Hormones, Trauma & Neurodivergence in Midlife with Paula Rastrick

This is such a rich conversation about hormones, trauma, neurodivergence, burnout and menopause - all of which feel really relevant in our 40s and 50s! In this episode I speak with Paula Rastrick about:

  • “Sensitive nervous systems” and her research into early life stress, adverse childhood experiences, ADHD, AuDHD and Highly Sensitive People and how that can emerge and impact perimenopausal hormonal changes. 

  • Seeing menopause as a continuation of hormonal experiences from womb to present moment

  • Stress “sensitivity”, hypervigilance and “symptom” variation

  • Cyles of anxiety and what often lies behind that

  • Social connections (and challenges)

  • Expanding and acknowledging context

Prefer to listen? Get the podcast here: Trauma, neurodivergence and menopause, a conversation with Paula Rastrick.

My favourite thing about this conversation was expanding the viewpoint of how we see ourselves approaching perimenopause or menopause, not just kind of sideways in terms of what am I eating? What am I drinking? What's my context like? What's my career like? What's my support system like? But also backwards.

So Paula has specialised in looking at the relationship between our early lived experiences in terms of childhood, trauma, neurodiversity and the impact that that plays on our hormonal sensitivity as we approach this time of hormonal changes. So we talk about early years, we talk about the impact of context of childhood, of anxiety or cycles of burnout and how that might show up for us in our late 30s, 40s, 50s. We also get quite specific about oestrogen and progesterone and how those help us cope with stress and what we may notice when those hormones start fluctuating. So I am so grateful to Paula for the research that she's done, the books that she's written, the things that she's sharing.

And I think you're going to have so many moments of pausing and thinking about maybe your own life and experiences in different ways. There are some real takeaways here in terms of thinking about your context, thinking about your capacity, thinking about the way that you're arriving into your 30s and 40s and the support that you might be able to give yourself. So I'm excited for you to be able to dive in and listen to this conversation.

Hi lovelies, I'm Maud, Women's Burnout and Leadership Coach, and you're listening to the Work, Family, Me podcast. This season, we're talking about the hormonal transitions that accompany female midlife, also known as perimenopause and menopause. Maybe you're just starting to notice shifts in your body, brain or cycle. Maybe you're rolling your eyes at the media frenzy around menopause. Maybe the whole topic feels uncomfortable or maybe you're curious and ready to embrace it. Wherever you are on this journey, welcome. As a coach, I help women navigate their time, energy, and wellbeing across their 30s, 40s, and 50s without burning TF out. This phase of life also brings substantial biological and chemical changes, and expanding our awareness of those allows us to support ourselves in every aspect of life.

I've trained in various modalities, including women's sexual health, and I'm passionate about supporting women with knowledge, confidence and self-friendliness over this time, and in all times actually. For this series, I've spoken with a range of experts from physical, mental and emotional health fields to bring you insights, tools and perspectives you can integrate into your own day-to-day. I'm grateful we live in a time where we can have honest and open conversations about women's bodies and I look forward to sharing these discussions with you. If you're looking for personalised support, you can connect with me through the link below. But for now, let's dive into today's conversation.

As part of a series of conversations on, what should I call it? Perimenopause, menopause, midlife transition, like the 10 to 15 years where things are changing. So thanks for being here. Would you like to tell us a little bit more about the work that you do in the world and your experience?

Yeah. So my experience of perimenopause started in 2017. It's been a bit of a journey, which has led me to where I am now. So I have written a book, which is being published next year. And it's based on my story and the understanding of what I'm going to call in the science is hormonal sensitivity. So as we've started to learn more about menopause and perimenopause because it's become much more mainstream.

I have started to look at joining the dots in the science based on my story and what happened to me, which I'll go into, of why some women are more hormonally sensitive and those links to childhood and into trauma and into what's called early life stress. So I'm linking the research for women with complex PTSD.

Which you probably don't realise, ADHD, autism and what's classified as a highly sensitive person, but what actually I've done is link the fact that it's all related. So I've started the journey from the womb and I've started in what's called foetal programming. And then I've taken it through all of the life stages of puberty, pregnancy, perimenopause and I've linked up through my own, the science, which explains the nervous system. And it explains why you can have issues with PMS, PMDD, you can have issues with perimenopause and all of these pregnancy like me and why that happens. So that's where I'm at now. The book's written and it's out for testing at the moment because there's quite a lot of science in it.

