When Coping Strategies Have Expiration Dates: Perimenopause, the Nervous System, and the Therapeutic Relationship with Leah Landis, LCSW
Crossing the Threshold: Personal and Professional's stories of the menopauses—where the old structures fracture, the rules get rewritten, and the human spirit becomes unbound.
"One thing I find interesting about this transition is that coping strategies can have expiration dates." - Leah Landis, LCSW ,
Meet Our Guest: Leah Landis, LCSW, New Terrain Therapy, LLC
What happens when the ways we've learned to manage stress, care for others, maintain relationships, and move through life begin to work differently?
For the first installment of Crossing the Threshold, we're featuring Leah Landis, LCSW, an EMDRIA Certified Therapist™ and founder of New Terrain Therapy in Colorado.
With more than 15 years of experience in health and mental health, Leah brings a perspective informed by trauma, EMDR, Polyvagal Theory, and specialized perimenopause education.
In her reflections, Leah brings together two experiences that are often discussed separately: the personal experience of moving through a significant life transition and the experience of being a therapist accompanying others through that same territory.
She considers how our histories, nervous systems, relationships, and long-established adaptations may intersect with the menopause transition. Her reflections also invite us to consider the strengths within those adaptations, even when they no longer serve us in quite the same way.
And importantly, Leah makes room for the future—not as a perfected version of ourselves, but as a life that might hold more curiosity, pleasure, connection, and choice.
We invited Leah to share her personal and professional reflections on perimenopause, the therapeutic relationship, and what we may still be missing in conversations about menopause and mental health.
On This Phase of Life, called Perimenopause, and the Therapist as Self
How are you experiencing this phase of your own life? Has anything surprised you about yourself, what matters to you, or how you see yourself now? I'm also interested in any thoughts you have about the therapist as self during this transition.
One of the biggest surprises of this phase of life is realizing I’m not trying to become a different person. I’m becoming more myself. My perfectionist part of me is learning that it’s okay to just be instead of constantly doing, fixing, or figuring things out. We’re calling it a work in progress as naturally this side of me would like a timeline for that. There’s been a lot of letting go of expectations, old ways of proving myself and identities I thought I needed to hold onto. It can feel disorienting but sometimes what feels like being “lost” or in the “unknown” is just learning to navigate differently. I’m more interested in living from the inside out.
Asking myself what feels true, what I want life to feel like and where I can stop working so hard to earn certainty, belonging or approval. I see this in my work as a therapist as well and normalizing our collective human experience we help others navigate. We bring our own histories, nervous systems, relationships and unfinished edges into the room. There’s something meaningful about being able to say, “I know this territory, too,” while making room for change to occur. Maybe maturity is less about having it all figured out and more about trusting ourselves to meet what comes next with curiosity.
Maybe maturity is less about having it all figured out and more about trusting ourselves to meet what comes next with curiosity.
The Nervous System Has a History
What do you think we haven't learned—or simply haven't talked about—when it comes to this transition? I'm especially interested in your perspective on the nervous system, the body, chronic stress, and what you think women may arrive at this stage of life not understanding about themselves.
I think we’re having more conversations about how symptoms show up during this transition but less about understanding the individual experiencing them or helping loved ones understand just how much can be changing. We can talk about hormones, sleep, anxiety, brain fog and weight changes while the external demands continue and having enough willingness to slow down to connect these dots can be hard to accept when life continues to life in some pretty challenging ways.
I am there to be curious and offer a space to slow down to give them their own manual to their nervous system of what happens when those changes occur in a nervous system that’s spent decades adapting to stress, trauma, caregiving, perfectionism, or overriding its own needs? Women can arrive at this stage thinking something is wrong with them; when maybe the better question is: What is my body telling me that I haven’t had to listen to before? The strategies that once helped us push through, care for everyone and keep going may no longer work the same way. That can feel like failure, especially for those of us whose perfectionist parts would really appreciate a clear set of instructions for navigating this whole thing.
I’m more interested in seeing these changes as information. Our nervous systems aren’t character flaws and our bodies aren’t betraying us. Maybe this transition is an opportunity to better understand how our biology, history, and the lives we’ve built all intersect. While I want to acknowledge that can feel overwhelming when you’re not sure where to begin. This is where the therapeutic relationship matters: having space to get curious, make connections and figure out what comes next together.
Women can arrive at this stage thinking something is wrong with them; when maybe the better question is: What is my body telling me that I haven’t had to listen to before?
When Perimenopause enters the conversation: what Happens in the Therapy Room?
What are you seeing in the therapy room related to this transition? Does the menopause transition come into the conversation? And when it does, does it change anything about what you notice or how you understand what's happening for someone—particularly when trauma, CPTSD, anxiety, or medical complexity are also present?
I’m seeing women who have spent decades doing all the things: building careers, raising children (who might be teens in the present day while in this transition) caring for aging parents, managing households, and meeting everyone else’s needs. They’re incredibly capable, until something starts to shift and they think, “Why don’t I feel like myself anymore?”
When perimenopause enters the conversation, I want to widen the frame. Sometimes we’re not looking at a psychological problem so much as a system that’s been running at full capacity for decades and could be asking or sometimes screaming for a reboot. Which, for those of us with perfectionist tendencies can be hard to accept, there is no clear instruction manual of what this will look like and I don’t pretend to know that I have the secret manual because I don’t. However, with enough trust, safety and willingness to give space to the unknown I get to provide psychoeducation of how symptoms arise, bring in curiosity to the patterns and explore what this could mean to them in what their body is trying to express and give more language in the room to what’s occurring.
