Originally published on Care Curriculum by Rachel Piper

Every month, there are inevitabilities. There will be days that, no matter the beauty or kindness they hold, feel extremely ‘off’.

This will look like weeping a lot. This will feel like feeling incapable despite all you’ve managed to do. This will feel heavy and achy. This will feel like physical weakness and exhaustion, like all the life force has been drained. Thoughts will be indecipherable through a heavy fog, some of those thoughts will be sharper, self-destructive, and possibly suicidal. This all will feel simultaneously unsettling and like drowning. Like a heavy and slow quicksand in which electric eels are lurking ready to sting. These mental and physical symptoms might have a knock-on effect on how everything else feels.

For me and many others, this is what the week or so before our menstruation, or ‘the luteal phase’ is like. (I’m not even sure I know how to pronounce the word ‘luteal’ as I’ve barely heard it said aloud. Isn’t that telling)

In the opening of this post, I wrote ‘this will feel’ because it is, to an extent, an inevitability. Nothing I have done has removed these symptoms or feelings. There is no cure. But, as I am grateful to have learned from Eli Clare’s work, perhaps cure is not the (only) answer. An answer to the call of these difficult days is perhaps instead a world that allows the body-mind to be, as it is, right now. Another answer to the call of these difficult days is to find out what softens, relieves, or eases.

Premenstrual Dysphoric Disorder (PMDD) is a more severe version of PMS or PMT. We need words to describe the experience, and I am grateful for those who have brought this experience into public conversation. But, the term PMDD doesn’t sit with me 100% right. I can imagine why we call it that though. ‘Premenstrual Dysphoric Disorder’ fits into the grammar of medicine. The word ‘disorder’ gives it the legitimacy needed to be legible, to be understood as something that requires care. It makes it somewhat easier to seek accommodations in the rigidity of capitalism. It is an attempt for its severity to be taken seriously. And we do need to be taken seriously. We really need it to be taken seriously.

The term PMDD is calling the severity of the symptoms a ‘disorder’, it’s not calling the menstrual cycle as a thing a ‘disorder’. However, if we take the word ‘disorder’ literally, it doesn’t quite sit right with me. In my experience, the cycle (including a severe pre-menstrual phase), has its own order. This is not an order of linear progress, but of cyclical rhythm. A rhythm that is messy and ‘disordered’ compared to the dominant order of the day. But an order which is synced up to something more like the seasons of life and death. Having said this, it doesn’t feel quite right to chalk up these cycles to being somehow ‘closer to nature’. It is too reductive to say that ‘women’ inherently understand better what it is to be part of nature.

All bodies are a part of nature and subject to cycles. For example, testosterone in an assigned male at birth body (and actually all bodies to differing degrees) also works in cycles, cycling through and affecting mood in a 24-hour loop, and there is a ‘male’ menopause, of sorts. I do not say this to dismiss the much more severe ways those assigned female at birth are affected by their cycles, but just to say that the human body, in all its sexual variance, is built to go through cycles. But a dominant system and politics have been designed based on the idea of linear progress, rather than cyclical growth, death, renewal, rebirth, and so on. We are all alienated, to varying degrees, from nature and our own nature. But we are all of nature. We are all nature. It is how we pay attention and show up in the world that results in our ‘closeness to nature’, not our body parts, hormones, or symptoms.

I have felt the ‘ick’ when I see workshops that link menstruation to ‘mother nature’, because unless it’s done carefully, it’s a biological essentialism that misses something. It has often felt like spiritually bypassing the significant impacts of living with medical misogyny. Skirting over the trauma that comes with living in a menstruating body in a patriarchal world. Telling people they should ‘embrace their moon’ whilst not naming the ways in which menstruating (especially if it comes with debilitating symptoms) economically and socially disadvantages people, can be less empowering than hoped. We must first name the challenges before we can rewrite our narratives.

I haven’t necessarily wanted to embrace my cycle when it has caused me so much pain and distress. There is a risk in embracing one’s cycles out loud. When I ‘embraced’ that I actually had bad enough Endometriosis to have to work less, I lost a fifth of my income. To actually admit that I am differently able at different times, in other words, to disclose that I am disabled, is risky under ableist capitalism. Not everyone is safe or financially able to be entirely honest about their health or disability. I have hidden my PMDD experience in work settings, or spoke about it in coded ways, for fear of my work being taken less seriously. Or having my ideas undermined: someone saying ‘she’s just on her period’ to dismiss legitimate rage or disagreement.

