Today we’re going to focus on high-functioning depression. What is it? What’s it not? Is it dangerous or is it not? And what does that mean anyway, ‘’high-functioning” depression"? It’s still depression, isn’t it? It’s the newer term for what’s “properly” called Persistent Depressive Disorder, which used to be called before that, Dysthymia. Maybe it’s a little sexier to call it ‘high-functioning depression” or “smiling depression.” But here’s my thought: if more people react to one label better than they do others, more power to that label. I don’t particularly care what we call it – and if more people can say, “Oh yeah, that’s me,” and recognize its validity or presence, then I’m all for it.
Let’s make sure we all understand that I can’t think of any mental illness or disorder that’s not on a spectrum.
You have depression. How you cope with it is based on myriad of factors. And there are millions of people who are coping every day around the world. I hope you'll benefit from listening and sharing this episode about moderate depression, or high-functioning depression.
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What Cleveland Clinic says about PDD or Persistent Depressive Disorder
My TEDx talk that today has earned 60,000 views!
You can hear more about this and many other topics by listening to my podcast, The Selfwork Podcast. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook!
And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
(00:10):
This is SelfWork and I'm Dr. Margaret Rutherford. At SelfWork,we'll discuss psychological and emotional issues common in today's world and what to do about them. I'm Dr. Margaret and SelfWork is a podcast dedicated to you taking just a few minutes today for your own selfwork.
(00:29):
Welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford. I'm a clinical psychologist, and I started SelfWork almost seven years ago in order to extend the walls of my practice to those of you who might already be interested in psychotherapy or you're in therapy, to some of you who may have just been diagnosed with something or you're having a problem you can't figure out and are looking for answers. But also to a third group of you who are very skeptical about mental health treatment, mental illness in general, or you just think psychologists and therapists are a little wacky <laugh>. Well, anyway, so here we are today. I wanna give a trigger alert to this episode because we are gonna be mentioning suicide. So just to trigger alert, to keep you safe. Today, we're going to be focusing on high functioning depression. Now what is that and what is it not?
(01:18):
Is it dangerous or is it not? And what does that mean anyway? High functioning depression. It's still depression, isn't it? It's actually the newer term for what's properly called persistent depressive disorder, which used to be called before that dysthymia. Maybe it's a little sexier to call it high functioning depression, or I've also heard it called smiling depression. But here's my thought, if more people understand or respond to some label or another better than they do others, then more power to that label. I don't particularly care what we call it, but if more people say, yeah, yeah, that's me, and recognize its validity or presence, then I'm all for it. I want you to understand, however, that I can't think of any mental illness or disorder that's not on a spectrum. Everything from schizophrenia to bipolar disorder to phobias to anxieties. But the major reason I wanted to point out the distinctions between good old classic depression and high functioning depression is that it can be too easy to believe one is better than the other, or that somehow people who aren't high functioning have some kind of innate weakness.
(02:23):
than they're more high functioning counterparts. I don't believe that at all. At all. You have depression. How you cope with it is based on a myriad of factors, and there are millions of people who are coping every day around the world. We'll get more into that in the body of the episode. We don't have a voicemail for today, <laugh>, as I got into writing this so much that I ran out of time, but we'll feature that voicemail next week. It's from a mom of two small children whose own mother she describes as borderline and is having huge problems in the past with alcohol. She's in a tough spot with her mom. She's trying to figure out how she can best, best keep her children safe. So I'll do my best to answer. But again, that's next week. Before we get started, let's hear from one of our wonderful sponsors whose support really allows me to offer y'all self work. Let's hear from AG1.
(03:18):
Our next partner is AG1, the daily foundational nutrition supplement that supports whole body health. I drink it literally every day. I gave AG1 a try because I wanted a single solution that supports my entire body and covers my nutritional bases every day. I wanted better gut health, a boost in energy immune system support. I take it in the morning before starting my day, and I make sure and leave it out for my husband because he tends to forget. I love knowing that I'm starting my day so incredibly well, and I wouldn't change a thing because it's really helped me the last two or three years I've taken it. And here's a fact, since 2010, they've improved their formula 52 times in the pursuit of making this nutrition supplement possible and the best it can be. So if you wanna take ownership of your health, it starts with AG1. Try AG1 and get a free one year supply of vitamin D and five free AG1 travel packs with your first purchase. Go to drinkag1.com/selfwork, and that's a new link. Drinkag1.com/selfwork. Check it out.
(04:40):
It is always a bit embarrassing when you find out that what you've been saying about something isn't quite accurate, especially when you're supposed to be an expert. And that for me is with depression, or at least I've written a book about it. As I was researching for my book Perfectly Hidden Depression, I read several articles on what was termed "smiling" or "high functioning" depression. I never saw real symptom lists. What I read or what I thought I understood was that people who identified with high functioning depression knew they were depressed. They could see themselves in some, or a lot of the diagnostic markers of depression, foggy thinking, indecisiveness, fatigue, sleep or appetite issues, not enjoying the things they used to enjoy and an overall sense of being down a lot or most of the time. But these symptoms weren't so severe that they weren't able to slap a smile on their face, take their meds, go to therapy - or both - get in a couple of good walks, get the kids to school and get to work.
(05:37):
So I made the simple assumption that high functioning depression wasn't as debilitating as someone with more severe symptoms or classic depression. So I was right, but I also didn't understand the entire picture.
This week, I was interviewed for an article for Wonder Mind about high functioning depression, and the author asked what the symptoms were. I somewhat confusedly said, "wWell, it's not a diagnosis, so it doesn't have symptoms. It's more a way of people talking like they know they have depression, but they developed really good coping skills, or they know what their triggers are and avoid them," or some such language, and she seemed a little confused. So what did I do? The next morning? I looked more into the term high functioning depression. What I had not realized, even when I was writing the book, was that the term high functioning depression was the newer term for what used to be called the more moderate depressive state of dysthymia, and now it's termed persistent depressive Disorder or PDD for short.