So I combine the science of hormonal sensitivity. My mission is to get the word out there amongst not just women, but medics as well, because we're not understanding, in my opinion, there's very few medics that understand the kind of biopsychosocial model of health. They look at it from a very bio-medical and from the experience I've had, that if you're treating somebody with more sensitivity or more sensitive nervous system, that can cause a lot of problems. And that is what happened to me when I was dosed with hormone replacement therapy. That's what it's called still in the UK, HRT. But that was what started the journey.

There's so much you're saying there about so many different things. And two things that I want to pick out is the multifaceted look at what happens to us through the lens of everything else that has happened to us prior to that. This extension of how we see our quote unquote symptom, right? And our experience of that.

And the other thing you're talking about is maybe the lack of in-depth information out there, not just for individuals, but in general in research. Isn't that incredible that here we are in 2025 saying there's still so much we don't know or there's still so much that's not understood.

When you talk about hormonal sensitivity, think your book is called Sensitive Women. What does hormonal sensitivity mean?

So going back to the research then, so you're quite right in saying that one, we have limited research within women's health. We are very under-researched women and that is typically because of the hormonal cycles that we go through. So we are too difficult to research. That's been one of the issues around women being used in clinical trials.

There's a team of researchers in America that are looking at PMDD. Do you know what PMDD is? I don't want to assume that people know what PMDD is.

But let's explain it. Tell us.

So premenstrual dysphoric disorder is a condition that's within the DSM. So it's in the diagnostic standard manual of it's classified as a disorder. Like all the classifications are of disorders. That's something that I'm not a big fan of, if I'm honest. I think if we understand the nervous system and understand where it comes from, we can stop saying that these things are disorders and start understanding that it's a human condition based on lots of other things. So basically with the PMD. What context am I operating in and what's maybe quote unquote natural response to that and what are we calling disorder?

And what are adaptations? What are we adapting? It's the understanding of the nervous system. So that's my work. So with PMDD, I started with looking at the research from a team based in America that refer to PMDD as hormonal sensitivity. Now their research then is limited at the moment to PMDD itself.

So what I started to do over a very long period of time was I took their research and I started to understand, right, so what makes a woman, because a woman can struggle with PMDD at any point in their life. So PMDD is something that can happen when you're in perimenopause. It's something that can happen at puberty. So I was thinking, this doesn't make sense.

Then I started to look at the fact that it was linked to trauma. And then I started to look at the research in perimenopause and adverse childhood experiences. And then over a long period of time, I've joined DOTS in research to make my own kind of hypothesis, if you like, based on my story as to why women struggle with hormonal fluctuations and it's hormonal fluctuations and hormonal changes.

So for example, I look back on my life and see that I was probably on that spectrum, because it's all on spectrums of PMDD. Co-concurring with that, I have a very complex trauma background, but co-concurring with my cycles when I was in my teenage years and my twenties, I was using substances. I had binge eating problems. I would be burning out. I had anxiety. I had depression.

So when you start to look at all of what I call the co-occurring symptoms, and then you start to cross-reference that with ADHD and then autism, then you start to understand that it's all related and it's all based on nervous system development and epigenetics. Does that help?

Because we are products of our environment. A nervous system is constantly reacting to our environment and so are our hormones. And so women that are more sensitive, I call it sensitive and I'll explain that, is based on the science that I've collated that says stress sensitivity. Some women are more sensitive to stress. More sensitive to the environment.

You look at somebody who's a highly sensitive person or autism or ADHD, but complex traumas there's a more hyper-vigilance to the environment. You're picking up more cues externally. So it's quite complex, but it's giving science and reasoning based on the nervous system. Whereas we look at it from a symptom type of, well, I've got really bad perimenopause symptoms, but if you look at those perimenopause symptoms.

A lot of them are cognitive, psychological and emotional. And that I believe starts from your early years and not at perimenopause. It is by the time you get to perimenopause, you have what I call a narrow window of stress tolerance. So if you've gone through your life, burning out, getting back up, burning out, going through hormonal cycles like me, by the time you get to perimenopause, that's your last junction. And it's quite a significant period of brain and nervous system recalibration. And I think we should stop looking at the symptoms and start looking at the why. Why do some women have more severity of what we call symptoms?

