The “Burn It Down” Urge in Perimenopause: What It Means and What to Do

PERIMENOPAUSE • April 25, 2026

Eleven Forty-Six P.M. and a One-Way Ticket to Lisbon

It’s 11:46 p.m. Noor, a partner at a global law firm, sits alone at her kitchen island. The house is quiet — just the steady hum of the refrigerator and the faint sound of her husband’s breathing from the bedroom down the hall. Her laptop is open, cursor blinking in an email draft she can’t bring herself to finish. Without fully deciding to, she opens a new tab. Pulls up a flight booking site. Types “Lisbon” into the search bar and selects a one-way ticket for tomorrow.

The screen refreshes. Her name appears in the passenger field, perfectly typed, as if it could be real. The price flashes back at her: $342. She stares at it for a long moment, imagining what it would feel like to click “confirm.” The cases she’s managing. The school pickup schedule. The parent-teacher conference she rescheduled twice. The husband who will wake up tomorrow expecting her to have answers for things she no longer understands. The version of herself she has been maintaining — competent, present, unshakeable — that is starting to crack at the seams.

She doesn’t click. She closes the window. Closes the laptop. The fantasy retreats for now, like a tide going out. But it will be back tomorrow night. And the night after that.

If you’ve had a version of this fantasy — the urge to leave your marriage, walk out of your career, disappear from every obligation that requires something of you — you are not alone. In my clinical work with driven, ambitious women navigating perimenopause, this fantasy is nearly universal. It shows up in CEOs and surgeons, in attorneys and academics and founders. It crosses income brackets and relationship structures and family configurations. And almost everywhere it shows up, it is misunderstood.

It gets labeled a midlife crisis. It gets dismissed as hormonal. It gets pathologized as instability. What it rarely gets is what it actually needs: serious, non-judgmental, clinically informed attention.

This post is that attention. Drawing on Jungian depth psychology, trauma-informed neuroscience, and over fifteen years of clinical work with driven women, I want to offer you a different framework for the “burn it down” urge — one that takes it seriously without treating it as a mandate. Because this fantasy is not a prescription. But it is, almost always, a message worth reading.

What Is the “Burn It Down” Fantasy?

Before going further, I want to be clear about what this fantasy is not. It isn’t suicidal ideation — which involves a genuine intent or desire to end one’s life and constitutes a clinical emergency. If you or someone you know is experiencing thoughts of self-harm, please contact the 988 Suicide & Crisis Lifeline immediately. The burn-it-down fantasy focuses on escape from roles and obligations, not from existence itself. If you’re unsure which you’re experiencing, please reach out to a clinician right away.

The burn-it-down fantasy is also distinct from dissociation — the experience of disconnecting from reality or from the self, often as a trauma-protective response. This fantasy is a conscious, vivid, imagined scenario. It’s active. It’s purposeful. It feels, in the moment, both monstrous and irresistibly appealing. That combination — the shame and the magnetic pull — is itself clinically important.

What makes this fantasy particularly significant in perimenopause is the convergence of neurobiological and psychic forces that perimenopause unleashes. The hormonal reorganization of this transition amplifies everything that was already simmering: old resentments, deferred needs, grief for unlived choices, accumulated exhaustion from roles that were never truly chosen and never truly fit. Perimenopause doesn’t create the dissatisfaction. It removes the buffer that was keeping it manageable.

The Neurobiology and Depth Psychology of Midlife Rage

James Hollis, PhD, Jungian analyst and author of The Middle Passage: From Misery to Meaning in Midlife, frames midlife not as a crisis but as a passage — a developmental threshold where the first adulthood’s agenda collapses, and the psyche demands a more authentic relationship with the self. The “burn it down” fantasy is one of the most visceral expressions of this demand. When it arrives in perimenopause, it arrives with additional force, because the hormonal shifts of this transition remove the neurochemical buffers — estrogen’s effects on serotonin, dopamine, and stress regulation — that previously helped contain what was pressing from below.

