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CHAPTER 19
Resisting the Mantle of the Monstrous
Feminine: Women’s Construction
and Experience of Premenstrual Embodiment
Jane M. Ussher and Janette Perz
The female reproductive body is positioned as abject, as other, as site of
deciency and disease, the epitome of the ‘monstrous feminine.’ Premenstrual
change in emotion, behavior or embodied sensation is positioned as a sign of
madness within, necessitating restraint and control on the part of the women
experiencing it (Ussher 2006). Breakdown in this control through manifesta-
tion of ‘symptoms’ is diagnosed as PMS (Premenstrual Syndrome) or PMDD
(Premenstrual Dysphoric Disorder), a pathology deserving of ‘treatment.’ In
this chapter, we adopt a feminist material-discursive theoretical framework to
examine the role of premenstrual embodiment in relation to women’s adop-
tion of the subject position of monstrous feminine, drawing on interviews we
have conducted with women who self-diagnose as ‘PMS sufferers.’ We the-
orize women’s self-positioning as subjectication, wherein women take up
cultural discourse associated with idealized femininity and the reproduc-
tive body, resulting in self-objectication, distress, and self-condemnation.
However, women can resist negative cultural constructions of premenstrual
embodiment and the subsequent self-policing. We describe the impact of
women-centered psychological therapy which increases awareness of embod-
ied change, and leads to greater acceptance of the premenstrual body and
greater self-care, which serves to reduce premenstrual distress.
© The Author(s) 2020
C. Bobel et al. (eds.), The Palgrave Handbook of Critical Menstruation
Studies, https://doi.org/10.1007/978-981-15-0614-7_19
216 J. M. USSHER AND J. PERZ
Unraveling PMS: Pathologizing FeMininity
and the FecUnd Body
It is estimated that around 8–13% of women meet a PMDD diagnosis each
month, with around 75% meeting the lesser diagnosis of PMS—the same
conglomeration of symptoms, just experienced to a lesser degree (Hartlage
et al. 2012). However, the very notion of premenstrual change as deserving
of diagnosis, and the inclusion of PMDD in DSM-IV, has met with wide-
spread feminist opposition (Cosgrove and Caplan 2004). Feminist critics have
dismissed this process of pathologization, arguing that premenstrual change is
a normal part of women’s experience, which is only positioned as “PMDD”
or “PMS” because of Western cultural constructions of the premenstrual
phase of the cycle as a time of psychological disturbance and debilitation
(Chrisler 2004; Ussher 1989). This view draws on broader post-modern
debates in critical psychology and psychiatry where all forms of mental illness
or madness are positioned as social constructions that regulate subjectivity,
disciplinary practices that police the population through pathologization
(Fee 2000; Ussher 2011).
The process by which women take up the position of abjection person-
ied, where premenstrual change is pathologized, and the fecund body is
positioned as the cause of distress, can be described as a process of subjecti-
cation (Ussher 2003, 2006). The regimes of knowledge circulating within
medicine, science, and the law, which are reproduced in self-help texts and
the media (Fahs 2016; Bobel 2010; Chrisler and Caplan 2002), provide the
discursive framework within which women come to recognize themselves as a
‘PMS sufferer.’
In this vein, attention has been paid to women’s internalization of the
idealized ‘good wife and mother,’ combined with over-responsibility within
the home, which can result in a pattern of self-silencing and self-sacrice,
leading to psychological distress. For some women, this self-silencing can
lead to a build-up of emotion that erupts premenstrually (Perz and Ussher
2006; Ussher 2004). However, expression of anger or discontent is pathol-
ogized because women are deemed ‘out of control,’ resulting in legitimate
emotion being dismissed as ‘PMS’ (Ussher and Perz 2013a, 2010). The
self-positioning as PMS sufferer acts to maintain and reproduce the bound-
aries of femininity, with women judging themselves as bad, mad, or insane in
relation to the ideal (Ussher 2006, 2011; Chrisler 2011).
diSciPlining the UnrUly Body: concePtUalizing
PreMenStrUal eMBodiMent
The positioning of woman as closer to nature, with subjectivity tied to a
body deemed to be unruly or inferior, necessitating discipline and contain-
ment (Bordo 1990), is central to women’s subjectication as PMS sufferers.
