Passage 2: Thresholds (rites of passage and the shape of change)
Across cultures, continents, and centuries, people have always made maps of the territory of transition.
Birth, adolescence, partnership, death—these were never meant to be private experiences. They were marked, named, and held in community. Rituals, ceremonies, and shared practices surrounded the person in the in-between, giving shape to what might otherwise feel like pure free fall.
In last week's Passage, we stayed close to the body and to the early stage of a transition—endings—and to the way the nervous system quietly says no more. This week, I want to broaden the frame and examine how humans have long refused to let those thresholds pass unmarked.
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““The life of an individual in any society is a series of passages from one age to another and from one occupation to another.””
In a small Ndembu village in what is now Zambia, that might have meant an adolescent sleeping in a separate shelter at the forest's edge for several nights, wrapped in special cloth, listening to stories and teachings intended only for those crossing into a new stage of life. They would return to the community with a new name, new markings, or a change in dress that signified: something has ended, something else has begun.
Or think of a dissertation defense—years of hovering between "student" and "expert," followed by a single, charged ritual hour in a room with a committee. You enter with one identity and walk out with a new title, a different email signature, and access to rooms and responsibilities that weren’t open to you before. A passage, even if no one names it that way.
You can probably easily call some other examples to mind:
The baby welcomed with blessings, holy water, a Bris, or a naming ritual.
The adolescent ushered into a time of teaching, challenge, or celebration before returning with a new status (the vision quest, quinceañera, bar/bat mitzvah, time in the bush, etc).
The wedding that doesn't just mark "a party," but a societal crossing from one way of being in the world to another.
The funeral, with its specific clothes, words, and gestures that help a community move from "they were here" to "they are gone, and we are changed."
The passage may look different depending on your generation and geographical location, but the impulse is the same: to mark a threshold, to give the in‑between a container, and to welcome someone back as not quite the person they were before.
“The impulse is the same: to mark a threshold and give the in-between a container.”
And yet there are understated, more ordinary moments that may need to be observed in our lives, too.
Some cultures mark a girl's first bleed as a gateway with shared meals, songs, or seclusion that honor the fact that your body is changing, and you belong. There have been ancestral ceremonies around pregnancy and birth. Around miscarriage. Around the postpartum labyrinth of identity and physiology, when sleep, mood, and milk supply are as much a part of the story as the baby itself.
And in some traditions, menopause is also marked as a passage rather than a hushed medical event or a time to replace the chemistry waning within. Families or communities acknowledge the last bleed, or the years around it, as a time of initiation. These transitions have been formalized through ritual, legal, or communal recognition. Post‑menopausal women may become the ones who tend the fire, keep the stories, lead the prayers, sit on councils, or enter ritual spaces that were previously closed to them. Menopause, when culturally acknowledged, can catalyze the reconfiguration of gendered power structures, the expansion of legal and economic rights, and the emergence of new communal and creative roles for women. The closing of the reproductive chapter is recognized not only as an ending, but as the beginning of a different authority, a different kind of visibility and power—a shift from being needed for fertility to being relied upon for wisdom, mediation, and care.
Even where formal rituals around this particular transition have faded or never existed, the body still carries the expression of a rite of passage that we call perimenopause. Cycles that stretch or shorten. Hot flashes and night sweats. Changes in sleep, vaginal tissue, mood, bone density, and blood pressure. If we listen through both a Functional Nutrition and a narrative lens, these are not just symptoms to suppress. They're the biology of a passage—another way the body says: something is ending, and something else is trying to begin.
In contemporary medical settings, we can see shadows of this older wisdom about rites of passage. A "ringing the bell" tradition after chemotherapy. A white coat ceremony in medical school. The first time you're asked to speak to others walking a similar path, not as "patient" but as "guide." These are all attempts, however imperfect, to mark that something significant has changed—you are not who you were before.
“What if your body has been walking a rite of passage with or without the ceremony?”
Changes in your body or days that don't quite fit your old story—a new diagnosis, test results that drift out of their usual range, a recovery that's taking longer than you expected, the moment when you move from being the one who always gives care to being the one who needs it—are not random glitches. They, too, are part of a larger transition. When we place them inside a story, a ritual, a shared understanding ("this is a passage"), they can feel less like a betrayal—to both ourselves and those around us—and more like information.
The same is true for shifts in how you're seen in the world: stepping into leadership after years of being the reliable behind‑the‑scenes support, retiring from a role that once defined you, or quietly becoming less central in a community you helped build. Each one is a transition, with its own before, middle, and after.