I’ve witnessed and observed that an upgrade doesn’t always mean doing more, which can be hard to accept. Sometimes it means slowing down enough to notice what we’ve overridden for years: Am I eating enough? Getting adequate nutrition and sleep? What might contribute to those 3 a.m. wake-ups? Is it stress, hormones, nutrition, or something medical that deserves attention? These questions may sound basic but for someone who’s spent years pushing through they can be a powerful place to start reclaiming a sense of control when so much feels outside of it.
I want to also acknowledge how this transition can feel deeply unsettling when the strategies that once helped us feel capable and in control no longer work the same way. Part of the therapeutic work is exploring where we do have influence; not over every hormone or symptom but over how we respond, what we need, which boundaries we set, and when we seek support. Which for women who are neurodivergent or have a history of CPTSD can already be a very scary time to even think of within their relationships to know what they want, need or feel first and then practicing expressing this may be very new practice for them. Our histories and nervous systems matter but so does our biology. Symptoms deserve curiosity, not assumptions, and sometimes medical evaluation alongside therapeutic support. This has also given me an opportunity to get curious with clients about a different question: What might my nervous system and body be asking me to do differently now? Not as another thing to perfect, but as an invitation to listen, understand, and respond in a new way.
When Coping Strategies Have Expiration Dates
What are you noticing about coping, regulation, and attachment during this transition? I'm particularly curious about what happens when ways of regulating or coping that may have worked for years don't work quite the same way anymore, and what your Polyvagal lens adds to how you understand that.
One thing I find interesting about this transition is that coping strategies can have expiration dates. Something that helped you regulate for 20 years may suddenly stop working the same way, leaving you wondering, “If this used to work, what’s wrong with me now?”
Maybe nothing. Maybe the strategy worked beautifully, but it belonged to an earlier version of your life.
Through a Polyvagal lens, I’m curious about how changes in hormones, sleep, stress and capacity may influence our sense of safety, connection and ability to regulate. What once felt manageable may suddenly feel overwhelming. When our usual strategies/adaptations stop working, it can leave us questioning not only our coping but how we relate to ourselves and others.
This is where I value the therapeutic relationship: making room for fear before jumping into problem-solving mode. Together, we can explore what feels familiar; how earlier experiences may be showing up in the present and what our bodies and nervous systems might need now. I also want to reflect the strengths within those adaptations. The part that learned to anticipate everything may be incredibly perceptive. The part that kept going helped you survive. The part that became highly competent may have helped you build a life you love. I am also very clear to individuals that we are not here to get rid of those parts.
Through IFS-informed parts work, we can build self-awareness and compassion while exploring whether those parts still need to work quite so hard. For those who want to explore how earlier experiences continue to shape the present, EMDR may also be an option. EMDR can also be very helpful with symptoms that are arising in the present creating more doubt to “what’s wrong with me”. The goal isn’t to erase the past or discard what helped us survive. It’s to build enough capacity to have more choice in the present to find new ways of regulating, connecting and feeling safe that fit the life and body we have now which also shapes attachment in the room with how it may show up, shift and opportunity to become more secure.
Making Room for the Future Self
And what about the future self? I’m interested in whether and how we picture ourselves on the other side of this transition. There is so much fear-based messaging around perimenopause and menopause right now. Where is the conversation about the life ahead, and what might we be missing?
I think we need to make more room for imagining who we might become on the other side of this transition, not just what we might lose. Maybe she has less tolerance for relationships that require her to abandon herself. Maybe she knows the difference between responsibility and over-responsibility. Maybe she stops confusing being needed with being loved. Maybe she has a body she understands rather than one she feels she has to constantly manage. Maybe she becomes more playful and present for the joys of living. There can be so much seriousness, uncertainty and heaviness around midlife as those experiences deserve to be acknowledged. But this doesn’t have to be framed as the traditional “midlife crisis.” What if we also made room for curiosity, pleasure, creativity, humor, sexuality, friendship, adventure, and being a little less invested in performing adulthood correctly in our capitalist society?
Don’t get me wrong I don’t think our future self has to be a perfected version of us. Maybe this stage invites us to explore who we are becoming, what we want our lives to look like, how we want to connect with others and what we want to make room for ourselves. I want us to make room for her, too. The women I work with are already baddies in their own ways. It’s my honor to walk alongside them as they discover who else they might be when there’s more room for their own wants, joy, curiosity, and freedom not just everyone else’s needs.
About Leah Landis, LCSW
Leah Landis is a Licensed Clinical Social Worker, EMDRIA Certified Therapist™ and founder of New Terrain Therapy in Northglenn, Colorado.
With more than 15 years of experience in health and mental health, Leah's work focuses on trauma, anxiety, complex PTSD, medical complexities, and the menopause transition. She incorporates EMDR, mind-body approaches, and Polyvagal perspectives into her clinical practice and has pursued specialized perimenopause training through Perry Academy®.
Outside her professional work, Leah enjoys hiking, gardening, kickboxing, powerlifting, refinishing furniture, and spending time with her husband and three cats.
Learn more about Leah and New Terrain Therapy:
About Crossing the Threshold
Crossing the Threshold is a guest writing series from The Menopauses™, featuring personal reflections, professional perspectives, and conversations about menopause, mental health, identity, relationships, and the experiences that shape our lives.
Each chapter offers space for a different voice and a perspective worth sharing.
The Menopauses™ is an educational project founded by Julie Cardoza, MS, LMFT, exploring the psychology of menopause and supporting the development of menopause-informed psychotherapy.
The views and personal reflections expressed by guest contributors are their own. This article is intended for education and reflection and is not a substitute for individualized medical or mental health care.
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