19 RESISTING THE MANTLE OF THE MONSTROUS FEMININE … 217
The bio-medical model which dominates research and treatment on PMS and
PMDD, implicitly positions women’s difference and deciency as inevitable,
and open to bio-medical ‘intervention’ (Ussher 2006). Thus in 1931, when
‘Premenstrual Tension’ rst appeared in the medical literature, it was attrib-
uted to the ‘female sex hormone’ estrogen and regulated through correction
of hormonal ‘imbalance’ (Frank 1931). In the intervening years, many dif-
ferent bio-medical theories of premenstrual symptomatology have been put
forward, which have led to the adoption of a range of pharmacological inter-
ventions, with serotonin-reuptake inhibitors (SSRIs) currently recommended
as “rst line treatment” for PMDD (Ismaili et al. 2016).
At the same time, a gamut of psychological theories have been proffered
to explain premenstrual distress, leading to the endorsement of Cognitive
Behavior Therapy (CBT) as an effective solution (Kleinstäuber, Witthöft,
and Hiller 2012). The body has a somewhat peripheral presence within this
model of PMS, with distress assumed to arise from ‘cognitive distortions,’
and interventions focusing on women’s psychological reappraisal of emo-
tional and behavioral change premenstrually, alongside the development of
behavioral coping mechanisms (Blake 1995). Common to both bio-medical
and psychological models is that embodied change is positioned as a ‘symp-
tom’ of PMS or PMDD, a material manifestation of disorder within. This is
expressed as premenstrual bloating, swelling, breast tenderness, joint or mus-
cle pain, headaches, and for some women, diarrhea and hot ushes (Endicott
and Harrison 1990). However, such change has to be accompanied by a
psychological ‘symptom,’ such as depression, anxiety or anger, to warrant
diagnosis of a premenstrual ‘disorder’ (American Psychiatric Association
2013), implicitly positioning the body at the periphery of diagnosis of
premenstrual disorders (PMDs).
reSearching PreMenStrUal eMBodiMent: PoSitiviSM verSUS
critical realiSM
Psychologists have made some attempt to examine the nature and func-
tion of embodied premenstrual change, reporting that body image ‘dis-
tortion’ and body dissatisfaction is higher in the premenstrual phase of the
cycle in the ‘normal’ female population who don’t self-position as PMS suf-
ferers (Kaczmarek and Trambacz-Oleszak 2016; Teixeira et al. 2013; Jappe
and Gardner 2009; Carr-Nangle et al. 1994; Racine et al. 2012). In those
women who do present with PMDs, levels of premenstrual symptom severity
have been reported to be associated with body image disturbance (Muljat,
Lustyk, and Miller 2007) and with body dissatisfaction (Kleinstäuber et al.
2016). Conducted through survey methods, which correlate menstrual cycle
phase or premenstrual distress with perception of body size or body satisfac-
tion, this body of research has proven inconclusive in determining whether
“body dissatisfaction or a disturbed body image are vulnerability factors for,
218 J. M. USSHER AND J. PERZ
or consequences of premenstrual complaints” (Kleinstäuber et al. 2016, 761).
This particular question, and the body of correlational research that informs
it, is framed within a positivist epistemological standpoint (Keat 1979), which
understands causality in terms of antecedent conditions and general laws gov-
erning phenomena, and utilizes the scientic method—in this case stand-
ardized survey instruments and statistical analysis—to ‘objectively’ examine
variables of interest (Ussher 2005). What is absent from this analysis is the
meaning and experience of embodied change from the perspective of women
who inhabit the unruly premenstrual body, in the context of broader con-
structions of femininity and embodiment.
Feminist social constructionists have provided insight into the role of cul-
tural discourse in the pathologization of the premenstrual woman (Chrisler
2004), as outlined above. However, social constructionism has been crit-
icized for ignoring the “real” (Speer 2000), and marginalizing experience
outside of the realm of language, in particular embodiment (Sims-Schouten,
Riley, and Willig 2007). This is problematic, as a substantial proportion of
women do perceive or experience emotional changes during the premenstrual
phase of the cycle (Nevatte et al. 2013; Ussher and Perz 2013a, 2013b), as
well as corporeral changes, including water retention and bloating (White
et al. 2011), of that there is no doubt. It can also be seen to negate embod-
ied or psychological change across the menstrual cycle, or other mate-
rial aspects of women’s existence that may be associated with their distress
(Ussher 2005).