The trouble is that many of us now live in contexts and cultures that have lost a lot of the scaffolding that marks a transition as a rite of passage.
You may still have the wedding or the graduation, but you might not have a moment to mark:
the first time a chronic illness interrupts your work or parenting,
the decision to stop trying to conceive,
the time you realize your role as caregiver has eclipsed every other part of you,
the challenging decision to step back from a profession or calling that once felt like your whole identity,
the slow realization that a friendship or community you've leaned on no longer feels like home,
the first time you need help with something you used to do easily on your own,
the inner knowing that you can't be the default emotional anchor or buffer for everyone anymore, even if you haven't said it out loud yet.
From the outside, life looks "normal."
On the inside, you're in a liminal space—no longer who you were, not yet who you're becoming.
In Passage One, we approached that liminal space through Bridges' language of endings and through the physiology of loss and disorientation. Here, we'll look at another deep lineage of understanding: the anthropological work on "rites of passage" and what it can offer those of us navigating health transitions, aging, changing bodies, and significant shifts in our roles or identities.
Anthropologists like Arnold van Gennep (1909) and Victor Turner (1960s) noticed that, across wildly different cultures, these transitional rituals tend to follow a similar arc. There is a letting go of an old identity, a threshold phase where you are betwixt and between, and a return to life with a new name, role, or place in the community. We'll spend this Passage with that arc as another practical map you can hold alongside your own body's signals.
As you read, you might keep your own health and life story in mind:
A diagnosis or event that changed the way you move through the world.
A season of treatment, or of "nothing more to be done," that left you in strange, in‑between territory.
A change in your role at work that quietly altered who looks to you, and for what.
A family threshold—bringing home a baby, a kid leaving for college, a separation or divorce, or returning to work after being home with children.
A shift in how you understand yourself—your beliefs, your body, your place in the world—that you can't roll back, even if nothing on the outside has an official name for it yet.
What happens if we recognize these as passages?
What if your body has been walking a rite of passage with or without the ceremony?
Let's explore this three‑part pattern of transition, see how it shows up in bodies and communities, and consider how you might begin to reclaim small, meaningful rituals for the changes you're living through now—even if no one around you seems to recognize your right to the rite.
Naming the pattern: separation, threshold, return
Van Gennep often noticed something significant when he observed rituals of change across cultures. Underneath the surface distinctions—different clothes, songs, foods, symbols—there was a shared pattern.
Van Gennep identified it as a three-part structure:
Separation – leaving an old status or identity
Liminality – a threshold phase
Incorporation – returning with a new status, name, or role
About six decades later, Victor Turner picked up van Gennep's work and lingered especially on that middle part, the liminal phase. He saw that it wasn't just a blur between "before" and "after," but its own potent territory—odd, creative, disorienting, full of both vulnerability and possibility. He referred to that time as the "betwixt and between." Later scholars reminded us that these aren't just abstract stages in someone's head. They're lived, embodied, and profoundly shaped by power, culture, and context.
For our purposes here, I want to focus on the pattern's simplicity and ask: What happens if we name these three movements in our own transitions—especially around health, aging, and identity?
1. Separation: when the old story starts to loosen
In the language of ritual, separation is that first, unmistakable shift—you're stepped out of ordinary life, set apart from your familiar role, and treated as someone who is no longer where—and who—you were.
That might be a very literal shift—leaving home for a significant experience or expedition, or moving across the country, taking you farther from (or closer to) family. Separation can also be more subtle: a haircut, a new name that signals "something is veering here", or the projects that once had your fingerprints all over them suddenly moving on without you.
In the realm of health and life transitions, separation can look like:
The day you hear a diagnosis spoken out loud for the first time.
The email that announces your role is changing… or ending.
The first missed period that isn't followed by another.
The moment you realize you can't keep pretending that your energy, your sleep, or your pain levels are "fine."
On a day-to-day basis, not much may have changed yet.
You might still be showing up for the same job, living in the same house, following the same daily routine. But inside, your body and your story have already moved beyond the old baseline.
You can't unknow what you now know.
From a Functional Nutrition perspective, separation is when we first see the nervous system lean forward, as we explored in the first Passage, with Bridges’ model and the focus on endings. More vigilance. More scanning for danger.
