Christine Carter, PhD, reads her articles

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  How to Disappoint People 17.09.2026 7นาที

  I have spent my life making a concerted effort not to disappoint others, starting with my well-meaning worrywart mama. She passed away in 2023; that same year, I went through medical menopause thanks to breast cancer. Estrogen deprivation and grief handed me a valuable membership to the “we do not care” club; I finally felt like I had permission to prioritize self-care.At first, I chalked it up to the clarity that arrives when you bury your fiercest champion and face your own mortality in a single brutal year. But there’s both a biology and a sociology to it.Estrogen amplifies the brain’s bonding chemistry, which may help explain why many women spend their reproductive years finely tuned to others’ needs. As estrogen declines in midlife, the hold that chemistry has on us may loosen.Midlife is also when the roles that demanded all that attunement start to change: kids leave the nest, parents pass away, and we have more time to focus on other things. Our behavior shifts: one of the longest-running studies of women’s lives found that women exhibit rising social dominance, assertiveness, and self-confidence in midlife.Declining estrogen also brings wrinkles, sagging skin, weight gain, and greying, thinning hair. All our lives, we’ve been appraised by how we look, and many of us have spent staggering amounts of time, money, and energy trying to measure up, whether or not we ever felt we did. In midlife, the spotlight shifts dramatically to younger women. Invisibility stings, but it’s also liberating. When nobody’s watching, we can stop performing. We can value ourselves for all the things that matter so much more than looking young, things we actually have by now: crystallized intelligence, self-compassion, relationships that have lasted decades, and a lifetime of experience.A core theme across decades of interviews with women in their 40s and 50s has been that menopause is a turning point when women describe finding their voices and giving themselves permission to take care of their own bodies and needs rather than everyone else’s. Margaret Mead is said to have had a name for it: “postmenopausal zest.” I’m telling you, I’m really feeling that.Although I formally gave up people-pleasing the way some people give up addictive substances in 2016 (see this TEDx Talk about truth-telling), before I was diagnosed with cancer, I still found it challenging to put my own needs, especially those related to food, rest, and exercise, ahead of others. But now the biological and sociological currents are running in my favor.Joining the “we do not care” clubFor most of my life, I held an unconscious belief that I should be able to do it all, meeting my own needs and everyone else’s expectations. (I am a classic eldest daughter.) When someone didn’t get what they needed or wanted from me, I felt responsible for their disappointment. I’d scramble to fix it, smooth it over, and make both my discomfort and theirs go away.What I see now is that disappointing people is simply what happens when a person tells the truth about their limits. The reality is that no matter how productive we are, how much we work smarter (and, let’s be real: longer and harder), or how fabulous our time management and prioritization are, time is a non-renewable resource. There are only ever 24 hours in a day. That’s just reality.When we disappoint people by not giving them everything they hoped for, it isn’t a failure of our generosity, character, or ability. It’s a feature of our honesty about the limits of time.So when we disappoint people by not giving them everything they hoped for, it isn’t a failure of our generosity, character, or ability. It’s a feature of our honesty about the limits of time. When we skip sleep, exercise, or meaningful work just to check something off someone else’s list, something very real in us dies. Avoiding others’ disappointment is a costly effort paid for in resentment, anxiety, and exhaustion. I believe both my mother and I paid for it with our health: she with the ovarian cancer that killed her, and me with the breast cancer I developed while raising four kids and working full-time for a startup from my mom’s hospital room.Not being able to do it all doesn’t mean that we should try to expand our capacity to do more. The core skill here is to give yourself permission to take care of yourself, even if it means disappointing others.How to give yourself permissionThere’s no single moment when we finally give ourselves permission to prioritize our own needs. It’s something we renew, quietly, over and over. Here’s how to start.1. Take inventory.Ask yourself: Am I sleeping enough to be present with the people I love? Am I moving my body enough to stay in the game? Am I feeding myself well enough to think clearly? Am I doing the things that bring me joy and fulfillment? Do I have time to relax? To see my friends and the people I love? If the answer is no anywhere, identify your core unmet needs and start thinking about what will need to give—and who will be disappointed when it does—for you to meet them.2. If you feel guilty for taking care of yourself, recognize what that means.It does not mean that you’re lazy or that you’ve done something wrong. I know you know this, but self-care isn’t selfish. Self-care is what makes it possible to keep supporting others over the long run. When you feel guilty for going to bed instead of calling your mother-in-law, or careless for exercising instead of getting to work early, that feeling isn’t information about your character. It’s a learned response running quietly in the background. Once you label it an old alarm trained on the wrong danger, it will no longer carry the same weight.3. Practice self-compassion.When self-compassion increases, guilt about prioritizing self-care tends to decrease, and healthy