A critical realist epistemology (Bhaskar 1989) allows us to acknowledge
the materiality of change across the menstrual cycle, including changes in
corporeality, mood, or women’s perception of embodied change, but also
conceptualize this materiality as mediated by culture, language and politics.
Described as a material-discursive standpoint (Ussher 2008b), critical realism
has been positioned as a way forward for research examining embodiment in
a sociocultural context (Williams 2003).
In the remainder of this chapter, we adopt a critical realist epistemology
and a material-discursive framework to explore the implications of changes
in premenstrual embodiment, and constructions of the idealized feminine
body, on women’s acceptance and resistance of the position of the mon-
strous feminine. We do this through drawing on interviews with women who
self-identied as PMS sufferers, collected as part of a study examining the
efcacy of a women-centered psychological therapy for moderate to severe
premenstrual distress (which we henceforth dene as PMS), the methodol-
ogy and results of which are presented elsewhere (Ussher and Perz 2017). In
summary, we interviewed 83 women, average age 35, who reported moder-
ate-severe PMS, conrmed by three months of daily diary completion, about
their subjective experience of premenstrual change. In the accounts below, we
examine women’s experience of premenstrual embodiment, prior to and after
taking part in the psychological therapy.
19 RESISTING THE MANTLE OF THE MONSTROUS FEMININE … 219
inhaBiting the aBject PreMenStrUal Body
“I Feel Fat and Ugly and Hate Myself”: Self-Objectication
and Dehumanization
The majority of women we interviewed reported negative feelings toward
their bodies, and by implication their very selves, when they were premen-
strual, describing themselves as “fat,” “ugly,” “a blimp,” “gross,” “frumpy,”
“sluggish,” “disgusting,” “lumpy,” “sludgy,” and “unattractive.” In these
accounts, negative feelings were attributed to perception of embodied change
premenstrually, such as “bloating,” “tenderness in the breasts,” and “breasts
that feel bigger,” illustrated in the example below.
I’m more bloated my boobs are already big so they’re heaps bigger, my stom-
ach’s swollen and generally I feel quite puffy and uid lled so I wouldn’t say I
feel particularly attractive at that time.
This bloating and self-positioning as “fat” was associated with perception of
premenstrual weight gain. Women told us: “Two kilos goes on and it just
makes me feel like crap, puffy in the face and round the guts, like right
around my abdomen just puffs up”; and “physically I just feel about ve
times heavier than normal and bloated.” Women explicitly described these
changes as acting to annihilate their “self-condence,” “sense of being attrac-
tive,” and “self-esteem”—their very sense of self as a woman. As one partic-
ipant told us: “Yes I hate myself, I don’t have any self-condence and don’t
even want to look in any mirror.” In contrast, women said that they felt “less
concerned” about their bodies, or positioned them as “OK,” when they were
not premenstrual.
These accounts suggest a form of self-objectication (Fredrickson and
Roberts 1997), wherein women have internalized a critical gaze that nds
them wanting, because the “bloated,” “fat” premenstrual body does not con-
form to the slim, contained, and feminine ideal. Similar accounts of surveillance
and internalized judgment, have been found in interviews with women who
position themselves as “overweight” or “obese” (Tischner 2013). Women’s
body fat is discursively positioned as ugly and stigmatizing within western
culture, associated with loathing, disgust, and revulsion (Lupton 2013), with
women expected to discipline and regulate the body, and thus the self, to main-
tain a slim, contained form (Chrisler 2011; Bordo 1993). Body fat is posi-
tioned as both a threat to health and morality (Lupton 2013), with “excess” fat
a sign of women “letting themselves go” at both levels (Chrisler 2011, 205).
Many women reported a disruption in their normal patterns of dietary retraint
or “healthy eating” premenstrually, feeling “desperately in need of chocolate,”
or “down and depressed so I’d eat blocks of chocolate and chips.” It is thus
not surprising to nd that women experience distress and self-loathing in rela-
tion to perceptions of a “fat” premenstrual body that “takes up more space.”
220 J. M. USSHER AND J. PERZ
Hatred of the fat body, and by implication the self, was evident in many
women’s accounts, with animalistic metaphors often being used. For
example, “I feel like an elephant, very unattractive”; “I look at myself and
I go ‘You big fat pig,’ I hate it”; “you’re feeling revolting in yourself . . .
you don’t feel as feminine. I look like a dragon”; “I feel like a whale and
hate my body during this time”; and “I feel like a frog . . . heavy, bloated,
slow and lethargic.” Animal metaphors are associated with dehumanization
(Haslam, Loughnan, and Sun 2011) and social exclusion (Andrighetto et al.