So if we think about nervous system regulation and we think about feeling safe in our environment and we think about what are the context that I learn who I am and learn about other people and learn about the day and learn about where I'm safe and all the steps that lead me to be a woman who believes that.

We're saying all of those pieces and all of that information that the nervous system get or doesn't get around safety and danger is acting up. So interesting to think about. The more stress or the more danger or the lack of safety that I felt the need to be looking for danger, which creates more stress to be released, which means I'm working at a different level of functioning. And so I have a different capacity for what's going on. It feels different in my body and I'm using that over and over again. And then when I get to this time, I love the word recalibration of huge change in my whole line. Some of them are depleted. My nervous system may be at a point to not handle anymore and I'm experiencing something different to somebody else who's the same stage in their life.

And it depends on your start in life. So you don't just arrive at perimenopause and all of a sudden you're in the middle of your life. This is what I'm trying to demonstrate is, so I kind of crashed into perimenopause. I had no idea about perimenopause. I was running a business. I was in a very high stress state. There was lots of environmental factors going on and I had no idea what perimenopause really was in 2017. Remember that's a few years ago before it was mainstream. When you start to look at how are you arriving there? It's like, you know, arriving at a destination, isn't it? So prior to you arriving there, you've had multiple chapters in your life. You've had epigenetic changes.

What I think we need to understand is how do you arrive at perimenopause? So what I've done is I've gone backwards in my own life and started in foetal development. So your hormonal ratios start then.

Your hormonal ratios, your hormonal profiling, your sex hormones start in the womb, not at perimenopause. So what we've got to understand is, that your sex hormones are part of your brain sort of organisation when you're in the womb. Because it determines, in very simple terms, are you going to be a boy or a girl? So you've got to think about your sex hormones then. And then what happens is that they then go quiet. So your sex hormones organise, help organise your brain whilst you're in the womb. And then when you're born, okay, those sex hormones, oestrogen, progesterone and testosterone, they go relatively quiet until puberty. They're not involved in the first 10 years or so of your life. Because the brain and the nervous system is geared towards survival.

So survival comes first and reproduction comes second. So in your neurodevelopmental years, this is where you're going to see ADHD. You're going to see, we might not know at this point that it's ADHD because we don't know because we're only starting to discover about neurodivergence... I hate the word neurodivergence, neurodiversity, right? Because we've all got different brains, we've all got different nervous systems.

So the way that you start your life and then you go through puberty and then you go through your life is how you're going to end up when you go into perimenopause. And I think we've missed this huge opportunity to understand that. Does that make sense?

Absolutely. How are you arriving here? I think it is such a beautiful phrase for us to keep in mind of not just the short term, what was my day like, what was my week like, what was my month like or year like, but actually what was the setup? How was this organised? What was my childhood experience like? And what capacity do I have now for handling this window of reorganisation? The work that I do around burnout prevention and stress management is often with women in their 30s, 40s, and 50s who are strict beyond capacity in handling all of the things that they have in their life. And there's something about using up that constant stress hormone. But then so interesting for me to stop and pause and think back. There's chapters that come before that, as you say. There's all of this before and how interesting to think of all of that contributing to my experience of hormones in my 40s and 50s.

Yeah. And I think with burnout, so what you'll find is if you look at the science and the research, so women who have a more sensitive nervous system, okay, and I'm saying this in a kind of, I'll try to keep it simple. Women like me who have a more sensitive nervous system, I was diagnosed, I've got a complex trauma background. We burn out a lot quicker. So I go through cycles and have done throughout my life of burnout.

This is a common feature with women who have more stress sensitivity because what happens is, that during your monthly cycle, your sex hormones, oestrogen and progesterone, let's just keep it simple. They cycle, don't they? They go up and down, right? So women that tend to burn out more tend to be higher in excitatory tone. They tend to be higher in oestrogen.