behaviors follow. Higher self-compassion predicts better sleep, eating, exercise, and overall health behaviors.4. Write yourself a permission slip.At Annosa Health, I help women get into new, healthy habits, and corny as it is, the first thing we do is fill out a permission slip: “I authorize myself to [fill in the blank], even if I feel like I “should” be doing something else.” It helps because it names the specific thing you keep almost doing, the one you really intend to do but never quite let yourself do. Spelling out the specific behavior AND the obstacle it will bypass — “I will do X, even when Y feels louder” — roughly doubles follow-through compared to good intentions alone.5. Start small.Practice saying no to something relatively minor: decline an optional coffee, leave a dinner party a little earlier than you feel you should, don’t respond to a text within the hour. Watch what actually happens. We tend to be wrong twice: we overestimate how disappointed other people will feel, and also how long they’ll feel it. People move on faster than we imagine.When you tell someone you can’t do something, you’re trusting them to accept the truth that you are human, living in a material world where time is limited. Their disappointment is real. You can handle it, and they can too.This is the practice. Consciously choose your own core needs and highest priorities first, rather than deferring to others’ requests or expectations. It’s what membership in the “we do not care” club actually looks like: not indifference to the people you love, but honesty about your priorities given the finite nature of time.Every Thursday, I post a research-based essay for people in the middle of life about how to live well in body, brain, and spirit. No supplement links, no 2+ hour podcast, no promise that you’ll make it to 120. If that’s the kind of well-being you’re after, subscribe.ResearchEstrogen and social bonding: Acevedo-Rodriguez, A., Mani, S. K., & Handa, R. J. (2015). Oxytocin and estrogen receptor β in the brain: An overview. Frontiers in Endocrinology, 6, 160.Personality change in midlife: Helson, R., & Moane, G. (1987). Personality change in women from college to midlife. Journal of Personality and Social Psychology, 53(1), 176–186.Helson, R., & Wink, P. (1992). Personality change in women from the early 40s to the early 50s. Psychology and Aging, 7(1), 46–55.Helson, R., Jones, C., & Kwan, V. S. Y. (2002). Personality change over 40 years of adulthood: Hierarchical linear modeling analyses of two longitudinal samples. Journal of Personality and Social Psychology, 83(3), 752–766.Bodily changes in menopause: Zouboulis, C. C., et al. (2022). Skin, hair and beyond: The impact of menopause. Climacteric, 25(5), 434–442.Viscomi, B., Muniz, M., & Sattler, S. (2025). Managing menopausal skin changes: A narrative review of skin quality changes, their aesthetic impact, and the actual role of hormone replacement therapy in improvement. Journal of Cosmetic Dermatology, 24, e70393.Crystallized intelligence: Hartshorne, J. K., & Germine, L. T. (2015). When does cognitive functioning peak? The asynchronous rise and fall of different cognitive abilities across the life span. Psychological Science, 26(4), 433–443.Self-compassion across the lifespan: Tavares, L., et al. (2026). Lifespan perspective on self-compassion: Insights from age-groups and gender comparisons. Applied Developmental Science, 30(3), 290–306.Women’s accounts of the menopause transition: Wood, K., et al. (2025). Women’s experiences and expectations during the menopause transition: A systematic qualitative narrative review. Health Promotion International, 40(1), daaf005.de Salis, I., et al. (2018). Experiencing menopause in the UK: The interrelated narratives of normality, distress, and transformation. Journal of Women & Aging, 30(6), 520–540.Morrison, L. A., et al. (2014). Voices from the Hilo Women’s Health Study: Talking story about menopause. Health Care for Women International, 35(5), 529–548.Self-compassion and self-care: Miller, C. L., & Strachan, S. M. (2020). Understanding the role of mother guilt and self-compassion in health behaviors in mothers with young children. Women & Health, 60(7), 763–775.Phillips, W. J., & Hine, D. W. (2021). Self-compassion, physical health, and health behaviour: a meta-analysis. Health Psychology Review, 15(1), 113–139.Making a specific plan: Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Advances in Experimental Social Psychology, 38, 69–119.Sheeran, P., et al. (2025). The when and how of planning: Meta-analysis of the scope and components of implementation intentions in 642 tests. European Review of Social Psychology, 36(1), 162–194.Predicting emotional reactions to future events, and why we’re often wrong about it: Wilson, T. D., & Gilbert, D. T. (2005). Affective forecasting: Knowing what to want. Current Directions in Psychological Science, 14(3), 131–134.Gilbert, D. T., et al. (1998). Immune neglect: A source of durability bias in affective forecasting. Journal of Personality and Social Psychology, 75(3), 617–638.Wilson, T. D., et al. (2000). Focalism: A source of durability bias in affective forecasting. Journal of Personality and Social Psychology, 78(5), 821–836.Photo by Spencer Plouzek on Unsplash This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com
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  Audio: What if the Most Powerful Drug We Have Isn't a Drug? 10.09.2026 6นาที