2016), signifying a base and immoral nature, that lacks agency and rational-
ity (Haslam 2006). Women who are animalized are positioned as creatures of
emotion, nature and desire, and inferior to men (Tipler and Ruscher 2017),
with pig and whale metaphors, in particular, signifying depravity (Haslam,
Loughnan, and Sun 2011). Such dehumanization is also associated with the
objectication of the female body (Morris, Goldenberg, and Boyd 2018),
and thus self-positioning as animalistic serves to both denigrate the reproduc-
tive body and reinforce women’s self-objectication during the premenstrual
phase of the cycle. As the specic animal metaphors used by women signify
fatness, self-hatred of premenstrual embodiment cannot be separated from
the all-powerful cultural hatred of fatness.
“I Feel Really Exposed”: Concealment and Separation of Self from the
Unruly Premenstrual Body
People go to great lengths to distance themselves from or conceal their own
‘beastly’ animality (Haslam, Loughnan, and Sun 2011) or ‘creatureliness’
(Goldenberg et al. 2001). In this vein, visibility, and invisibility was central to
the disciplining of the uncontained premenstrual body, associated with fear of
surveillance from others, as well as constant self-surveillance. Many women
attempted to conceal the premenstrual body from the critical gaze of others,
reporting wearing “baggy clothes,” “different clothes,” “never leaving the
house,” or “staying away from the beach.” This wasn’t positioned as a form
of coping or self-care in the face of discomfort—strategies that can reduce
premenstrual distress (Ussher and Perz 2013b), but rather as a concealment
of premenstrual abjection, and a resignation to making “less effort,” all of
which appeared to serve to add to women’s distress.
I do denitely feel bloated probably around that time, and so I won’t wear the
same clothes, I’ll wear more frumpy sort of clothes and then I don’t feel as good
about myself as well. And that probably adds a little bit to the negative moods.
Women’s attempts to conceal the fecund body reects internalization of
the discourse of the reproductive body as unclean and a source of pollu-
tion (Ussher 2006), which contributes to menstrual stigma and shame
(Johnston-Robledo et al. 2007; Chrisler 2011). As one woman told us:
19 RESISTING THE MANTLE OF THE MONSTROUS FEMININE … 221
I feel that others are able to see my bloated stomach and recognise in me that
I’m walking around premenstrual. It’s like I’m carrying an extra burden of
woman-ness around and I feel really exposed by that.
Another woman said “I change how I dress because I don’t want to
draw attention to the fact I’m about to bleed.” Concealment of biolog-
ical functioning is part of women’s bodywork (Roberts 2004), and thus
self-objectication serves as a “ight from corporeality” (Goldenberg et al.
2001) that ‘thingies’ the premenstrual body and separates it from the self.
For many women, concealment was also focused on hiding “large,” “swol-
len,” “problematic breasts,” that “go up a bra size.” For example, “my
breasts arrive a long time before I do if I’ve got PMS . . . I can be really
self-conscious and embarrassed about it, so I try to cover it up”; “I feel my
tits are so big that I can’t put them in a particular shirt. So I’ll want to hide
them.” These accounts reect the positioning of a woman’s breasts as sig-
niers of feminine sexuality (Young 1992), with large breasts associated
with greater sexual objectication of women on the part of men (Gervais,
Holland, and Dodd 2013). This can result in women feeling that they are
constantly under surveillance and that their large breasts make them more
noticeable and visible than other women (Millsted and Frith 2003). Whilst
some women feel ‘more attractive’ as a result of premenstrual breast changes
(King and Ussher 2013), or having large breasts (Millsted and Frith 2003),
the accounts of women we interviewed reect the greater body shame and
social physique anxiety associated with an anticipated male gaze and objecti-
cation (Calogero 2004).
