The Kind Voice in Midlife: A Free Compassion-Focused Worksheet for Menopause and Perimenopause

What it helps with

• Seeing how threat and drive can crowd out the soothing system.
• Noticing what the inner critic says about ageing, the body, mood, memory and work.
• Understanding that the critic is often trying to protect or motivate, and how well that works.
• Building a kind-voice card the client can use after a poor night or a flush in public.

How clinicians use it

• Use it at Session 4 and go slowly if compassion feels uncomfortable.
• Ask for rough percentages across the three systems and look at where the client lives.
• Practise the soothing rhythm breath, then write the kind response together.
• Ask the client to use the card at least once a day.

Clinical Implementation Guide

1. Give rough percentages for the three systems.
2. Write what the critic says and what it is trying to do.
3. Write the kind voice and a card to carry.

What the worksheet looks like

Clinical cautions

Not a diagnostic or medical tool. Psychological support sits alongside medical care: encourage review by a GP or menopause specialist, especially for heavy or unusual bleeding, new or sudden symptoms or any symptom that worries the client, and never advise on starting, stopping or choosing hormone therapy. Screen for depression, anxiety and suicidal thoughts with your usual risk protocol before and during the work, because mood can worsen in the transition. Avoid pathologising a normal life stage or implying that symptoms are psychological in origin, and use inclusive language. Heat, sweating and breath focus can be activating for clients with trauma or panic, so go slowly, offer choice and let the client keep their eyes open. Breathing is taught to settle the body and the fear response and must not be promised to reduce hot flushes (Huang et al., 2015). Sleep window work needs the checks in the guide: avoid or modify it for bipolar disorder, seizure disorder, safety-critical work and suspected untreated sleep apnoea, and keep time in bed at or above about five and a half hours without specialist guidance. After breast cancer treatment or surgical menopause, coordinate with the oncology or medical team.

References

1. Houston, E. E., Brown, L., Jones, K. M., Amonoo, H. L., & Bryant, C. (2023). Does self-compassion explain variance in sleep quality in women experiencing hot flushes? Maturitas, 172, 39-45. https://doi.org/10.1016/j.maturitas.2023.04.003.
2. Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. https://doi.org/10.1111/bjc.12043.
3. Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28-44. https://doi.org/10.1002/jclp.21923.

Copyright and use in research

© 2026 Dr Richard Pomfret and Third Wave Therapy Tools. May be used in research with the author and site cited. Version 1.0, approved 20 October 2026, revised as the evidence develops.

Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady Through the Transition: A third-wave protocol for menopause and perimenopause (Version 1.0) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/

Part of

Steady Through the Transition

Related worksheets

• Therapist Guide: Steady Through the Transition
• My Transition Map
• Settling the Heat

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