gift to yourself that you haven't
figured out how to do you giveor get before, and so it's a
little scary, but also it's alittle exhilarating once you
figure out that.
Oh, you can notice you can dosomething different.
April Haberman (37:16):
Yeah, it's freeing yeah, for sure well, kim
.
I'm just wondering, as we beginto wrap up the conversation
what, what changes would youlike to see?
I'm sure you have many, associety addresses the
intersection of menopause andmental health.
What, what would you like tosee?
Kim Crispeno (37:38):
Well, I'm seeing it with the two of you and what
you are doing to educate womenand workplaces and men and all
the you know, all the peopleabout what's going on.
I definitely see that that isso needed.
The more that we talk aboutthis, the more that we see
(38:01):
creative ways to go forward.
I'd love to see more researchmore funding for women's mental
and physical health.
I mean, I don't know, there'sthat book Invisible Women.
I can't remember who it's by,but it's just atrocious in terms
of the lack of funding forwomen's health studies and
(38:28):
things like that.
So I'd love to see more of that.
I'd love to see us enter intomore of a playful space around
like this idea of seasons andtransitions and normalizing that
we actually change is a goodthing and that sometimes it
(38:49):
sucks how it happens and it'snot.
There's uncomfortable thingsthat happen, but if we can
reframe change as being, yes, itcan be scary, but there's an
invitation always, I think,embedded in change.
Kim Hart (39:06):
Yes, for sure, just a whole other podcast.
April Haberman (39:09):
Yeah, oh yeah yeah, it'd be a good one, though
, so we'll come back to that one, kim.
Yeah yeah, those are all good,kim, and we completely agree
with you on all three of those,especially that research piece.
We need that Again could be awhole other podcast as we unpack
that.
But before we let you go, wehave our last question that we
(39:32):
ask everyone what is the bestpiece of advice that you've ever
received or given?
Kim Crispeno (39:40):
That's a hard one and I'm going to answer it in a
kind of menopausal way.
Um, in the sense that itdepends.
It depends on the on the day,or the mood, or what's going on
in terms of what is the advice Imost needed to hear.
But I think consistently andthis is so is so silly and so
(40:03):
simple, but it is something Ireturned to again and again and
it was my own therapist whobasically just kind of drilled
into me to can you be kind andcurious to yourself and about
your experience?
And kind and curious and I cando that for other people, but I
(40:26):
have always struggled aroundthat for myself, and even last
night I had an experience.
I was at a social event and Iwent into a complete shame
spiral and I'm still like thismorning, like in that place, but
I've like been like oh, can Ibe kind to myself about this?
(40:49):
Can I be kind and curiousaround why?
This was why I went into thespiral?
Well, it triggered that, and sothat's, I think, where I come
back to a lot.
Is that kind and curious aboutmyself?
Kim Hart (41:05):
yeah to myself that's such a good thing to do for
yourself too.
April Haberman (41:09):
We don't do that very well no, but it's good,
kind and curious and that, Ithink, really applies to women
in menopause.
Kim Crispeno (41:17):
I mean, like, can you be kind to yourself, what
does that look like?
And in this moment?
Kim Hart (41:27):
And then can you be curious, yeah that feels
emotional to me a little bit.
I'm honest, right, can you bekind to yourself?
You know, I don't know if we,if we think about what that
would mean.
So I appreciate you bringingthat up because I think that's a
little like thing we shouldjust keep in our head in those
(41:48):
moments Like, okay, what wouldthis be like if I was being kind
, kind, kind, kind.
We know how to be kind, justnot to ourselves, not to
ourselves.
Oh well, kim, what a greatpleasure to have you on.
We wanted to do this for a longtime.
We think the world of you,obviously, but the work that
you're doing is so important.
(42:10):
And thank you for creatingcommunity, for helping people
find their truth, for supportingpeople through trauma big T,
little t trauma, because thoseare hard things to get through.
So where can people find you?
Kim Crispeno (42:26):
They can find us at the aftermath agencycom.
We're on Instagram, we're alsoon LinkedIn, so they can find us
that way.
Perfect.
April Haberman (42:38):
We'll put all of that in the show notes.
Thank you again for your timetoday in this rainy Friday,
seattle weather, and until wemeet again, everyone go find joy
in the journey.
Thanks, kim, thanks Bye.
Thank you for listening to theMedovia menopause podcast.
(42:59):
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
episode with a friend.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
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