“I Feel Betrayed by My Body”: Condemning Premenstrual Corporeality
Implicit in accounts of premenstrual embodiment is a body outside of the
woman’s control, undermining idealized femininity, wherein self-control
is expected of ‘good’ women (Chrisler 2008). This was evident in accounts
where women described the premenstrual body as a separate entity that was
“doing” something to them, as evidenced in the following account: ‘I hated
my body very much for what it did to me . . . By ‘hating my body for what
it did’ I mean everything, not just the physical effects.” In this vein, many
women condemned and further separated themselves from the premen-
strual body, reporting feeling “betrayed,” “disappointed,” or “let down”
by embodied changes. The ‘out of control’ premenstrual body is both posi-
tioned as cause of the woman feeling “fat” and “abby,” but also cause of her
unruly emotions, illustrated in the example below.
I tend to put on a little bit of weight and stuff during that time too. So that
makes me angry, because I am upset about that, and then I tend to take it out on
other people.
222 J. M. USSHER AND J. PERZ
The body is also implicated more broadly as a cause of premenstrual distress,
described variously by women as caused by “crazy hormones,” a “biological
process” and “illness”:
I don’t have control over how many hormones are ying about in my body, or
anything like that.
I feel like my hormones are not balanced, like they’re completely out of whack.
And – and then the brain whatever function. I denitely feel that it’s, for it’s
biological, you know, affecting the way I think and feel.
The unruly premenstrual body therefore stands as a double assault on femi-
ninity—abhorrent, animalistic, fat, and “taking up more space,” as well as out
of control—the embodiment of the monstrous feminine (Ussher 2006). If
women see themselves as uncontained and at the mercy of raging hormones
or fatness, they position themselves as being attacked from within. The body
becomes further objectied, alien to the woman, something that is acting
against her (Ussher 2006). This blaming of the body may appear to func-
tion to exonerate the woman from judgments that attack her sense of self,
as her abject corporeality and emotional transgressions are split off and pro-
jected onto a pathological condition, over which she has no control. Yet, as
the focus of this projection is the reproductive body, which is implicitly posi-
tioned as disordered, unruly, and deviant, the outcome of this self-policing is
a direct assault on the woman’s corporeality (Ussher 2011). As Joan Chrisler
argues, the fear of loss of control, and worry that others think we are out of
control, serves as a form of “internalized oppression” that acts to “enforce
gender roles and keep women from developing authentic selves” (Chrisler
2008, 8). However, this is not an inevitable process. Women can experience
and acknowledge changes in premenstrual embodiment, without fear of loss
of control or denigration of the self. The pull of the monstrous feminine can
be resisted or reframed.
reFraMing PreMenStrUal eMBodiMent: reSiSting the PoSition
oF MonStroUS FeMinine
The women we interviewed all reported embodied change during the pre-
menstrual phase of the cycle. However, these changes are not ‘pure,’ some-
how beyond culture, beyond discourse. They are not simply caused by the
reproductive body, by a syndrome called ‘PMS.’ And they are not inevitably
experienced as distressing or problematic. It is important to acknowledge
women’s agency in negotiation of premenstrual change, and their ability to
cope and make sense of premenstrual corporeality (Ussher and Perz 2013b).
For example, let us examine the debate about the reality of increases in
body weight or “dimensions” during the premenstrual phase of the cycle.
One study reported that whilst women reported premenstrual bloat-
ing, “objective” measurement could nd no change, and the “discrepancy
19 RESISTING THE MANTLE OF THE MONSTROUS FEMININE … 223
between the perceived body size and the actual body size (perception error)
was signicant” (Faratian et al. 1984). This may suggest that women are
experiencing a “distortion of body image” premenstrually, a change in how
they construct and position the body, rather than a material change in the
body. Many women we interviewed appeared to construct embodied change
in such a manner, aware that such change was more perceptual than material,
and even describing corporeal self-condemnation as “irrational,” as evidenced
by the following extracts:
Yes. I feel unattractive. I know I still look the same – it is all in my mind but that
doesn’t make me feel any better. I feel fat. I also will dress differently at that
time of the month.
I see all faults and feel that they are larger than they are (that is, my stomach,
thighs) to the point that I can’t stand to look at myself.
Some women told us that their partner reassured them that they “look as
good today as you do any other time,” but this had no impact, in the face
of their “inner critic,” which led one woman to say: “I feel fat. I feel ugly,
I feel unattractive, unwanted. I feel really paranoid.” In these accounts,
women are both undermining the legitimacy of the embodied change that
is the focus of their self-condemnation, and at the same time reinforcing
self-criticism, by positioning hatred of the body as “irrational” or “paranoia,”
a manifestation of the pathology that is “PMS.” However, women are also
demonstrating awareness that they are perceiving the premenstrual body as
“fat and ugly” and taking up the subject position of monstrous feminine
as a result of this perception, which opens the door to the possibility of a
reframing of both embodiment and the premenstrual self. This awareness is
the rst step in developing strategies of self-acceptance and self-care, and as a
result, resisting self-objectication and self-positioning as the monstrous fem-
inine (Ussher and Perz 2013b). It is a process that can be facilitated through
women-centred psychological therapy.