Neurobiologically, perimenopause is characterized by significant fluctuations in estrogen and progesterone that modulate neurotransmitter systems responsible for mood regulation, impulse control, and cognitive processing. Pauline Maki, PhD, professor of psychiatry and psychology at the University of Illinois Chicago and a leading researcher on perimenopause and cognition, has documented how estrogen variability during the menopausal transition heightens emotional reactivity and reduces the brain’s capacity to modulate stress responses — meaning that what was once contained is no longer contained. The limbic system — the brain’s emotional processing center — becomes more reactive. Irritability sharpens. Rage surfaces. The threshold for tolerance drops.

Rebecca Thurston, PhD, professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh and director of the Women’s Biobehavioral Health Research Center, has additionally documented how trauma history compounds this neurobiological vulnerability during perimenopause. Women with significant adverse life experiences show heightened stress reactivity, elevated inflammatory markers, and greater emotional instability during the hormonal transition — which can dramatically intensify the “burn it down” impulse in women who have, for decades, managed the accumulated weight of relational trauma, invisible labor, and emotional self-suppression. You can read more about this dynamic in the context of perimenopause trauma reactivation here.

The neurobiological and the depth psychological are not in competition here — they’re telling the same story from different angles. The shadow is rising. The limbic system is amplifying. The unspoken is becoming unspeakable to contain. And the psyche finds its voice in fantasy — in the vivid, electric image of the one-way ticket, the empty inbox, the life that doesn’t require anything more.

How the Fantasy Shows Up in Driven Women

What does the burn-it-down fantasy actually look like in the daily life of a driven, ambitious woman navigating perimenopause? Let me share two composite portraits from my clinical work.

Simone, a hospital Chief Medical Officer in her late forties, has spent a decade overseeing clinical operations for a major urban health system. She is known for her steadiness — the leader people turn to when the crisis is escalating and the room needs someone calm. For the past two years, she has ended every working day with the same vivid mental scenario: driving past the exit for her neighborhood and just keeping going. Past the city. Past the state. Somewhere with no pager, no performance review, no executive team who looks to her to hold the emotional climate of the entire organization.

In therapy, Simone made a discovery that changed everything. She didn’t want to leave medicine. She didn’t even want to leave her marriage. What she wanted — what she had never once been given permission to want — was to stop being the emotional caretaker for her husband’s anxiety. She was exhausted from absorbing his worry, managing his mood, and holding the space for his feelings while her own went unrecognized and unvoiced. The escape fantasy wasn’t about medicine or marriage. It was about the invisible labor that had accumulated under both — silently, over decades, with no name and no accounting.

Tessa, a tenured professor of law in her early fifties, had a different version. Hers arrived in the form of a recurring image: packing one bag, walking out of her office, and never explaining anything to anyone. Not leaving for somewhere else — just leaving. The fantasy was less about destination than about the silence on the other side of departure. What she craved, it turned out, was the absence of obligation. Not people, not work, not even her research — but the relentless being-needed-by that had become indistinguishable from her identity.

In my clinical work, the burn-it-down fantasy typically arrives with several consistent features: it’s vivid and specific; it brings a momentary sense of relief just in the imagining; it coexists with genuine love for or investment in the things it names abandoning; and it’s accompanied by significant shame. Women don’t usually tell their partners or colleagues about this fantasy because it feels monstrous in the context of the lives they’ve built. That shame, and that silence, is part of what makes it more powerful, not less.

What the fantasy is rarely about, in my clinical experience, is what it appears to be about. It’s rarely actually about leaving. It’s almost always about something that isn’t being spoken — and the fantasy is the psyche’s way of speaking it in the only language dramatic enough to be heard.

What the Fantasy Is Actually Encoding

When driven women bring the burn-it-down fantasy into therapy, one of the first things I do is slow it down. Not dismiss it — slow it down. Examine it. Because inside the vivid image of the one-way ticket or the packed bag, there is always a message. And the message is almost never “leave.”

What I hear consistently, underneath the fantasy, is a demand for power redistribution. The fantasy appears where power has been ceded, usually unconsciously, over a long period of time. In Simone’s case, it was emotional labor in her marriage. In Tessa’s case, it was the diffuse obligation to be available that had colonized her professional and personal identity. In both cases, the fantasy was pointing directly at the place where something fundamental had gone out of balance — and had stayed out of balance long enough to generate a survival-level response.