(06:39):
The Cleveland Clinic says about PDD, it's mild or moderate depression. That doesn't go away. A person with PDD has a sad, dark or low mood or two or more symptoms of depression. The symptoms last most of the day on most days over a long period of time. So it's a change of nomenclature or what we call moderate depression. And as I said in the intro, I don't really care what we call it. If a term is more meaningful now in 2023 than dysthymia or PDD was, it's certainly far less jargonistic sounding. Let's go with it. <laugh>. I emailed the author immediately and explained to her what I'd figured out felt a little silly, but we all have to sometimes say we make mistakes.
Let's also make this point. All mental illness exists on a spectrum. I said this in the intro, as I suppose medical illnesses do.
(07:33):
You can have really severe bronchitis or you can have a much milder throat infection. So all that's very simple. But depression has been and will always be on a spectrum.
So let's first go through the pros of high functioning depression. Not that having depression is in any way a "pro" or some kind of benefit. A darkness still exists for you. Your emotions are difficult. You have physical symptoms and trouble with your thinking, and those things have been that way for quite a while by diagnostic standards, in fact, at least two years. But compared with more severe depression, this kind of depression doesn't sabotage your life as much as a deeper depression can and often does.
So here are some of the pros of high functioning depression when we compare it to deeper, more severe depression. Obviously, most of the time you can work and get things done.
(08:23):
That's the easiest pro to see. You may hate going to work or dislike your job, but perhaps you figured out how to maximize what you most like and minimize what you don't. Maybe you have a hobby that you look forward to doing after work that brings you much more fulfillment and stands as a balance for what you don't enjoy so much. Maybe you love your kids and being around them or doing for them is very meaningful for you. So you're coping. There's much research out there, for example, on resilience in times of war. By no means for anyone are things right, and certainly depression does exist. You may long for what used to be, but you're going through a collective experience and that connection is what can sustain you. So resilience may be part of holding down a depression to a more moderate depression, but again, it's multifaceted.
(09:13):
One of my other observations is that when a less severe depression is occurring, your connection with others mostly remains intact. Physical symptoms may not be as likely and meaningful connections are still possible, and that's quite a feat. Really, it is. You may not see it that way. You may not give yourself credit for keeping on, keeping on, but it's huge. You can admit some days are harder than others, but you can talk about it hopefully, or if you can't talk about it, perhaps you journal or you exercise to get some of your anger or sadness out. I realize how much I'm saying the words "may" or "can" here. There's not one picture of the moderately depressed person. I'm sure your culture, your gender or gender identification, your race, your age, all of these human characteristics are going to come into play when someone describes the moderately depressed person or the high functioning depressed person.
(10:09):
It's the term. In fact, Chesley Kryst used about herself, at least her mother said she did after her suicidal, tragic death, who was Chesley Kryst? She was Miss U S A in 2019 and 2022 years due to the pandemic. She was the oldest Miss U S A at the ripe age of 28. She was shorter, more muscular, stunning, and brilliant. But I quote her when I'm teaching my class on perfectly hidden Depression to clinicians as she says that she only finds emptiness in achievements that her culture told her would bring fulfillment, and she jumped out of a New York City high-rise apartment building in January of 22. Obviously to her death. I don't think that Chesley Kryst had high functioning depression. I think her depression had worsened in a major depression, which then she didn't realize, or perhaps she would've identified with perfectly hidden depression. We'll talk about that difference as well as other pitfalls of high functioning depression after this word from Better help.
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I recently heard a fascinating reframe for the idea of asking for help. Maybe you view asking for help as something someone does who's falling apart or who isn't strong. So consider this. What if asking for help means that you won't let anything get in your way of solving an issue, finding out an answer or discovering a better direction? Asking for help is much more about your determination to recognize what needs your attention or what is getting in your way of having the life you want better help. The number one online therapy provider makes reaching out about as easy as it can get. Within 48 hours, you'll have a professional licensed therapist with whom you can text, email, or talk with to guide you, and you're not having to comb through therapist websites or drive to appointments. It's convenient, inexpensive, and readily available. Now, you can find a therapist that fits your needs with better help, and if you use the code or link Better help.com/selfwork, you get 10% off your first month of sessions. So just do it. You'll be glad you did. That link again is betterhelp.com/selfwork to get 10% off your first month of services.
(12:32):
Let's get back to talking about Chesley Kryst. I don't want to oversimplify what Ms. Kryst went through or get into some kind of label dispute about what we call it. She thought of it as high functioning depression. That's what she reportedly told her mother the day before she died. Perhaps even that's what she and her therapist talked about. But moderate depression or high functioning depression can morph into major depression, and if she indeed experienced perfectly hidden depression or her perfectionism and high achieving life was really camouflaging even deeper despair than she wanted to reveal, she may not have had a way to talk about the extent of her suicidal plans or impulses. What matters is that she very purposefully fell to her death and the world lost a woman. Her family lost a daughter or a sister, and she was no longer alive to figure out that she could get better.
(13:25):
In my TEDx talk, I warn against just this kind of silence or fearing what might happen if you reveal suicidal thoughts. I also know as a clinician for 30 years just how common suicidal thinking is. It's not weakness, it's not a sin. It's a human response to depression and abuse and whatever else has happened to you. I do wanna make the point here that no depression is easy. Not one kind of depression is better to have than another kind, but you can function better with what's called smiling, depression, high functioning depression, whatever. You just can live your life. You're still walking around having to cope with a sense of sadness and maybe even dread, but even high functioning depression has its pitfalls. So we're gonna talk about that and as always, what you can do about it. This is in no way a complete list, but it's what has come to me as I write this this afternoon, and I hope it's helpful.