Social constructionist and feminist critics have sometimes been critical
of psychological ‘intervention,’ positioning it as a disciplinary practice that
engenders self-policing through therapy, following a process of pathologiza-
tion (Fee 2000; Foucault 1979; Ussher 2011). Women are told by experts
within the ‘psy-professions’ others that they have a problem, and are then
effectively positioned within the realm of psychiatric diagnosis and treatment,
with all the regulation and subjugation that this entails (Ussher 2013).
However, we believe it is possible to simultaneously acknowledge the reg-
ulatory power of discourse and the role of the medical and psy-professions in
women’s subjectication, at the same time as recognizing the very real exist-
ence of distress, and the embodied or psychological changes women them-
selves experience associated with the fecund body. In order to do this, we
have been involved in the development and evaluation of a non-pathologizing
224 J. M. USSHER AND J. PERZ
means of therapeutic support for women which acknowledges individual
agency and the complex negotiations women engage in as they make sense of
premenstrual change, with the aim of facilitating the adoption of strategies of
self-care and coping (Ussher 2002). Drawing on both a narrative re-authoring
framework (Guilfoyle 2014), and cognitive-behavioral models of PMS (Blake
1995), the specic aims of the therapy are to critically examine cultural con-
structions of femininity and PMS and how they impact women’s premenstrual
symptoms; to valorize women’s expertise regarding their subjectivity and their
bodies; to provide a non-pathologizing space for women to tell their story
of PMS; to examine individual narrative constructions of PMS in the context
of women’s lives; to help women reframe their narrative to reduce distress;
to identify and challenge negative cognitions associated with the body and
with PMS; to examine perceptions of stress and of premenstrual symptoms
to develop coping strategies for dealing with distress; and to encourage asser-
tiveness and self-care throughout the cycle. This therapy has been found to be
effective in signicantly reducing premenstrual distress in a face to face one-
to-one (Hunter et al. 2002) and couples format (Ussher and Perz 2017), as
well as through self-help (Ussher and Perz 2006). In the face to face format,
women discuss these issues with a therapist, over six to eight sessions, and
engage in homework, such as doing things they enjoy, taking time-out, mak-
ing note of the thoughts associated with premenstrual change and how these
thoughts inuence behavior, and practicing assertiveness. In the self-help for-
mat women are given information and exercises to practice at home.
Reevaluation of premenstrual embodiment is core to reduction in dis-
tress following this therapy (Ussher and Perz 2017; Ussher 2008a). In
post-therapy interviews with women, we found marked reduction in reports
of feeling “fat and ugly,” or the use of animalistic metaphors. For example,
women said “I don’t feel bad about my body now. I couldn’t care less about
it now” and “I don’t really have any negative feelings about my body any-
more.” This was associated with greater acceptance and understanding of
embodied change, with less attention being paid to aspects of the body that
had previously caused distress:
What used to bother me before – bloating and not liking what I saw in the mir-
ror, now doesn’t seem to bother me as much, I do not dwell on it as much as I
did before.
There were also accounts of awareness that such changes are normal and tran-
sitory, rather than a sign of pathology: “I know it’s temporary and I know it’s
hormones and I know I’m bloated, so I’m not having as many issues with that.”
Awareness of cyclical changes facilitated self-care: “I’m very aware of it
when it is in the calendar and I can actually work my way around that with
the knowledge that I might need a couple of days of rest, that I didn’t used
to do, and now I do.” The development of active coping skills to deal with
premenstrual changes included self-talk to reduce premenstrual negative
19 RESISTING THE MANTLE OF THE MONSTROUS FEMININE … 225
moods, avoidance of conict, changing perceptions of premenstrual emotion,
and recognition of premenstrual needs: “taking the time-out to recognise
my own needs has been very useful.” Active engagement in coping strategies
which focused on “looking after my body” or “feeling better about my body”
included taking time to rest, engage in activities women enjoyed, exercise,
meditation, improved diet, and reduction in alcohol and caffeine, illustrated
in the example below.