Clarissa Pinkola Estés, PhD, Jungian analyst, describes this dynamic with unusual precision. The “burn it down” urge emerges when the soul’s life — the authentic, instinctive, deeply personal life — has been lost, stolen, or systematically neglected. It’s the psyche’s wildfire: destructive in its imagery, but also clearing. It arrives to say that the current structure cannot hold what is real in you any longer. And the question isn’t whether to burn it down. The question is: what needs to change so that the fire becomes unnecessary?

James Hollis, PhD, identifies several recurring themes in the burn-it-down fantasy of midlife women: the longing for autonomy that was sacrificed in the service of relationship or role; the grief for the unlived life — the version of herself she set aside at 28 or 32 to become the version the marriage or career required; and the rage that accumulates when that sacrifice is not acknowledged, when the woman herself doesn’t acknowledge it, and when the people she loves and serves have no idea that anything was given up at all.

Rebecca Thurston, PhD, at the University of Pittsburgh, whose research focuses on trauma and the menopausal transition, has documented how perimenopausal women with histories of trauma show heightened awareness of injustice and power imbalances in their intimate relationships — a perceptual sharpening that perimenopause’s hormonal shifts often accelerate. What was tolerable before becomes intolerable now, not because the situation has changed, but because the buffer has been removed. This isn’t instability. This is the psyche finally getting loud enough to be heard.

In this sense, the burn-it-down fantasy carries enormous clinical value — when approached with curiosity rather than alarm. It’s a map of what has been suppressed, overextended, or denied. It’s the shadow’s demand for honest reckoning. And the therapeutic work is to follow it, slowly, into the territory it’s pointing toward — not to run after it with a match.

You might also find it useful to read about the perimenopause rage that often accompanies or precedes this fantasy, as they tend to arise from the same root system.

Both/And: The Fantasy Is Real Data AND the Action It Names Is Usually Wrong

The most important clinical frame I can offer for the burn-it-down fantasy is this: both things are true simultaneously. The fantasy is real, valid, meaningful data — AND acting on it literally is, in most cases, the wrong response. Not because the woman’s pain isn’t real. Not because the structures she wants to leave aren’t genuinely broken. But because the fantasy, taken as a literal instruction rather than a symbolic message, bypasses the actual work and often produces regret, isolation, and the same internal conflicts in a new external setting.

This is the both/and of individuation. James Hollis, PhD, is clear on this point: the escape impulse at midlife — the urge to flee the marriage, the career, the self — is almost never the path to wholeness. It’s a shadow eruption, not a life plan. The work is internal and relational. It requires staying — not in the old, unconscious way, but in a new, more honest, more boundaried way — and doing the inner reckoning that the fantasy is calling for.

This doesn’t mean that nothing should change. In my clinical experience, the burn-it-down fantasy almost always points toward something that genuinely needs to shift: a conversation that needs to happen, a need that needs to be named, a boundary that needs to be set, a role that needs to be renegotiated. Sometimes it points toward a relationship that has genuinely run its course. Sometimes it points toward work that is no longer aligned with who the woman has become. The both/and frame doesn’t require staying in untenable situations — it requires distinguishing between what genuinely needs to end and what the fantasy is using as a proxy for inner transformation.

Pauline Maki, PhD, at the University of Illinois Chicago, notes that the hormonal shifts of perimenopause sensitize the brain’s threat response systems, amplifying emotional reactivity and creating a neurobiological environment in which everything feels more urgent and more intolerable than it might otherwise. This is clinically significant for the burn-it-down fantasy, because it means the urgency of the fantasy is not a reliable guide to action. The action it calls for may be right. But the urgency itself is neurobiologically amplified — and decisions made in that amplified state benefit from therapeutic processing before implementation.

Noor — the woman from the opening scene — eventually brought her Lisbon fantasy into therapy. Over several months, we discovered that it wasn’t about Lisbon at all. It was about a marriage in which she had been the primary financial, logistical, and emotional manager for over a decade — without ever having explicitly signed up for that arrangement, and without her husband having any idea of the weight she carried. The work wasn’t leaving. The work was having the conversation she’d been deferring for eleven years, in a therapeutic context where it could be held carefully. The conversation happened. The marriage is being renegotiated. The Lisbon fantasy hasn’t disappeared — but it has become quieter, and she understands now what it was asking of her all along.