All this said, I have found power in embracing my cycles with those I trust, and in settings in which I have more flexibility. Tracking my symptoms and cycles, I am able to adapt how I treat myself. I am able to match my cycle with an appropriate cycle of care.

We can learn a lot about the societies we’d like to build by looking at nature and seeing ourselves as part of its cycles. Through Healing Justice London’s Reimagining Health and Care: Addressing Medical and Institutional Trauma (REMIT) group, Tulika Jha, Dzifa Afonu and I ran a workshop Bodies of Water: Trauma and Healing in Health and Care. Tulika has since published a poem that came out of that work. This part of it speaks beautifully to the cycle of care that needs to go alongside the cycles of life:

Now you see, now you don’t
Doesn’t mean they didn’t exist

It shows itself shapeshifting
in puddles, lakes, rivers
making size of the container immaterial
Care is a cycle that contains
Giving and receiving like vapour and rain

I can give more care at some times, I need more care at others.

In the past, I have thought that if I accept how my health is I am giving up or giving in. That somehow if I accept the ways in which I am unwell I am not fighting enough (the idea of an ‘Endometriosis Warrior’, or ‘battling’ disease doesn’t help, another post on that soon! ). That if I accept the ways in which I am unwell, I am accepting the ways in which I am not cared for enough. If for example, I accept that I experience PMDD, and call it inevitable (at least at the moment), that somehow I am excusing all the medical misogyny that has led it to be so misunderstood and under-supported. It is complicated to disentangle what is ‘inevitable’ from what is a result of a patriarchal world. I only discovered the term PMDD a couple of years ago and only found out the word Endometriosis after going to the doctor with pain for years. That could have been so very different if periods weren’t stigmatized. If our pain was taken seriously.

To be clear, perhaps one day there will be a cure for PMDD or Endometriosis, but for now, I have to accept I experience both in order to get care. I experience cyclical changes, and right now, I have to accept they happen and tend to them. It is understandable to want to push away pain, but time and chronic pain has taught me: pain quietens when it is accepted. In giving into the inevitability of the changes throughout the month, I am no longer fighting against my bodymind. This release benefits me in some deep honouring way, and despite attempts in this writing, the language for it evades me. It is a quiet thing, because like I said before, some places allow me to be more open than others. But I am trying to be truthful with myself at the very least.

Since I have been accepting, it has all weighed less heavily. I have noticed and named the discomfort, rather than pushing it away, and almost counterintuitively that has meant it sucks me in less. The quicksand slows. Accepting some level of inevitability is another way of saying ‘of course’. There is a kindness in ‘of course’. In a recent Mindfulness for PMDD course, the teacher Bianca shared the idea of saying ‘of course’ to yourself as a way of being compassionate. I wept (and I wasn’t even in the PMDD phase! I wept with relief).

This was the practice (thank you Bianca), I adapted for myself:

Saying to yourself something like: “Of course you are feeling sad when your body is achy. Of course you feel scared to feel like this. Of course your body goes into high alert when you’re in pain. Of course you’re tired. Of course you’re less patient. Of course you are scared of being rejected right now. Of course you want to be held through it. Of course you want to be loved, not despite it all, but through it all. Of course, of course, of course”

It will feel like:

“OF COURSE” translates to: soothing and being soothed

“OF COURSE” translates to: consoling and being consoled

“OF COURSE” translates to: reassuring and being reassured

“OF COURSE” translates to: reasoning, beyond facts, into truths

“OF COURSE” translates to: accepting we need care

We also use the words ‘of course’ when we have a lightbulb moment.

This practice felt like a realisation, and that realisation felt like a relief. And with relief came release. And with release came rest. And with rest came all the rest of it all.

With care, (of course)

Rachel x

MEET RACHEL

Rachel Piper (she/they) is a UK based writer, community organiser and facilitator. She writes the Substack Care Curriculum, sharing reflections and guidance on the loving work of care, informed by lived experience, gender and queer theory, disability justice and ecology. 

@carecurriculum | Substack