And that's because of ratios and that's the way the nervous system develops. So if you look at somebody with ADHD, if you look at a woman with autism or you look at a woman with a complex trauma background, their nervous systems are running on higher adrenaline, higher cortisol, higher glutamate, higher oestrogen. These are your excitatory chemicals, and we have less GABA, progesterone and they are your inhibitory chemicals. They manage the stress response. So someone like me who doesn't know any of this at this point goes through my life cycling on my hormones and in my high oestrogen phase, that is when you are more likely to be addicted because we've got dysregulated nervous systems. So subconsciously we're looking to regulate, we're looking to try to calm the nervous system down.

And you'll find women reaching for the wine. Then what will happen is as you start to get older and older and older, these coping strategies, they don't work as well as they used to when I was in my thirties. And then I will go to the point where I will burn out because my system is running on higher excitation.

The way the nervous system works is when it senses that we're running too hot. We're going, go, go, go, go. I'm burning that prefrontal cortex. I'm a massive over thinker. I'm all of that stuff. I'm highly anxious. I'm running on more of a high anxious, high functioning anxiety. Because that's the way I've lived my life. I'm a high achiever, but I'm a high masking, high functioning anxiety person. And then eventually as you age, you won't be able to sustain it and the system will shut down in order for you to conserve energy.

So that is what burnout really typically is, isn't it? It's when your system says, no, enough. And that stress response is just being pushed and pushed. And there's cycles of that with women like me. We will cycle like that all our lives, but when you get to perimenopause, what happens is that progesterone is the first chemical, really your progesterone drops. Oestrogen is still spiking up and down, but progesterone manages that stress response. And you'll find in midlife, your coping skills and your stress resilience will be less than what you were used to. And that is that process of the nervous system recalibrating.

Because if you think about it from a biological perspective, evolutionary. We are designed to go through menopause. I'm talking from an ageing perspective. I'm not talking about surgical menopause. I'm talking about biologically, you are programmed to then move into the next phase of your life, aren't you? That's from an evolutionary. But we live in a world where there's a bit of a mismatch now, isn't there? In terms of our biology and our evolutionary processes, we're living in a world that's overstimulating, overwhelming 24/7. And if you're sensitive and you've got a more sensitive nervous system, you're going to struggle more with your stress and your burnout.

So if someone is listening to this and says, I hear myself here over and over again, and I want to prepare myself for how I arrive, or maybe I feel like I am arriving into this perimenopause and midlife window, what could I do at this stage to support my nervous system and to create change if I've maybe had adverse childhood experiences, or I've had a diagnosis even, or the cycle of burning out or vigilance or working all the time or anxiety and overwhelm. What can I do to start fixing that?

So based on that retrospectively, the one thing I will say is that one of the ways you identify when you start to go into perimenopause is heightened anxiety. You will be more anxious. So your normal high functioning anxiety will change and you will become another level. You'll go into what's called, I call hyper-arousal. Because of those changes. You're being stripped back from that stress response, you've got a very delicate window of stress tolerance.

First of all, understand, because I never understood, that is what's going to happen. That is very likely going to happen. So when your anxiety starts, because then your sleep will be affected, you see what I mean? It's a vicious circle then, isn't it? You're not going to cope in the way that you used to. So one of the reasons I've written the book is to understand. Some women then say, oh, right, shall I get my hormone, HRT, because this is now a big thing.

One of the messages I'm keen to get out there is it can be really good if you get it right. And it can be horrendous if you get it wrong because we don't really understand the nervous system. So it's a bit hit and miss, isn't it? So a lot of women are now turning to hormone replacement therapy and then wondering why they have side effects and it's not going well. And that is something that I think we need to understand, which is why I've written my book.

Women like me, more sensitive, we have low vagal tone. So one of the things that I would start looking at is how can you learn? This is obviously what I do. I do trauma therapy and I do nervous system regulation. I do that through a science based application, but HRV training. So heart rate variability. This is stuff you can do yourself. You can start looking at more yoga, more understanding somatic work, understanding that you will need to regulate that nervous system because you have a very narrow window of stress tolerance. And I think the biggest thing is starting to relook at your life. I know that sounds a bit broad, actually what, because one of the key messages and it's not to scare people is that the biggest indicator of disease and health issues is inflammation.

