When we sit with our clients – whether it’s a medical consultation, a therapy session, a group program or even spiritual guidance – what happens when we include a woman’s cyclic nature in the conversation?

As a holistic reproductive health coach using the Hakomi somatic counseling method, this question is not only unavoidable but inevitable.

Hakomi is a therapeutic method that uses mindfulness in our present time experience to discover unconscious beliefs that either resource or limit us. Put another way, we bring a woman’s awareness to what is happening in her body as we’re consulting with her. This is done with the understanding that our bodies are as much a part of our experience as our cognitive experience (how we make meaning) but they have a less perfected filtering and editing capacity, making them a wonderfully effective access route to our unconscious – our experience outside our awareness.

Many of my clients come to me for help with their emotional hormonal symptoms (perimenopause, PMS). Below are a few different ways I work in this hormone/psyche/somatic interface. I thought this might be a place for us to share what we’ve discovered.

Knowing Where She’s At

I begin each session by establishing which phase of her monthly cycle and/or life-cycle she’s in. We explore how she experiences these phases (which initially requires teaching tracking and observation skills). I also find it extremely helpful to find out what birth control she uses to ascertain whether she is using endocrine disruptors.

Her Relationship to Her Cycle

We get to know what beliefs she has about her cycle and her body. Many core beliefs about the Self reside in her relationship with her body and can show up in how she experiences her period, her birth control choices, how she inhabits different parts of her body – specifically her reproductive organs and pelvis, etc. (I like the work of Tami Kent on this last point). Many issues of self-regard, self-compassion and agency might also be expressed through this relationship.

Menarche

We explore her first period experience; for example, how old she was, what was happening in her life at that time and the messages she got leading up to and including her first period. These might include difficulty in accepting her sexuality; anger and resentment towards the masculine, or the feminine; shame, confusion, disappointment or rage about her menstruating body; relief and excitement about being a woman; etc. We also explore her significant relationships at that time – with mother, father, sisters, brothers, grandmother etc. We note whether she experienced any loss of relationships because of her menarche. We offer her the “missed experience” of acceptance of her womanhood, fertility and sexuality (with gender-identity appropriateness).

Normalizing the Fluctuations

We discuss variations in energy, temperament, sexuality, mood, “liminal” state (see Alexandra Pope’s Wild Genie), etc. through her cycle. She learns to recognize her unique patterns. We explore any fears/judgments/beliefs about being “unpredictable” or “inconsistent”, specifically in relation to expectations she might have for herself.

The Resource of Hormonal Literacy

We point out new signs and beliefs as she begins to integrate her hormonal experience. for example, moments of self-compassion, nonjudgmental, embodiment, empowerment, etc. We work somatically to create new neural pathways that integrate her developing hormonal literacy.

These are a few areas that I feel warrant further discussion and examination in how we include a woman’s hormonal experience in our interactions with her in a session. There are more, of course, like the counselor’s relationship to hormones and menstruation (counter-transference) as well as bringing hormone awareness to treatment with addiction or trauma. Rich stuff.

What I’ve noticed by including this interplay between hormones, psyche, and the body is the phenomenon of how awareness changes a woman’s experience. When she connects the dots between her hormonal cycle and her experience, it not only empowers her but shifts her hormonal experience itself.

I know we all look forward to the day when our hormonal and somatic awareness are so integrated, they become the water we swim in – that great day when we are not appreciated and valued regardless of our hormones but because of them. Until then, I believe we can best serve women by including hormonal literacy in our work together.