From a Narrative Medicine perspective, it's when the old plotline starts to pivot. "I'm the healthy one," or "I'm the one everyone leans on," or "I'm the person who always pushes through." These identities no longer fit the way they used to.
“You can’t unknow what you now know.”
Sometimes we resist this phase with everything we have. We downplay the test results, minimize the symptoms, ignore the dread, double down on the old story. Other times, separation comes like a clean break: a surgery date on the calendar, a final work day, a loved one moving out or being dropped off at college, or even an accident. Either way, in van Gennep's terms, we've stepped out of the old circle. We're no longer just "before."
2. Threshold: living in the in-between
Our mid-20th-century anthropologist, Victor Turner, called the middle phase liminality—from the Latin limen, meaning 'threshold'. It's the in-between zone where old roles no longer quite apply, and yet new ones haven't fully formed.
““Liminal entities are neither here nor there; they are betwixt and between the positions assigned and arrayed by law, custom, convention, and ceremonial order.””
In traditional rites, this might be a literal "elsewhere": a forest clearing, a tent, a camp, a special room. Standard rules are now suspended or inverted. Initiates are instructed, tested, or held apart from daily life. Turner noticed that people in this phase often form a kind of communitas—a raw, leveling intimacy with others who are also in the in-between.
Communitas serves a purpose. When you're not who you were and not yet who you're becoming, it's a relief to be among people who recognize that suspended state, who aren't asking you to be "back to normal" by Monday. In those circles, hierarchy softens. You're not the "strong one," the "sick one," the "expert," or the "caregiver." You're simply a human in passage, witnessed and accompanied. That shared recognition helps metabolize the fear, the disorientation, and even the physical symptoms of transition.
You're not carrying or moving through the threshold alone.
When we're severed from that kind of holding—from the places where our in-between-ness is seen and named—the liminal phase can feel harsher. (And so can we.) Instead of communitas, we get isolation: scrolling in waiting rooms, pretending at work that nothing significant is happening, trying to manage hot flashes, blood test results, identity shifts, or caregiving fatigue in private. The body is still moving through a rite of passage, but without a circle around it, the load lands more heavily on our biology, our relationships, and our sense of self.
Contemporary health transitions have threshold spaces too, though they're not always clearly named or collectively held:
The months (or years) of interventions where treatment schedules, lab results, or medication changes rule life.
The ambiguous stretch after "watchful waiting" is recommended when you're no longer in an active crisis but never quite as naive or at ease as you once were.
The first years of perimenopause, when cycles, sleep, mood, cognition, and identity all feel like they're in flux.
The abrupt aftermath of an injury—a fall, a fracture, a concussion—when you're technically "out of danger," but daily life is reorganized around healing, limitations, and the question of what will (or won't) return to how it was.
The long middle between leaving a defining role and not having any idea who you are without it.
Physiologically, this threshold period is when the body burden may continue to increase. Stress chemistry is even more easily triggered, digestion more sensitive, sleep more fragile, and old vulnerabilities are louder. Psychologically, it can feel dizzying—you can't go back, but you also don't yet have a clear image of the future.
Further sociological work on ritual informs us that the impacts of this phase aren't just "in your head." The threshold is political and social, too. Some people are given resources, time off, social recognition for their liminal season—parental or sick leave, meal trains, ceremonies. Others are expected to endure their in-between state silently, while still performing as if nothing has changed.
In fact, without much ritual surrounding our transitions in modern life, people can end up in extended liminality—long stretches of in-between with no clear re-entry: chronic illness with no prognosis, jobs or housing that are perpetually precarious, ongoing caregiver roles with no endpoint. From a systems lens, this matters too. Bodies are not designed to live indefinitely in threshold mode. When the "temporary" physiology of adaptation becomes the norm, we're more likely to see chronic symptoms, fatigue, and a slow erosion of who we know ourselves to be—something that can blunt our sense of meaning and purpose and, over time, shape our long-term health outcomes.
Part of what we're doing in this series is naming, not blaming: If you feel like you're living on a threshold right now, you probably are.
“Bodies are not designed to live indefinitely in threshold mode. ”
3. Return: coming back changed
In van Gennep's model, the third phase is incorporation—literally being "folded back in." In traditional ritual form, that might look like a public ceremony, new clothes or markings, a feast, or a blessing. The community says, in effect: "We see who you are now. We recognize this new form of you."
In health and identity transitions, return can be trickier:
You finish treatment and ring the bell, but your energy, fears, or labs don't feel "back to normal."