And inflammation goes up when we start going into perimenopause. And if you're already in that high functioning inflamed state, which I believe a lot of us are, and that's what burnout is, is to try to protect the system, you can't keep going like that. Then we need to take that seriously and we need to start looking at stress management techniques and understanding my triggers and understanding what relationship and social connections are not serving me anymore because intrinsically we're also people pleasers so we end up doing things that we don't want to do because we're trying to please others and it's starting to take a whole new outlook in terms of what's serving me?

What takes up my space, my brain space? Is it this friend here that I've had that actually I don't get anything from but I still continue to see them every week because I feel obliged to. That's taking up your energy. And when your energy is going down, which it will do, you're going to need to preserve that battery. And these types of things, I can't underestimate who you spend time with, how you allocate your resources. And it's a time of shedding. It's a time of saying, this no longer serves me. I need to do what's right for me because we move out of that nurturing stage.

But look, you start to prioritise. And this is what I do. I start to say to people, you need to prioritise who you are and what you're here for. Because if you're doing the things you love, you've got far more energy. You're less likely to burn out. If you're doing things that you hate and you're around people you don't want to be around, and that can include partners as well, I'm sorry to say, because it's a big time of children are leaving home. You've got different things. It becomes this time of real looking inwardly and understanding what are you doing? Where's your authenticity? Who do you want to be? What do you want to do rather than externally always focusing on what others need from you? I hope that makes sense.

So there's something there about also really honouring your energy and your health and your time for recovery.

When you talked about the vagus nerve and vagal tone, making time to do things that strengthen that. And I know that that's something that so many people find so challenging. As you say, maybe we haven't grown up with boundaries. We've never seen that model. We've never done it ourselves. And now we're getting to the time where our energy is more precious than ever or more scarce.

And we're already wanting to be focused or intentional maybe is the right word about what we're doing and how we're doing that. And this moment of looking around and thinking, how do I support the system? How do I make it better?

You've got to understand the system because if you're pushing against the system and you can be pushing against your system in multiple ways, who do you spend time with? Where do you put your resources? If you're pushing against your nervous system, which to be honest with you, I've done all my life, you will find that you will not be able to do that when you come into perimenopause because it is that time where it's like the junction. It's like all of your previous life experiences collide. It's the only way I can describe it. when you look at symptoms, symptoms are messages from the body, aren't they? That's what your body's telling you. If your body's telling you, you have heightened anxiety, that's because you're running, you're burning the system, you're in high functioning anxiety. And that is the messages you need to listen to because that's what your brain is telling you. Your brain and body is telling you.

So if it's cognitive fatigue, executive functioning, ADHD, for example. There's a lot of research around, ADHD, around dopamine seeking. Well, it's a bit more complex than that, but women that are now being diagnosed with ADHD is becoming very common, isn't it? It's actually a thing that's happening now in midlife. More and more women are being diagnosed with ADHD. Well, ADHD, if you're not doing the things you love doing and you're not serving your purpose and actually then that is when you get cognitive burnout because your energy is being pushed in the wrong direction.

It's like understanding there are things I'm going to shed, I'm going to let go of. And that could be people and that could be things that you are clinging onto because it's what you've always done. But it's a time of saying, no, I'm struggling.

And if I'm struggling and I need to serve others and I want to serve others, I'm going to need to recalibrate. I'm going to really need to look at my priorities.

Two things I'm thinking about. Number one, you talked about this relationship between internal and external as we grow up and as we live our lives. And one thing that I see being a challenge for women who are wanting to create change in their midlife is you talked about this pressure from the external. Maybe I need to be making money or I'm in a senior role or I'm running my own business or why teenage children who have needs from me. So some things I might be able to strip back on or create some space around. Some things feel like maybe they don't bring me joy or they don't feel like purpose, but they're necessary in this kind of fast paced world or in the socioeconomic paradigm that I need to exist in. So it's finding these pockets of space and taking a bit of time to pause and see, well, what could I say no to or something that I also find useful is just acknowledging that this is difficult. And so maybe there are tiny moments of rest, micro rest in between.

Micro changes. It's a bit like the concept of glimmers. It's like micro glimmers. Yes, it's not feasible. But also, think it's as much as saying yes to things that you want to do, as much as saying, I don't want to do that anymore.