The both/and frame is particularly important for the perimenopause divorce rate, which research shows is notably elevated. Not every marriage needs to end. Not every departure from a career or a life structure is premature. But the quality of the decision matters enormously — and a decision made in the white-heat of a burn-it-down moment, without clinical support and honest introspection, is a much riskier decision than one made after the fantasy has been decoded and the genuine needs beneath it have been addressed.

The Systemic Lens: Silencing and the Cultural Script for Women Who “Have It All”

The burn-it-down fantasy doesn’t emerge in a vacuum. It emerges from a cultural context that has systematically silenced women’s rage, pathologized women’s dissatisfaction, and constructed a myth of the woman who “has it all” as a woman who therefore has nothing to complain about and no right to want more, want differently, or want out.

Driven, ambitious women are particularly caught in this bind. They’ve built the careers, the relationships, the financial security, the social capital. By every external metric, the life is successful. And so the burn-it-down fantasy arrives with an additional layer of shame: How dare I? What right do I have? Look at everything I have. What this narrative misses entirely is that having it all is not the same as having what actually feeds you — and that the structures a woman built in her twenties and thirties may genuinely no longer fit who she has become in her forties and fifties.

Clarissa Pinkola Estés, PhD, writes about the domestication of the feminine instinct — the way women are trained, from childhood, to suppress the wild, authentic, knowing parts of themselves in service of social acceptability and relational harmony. Perimenopause often breaks this domestication open. The wild self that was managed and contained starts breaking through the structures that held it. The burn-it-down fantasy is one of its voices.

The medical and mental health systems have compounded this silencing by historically pathologizing perimenopausal mood disturbance rather than contextualizing it. When a woman reports rage, escape fantasies, and intolerance of her life’s existing structures, the typical clinical response has been medication for anxiety or depression — an intervention that can sometimes be appropriate but that, without the depth psychological and systemic framing, addresses the symptom while leaving the root system entirely untouched. What is needed is not suppression of the psyche’s signal. What is needed is a clinical space in which the signal can be heard, decoded, and used as a guide for meaningful change.

The perimenopause identity crisis that underlies the burn-it-down fantasy is a legitimate developmental experience, not a psychiatric pathology. It deserves to be treated as such. And the systemic silencing of midlife women’s dissatisfaction — in medical offices, in boardrooms, in dinner party conversations where no one will quite meet your eye when you say you’ve been having strange thoughts — is itself a form of gaslighting that compounds the experience.

Women who actually do leave — marriages, careers, cities — during perimenopause are not making irrational choices. Some of them are making the truest choices of their lives. The point isn’t that staying is always right. The point is that the cultural narrative offers no nuanced language for what midlife women are actually navigating: a genuine developmental passage that demands honesty, courage, and support — not silence, dismissal, or urgency.

There is also a grief dimension worth naming. The burn-it-down fantasy often encodes grief: for the unlived life, for the choices not made, for the version of herself the woman set aside and can hear again now, speaking clearly, demanding to be acknowledged. This is the perimenopause grief that sits at the heart of many women’s midlife passage — and it deserves its own careful attention.

Decoding the Fantasy: Therapeutic Work, Not Action Work

When a driven woman brings the burn-it-down fantasy into therapy, the first thing I do is receive it without alarm. Not dismiss it, not immediately strategize about it — receive it. Because the woman who is sharing this fantasy has almost certainly been holding it in shame for months, sometimes years. She needs the experience of being met in it before she can begin to decode it.

The therapeutic work that follows is fundamentally about translation. What is the fantasy actually saying? Where is it pointing? What has been silenced, suppressed, or ceded that is demanding return? The Jungian frame — and James Hollis, PhD’s work specifically — offers a clinical structure for this inquiry: the fantasy is a shadow eruption, an individuation call, a psychic demand for honest reckoning with the unlived self. The therapeutic task is to create enough safety and enough honest reflection that the woman can engage with what the shadow is asking, rather than either acting it out or shutting it back down.