(14:22):
First, loneliness can creep up on you. With high functioning depression, you can easily tire of keeping up appearances, but you can get trapped in doing so and begin to have thoughts of being caged in by the life you've created into the depression that never seems to get better or worse. It's just there. So let me say high functioning depression has a root cause, just like more severe depression. Let me repeat that. It has a root cause. So what could that be? The first cause could happen through learning. What I'm saying is that high functioning depression can become almost its own lifestyle. You absorb depressed thinking or behavior as a child. Basically, you learn it. Think about if your parents never praised you or rarely gave you the message of what they saw in you that was your power or talent or skill. You can grow up feeling less than maybe your parents also felt that they were less than, and so you learn that from them.
(15:22):
But it isn't reality or it doesn't have to be. The problem is you can absorb low self-esteem. You can be told you don't wanna try too hard or show that you really want to work hard for something because that's how you get hurt. That's when you look stupid. So you don't risk, you don't try. You don't even have a clue of what your potential is. You live your life very carefully or you avoid risk or you avoid the chance of others seeing whatever your real struggles are. Now, you might say, "Well, I was never abused as a child." That's good. In fact, that's great. But damage can also be done by growing up in a vacuum where you were taught or it was modeled for you, that you just get through life. You settle, and guess what? That's depressing. Life can seem just okay, not bad, not good, just okay, so maybe you do put that smile on your face every morning.
(16:17):
Maybe you clock in at work and remember it's your colleague's birthday and you wish them a good day. Maybe you love your daughter and she's excited about a soccer game she's going to play that day. You've tried to give her what you never had and good for you, but your own life seems pretty humdrum.
What I'm not saying is that there's something inherently bad about normal. I think it's sort of funny... normal has become a negative term. Why? I'm not sure - the only time I hear it used positively these days is when you get a test back and the results are normal or when your life has been chaotic and you're glad to get back to normal. But I've seen on social media for example, that normal is simply not okay, and that can be a part of high, high-functioning depression. My life seems normal, but I'm telling myself that's not good enough.
(17:05):
Really, that's a setup for selfs sabotage. But humdrum is not normal. Now, there are days that are pretty humdrum <laugh>. We all have them, but if your life stays that way, that's the point of high-functioning depression that you don't get out of it. It's only when you stigmatize normal, when you see it as not bright enough or shiny enough or not good enough, that normal becomes a message to yourself that you have failed somehow.
So let's get back to the cause of high functioning depression. Maybe it's not learned. Maybe your high functioning depression is the product of something else, a relationship that went sour that you've never gotten over, some loss of a dream that you've never recovered from. Maybe you stopped going to school, dropped out. Maybe you've got a learning disability that's either never been diagnosed or you've not wanted to admit it.
(17:55):
Maybe you've grown up feeling that because of your race, you don't have a chance because you've been bullied and you've absorbed that message that you're less than, that you need to hide. You've got to look for what you believe about yourself or about life in general to determine what may be getting in your way of having a good life or what I like to say, a good enough life, which is not humdrum. It's just good enough, and that can help you overcome depression that you don't believe the messages you got from your neighborhood or your family or your culture. If not, your condition can devolve into feelings of self-loathing or self-doubt, the stuff of more severe depression. Now, I'm very aware as I'm talking that I'm a white financially secure woman. It may seem easy for me to say these things, but then I think of situations like the one I'm about to tell you the things I've learned from my own patients.
(18:49):
One day when I looked on my schedule, I saw something kind of interesting. One of the patients I was going to see that day was the mother of someone I'd actually seen years before. And that patient, the one I'd seen years before, had asked a special favor of me to see her mother. Let's call her mom Emma. That was not typically my practice to see someone's parents, but her mom had heard about me from her daughter and she knew I hadn't thrown her under the bus, but had recommended instead that her daughter work through the legitimate feeling she had, while also have whatever compassion she could for her mom. Emma had had a really, really rough life and hadn't been all that great of a mom. The daughter told me that she'd apologized a hundred times over, but she'd also told her daughter she wanted to share something with me she'd never shared before.
(19:36):
So I agreed to see her mom. Emma.
Also on my roster that day was a man who was one of the head honchos of the corporation where Emma worked. She worked on the chicken line, cutting up chicken parts. She'd never even finished elementary school. The other man I was about to see was a big wig in the chicken company. I smiled a little when I saw that and wondered what my day might bring.
Emma came in first. Sure enough, she got tears in her eyes when she talked about the damage she'd done to her daughter. Her feelings were very sincere. She thanked me for helping her daughter. But when I asked why she'd wanted to come in for herself, she said, "I've never told this to anyone, but I've never forgotten it and I know that I've been affected by it". And there was a pause.
(20:25):
"I was sexually abused by my brother for years and I've never told anyone", and she got tears in her eyes again. Of course, I asked, "How does it feel to tell me?" And she said, "Like a weight just dropped off my shoulders." She went on to describe other things in her life. For example, she was taking care of her ex-husband who now was almost completely unable to care for himself, and he had been horribly abusive to her. She asked for no sympathy. She simply wanted to tell someone about the abuse and felt tremendous relief as she said. I admired her candor and continued to work with her for a few more sessions. 'cause she needed to help setting some boundaries. She needed to remember that she had to care for herself. That wasn't through massages, but real self-care, some time to herself, some rest.
So that same day, as I said before, I saw the big wig as we'll call him <laugh>, we'll call him Pete.
(21:23):
Pete had had all the education and opportunities that life could offer, and those were many. He was smart, but as I like to say, he was his biggest fan and it wasn't attractive. He came in with his wife and seemed to have the agenda that I tell her there was no reason for her to be depressed, that she had everything a woman might want. His wife looked at me and said, "I have everything except Pete's love." Pete scoffed at that and looked at me as if I'd agree with him. Some basic narcissism, of course, but what was so evident to me that Pete didn't have a clue about what real connection was or could be.
The differences between Emma and Pete were many. I could have said back then that maybe both of them in their own very unique way were experiencing chronic but moderate depression or high functioning depression.