There's things that you probably haven't done that you want to do. And it's that, I'm going to say yes to this and no to this. It's a little bit more looking at who your social connections are. Because the one thing we do know is that your social connections are the most important. Who you spend your time with, your social connections are the most important preventative measure for dementia.

So one of the things that we probably do let go of when we're tired and when we're exhausted and when we're running on empty is, I can't be bothered to do this because I'm too tired, but actually it should be flipped to these things give me energy. So I should do it, but something else might need to go.

I packed in my business last year because I realised, and this is not, I'm not by any chance privileged or anything. I just knew it got to the point where my burnout, I couldn't do it anymore. I wasn't serving. Then I've retrained and I'm doing what I'm doing now. I've written a book. I'm not suggesting that everyone should do that because it's not realistic. But what I have done as well is realised that was they just were not people that gave me energy. They were people that drained me.

I'm telling you, there will be people in your life that drain you. It's about reprioritising. Who do you share your time with? Because if you meet people and you sit down and you're with a bunch of women and they light up your brain or somebody with you, that's giving you energy that it will fuel your tank. If you sit down and you're with somebody that drains your energy for three hours, then you have lost more battery.

This point that you made about hormone replacement therapy as not being a magic fix for everybody and looking at your life holistically in terms of what am I doing with my nutrition? What am I doing with my exercise? What am I doing with my community and my network and my work and my rest? And how do I feel in my body? And then maybe if there are supplements or an extension of medication that I'm using to support myself and not expecting an HRT treatment to make everything better. And you talked about this having potentially negative effects for women if they're maybe going into it with that mindset or if they're not partnering or if their doctor maybe doesn't know as much.

What's your experience around hormone replacement therapy and what do you see in the work that you do?

I had a particular story. I was given very high doses of HRT. I didn't realise that at the time, but it was very, very high doses. And that led to very, very significant side effects for me, which is why I'm doing all this work. Because the thing about HRT is that right now we've got this advertising of HRT as if it's going to fix absolutely everything. Right? And I think you've hit on a really good point. HRT absolutely does have its place. But from the work that I've done on the nervous system in the brain, if your nervous system is way out of kilter, like mine was. And you don't understand that, sticking more hormones in, because that's what it is, can be a disaster. Because there's an expectation now that giving yourself the hormones that you think that you're losing is going to fix everything and it's going to make you feel better.

Now, a lot of women are very successful on HRT. Let's be fair, a lot of women are. But there's equally the same amount of women, I believe, that aren't. And no one talks about that because it's almost like, well, I failed and they think they're the only ones that it hasn't worked for. And I'm really keen to say to women, honestly, I would say that for most women, them in getting it right is really, really difficult. And that is because your hormones, as I've said before, are interacting with your environment.

So if I give you an example, the new thing of testosterone will improve libido and it will help you with your sex life. Well, that's not how it works because if your relationship and your social stresses and your marriage is not good, no amount of testosterone is going to make you want to have sex with your husband. Do you see what I'm saying? It's your environment that you're in. You have to change your environment first.

When your environment, as you said, your environment includes, how am I looking after myself? Where am I at? Once you've got your environment to the best place, then try the hormones because your hormones will interact with that environment, whereas we're doing the opposite, which is my environment's rubbish. If I'm trying, I'm just being blunt. And I'm going to put hormones in. It won't work. Only because I have studied this so comprehensively based on my experience and understand the nervous system.

Now for some women who are not more sensitive. They can play around with their doses. And they'll get it right. It'll be like, no, I've got it. I've tweaked it and it's fine. But see if you're more sensitive. You're going to find it a bit of a journey to get it right. And that's because you're interacting with your environment. So if your environment's not stable, you're not stable. Your environment's not as safe and as stable. The hormones aren't going to suddenly bring that nervous system regulation.

It could make it worse, which is what happened to me. So it's really important that we understand what hormones are and how they work with the brain and nervous system. And if you're going to go along that road to understand that it's a bit of a difficult process.

I've spoken honestly for my book. I've spoken to so many women that are really struggling to get it right and then they feel as if they failed because the hormones aren't working for them. But if your environment isn't right, those hormones will, you will struggle. You will struggle to get it right. I hope that makes sense.

So there's something there about some grace over experimentation in terms of partnering with our doctors, our levels, and maybe different ways of taking hormone treatment if that's a route that we choose to go. And there's something around supporting ourselves in other ways as well and not just putting one thing into the mix, but also looking at what else is.

