Simona Stokes explains how CBT can help us in perimenopause

Middling Along

This time I welcome Simona Stokes, Counselling Psychologist and the Founder of Menopause CBT Clinic, an independent psychology practice which aims to support the psychological wellbeing of women going through the perimenopause and menopause. Based on her extensive clinical experience in this area, Simona has developed EMBERS® Menopause CBT Model which is centered around the psychological principles supported by the best evidence-based research and interventions in the field of mental and emotional wellbeing. She holds professional registration and accreditation with several bodies including the BPS, BABCP, and BACP and has been working in the mental health field for over 20 years.

We begin with an explanation of what CBT is and how it works for anyone who is not familiar with Cognitive Behavioural Therapy. Simona explains little more on the different types of CBT, and her experience is that ‘third wave’ CBT approaches seem to work best with those experiencing perimenopause symptoms.

The draft NICE guidelines issues at the end of 2023 caused quite a media stir with the increased focus on CBT as a treatment for menopause. We discuss why the headlines were misleading and how CBT can help with hot flushes and sleep disturbances, as well as psychological and emotional symptoms. As Simona outlines, even individuals who are taking HRT sometimes struggle with their mental health and access to CBT can be helpful. Medication alone cannot address struggles with confidence, self esteem, self-worth, and identity.

We delve deeper into menopause as a psychological developmental stage - just as pregnancy and puberty (see Lisa Mosconi’s book The Menopause Brain for more on this). In all these life stages our brains are remodelling themselves - we are updating who we are and our perspective on the world…a process some of us will navigate on our own or with support of our own networks of support, and some of us may need a little extra help and support from professional - space where we can safely explore these topics.

Simona explains that the way we think about physical symptoms can amplify the symptoms themselves…CBT helps us look at the kinds of stories we tell ourselves and write new ones. It can support us to make meaningful change in areas that help us regulate our bodies and thereby mitigate symptom severity.

Unfortunately as Simona highlights, the types of CBT available on the NHS are not always tailored to the needs of women going through the menopause and that can lead to sub-optimal experiences when people do choose to pursue CBT as an option. We end by agreeing that there is certainly scope for more practitioners to be trained in menopause-informed CBT practices.

You can find Simona at https://www.menopausecbtclinic.co.uk/ and https://www.instagram.com/menopausecbtclinic

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