  Billy is one of my favorite people on the planet. My husband’s oldest and dearest friend; he and his daughters are family.Seven years ago, Billy had a heart attack. He was running his own business and had full custody of his two teenage girls; he was carrying an enormous amount of stress with nobody to tap out to.When my husband and I arrived at the hospital, Billy was awake and talking and was going to be fine, thank God. Given that hospital food is what it is, we offered to get him dinner.He brightened right up. Could we bring him a burger and fries?He was joking, of course, but ironically, the hospital food service delivered Billy a burger for dinner that night. This happens in hospital rooms every day, all over the country. An artery closes, a cardiologist opens it, everyone is relieved. No one is thinking that food might be part of the treatment starting right then.Three decades earlierIn 1990, a San Francisco cardiologist named Dean Ornish ran a small, strange, genuinely radical experiment. He took people with coronary artery disease and, instead of another procedure, gave them a program: a low-fat, whole-food, plant-based diet, moderate exercise, stress management, and a support group that met twice a week.When he remeasured their blockages a year later, they’d gotten smaller. Five years out, their arteries were still opening while the comparison group’s kept closing, and they’d had fewer than half as many cardiac events. None of them were on cholesterol-lowering drugs.The prescription we didn’t getWhen I was diagnosed with breast cancer, I got excellent treatment. I cannot say enough good things about my surgeon, my radiation team, my nurse navigator, and everyone who cared for me.But, like Billy, nobody handed me a prescription for how to live once my active treatment ended, or told me what might raise or lower my risk of recurrence. Nobody told me what the research says about physical activity after a cancer diagnosis, which is a lot, or what dose of it I’d need.Nobody treated my sleep, which was a disaster, as a clinical variable. Nobody asked about my stress, though I’d just lost my mother, was working full-time, and was living with my grieving father while we fixed up a new house the sellers called a “contractor’s special.” Nobody asked whether I had people to support me, or what I was eating on the days I could barely stand up. Nobody mentioned alcohol, which raises breast cancer risk even in moderation.Everything my doctors could do, they’d done. Like Billy, I walked out of a medical system into a life where the thing most likely to determine how long and how well I lived was my own behavior. I had no prescription, support or structure for that.Structure is surprisingly powerful medicineLifestyle medicine isn’t wellness, supplements, or an alternative to your doctor. It’s a board-certified medical specialty that uses behavior as treatment: nutrition, movement, sleep, stress management, social connection, and avoiding substances that hurt us. It treats both the cause and the symptom and can actually reverse disease.There are three categories of disease likely to determine how your last decades go. And in all three, lifestyle is both preventative and curative:Heart and metabolic disease. Heart disease kills more Americans than anything else, including 1 in 5 women, and Dean Ornish’s study has now been replicated many times over. We know definitively that lifestyle change can open clogged arteries. Medicare even reimburses an intensive cardiac program whose official name contains the phrase “Reversing Heart Disease.”Cancer. Across more than a hundred studies, people who move more after a cancer diagnosis live longer.Cognitive decline. In 2025, a trial put two thousand older Americans at risk for cognitive decline into a lifestyle program of exercise, diet, and cognitive challenge. Half got a structured version with frequent team meetings; half got the same information with far less support. Both groups improved, but the group with more structure, accountability, and a room full of other people doing the same thing improved more. Behavior change isn’t a knowledge problem. It’s a follow-through problem.Dose is keyTo be effective in preventing and treating disease, behaviors need doses, just as drugs do. We get a small dose of behavior change every January, and then are discouraged when it doesn’t fix us. If you started a new drug and only took it for the first week in January, would you expect it to work? When Dean Ornish used behavior changes to treat coronary artery disease, it was intensive work.If intensive lifestyle change can shrink the plaque inside our arteries, it’s worth asking what it can do for our midlife aches and pains, our exhaustion, our brain fog. Our nervous system that never powers down.That is why my coaching program, Annosa Health, prescribes behavior at a real dose, with the structure, accountability, and other people that research shows are active ingredients.Post ScriptWhen I brought my concerns about the lack of survivorship support in my breast cancer treatment to Dr. Rita Kwan-Feinberg, the Medical Director of Sutter Health’s Carol Ann Read Breast Health Center, she took them seriously.We’re now designing a clinical study together to test the Annosa Health program for breast cancer survivors, for women going through menopause, and for burned-out physicians. I’ll write about what we find here.Photo by Chris Ralston on Unsplash This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com
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  Audio: September is the New January 03.09.2026 9นาที

  5 power moves for forming a habit that sticks, none of which involve trying harder. The problem is never your discipline. I swear. The text version has a zillion links to all the research. Links to the further practices referenced are here:* If guilt is keeping you from giving yourself permission to take care of yourself, this practice can help.* If you’re worried about failing others, know that we’re reliably wrong about disappointing people, overestimating both how upset they’ll be and how long their disappointment will last. See also this post about how to disappoint others with grace.* Here’s a practice for dealing with discomfort and difficulty.* This post is about why a daily reflection builds the self-awareness we need to make changes or adopt a new habit. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com