I wanted to ask you about trauma. So you've talked about coming from a complex trauma background and how sensitive women may have gone through adverse childhood experiences. Now I know what you're talking about and you know what you're talking about, but maybe not everybody listening has an understanding of what that is or how that might fit with them or what people might have experienced. How would you define simple and complex trauma?

So based on the nervous system development, if you have not just trauma, if you have early life stress, so stressors, okay, that affects the developing nervous system. It will impact your production of cortisol. It will affect your stress response. And this is the thing that we're not realising. But when we actually talk about the science of what's called adverse childhood experiences, then we're looking at the research that is pointing to the fact that adverse childhood experiences are heavily researched now for adult health outcomes.

That across menopause, we have research that says women with adverse childhood experiences will struggle more with menopause symptoms. Okay. And that's what I cover in my book. But adverse childhood experience, the original science of that, was based on 10 questions. And it was typically, was there violence in the household? Was one of your parents or parents an alcoholic? Was there substance abuse? Was there emotional abuse….

So that was the kind of original sort of top 10, if you like, but that's now been expanded because we've got more awareness of attachment. We've got more awareness of how your early attachment processes with your mom, how that affects your nervous system and your behaviour and your relationships and your safety and your feeling of self and who you are in the world.

So when you start to look at my background, my dad was a narcissist. Now I didn't know that my dad was NPD, but because I wouldn't have done would I, when I was a young girl. But I was living under what you would call a narcissistic facade and my dad was abusive and he was violent and he was abusive to my mom.

And my mom was also a product of that abuse. So I grew up in a very toxic family dynamic that has shaped my nervous system. And then I was abused when I was younger. So I had sexual abuse when I was eight, not from a family member. And I believe that these types of conversations are not being spoken about because I was born in 1972. And I, this isn't me saying this, I reckon there's more women out there that were abused that haven't ever said anything. I didn't ever say anything because I was conditioned to get on with it and brush it under the carpet. And it's only now we're starting to see violence against women, abuse against women that is coming out.

We're starting, but I believe that that's happened to a lot more women and I'm not the only one, which is a bit of a delicate subject, I appreciate. But if we don't start to understand that and we understand how that affects your nervous system and your hormones. How are we ever going to understand this stuff and the crossovers between mental health.

Depression, anxiety, bipolar, all of these, what they call more female disorders, which I don't like, I don't like the word disorder, these are adaptations, that start in your younger years based on your nervous system. And a lot of that can be to do with your attachment processes to your primary caregivers. This is what I'm trying to get out there. That it's not as linear as, we are a product of our environment. That's how our nervous system is shaped for survival. And a lot of us have got adaptive coping strategies. Alcohol was one for me, drugs.

I didn't know that, in my teens, that that's what I was trying to do was just self-regulate my nervous system. And I think the more we know about this, the more we can put those things in place to understand our stress management and understand our nervous systems and our psyches and our behaviour, because it's all connected. It's all crossing over and connected.

So if you're suffering from burnout, there's probably co-occurring stuff that's going on there. You will have had anxiety, depression because the system when it burns out will put you in a flat inhibited state and that means more low arousal, which is more like your shutdown type of states. And I think we need to understand that this is the nervous system we're talking about, not just in isolation.

One of the things that I wish we would teach in education for children is what the nervous system is. And how we can come to those regulated windows of tolerance, how we can regulate to a place of connection, self-regulation.

This is why I've done the book because the brain is plastic. So one of the reasons that adverse childhood experiences in our younger years imprint into our nervous system is because the brain is highly plastic at that point. So it's wiring. But the brain stays plastic throughout life, you can't reverse what's happened. But imagine if I was eight and I had abuse and this was treated properly. And it was stress buffered and I had the emotional support that I needed and I learned to trust and I learned to rely and I was safe. That's an intervention that should be happening in childhood, not in adulthood where we've now got a mental health crisis and there's not enough services.

We should be starting at the beginning, not in the middle. And this is one of the arguments that I've got is that we've got the worst mental health ever at the moment. I'm speaking to my friend earlier and she's a social worker. She said that the amount of children in distress since COVID. Now those children are going to be adults and eventually we're going to be talking. They're me, aren't they? They're you. Where are they going?