(22:12):
But Emma had found a way to stay connected, to seek forgiveness, to care, to choose to be transparent and allow her pain to lessen. Whereas Pete had very little to no empathy for the chaos of his marriage, nor did he understand what true connection was. I knew at the time that underneath what looks like narcissism, what looks like bravado is sadness, insecurity, and depression.
Now, whether we wanna call it high functioning depression or what, I don't know. Pete only came in twice because he also didn't know how to risk true connection with me.
I actually worry more about the Petes of the world than I do the Emmas. Emma has developed coping skills. Pete, not so much, except in the area of achievement. It was Pete's life that was full of sadness. It was Pete that was caught. It was Pete whose life would stay chaotic until he could try to risk understanding what made him - him, what had happened to him.
High functioning depression, despite its name is still depression. That's a point that I hope I've made clearly. But I hope that this episode has helped you realize that you can figure out where those feelings and thoughts came from, and you can begin to change them. Because life is worth living very fully. And if SelfWork has helped you do that or make changes in your life that are important to you, please let me know.
(23:48):
Thanks always for listening. You can let me know that by leaving a rating or review of wherever you listen to self work, it always means so much. Ratings are simply a quick, yes, I like this <laugh>, or a star rating. I guess it's a 5, 4, 3, 2, 1. And of course, review is a little more detailed, but all of it means so much to me.
I just spoke last night to a small women's caucus. I wanna remind you that I'm available to speak to your organization. I don't care if it's 20 people or 200 people. I can speak virtually or I can come to you given the appropriate circumstances. I'd love to do that so we can all share the wisdom that we all have.
You can also join my Facebook group at facebook.com/groups/ selfwork. We're at about almost 3,600 people. Some people go and then some people come. It's a great group. We'd love to have you there. And as always, you can buy my book Perfectly Hidden Depression@amazon.com or wherever you buy your books, and it gives you 60 exercises that you can follow along and learn how to get in touch with your own emotions very safely and securely.
Again, thank you. I'm always grateful you're here. Please take care of yourself, your family, and your community. I'm Dr. Margaret, and this has been SelfWork.
I wasn’t feeling so hot yesterday so took a time-out day and watched "Shrinking", the Apple TV series that has a superb cast and follows the lives of three therapists and their friends and families. It’s full of expletives, especially the f bomb. Which is fine by me but there’s wasn’t one person in the cast who didn’t explore its complete usage… It’s also very moving. And I was relieved to see that except for some entertaining but weirdly unethical behavior, the therapists are painted as caring and trying hard to help. But also having HUGE struggles in their own lives.
I get it. There have been times when my struggles have been larger than others. And yet it’s still my job to be there for my clients – the way they’ve come to expect me being there. Because I’m a shrink.
So, I thought today we could talk about what those expectations – at least the basic ones – the stuff that both behind the scenes and front and center can be the building blocks of trust and safety in therapy. an episode on creating emotional safety in therapy. That’ll be in your show notes. Today, we’re focusing on basics.
The listener email today is from a listener in Bermuda who’s tried several therapists but not found one that has helped her – what she calls “manage’ her depression as its recurrent. And do I know any international treatment options? ‘I’ll do my best to answer her.
Click HERE for the NEW fabulous offer from AG1 - with bonus product with your subscription!
Have you been putting off getting help? BetterHelp, the #1 online therapy provider, has a special offer for you now!
An episode on creating emotional safety in therapy.
You can hear more about this and many other topics by listening to my podcast, The Selfwork Podcast. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook!
And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
350 SelfWork: Being A Shrink and What You Can Expect from Yours
I wasn’t feeling so hot yesterday so too a time-out day and watched “Shrinking” the Apple TV series that has a superb cast and follow the lives of three therapists and their friends and families. It’s full of expletives, especially the f bomb. Which is fine by me but there’s wasn’t one person in the cast who didn’t explore its complete usage… It’s also very moving. And I was relieved to see that except for some entertaining but weirdly unethical behavior, the therapists are painted as caring and trying hard to help. But also having HUGE struggles in their own lives.
I get it. There have been times when my struggles have been larger than others. And yet it’s still my job to be there for my clients – the way they’ve come to expect me being there. Because I’m a shrink.
So, I thought today we could talk about what those expectations – at least the basic ones – are. There are skads of different approaches and schools – that we’ll leave for another episode. But I’m talking basic stuff here – the stuff that both behind the scenes and front and center – can be the building blocks of trust and safety in therapy. I’d already published an episode on creating emotional safety in therapy. That’ll be in your show notes. Today, we’re focusing on basics.
The listener email today is from a listener in Bermuda who’s tried several therapists but not found one that has helped her – what she calls “manage’ her depression as its recurrent. And do I know any international treatment options? ‘I’ll do my best to answer her – have done several episodes on emotional regulation or managing emotions so I’d start by having her search for managing depression or managing emotions on my website at drmargaretrutherford.com to help locate things I’ve already mentioned could be helpful.
Before we go on, let’s hear from BetterHelp – rated the “best” online therapy service…
Yesterday I woke up in a bad mood.
I’m usually quite cheerful in the morning, a trait others might love or might need me to tone down a bit, depending on their own morning ritual.
But yesterday, several things cropped up. We'd eaten at a place that we hadn't been to in a long time for dinner the night before. And my stomach didn't particularly care for what it had been offered. And my gut is usually like iron, so I haven't built many skills for handling that discomfort.
And I was tired. I'd been going pretty strong for several weeks with no break - and like every other time I do that, the same thing happens. Overwork and overbusy brings bad mood - a little feeling of self-pity or entitlement that I can act less nicely to my spouse - just because I'm in a bad mood. That choice only makes my mood worse however, because I know what I'm doing - giving myself permission to be a jerk - when the little part of me that's watching what's going on is saying, "What in the hell are you doing and why did you talk to him like that?'