You're technically "in remission," but your relationship to your body, time, and priorities has permanently changed.
Your period has ended, but the culture around you doesn't acknowledge any new authority or freedom that might come with that shift.
You step out of a caregiving role or a leadership position, yet people still treat you as if nothing significant has changed.
In other words, your body and story have moved into a new phase, but the world hasn't caught up—or hasn't built a meaningful way to welcome you back and acknowledge that you are now, infinitely, different.
From an integrated and Functional perspective, this is when we ask: What does regulation look like now, for this body, in this chapter? Not "how do I get back to who I was before," but "how do I support the physiology I have, with the history and reality I now carry?" From a narrative perspective, it's when we begin to author a next chapter that acknowledges what happened and how it moved us, without making the ending or the illness the only defining feature of our identity.
Turner would say that incorporation is where structure reasserts itself after the anti-structure of the threshold. The questions may become: What kind of structure am I returning to? How do I now fit in?
Is the structure one that ignores what we've lived through? Or one that can make room for the ways we've changed?
Sometimes, incorporation is something we must initiate ourselves:
Marking the end of a treatment cycle with a small personal ritual.
Naming out loud, with a trusted person, the new limits or values that emerged from a health crisis or circumstantial change.
Creating a simple practice—a walk at sunrise, a weekly meal with friends, a morning journaling ritual—that anchors this new phase of life in our nervous system and on our calendar.
The point isn't to romanticize every transition or deny the losses. It's to recognize that your body, your relationships, and your roles are already moving through these three movements—separation, threshold, return—with or without cultural support.
“Naming the pattern doesn’t erase the difficulty. But it can offer a bit of orientation”
Naming the pattern doesn't erase the difficulty. But it can offer a bit of orientation:
Oh. This is the separation.
Oh. This is the threshold.
Oh. This is a form of return, even if I don't yet know what to call myself.
From there, we can start to ask different questions about care—not just "How do I fix this symptom?" but "Where am I in the passage? What might support look like at this particular phase, for this particular body and life?"
The physiology of a rite of passage
By now, you've probably noticed a pattern—transition is not just a story arc. It's a physiological one too.
Endings and thresholds land in the nervous, endocrine, and immune systems. What changes in this Passage is that we're looking at those shifts through the three-part arc of a rite of passage: separation, liminality, and return. It might help to step back and consider how the transition phase we're in might shape our conversations with the people who care for our health.
Separation: the physiology of being "not where you were"
In the separation phase, something has already been stripped away or is in the process of loosening: a role, a relationship, a sense of self, a capacity you once took for granted.
Biologically, separation often looks like:
a spike in stress chemistry (that early-morning waking, the racing thoughts),
a tightening in muscles and breath,
appetite changes or an unsettled gut as your system registers, "This is not what it used to be."
If you're sitting with a practitioner, it can help to name both the change and its impact: "I'm in a season where a lot is ending—my role at work is shifting, and I'm caring for a parent. My sleep and digestion changed around the same time. Can we look at my labs and symptoms in that context?"
You're not asking anyone to fix the ending or truncate the liminal space. You're asking your support team to see your physiology as part of a passage, not as a random collection of complaints.
Liminality: the physiology of the threshold
The liminal phase—that "betwixt and between"—is where the old rules don't quite apply and the new ones aren't clear yet. You might be mid-treatment, mid-transition at work, in perimenopause, in recovery, in grief. You're not where you were, but you're not in the "after" either.
In the body, liminality can look like:
being "wired and tired" at the same time,
more flares of whatever is most vulnerable for you (autoimmunity, migraines, gut issues, mood),
feeling like your capacity is thinner than it "should" be for what's on your plate.
From a Functional lens, this is the phase where strain on your system is often highest, and buffers are lowest. You're asking your biology to keep re-negotiating your reality. That's a lot.
With a provider, you might name it this way: "I'm in the middle of a big transition—nothing about my life feels settled right now. I notice my symptoms are stronger, but I don't think I'm 'falling apart' so much as stretched. What would support my body through this phase, rather than assuming this is my new forever?"
You're signaling that you're in a threshold moment, not a static state.
Incorporation: the physiology of return
Return—or incorporation—is the part we talk about least in healthcare and medicine, even though it's where a lot of long-term health is shaped.
This is the after:
after the divorce is final,
after the acute treatment ends,
after the broken bone has healed,
after the move,
after the caregiving season shifts,
after the role or community is no longer reliable
after your cycles stop and menopause is no longer a question but a fact.