If we could get there in the early stages, you can get that nervous system and you can wire that nervous system to safety. And I think we're missing all of that. That's a real sad, we're trying to put medication in it when we're in our forties and our fifties. It's being led by medication now, rather than understanding that these are all safety responses. They're coping mechanisms, they're adaptations.

Every single mental health diagnosis, this is a bold statement, I believe comes from attachment, it comes from your nervous system, it comes from your early years, and then because it's not treated or you don't learn to self-regulate, you take that and it becomes maladaptive, it becomes a defense strategy, becomes your armour, it becomes narcissism, it becomes borderline personality, do you know what I mean?

But really it's coming from our younger years and you can't separate your nervous system and your biology and your psychology and your neurochemistry, it's all connected. And I think that if we could understand that more, well, wouldn't we have a, I don't know, a much nicer world, but then maybe that's a big dream.

It's a dream worth having. It's a dream worth talking about. It's a dream worth sharing with our friends and having discussions about of everything that's gone before, of how we were loved or not, how we were safe or not, and how we react throughout our lives. How defensive we are.

Separate to that they are interwoven with everything that we do and we feel and so it makes so much sense that we're going to be having a different experience of this change. The bio piece, the psycho piece, the social piece and the context that that is created in. What a beautiful conversation I'm enjoying being here thinking about that and talking to you.

If you would give somebody a resource to go to. So you've mentioned your book, Sensitive Women. So people will be able to find that. Are there any other resources that you would recommend people to look at? Because I think another challenge now is because perimenopause, the menopause has become quote unquote mainstream, there are now a whole lot of fancy things and influencers and magic pulls and potions that are being shown to us.

I've done a million books on perimenopause and menopause. I mean, when I say I am well-read and well-versed in perimenopause, and one of the books and one of the resources that I have found to be really valuable in terms of perimenopause and understanding the changes, the metabolic changes, all of that, is Lara Briden. So there's a book called Hormone Repair Manual. And I am a big fan of Lara Brydon. I think she's got a very good tone. She's got a very good manner. She's just has got something about her when it comes to what I'm saying is about perimenopause. There's not much out there in terms of what I'm doing, which is more about the trauma informed. There really isn't. That's why I'm kind of pioneering that with my with my book.

There is a very, very good endocrinologist, Professor Anise Mukherjee. She's on Instagram and she's on LinkedIn as well. She's a very good source of information. She talks about lifestyle. She's a breast cancer survivor. She talks about the holistic and she talks about hormones. This is my biggest piece of advice, right?

Do not pigeon hole yourself just to listening to people that prescribe HRT. Because the more you do that, the more it becomes this kind of cognitive dissonance in the sense that you just believe because they will tell you that it cure everything. Try to keep an open mind. So mix, because there's quite a lot of what I call echo chambers, and echo chambers are not good for the brain. I keep going on about the brain. But if you're hearing negativity all the time, and this is what happens with the brain. If you're being told it's doom and gloom and it's a disaster you're going to believe that and that is what's going to happen. Try to spread your information sources rather than just HRT prescribers because there's a lot of value.

Everything of getting some different opinions and looking at different points of view and different perspectives. Keep an open mind.

And really engage with the topic. Really give us some time, which I think often we don't with our health. We put that to the backseat. I'll just get through this, I'll make an appointment next year when there's a bit more time. We're often prioritising other things over our health. So this is really an invitation for anyone listening to take some time to explore, to research, to think about these things.

Make informed decisions out there. Thank you so much Paula for your time and for being in conversation with us. Appreciate you.

Thank you so much for having me.

I love having these conversations so, so much. Thank you for being here, for listening to the Work Family Me podcast. If you want to connect with me in real life, I would love that.

I am so grateful for this conversation and so pleased for you to have it as a resource. Paula has a Post Grad Certificate in Psychological Trauma, works as an Integrated Trauma Therapist (EMDR, Applied Polyvagal, Sensorimotor Psychotherapy) and Coach and is the author of a book called “Sensitive Women - A trauma informed, neurodiverse approach to hormonal sensitivity”. You can download her free e-book here Hormonal Sensitivity E-Book

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Maude Burger-Smith