But I rode in sullen silence to our usual Saturday breakfast diner. (which might've been a relief for said spouse...). And when we got there, they'd put in new lighting that was flickering every few seconds, a glitch that needed fixing. As I was already feeling kinda yuck, then I felt like I might be thrown back into vertigo which I'd experienced for the first and hopefully last time a few months back. So, I was staring down at the table, trying to decide what I could eat, trying to be nice to the waitress, when my husband made me laugh, making fun of the plethora of physical complaints expressed by the two of us since rising.
Thank God for laughter.
It didn't help my stomach - but my bad mood lifted almost instantly.
Not that that happens every time. Sometimes, like everyone else, I can hold onto worry or feeling sorry for myself - whatever's constituting my "mood..." until... I get to the office. And I become your therapist. My mood needs to change - and it's my job to know how to do that. To get out of my head as much as possible - and tune into you. Not that where I am isn't going to affect that. But I need to try as much as possible to take my little bruised ego and put it on the shelf (fancy word here.. compartmentalized) until I have the time and space to look at what might be causing it. And that time is AFTER I've seen you.
Interestingly, what I've noticed is that when this happens, or when I'm actually sad about something in my life, I focus differently. Maybe better in some way, because I'm coming from a quieter place? That's at least what I've thought.
So when I also finished watching the first season of "Shrinking" yesterday, I had to stop and consider - once again - how others may see their therapists, what they expect on both an intangible but also a very tangible, pragmatic level. The series is filled to the brim with f... this and f... that and there's a lot of sex being had, drugs being taken, and sarcasm being passed out. But all in all, at least the therapists are portrayed as really caring and wanting to help, although ethical boundaries are entertainingly (but not realistically) loose. Not since 1991’s "What About Bob" - which if you haven't seen it and you're in therapy, you definitely should see - has there been more dual or triple relationships between therapist and patient.
But back to how you see your therapist... I was always curious about mine. I was relieved when one very helpful but more soft-spoken therapist told me she'd thrown a plate at her husband when she got mad one time - after the hundredth time of me shaming myself in her office for the way I'd acted when angry. It's not that my choices didn't need to change. But her joining me in living with regret was helpful.
Now, we’re going to turn to talking about these basic intangibles and tangibles in the therapeutic process. I do want to announce this – I took a lot of this from my very first SelfWork episode! The one I created “in class” – I was so very nervous… So I used the ebook I’d created for subscribers to my website as my “structure.” It was funny – when I pulled out that book today to see if I could use any of the material, I realized that most of it is still very good. And hits the basics. What I need to add to that today is so much more about online therapy and changes in HIPAA due to that. Also, the rise of life coaches – a career that’s been around quite a while but within the last five or more years, has exponentially grown. And even more techniques to choose from – which is wonderful but also confusing.
So let’s first talk about the intangibles.. there are seven of them.
What does this mean? One my FB group members commented – when I told them I was writing this post and what might they want to add… said the “power differential” was difficult for her. Meaning that her life was the focus of the relationship as well as her vulnerability being exposed… and that was one of the most difficult things for her.
To me, this may mean the therapeutic alliance isn’t strong enough. She may want a more collaborative kind of therapy – one where there’s a little more ease – even though again, the work is hers to do. But you want to feel as if your therapist understands you – and is working toward helping you in the way you understand and want.
This may be harder with some approaches than others – and honestly, probably reflects my own bias toward a more collaborative approach. So, I’m admitting my bias. I think it fits our lives today – and with both of you knowing what you’re aiming for, the changes that when they happen, you’ll both be able to know you’ve done “the work” – that’s vital to me. That doesn’t need to mean the change itself isn’t in the emotional or mental realm. But knowing you got there – and how you got there – is important.
Believe it or not, I have heard stories of therapists going to sleep. Or forgetting major things that you’ve told them. This is a pragmatic thing but it has huge relational components. If you feel I am really listening to you, really seeing you, and helping you see yourself – then trust is built. I have a fairly new patient right now – a fairly young guy – who says he loves therapy because of this very thing. His family situation was tough in some ways – and being seen means the world to him.
What do I mean by this? Well, let’s say for the first four to six sessions, I tell you we’re going to start connecting your past with your present because, after hearing you tell your story in the first session, I think there would be some helpful connections to make – due to how you’re reacting to the present. Maybe things are making you so sad you can’t stand it. Or way too mad. Maybe if you understand how you’re getting triggered, then you can have more control over those emotions. And you agree to that.
But in the third session, I say, “I think we need to start couples work.” That’s never been mentioned – I just decide. You can see how that can be unsettling – now if I have a really good reason to change course, okay. Let’s talk about it. But out of the blue? Not helpful.
Okay… the fact is that what can make someone a good therapist may not be what helps them be a good business person. But if not, that’s not your responsibility. You need to understand the business aspect of your relationship and that needs to be solid and secure. We’ll talk more about that.
6 and 7. I realize six and seven are very integrated – they’re about the therapist gaining your trust with your information – not only written information, but you knowing and trusting that confidentiality is being highly respected. And that their business is operating in a way that their staff only has limited access to your information. And also vital – that personal physical and sexual boundaries are being respected as well. There is absolutely no reason why a therapist should engage in any kind of physical touching without your express consent or your request for it. Obviously if my patient suggested something sexual, then I’d need to establish a boundary there and that would become a therapeutic focus.
So those are the intangibles. What are the pragmatics? We’ll hear those right after this message from AG1.
So, here’s the quick and dirty list of what you can and should expect pragmatically from a therapist.
Listener email
Hello and good afternoon ,Dr Rutherford,
Hope you are well.
I am a huge fan of your podcast and listen to it regularly on my walks! I have gained a lot from it, but was also interested in one to one therapy! I am based in Bermuda, and understand from your website that you wouldn’t be able to help with potential clients outside of Arkansas; I just wanted to get in touch to ask if there is anyone globally that you would recommend that can provide therapy remotely? I have tried various therapists all over the world and none have seemed to work for me. I have suffered from recurring depression since a young age, but instead of accepting that and living with it, I would love to finally learn how to manage it.