Biologically, this is where your system is trying to build a new baseline, if allowed a proper re-entry. Inflammation may resolve or linger. New habits have a chance to take root. Identity starts to re-form around the changed terrain.
With a practitioner, this might sound like: "I'm technically 'on the other side' of a rough patch—but my body still feels like it's catching up. Can we talk about what recovery and re-entry look like, not just the event itself?"
You're asking to be supported not only through crises, but through the quieter work of integration.
Asking to be seen as "in passage"
Most of us were never taught to say, "I'm in a transition," in a medical visit. We're taught to list symptoms and hope they add up to something legible for a treatment.
You might experiment with adding a simple sentence that names the passage you're in without going into too much detail (unless asked):
"I'm in a major life transition, and my body seems to be reacting to that."
"This feels like a threshold season for me—can we keep that in mind as we look at my labs and my options?"
"I'm not just having hot flashes/flare-ups/insomnia. I'm also stepping out of a role that defined me. I think my body is trying to catch up."
I've been practicing this myself.
At my eye doctor, I asked that we wait a bit longer before changing my eye drop medication, despite the test results, noting that I've been under significant stress and that my system needs a little more time to show us what's baseline and what's situational.
At the dentist, I let them know that if there were more signs of clenching, it wasn't a new pattern to be treated as a fresh problem, but a familiar response amplified by my current circumstances.
And after my naturopath and I reduced my thyroid medication several months ago, with the intention to continue that slow adjustment, I asked for a longer stretch at the new dose, sharing that other significant factors in my life right now might blur our ability to truly see the effects of that titration.
“We’re only taught to list symptoms and hope they add up to something legible for a treatment.”
None of these conversations were long. I didn't offer a lecture on transition or rites of passage or a meandering account of my plight. I simply put words to the reality that my body is moving through an in-between, and asked my providers to factor that into how they read my signs, my symptoms, my test results, and my timelines. I would invite any of my clients to do the same with me, as it would absolutely influence my recommendations.
In naming it with my own healthcare team, I'm already practicing a steady act of self-health care—letting my body be understood as part of a larger story, rather than a problem to be fixed in isolation.
I encourage you to do the same.
Rite of passage in real time
When my husband, Isamu, died, I had just turned thirty-six three days earlier. He was thirty-four. Our son was not yet two.
In some ways, the facts were clear: a brain tumor diagnosis two years earlier, now a young widow and a single mother.
Inside my body, it felt like the floor had dropped out. The container of my life had dissolved. But in the broader world around me, nothing marked that shift. There was no signifier on my clothes, no visible emblem that said: this woman is in a passage.
I remember driving our maroon Subaru station wagon in those first weeks after he died, moving through Portland as if the air was thick like sludge. To the co-op to fill the glass jars with nuts, seeds, and grains, and back home. To the library for the Tiny Tots class with other parents and their toddlers.
The summertime light outside looked the same. The streets were the same. The cars around me were the same. But I was not the same.
I drove just a little slower than usual, a little more tentatively, as if grief had lengthened the distance between the brake and the road. The honks came anyway—sharp, impatient blasts from people who could not see that the woman driving the car ahead of them had recently watched her husband carried down the front stairs in a body bag, and was now learning how to navigate the world with an unchosen identity.
I felt like a ghost at the intersection—visible enough to be in the way, invisible enough that no one knew to make space.
And what I longed for, oddly, was something I'd seen in other contexts: the knowing nod between pregnant women on a bus, the tiny smile of recognition that passes between two people who share a particular difference in a sea of sameness. The "I see you" that doesn't require an explanation. It may even warrant more than a bow of recognition and elicit an embrace of familiarity.
There are so many ways we do this for each other when the transition is recognizable. The cast on an arm that signals: I'm healing. The graduation cap. The newborn baby strapped to a chest in the grocery store. Even a new engagement ring on the left hand. These are all symbols that signal that this person is in a passage. Something significant in their life is evolving.
I had none of that.
I still wore the same jeans, t-shirts, and sandals. I still made amaranth porridge with fresh berries in the mornings, standing at the stove while my son played nearby, his little fingers managing wooden blocks as if nothing in his universe had shifted. I still answered emails. Paid bills. Returned library books. From the outside, I looked like any other tired young mother trying to keep the day moving. Inside, I was walking through a landscape where every landmark had been rearranged.
Friends and family were attentive. They sent flowers. They checked in. They held us as best they could. But the world at large had already moved on.