Physically I need a bit more rest is the main thing, um, so that’s – that’s a posi-
tive thing that it gives me that time to just slow down a bit and, um, have some
time for myself. Like trying to do nice things for myself and do things that will
make me feel good.
These self-care and coping strategies were reported to have a benecial effect
on women’s moods, and their ability to control the experience and expression
of negative emotion, resulting in signicant reductions in premenstrual dis-
tress (Ussher and Perz 2017).
This form of psychological intervention does not remove premenstrual
changes, but it can reduce and de-pathologize them, empower a woman to ask
for appropriate support, and give her a greater sense of agency in relation to
her body. This is no longer a passive docile body which requires medical man-
agement, but a body (and mind) which is positioned as being understood and
accepted, potentially resulting in self-perceived “growth” through self-care:
I am more sensitive around that period of time and I’m more susceptible
to having old emotions and feelings that need to come up to leave me, but if
I process it in the right way, it’s a positive (and I’ve had) some growth out of it
. . . I just think the self-care thing is a really big one for me, yeah.
Because of this, the majority of women reported that they felt condent that
they could understand, and live with, their premenstrual changes, describing
themselves as more “empowered,” “energetic,” and “creative” as a result.
This is a movement away from the model of self-sacricing femininity found
to be associated with premenstrual distress (Ussher and Perz 2013a) to what
has been described as a “mature model of care” (Pettersen 2012, 378), which
acknowledges the importance of reciprocity and equality, and where self-care
is be incorporated with care for others.
conclUSion
This form of women-centered psychological support can be effective in sup-
porting women in the process of moving from an abject to an agentic sub-
ject position, without positioning her as needing to be managed, or her body
as an unruly vessel that needs to be contained by experts (Ussher 2008a).
‘PMS’ is no longer positioned as an out of control illness, rather, as a label
226 J. M. USSHER AND J. PERZ
that makes sense of women’s experience of psychological or embodied change
in the premenstrual phase of the cycle (Ussher and Perz 2014). Women can
resist the discursive positioning of the premenstrual woman as the epitomy of
the monstrous feminine through positioning premenstrual emotions as “nat-
ural” or a reection of “true feelings” about domestic, relationship or work
issues, and embodied changes as something that can be understood and toler-
ated. This adoption of a PMS as normal/natural discourse served to facilitate
women adopting an agentic position in relation to coping, through avoidance
of stress and conict, care of the self, and escaping relational demands and
responsibilities (Ussher and Perz 2014). It can also function to engage part-
ners in support, or facilitation of a woman’s self-care (Ussher and Perz 2017).
The body is central to this resistance of the monstrous feminine, as women
can accept and acknowledge embodied change and psychological vulnerabil-
ity, and even maintain the self-positioning as ‘PMS sufferer,’ without deni-
grating or pathologizing the body or the person.
This is analogous to the “tight-rope talk” identied by Sue
McKenzie-Mohr and Michelle Lafrance, wherein women construct them-
selves as both “agents and patients: both active and acted upon” (McKenzie-
Mohr and Lafrance 2011, 64), enabling women to take credit for agency in
coping and deect blame for “having” PMS. McKenzie-Mohr and Lafrance
(2011) describe this adoption of a “both/and” position as enabling the
re-authoring of emancipatory counterstories, which serve to challenge
the oversimplication of “either/or” binaries, where women are “agent
or patient,” “powerful or powerless”; or in the case of PMS, premenstrual
sufferer or non-sufferer/coper. As Catrina Brown (2007, 275) has argued,
this “both/and” position “honors women’s agency and power while not
minimizing the impact of oppressive social discourses and social relations.”
This allows us to both acknowledge the materiality and discursive construc-
tion of premenstrual distress, and women’s agency and power in understand-
ing and coping with premenstrual change. It also allows us to acknowledge
the complexities in women adopting the subject position “PMS sufferer,”
which both evokes connotations of the monstrous feminine and makes mean-
ing of women’s distress, through legitimizing their experiences as ‘real’ and
as something that may require support. The reproduction and resistance of
discourses associated with premenstrual embodiment are thus overlapping,
rather than being discrete and separate processes (Day et al. 2010), and offer-
ing women-centered therapy for ‘PMS’ is not a form of regulation, but a fem-
inist endeavor acknowledging women’s need for understanding and support.
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