I am very grateful for any guidance or recommendation you are able to share.
Kind regards,
My response:
Hello and thank you for being a listener. I wish I could help with the one-on-one part of what you’re seeking. Maybe a way I can help is to write a podcast episode about what “managing” depression actually means. I’d like to research that a bit myself because I can certainly think of clients of mine who do just that. But I’m sure you’re not the only person who doesn’t exactly know what that might look like. To me, it means asking yourself what’s happening or what are you doing or experiencing when you don’t feel depressed - and try to add those kinds of things more into your life. And then when you do feel more depressed, what do you do when you’re in it?
I hope that perhaps that might help. I’ll write myself a note so I don’t forget!
Basically, managing depression – especially recurrent depression – is managing triggers. Knowing what may cause a “flare-up” of emotions that can easily cycle into depression – and either avoiding those triggers if you can – or at the least, being aware of what they are. The most obvious example I can think of right now -.. let’s say a wife had an affair or several on business trips out of town. So they work really hard together and things are going well. Then the wife goes out of town without there being any safety or trust plan. Guess what? Something happens and al hell breaks loose. Trust is lost again – perhaps not due to any distrustful behavior, but because the couple hadn’t planned on how to stay in touch in order to AVOID a problem. I call that walking into a mine field, knowing it’s a mine field, but thinking you can do that unscathed. Being aware – even listing – what is likely to trigger me? Very helpful.
When I was contacted by Paulina Siegel about being on her podcast, Shit Talking Shrinks, I was intrigued. She and her friend and colleague Victoria Aron are in Season Two of an hilarious, fresh challenge to the stereotype of the "therapist" - someone who's emotionally calm and somehow "above it all." So this is an expletive-filled SelfWork episode today - because guess what? Therapists can use colorful language as well!
Yes, we offer our expertise in creating an emotionally safe space for you to risk your own healing and growth. But the old "immutable" therapist - the one who rarely interjects their own personality - is an identity that both these therapists challenge. And they do it with laughter and fun, intelligence and caring.
I've long been "myself" as a therapist. I don't suddenly don some cloak as soon as a patient comes through the door. The unique nature of the therapeutic relationship lies in the focus on the issues of one person, the client. And yet, to gain trust, these women believe that being more real is the key to what trust looks like in 2023.
So come laugh with us and listen in to what was a very fun conversation! And get to know Paulina Siegel and Victoria Aron, as they tackle issues that especially millennials and Gen Z'ers face.
BetterHelp, the #1 online therapy provider, has a special offer for you now!
You can hear more about this and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook!
And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
This is SelfWork. And I'm Dr. Margaret Rutherford. At SelfWork, we'll discuss psychological and emotional issues common in today's world and what to do about them. I'm Dr. Margaret and Self-Work is a podcast dedicated to you, taking just a few minutes today for your own self-work.
Hello and welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford, and I'm so glad you're here.
Let me read you an email I recently received. "I feel grateful to be able to write to you as I love the SelfWork podcast. It has brought me so much joy, vitality, support, and wellness over the months. Of course, that made me feel good. My name is Paulina or Pauly Siegel, and I'm a licensed clinical social worker, certified addiction specialist. And I'm master level trained mindfulness practitioner. I specialize in Gen Z and millennials struggling with trauma, O C D, anxiety and generational specific issues. I've also started a podcast called Shit Talking Shrinks, which intertwines clinical expertise and humor to bring you something that is both psychoeducational and entertaining. Our podcast breaks down mental health topics, the human experience and society at large, while leaving you with tangible tools to navigate life more effectively."
So, of course I listen to the podcast, and by the way, this one is going to be pretty baudy with lots of language. So, you know, use your own judgment in listening. But their podcast is entertaining and hilarious and real and informative and supportive. Polly has a no holds barred co-host, Victoria Arin, who's in practice herself. And between the two of them, there's an energy that was so refreshing and funny. In fact, I've never laughed more in an interview, and I hope you will as well.
As I said, there's a bunch of expletives in this one and we talk about sex. So a heads up there. These two therapists are angry at how the mental health profession teaches therapists that they need to somehow look above it all, or as if they're not human too. And we are most definitely human. We get teed off, we get constipated. We cuss... What we do have (that you've heard me talk about many times on SelfWork), we have experience in listening and sharing a different kind of relationship with you than you're going to get with a friend. We have expertise in certain issues and struggles, and we're going to offer that to you But because it's often deeply personal, we enter a relationship with you that hopefully feels safe and secure while we're also folks just like you. So this is gonna be a journey.
But before we continue, let's hear from Better Help.
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And now a different kind of SelfWork. For those of you who can handle the language and wanna have a great deal of fun, come join me and Polly and Victoria.
I'm really glad to meet y'all. I I've listened to a couple of your episodes and they're really good and I I was delighted. Yes. And so anyway I love what you're doing and Okay. Can you just tell me a little bit about yourselves First, I'd love to just find out who you are, where you are, where you came from, <laugh>,
Paulie, take the lead.
Okay. well, hello everyone. I'm Paulina Siegel. I have a private practice in both Illinois and Colorado. Oh, that's, that specializes...
That's a lot
<Laugh>.
It is a lot. It is a lot. But it's been fun and it's been going for five years now, so I'm really grateful for the journey. But I specialize in Gen Z and millennials.
How do you know Victoria?
Yes. So Victoria and I met in Illinois. I moved to Illinois in August of 2021. Mm-Hmm. <Affirmative> and I met Victoria through a mutual colleague. And this colleague ended up calling me and was like, "You have to meet Victoria. She is the coolest, she's cooler than you." And that's hard to say.
