Not so hysterical now? Psychotherapy, menopause, and hysterectomy

Abstract

In the context of the body, the essentially female; wombs, menstrual cycles, and concurrent hormones, have seen women ascribed madness, insatiability, untrustworthiness, and danger. Female bodies have been identified in selective parts, considered in abstract, or envisaged as having overwhelming power over the mind. “Hysteria”, the problematic neurosis of uterine origin was at the heart of early psychoanalysis. This diagnosis enshrines a slippage from the physical to the fantastical, and ultimately to the denial of the lived reality of women’s and girl’s bodies. In apparent collusion with patriarchy the neglect of some female bodily experience is perpetuated in contemporary psychoanalytic theory. Nowhere is this more evident than around menopause and hysterectomy (as experienced by either client or therapist). There has been little or no exploration of how practitioners might best support clients for whom menopause is significant, or how we might facilitate women before or after gynaecological surgery. It is as if removal and psychological loss of the same female body parts that our forebears used to so neatly differentiate, diagnose, and pathologise women are now not of note. I am interested as to how we as psychotherapists reclaim female body narratives from this outdated theoretical paradigm to best serve clients experiencing menopause, gynaecological surgery, and mid life in the twenty-first century.