The moment of Isamu's passing had come and gone. The memorial wasn't for several months. The legal forms and certificates had been ordered and signed. Officially, we had crossed some sort of finish line—the passing of a person who had struggled with a chronic health condition.
Unofficially, I was still in the middle, disoriented and raw, with no shared ritual to mark: this is where she is now.
Somewhere in that fog, I found my way to The Tibetan Book of Living and Dying. I stumbled into the language of the bardo—those in-between states in Tibetan Buddhism where the soul is understood to be moving through its own betwixt and between after death. The idea that there might be a recognized interval, a threshold time for the dead and for the living, landed like a small anchor inside of me.
If there was a bardo, then maybe Isamu and I were still in something together—not just him gone and me left behind, but both of us moving through a transition that had a shape, even if I couldn't see all its contours. It didn't fix the ache. It didn't give me a black scarf or a special cloak that the older widows would recognize. But it gave me a word, a frame, a sense that what I was feeling was not a personal malfunction. It was a rite of passage without a rite.
That loneliness—the loneliness of being in a threshold with no cultural container—has resurfaced in a different form in recent months.
For the last 15 years, I've inhabited a role of my own making, a role that's been more than just a job. It’s been a vocation, a calling, a place where my particular way of seeing the world—through systems, stories, and bodies—could take shape as real work in the world. I poured myself into building a body of teaching and a community of practitioners, holding the thread of a vision for how care could look different.
Then—slowly and then all at once—the context around that work changed.
The company I founded was acquired and then acquired again. New structures came in: different reporting lines, different priorities, different platforms, and projections. Somewhere in the corporate evolution, the role I had lived inside of—the role of founder, steward, primary voice—began to thin out. Decisions were made in rooms I wasn't in. Strategies were drawn up without consulting the person who had created the work.
There was no ceremony. No acknowledgement. From the outside, my position might have looked similar enough. The org chart still had my name on it. Emails still went out with my signature. But internally, the identity I'd inhabited for a decade and a half was unraveling. I felt, at times, less like an architect of a vision, and more like a handmaid—present, useful, but peripheral to the opinions that would now shape the house I'd built.
Over time, that long, quiet unraveling became something more concrete. The inner “no more” I’d been carrying turned into an actual choice: It was time to step away.
This, too, has been an unritualized passage.
If van Gennep were watching, he might say the separation phase had already begun: I had made a significant decision to leave, and I was intentionally unhooked from the old status, even if no one named it that way. Turner might recognize the liminality: the betwixt and between of still being called on for my expertise while no longer being the one steering the ship.
From a Functional lens, my body certainly knew. The jaw clenching, my dentist noticed. The 3:30 a.m. wakings. The tension and buzz of caution before showing up to work each day. The way my nervous system braced for the next "update" about the future of the brand I'd shaped with my own hard work, two hands, and endless late nights, built upon my own loss, understanding, and clinical experience.
Unlike my younger widowhood, there has been no single day to point to. No death certificate. No obituary. Instead, this transition has happened in emails, Zoom calls, budgets, decks, and content migrations. The grief is less visible, but it is profound: grief for a role, for a way of being in relationship to my work, for a season of clear purpose, agency, and leadership.
And again, there has been no common ritual to hold the transit.
No gathering to say, "This chapter is complete, thank you." No shared acknowledgement that the person who has carried this legacy of work is now in her own in-between, with a body and a nervous system doing their best to adapt. From the outside, it can look like business as usual, even publicly framed as an improvement and evolution. On the inside, it feels like walking through another rite of passage in real time, without a map, trying to honor the ending and the liminal space—to stay in it, without rushing ahead, to ensure that I honor the significant passage.
I share both of these stories to make something visible that so many of us live through without language. The loss of a partner. The quiet sidelining of a vocation. The shift from being central to being peripheral in a family, a company, or a community. These are all passages. They live in our bodies whether or not our cultures choose to mark them.
In the next part of this Passage, we'll stay with that reality and look at what it might mean to recognize these unmarked transitions for what they are—to give them at least a bit of structure, a little more kindness, and a little more of the ritual attention humans have always needed when crossing from one way of being to another.
Reclaiming small rites of passage
We've been circling this three-part pattern from field studies: separation, threshold, return. But what actually makes something a rite of passage, and not just "a hard week" or "a big change"?