Stephen Porges, PhD, Distinguished University Scientist and originator of the Polyvagal Theory, contributes a crucial neurobiological dimension here. The body’s capacity to engage in the kind of honest, emotionally risky self-examination that this work requires depends on a nervous system state of genuine safety — the ventral vagal state that supports social engagement, curiosity, and integration. When the burn-it-down fantasy is active, many women are living in a state of chronic sympathetic arousal (fight/flight) or dorsal vagal shutdown (freeze) — neurological states that make clear thinking about complex relational and identity questions nearly impossible. Part of the therapeutic work is establishing the nervous system safety that makes the real work possible. You can explore more about the perimenopause anxiety and nervous system dysregulation piece here.

There are, of course, situations in which the burn-it-down fantasy is not displacement — in which action is genuinely required. When the existing structure involves domestic abuse, coercive control, or profound physical unsafety, the psyche’s demand to leave is not a fantasy to be decoded but a survival signal to be honored. In these cases, the therapeutic work involves safety planning, concrete exit support, and the full resources of a trauma-informed clinician. Safety always comes first. If you’re in an unsafe situation, please reach out — connecting with support is the most important first step you can take.

For most driven women, however, the work is the inner work. It’s the labor of naming what has been ceded. Of having the conversations that have been deferred. Of renegotiating roles and expectations from a place of clarity rather than reactivity. Of developing the capacity to be in a relationship — with a partner, with a career, with a life — while remaining genuinely connected to who you actually are.

This is individuation work. It’s the most important work of the second half of life, and perimenopause — for all its disruption — is one of the most powerful catalysts for it. The burn-it-down fantasy, received with the right kind of clinical attention, can become a doorway into a more authentic, more integrated, and ultimately more sustainable life than the one it’s threatening to destroy.

If you’re curious about what this kind of depth-informed, trauma-aware therapeutic support looks like in practice, the Fixing the Foundations course offers a structured framework for the relational and identity work that underlies the burn-it-down experience. And for women who want to work directly with me, individual therapy and executive coaching are available.

The “burn it down” urge is not a sign that you are broken or unstable. It’s a sign that something real in you is asking — loudly, urgently, sometimes terrifyingly — to be heard. You don’t have to act on it. But you do have to listen to it. That listening, done carefully and with support, is where the real work begins.

I hold space for exactly this kind of inquiry in my work — the rage, the grief, the longing, the shadow, and the complicated, beautiful, exhausting process of becoming more fully yourself at midlife. You’re not alone in this. And you don’t have to figure it out alone. The Strong & Stable newsletter is a good place to start — the Sunday conversation you may not be having anywhere else.

Related Reading

1. Hollis, James, PhD. The Middle Passage: From Misery to Meaning in Midlife. Toronto: Inner City Books, 1993.
2. Estés, Clarissa Pinkola, PhD. Women Who Run With the Wolves: Myths and Stories of the Wild Woman Archetype. New York: Ballantine Books, 1992.
3. Maki, Pauline M., PhD, and Nancy G. Jaff. “Brain Fog in Menopause: A Health-Care Professional’s Guide for Decision-Making and Counseling on Cognition.” Climacteric 25, no. 6 (2022): 570–578. https://doi.org/10.1080/13697137.2022.2122792.
4. Thurston, Rebecca C., PhD. “Trauma and Its Implications for Women’s Cardiovascular Health during the Menopause Transition: Lessons from MsHeart/MsBrain and SWAN Studies.” Maturitas 182 (2024): 107915. https://doi.org/10.1016/j.maturitas.2024.107915.
5. Woodman, Marion, PhD. Addiction to Perfection: The Still Unravished Bride. Toronto: Inner City Books, 1982.
6. Porges, Stephen W., PhD. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. New York: W.W. Norton, 2011.
7. Mosconi, Lisa, PhD, et al. “Menopause Impacts Human Brain Structure, Connectivity, Energy Metabolism, and Amyloid-Beta Deposition.” Science Advances 7, no. 20 (2021): eabf8833. https://doi.org/10.1126/sciadv.abf8833.
8. van der Kolk, Bessel, MD. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.

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