The Hidden Breakdown: What Perimenopause Reveals About Personality Structure
We’ve been sold a lie: that perimenopause is a set of symptoms to survive or medicate. But what if it’s more than that? What if it’s a reorganization of the ego—a psychic stress test that exposes the scaffolding beneath our personality structure?
In this episode, I joined Ash and Danni to dissect how Nancy McWilliams’ psychoanalytic framework gives us a deeper, clinical language for what actually happens during perimenopause. We explored how five personality types—borderline, narcissistic, depressive, obsessive, and masochistic—respond to the biological and relational chaos of this phase.
Borderline personalities intensify in reactivity and fear of abandonment. The body’s hormonal swings mirror their internal volatility, often leading to splitting and emotional dysregulation.
Narcissistic structures feel assaulted by aging. Shame spikes, and grandiosity ramps up as a defense against perceived inadequacy and loss of control.
Depressive types sink further into self-reproach and withdrawal, internalizing every loss as personal failure.
Obsessive personalities try to manage the unmanageable—clinging to routines, intellectualizing symptoms, and spiraling when reality breaks structure.
Masochistic structures may unconsciously invite suffering, resist help, and reinforce their self-image as the one who endures silently—yet resents deeply.
What emerges is not a pathology, but a crucible—a phase that demands ego adaptation, relational recalibration, and communication upgrades.
This isn’t about casting blame. It’s about offering a map—for partners, providers, and women themselves—to navigate the terrain of perimenopause without falling into misunderstanding or collapse. When we change the frame, we stop pathologizing and start training the system to hold steady inside the storm.
This is what elevate.epo is built for.
🎧 Download the latest podcast: Perimenopause as Personality Collapse: A Psychoanalytic Deep Dive with McWilliams
Enrique Arteaga - Chief Reogranization Officer - elevate.epo © 2025 APG, All Rights Reserved