That's great. And Victoria, where are you? And, and you're in Illinois obviously, so
Yeah, so I'm in the suburbs of Chicago. And I have a private practice as well. Okay. I do, I do concierge, sober coaching and case management. Wonderful. So, yeah, so I'm trained as a social worker. I have certifications and process and substance use disorders. And I kind of, I'm actually coming up on the two year anniversary of my practice. And when I met Paulina, I had no real desire to be part of a podcast. Didn't really think about it. I just knew that I wanted to perform. I lo I've always loved it. I love being center of attention. I love telling stories. <Laugh>. So this is like the best
Of both? Both. That's not me at all. Not me at all. No, no, no. <Laugh>. That's how I have a whole room outfit. Right. Studio <laugh>.
Yeah. My whole career is built off myself, but I don't wanna be the center. So...
<Laugh> now Pauly, you were trying to tell us what you, what you focus on or what you specialize in. Yeah,
Yeah. No worries. Gen Z and millennials, so anyone 15 to 43. I do a lot of trauma o c d, anxiety work. I was very involved in the addiction world for a while and sort of phased out cuz I got a little bit burnt out. And that's why we have the Victoria's of the world because she, she has all the grit and resiliency that's needed to do the work. But I've really liked focusing on more of the strictly the mental health side of things.
But yeah, I I really I'm so pleased to talk with y'all and and just talk about millennials, gen Zs. I am always honored when someone, you know, in, in that, in those generations. I don't do Gen Zs, some millennials I do still. So I have a 28 year old son, so I'm at least somewhat in touch with that stuff. <Laugh>. Yeah. So what has the podcast? The podcast is called Shit Talking Shrinks. Mm-Hmm. <affirmative>. And you've been doing it for two seasons now, is that right?
Mm-Hmm. <affirmative>, we launched in January.
Oh. Oh. So mm-hmm. <Affirmative>, this is your second season that...
You're this is our second season currently.
What's it been like?
Incredible, incredible. I mean, not only has has like, just spending more time with Paulina and talking and talking about things we care about been amazing, but the way that people have responded to us in such a short period of time has been actually just like shocking.
Yeah.
You know, I did not know that it would be what it is and I have no idea where it's gonna go. And that's so amazing. And Paulina is just the most incredible partner. She's like the steam engine of it all.
Oh, yeah. It's nice to hear. You know, when I was trained, I went to the University of Texas Southwestern Medical School and it was shifting from a psychoanalytic viewpoint, which I wasn't wild about to a C B T, you know, and. But we were still these anonymous therapists, you know, we were supposed to not have personalities and lives and, you know, just be this immutable source. But I got really bored when I started actually practicing anyway. I... what I found was that the more real I got both as a therapist, not that I pounded people with my own story. But, and then, when I got on social media, the fact I have panic disorder and the fact that I have a history of anorexia and I've been divorced twice mm-hmm. <Affirmative>, all that stuff was just, you know, I, people loved it. I was scared they'd turn it off and go, well what is she doing being a psychologist? Is that anything like what y'all have experienced? Yeah. Yeah. So
That is that, that's the birth of Shit Talking Shrinks - exactly what you just said. Because when I went through my MSW program at DU, I remember it was the same foundation and the same philosophy. Don't disclose anything, be very polished, seem honestly like an alien. Like, don't bring any of your human, human elements. Keep a straight face, be very aware of your emotions. Right. It was all the, all this inauthenticity like that, that's how it was registered and that's how it was internalized. And then when I tried to take that and my private practice and embody it, because that's what I was told I should do as a clinician mm-hmm. <Affirmative>, it was awful. And it was boring and inauthentic and I, I didn't feel like I could fully be myself as I interacted with my clients. Mm-Hmm. <affirmative> and that, and because I couldn't do that, the work was dull. Mm-Hmm. <affirmative> and the work was bland and there wasn't the depth and the scope that I think is required to make eally transformative change with your clients. Mm-Hmm. <Affirmative>. And so I started to kind of like, tease with not being that way, but I still felt like this armor was on of like, I gotta do what, you know, my professors told me and what DU told me. And it got so exhausting to the point where I was like, I need to break free.
Like, we need to be Shit Talking Shrinks. Like, I just
Need to be able
To say the word,
Be okay with it.
Right, right, right. Yes. Yeah. Amazing. Anyway, what about for you, Victoria? What about for you?
Well, I mean, I experienced it in my personal life. Like, I've had conversations. I remember, you know, like before I was opening my own practice, I, my mom, I was, we were like talking and I was like, "Ugh, I hate that bitch". And she was like, "Oh my God, aren't you a therapist?" And I was like,
<Laugh>.
Yeah. I was like, I'm a human so I'm gonna hate people, you know, I'm not gonna <laugh>, I'm not gonna be perfect. And it's, and it's, you know, that's, I I tell people all the time who are who I'm consulting with or who I'm, you know, are, are seeing if they wanna, they wanna work with me like I am fully myself mm-hmm. <Affirmative> and not, it's not for everybody.
Right. It's not good to, and it's for everybody. Mm-Hmm.
No. And because I'm so intimate with my clients and I'm in their lives for such a, you know, substantial period of time, they better like me.
Yeah. You know. Exactly.
If they don't, we shouldn't work together.
So, so what are you finding with your work with millennials and, and Gen Z'ers that are their particular, what are you most concerned about mental health wise with this generation and what are you most glad about that has happened and it, and you see happening?