Anthropologists like van Gennep and Turner would say that a rite of passage is more than a date on the calendar. It has a few recognizable ingredients beyond the threefold structure. Those elements include intention, symbol, and some kind of witness (even if that witness is just you, present to yourself on purpose).
When those essentials are present, we're not just surviving change. We're participating in it.
A small pilgrimage instead of a sharp edge
When I dropped Gilbert off at college, the school gave us an unexpected rite of passage.
In the days leading up to goodbye, we drove around the neighboring towns of Oberlin, Ohio, gathering fans and kettles and hampers for his dorm room, listening to a playlist he'd made of songs from his childhood—our no-TV years, the odd mix of movie soundtracks and kids' music that had scored his wonder years. It felt like he was tucking home into his back pocket, stitching the old life into the new. I was touched that he'd assembled this collection.
Our Airbnb was a slightly cluttered house out in the not-quite-country, with a baby grand piano squeezed into the living room. Gilbert sat down and played each time he passed the ivory keys. I remember realizing how much I’d miss his music on the upright downstairs and the electric keyboard upstairs back home.
On the final day, after the first-year students were moved into their respective dorms, the college gathered us—parents and guardians—in a beautiful auditorium and, one by one, introduced us to the "new guards": campus safety, the head nurse, the mental health counselor, the person in charge of food. They told stories of other first-years who had stumbled in their new home and then found their way. They asked who was dropping off a first child, a last child. They laughed with the veterans who hooted and hollered and steadied the rest of us newbies, smiling through gritted teeth. Finally, the counselor came back onstage to give us our instructions: say goodbye once, don't hover, leave campus, let them falter, call the counselors (not our kids) if we were truly worried.
It was a formal handing-over, a ceremony of separation disguised as a parent meeting.
Afterwards, I found Gilbert on the quad, and we took one last slow loop in the white rental SUV. From the passenger seat, he said, "I'm scared."
I was shocked. It was as if the whole car lurched; my body braced before my mind caught up.
The kid I'd dropped off at camps and summer programs without a backward glance was naming what both of us felt: this wasn't camp. This was a crossing. He wasn't coming "home" in the same way again.
That car ride became our ritual. Our hug goodbye was his entry into a new life, a new home, a new anchor of becoming.
Fortunately, I had realized that I’d need my own middle chapter—a way to honor that something had ended before I tried to step back into the empty house and into whatever was next. So rather than flying directly home, I flew to New York, met my partner, and we travelled on to hike in the Italian Dolomites. I had anticipated the challenge and built in a small pilgrimage instead of a sharp edge. It was a deliberate spell of in-between before re-entering my "new" life as an empty-nester.
Was it necessary, in a survival sense? No.
Was it a rite of passage? Absolutely.
There was:
Separation – Leaving Gilbert at Oberlin; handing him over to the "new guards"; naming, out loud, that we were both scared and proceeding anyway.
A threshold space – Days of walking, climbing, eating, and sleeping in a landscape where no one knew me as "Gilbert's mom," where my nervous system could catch up to what had happened and go through its own transformation.
A return – Going home to a quieter house that I could now meet as the next version of myself, not as someone who had "lost" something overnight.
It wasn't a perfect ritual. It was privileged and intentional. But it gave my body and my story what so many transitions lack: a pause, a container, and a marked re-entry.
The basic anatomy of a rite (translated for real life)
If we strip the anthropological language down to something you can use on a Tuesday, a rite of passage often includes:
Name the ending (separation)
Saying, in some concrete way: this is over, or it's changing.
That might be writing a single sentence in your journal: "Today is my last day in my childhood home," or "We are no longer trying to conceive," or "Dad moves into assisted living this week."
It might be clearing a small shelf, returning a badge, or donating a piece of clothing from an old role.
Create a threshold (liminal space)
A pocket of time or space where you are not required to be your "old" self or your fully formed "new" self.
That could look like:
Taking the long way home after your final day in a job.
Sitting in your parked car for ten minutes after a medical appointment that changed your plan.
Choosing a spot—a park bench, a trail, a café—where you let yourself feel in-between without needing to resolve it.
Moving your workspace from one spot to another.
Choose a symbol
A simple object or gesture that carries the meaning of the transition.
A ring you move from one finger to another. A candle you light only when you're tending this change. A stone from a walk on the day you got the news. A playlist you build for this season.
In the rites studied by van Gennep and Turner, symbols did much of the heavy lifting. They reminded the person (and the community) who you were becoming, not just what you were losing.
Be witnessed (even just a little)
In traditional rites, there is almost always a "we" around the "you"—elders, peers, family, community.
In modern life, that might mean:
Telling one trusted person: "This is a big threshold for me. I'd love it if you could mark it with me somehow."
Asking someone to walk with you, share a meal, or say, "I see that this is an ending for you," instead of rushing to the bright side.
When no one is available or safe enough, your own attentive presence—and the way you tell the story back to yourself—can be a form of witness.
A conscious return
A small act that says: I am stepping into the next part of my life carrying what I've learned.
That might be planning a low-key "first" in your new identity—your first day not checking your adult child's every move; your first morning walk after finishing treatment; your first week with a slightly lighter caregiving load.
Or it could be as simple as writing: "From this point forward, I want to…" and naming one way you hope to care for yourself in this new terrain. (For me, in this season, that sounds like: From this point forward, I want to live in a way that protects my integrity—in how I work, how I care, and how I care for myself.)
The calendar as a built-in threshold
The end of one year and the beginning of another is one of the few remaining collective thresholds many of us still feel.
From a rites-of-passage perspective, you might experiment with:
Separation: Naming what this year has asked of your body, your health, your roles. What is done? What cannot be done in the same way?
Threshold: Giving yourself one quiet hour—between holidays, or sometime in January—that isn't about resolutions but about recognition. You might map your year on a timeline, the way we do in Functional Nutrition: major events, symptoms, stressors, supports, endings, and beginnings.
Return: Choosing one tiny practice that will help your system carry less load into the new year—an earlier "lights out," a steadier breakfast, a weekly check-in with someone who understands your current passage.
None of this has to be elaborate. The power is not in how "special" or grand it looks from the outside, but in how clearly it tells your nervous system and your narrative mind: this is a threshold, and I'm allowed to treat it as such.
Listening for where a rite might be needed
As you move through the coming weeks, you might choose to notice where your body and your life are already hinting at the need for a small rite:
A change in health status that hasn't really been acknowledged.
A shift in work or caregiving that has quietly rearranged your days.
A belief or story about yourself that no longer fits, even if nothing external has caught up yet.
Where might there be an ending that deserves to be named, a threshold that wants a little more protection, a return that could use a symbol or a witness?
Not every moment needs ceremony.
But some do.
And when we give even a few of those moments a gentle, intentional frame, we're not just borrowing from anthropology. We're practicing a kind of whole-person care—physiology, story, and context together—that reminds the body it doesn't have to walk these passages alone.
“Not every moment needs ceremony. But some do.”
What I hope you're beginning to feel is that none of this—your symptoms, your lab shifts, your changing roles, your altered energy—is happening in a vacuum. You're not "too much" or too weak to find it disorienting. You're walking through a passage, with or without the benefit of shared language, witnesses, or ceremony.
In this Passage, we've leaned on anthropology to remember something humans have always known: change has a shape. There is a letting go, a threshold, and a return. There are ways to be seen and held there, even if we have to rebuild them in small, personal, improvised ways.
Next week, I want to bring that same recognition into the places where most of us now go for help: exam rooms, hospital beds, consults, and follow-up visits. Nursing scholar Afaf Meleis and her colleagues have spent decades asking a simple but radical question: What if we treated transitions themselves as a focus of care?
We'll explore Meleis' Transitions Theory—how she names the properties of a transition, the conditions that can ease or complicate it, and the patterns of response that show up in real bodies and lives. And we'll ask what it might mean to bring those questions into your own healthcare, too.
For now, it's enough to recognize that you are not just "coping" or "off your game." You may be in the middle of a rite of passage. And that, in itself, is worth naming.
Warmly,
P.S. If you know someone who is also navigating an ending or a transition, feel free to forward this and invite them to subscribe at andreanakayama.com. And if you’d like to share any of your own writing or reflections as we go, you’re welcome to hit “reply” or email me at scribe@andreanakayama.com
References:
van Gennep, A. (1960). The Rites of Passage.
Turner, V. (1969). The Ritual Process: Structure and Anti-Structure.
Bell, C. Ritual: Perspectives and Dimensions (1997).
Thomassen, B. (2014). Liminality and the Modern: Living Through the In-Between.
Lock, M. (1993). Encounters with Aging: Mythologies of Menopause in Japan and North America. University of California Press.
Beyene, Y. (1989). From Menarche to Menopause: Reproductive Lives of Peasant Women in Two Cultures.