I would say for me, what I am so glad about is there's a connection and a value and authenticity and wanting to heal and wanting to do the work. You know, there isn't the same stigma or the same embarrassment, normal, normal that that previous generations, Gen Xers and Boomers had, where they're not embarrassed to say, I'm struggling and I'm anxious and I'm depressed and I'm stressed out. Like, there's, there's the willingness to, to take off the mask mm-hmm. <Affirmative>. And I think that really allows for the deeper work and for it to the, there as a clinician, there isn't the need to have to like crack the code, right? Mm-Hmm. <Affirmative>, it's like it's already there and they want to go in and they want to change. And so I think for that, that's for me the beauty and the richness of working with millennials. And then I think the concern is really the poor coping skills and the lack of grit and resiliency. Ugh. And, and research has confirmed this. Gen X and Boomers really developed a lot of grit and resiliency in coping mechanisms to get through the adversity and the life challenges. Millennials, on the other hand, due to parenting and different external variables, didn't develop the same sort of shields and the ability to move through the discomfort in the same way. And so we are really ill-equipped, and I see that clinically
I do too. I, I wrote down here fear of adulting. Yes. It's just, I see that all the time from college students to other people in that age group. But is that what you see Victoria as well?
I really like what Pauline said. Mm-Hmm. Yeah. I I think there's like fear in general, you know, like fear just seems like this perverse sickness that's especially with Gen Z, you know, like there's, they have more access to information than.. than ever before. Right. And it, they are paralyzed by it. Mm-Hmm. Like having a conversation with a Gen Zer is, I mean, I, it just makes me sick because it, there's such a lack and it's, of course I'm stereotyping and I'm overgeneralizing and it's all hyperbole because that's who I am. Right. But like, it sometimes it's like you could literally be the most brilliant on the earth. You could literally be the most educated, the most understanding, the most, you know, blah, blah, blah. But there's like no ability to actually comprehend anything because there's just being like, these people are just being bombarded constantly by information. Exactly. And so I, I think it is, I think it's fear and I would be the same. Yeah. You know, like, I'm millennial
Old. How old are y'all?
I'm 31.
Okay, so you're a millennial.
Yeah. And I started using drugs when I was 12, so I <laugh> I like fully understand Sure. That it's, it's terrifying to be a part of this world to be, you know, especially as it is today. Mm-Hmm. <Affirmative>, I couldn't even imagine. Paulie, how old are you? 26.
I'm 12 <laugh>. Do I look, do I, do I
Look 12? I hope so. I hope,
I hope the Botox is working. <Laugh>. It's
Working. You
Look like a baby. Yeah. No,
I'm
Dreams. Goals, hashtag goals. I am 32 and I will be 33 in January.
Okay. Okay. Yeah. Yeah. So, so are you also in recovery, Paulie?
I'm not. Okay.
Well, I'm in recovery from an eating disorder, but not in recovery from substances.
Okay. So what just immediately comes to mind is you want talking shrinks to be, what do you want people to walk away feeling, thinking, experiencing?
I'll, I'll go, I'll jump in. I want them, I want them to laugh. Yeah. I want them to be able to be lighthearted as they listen through an episode. I want them to have tangible tools where they walk away and they're able to have applicable skills that they can apply immediately to make life filled with more vitality. Mm-Hmm. <affirmative> and I, I, I want them to be able to feel our humanness and know that we are just ordinary people that struggle, that freak out, that have meltdowns that are in it. Like there's the collective human, the collective humanity of this mm-hmm. <Affirmative>. And if I think those three things, they walk away with their life being a little bit different. They laughed and they realize that we're we're just idiots. That's great. I'm happy.
Yeah, exactly. <Laugh>. Well, I had a patient walk away from a session recently, and as she was walking down the steps, she looked back over her shoulder and she goes, now she's around my age. And she said, I hope I'm like you when I grow up. And I thought that's what we're gonna talk about next session, <laugh>, because she's, she's projecting so much stuff onto me that, and I've been very real and that.
But maybe that's it though, Margaret, like, maybe because you are authentic, you know, because you are fully yourself and she,
That's a good point.
I think that's so at attract, I mean, that's what's become attractive to me mm-hmm. <Affirmative> as I, as I have become more myself because I... Good point....You know, like I've hidden myself for a long time at a lot of different parts. And so when I meet people that are like, who they are, I'm not perfect. This is what's going on. I'm like, oh, I like you
<Laugh>. Yeah. You know? Well, I mentioned it to her and I said something about, you know, we're focused on your struggles. This relationship isn't about focusing on mine, so I don't want you to forget that I have them. And she goes, oh, I know you do <laugh>. And I said, that's good. I love that.
How, how is doing the podcast changing you as a therapist, changing you as a person? What do you think?
Well, I think for, I think the podcast... the podcast itself is bringing so much joy and lightness. And as, as Victoria said, I also had that deep desire to be performative and theatrical. Yeah. Like that, that is so connected to who I am and my values. But really what's happened with the podcast is I've learned so much from Victoria in the sense that she has challenged me to look at the shadow parts of myself, the parts of myself that I think I've ignored for a very, very long time. Maybe not intentionally, I just didn't have the awareness to see that there were, there were wounded parts of me that kept manifesting in the process,
Not, people listening Don't know what" shadow" aspects of yourself are. Maybe you can explain that a little bit.
Yeah. I think the parts of myself that, you know, are, are wounded, the parts of myself that are rooted in attachment injury, the, the stuff that I experienced in my upbringing and really the, the darker adaptive parts of myself, the ways that I had to survive and survived the struggle that I went through growing up. Mm-Hmm. <affirmative>. And because those parts weren't healed, they were coming out in really ugly ways, not while we were recording, but behind the scenes Right. Where I was showing up in ways that were detrimental to Victoria and I, and I think she has shed so much light on that and has invited me to do the deeper work with my own therapist and do the deeper work that needs to be done for really the long haul mm-hmm. <Affirmative> and that I have an abundance of gratitude for.
Oh, that's nice. What about you, Victoria? Love that. Yeah. Really.
Yeah. That's a huge compliment. That's, thank you. It's true. It's been an honor to show you yourself, <laugh>. I like being a mirror. I, I do. Because, because it's the same for me, right. Like Paulina, Paulina and I are not just podcast co-hosts and not just colleagues, like we're we're soul sisters. That's, that's really what it is. I think the, the coolest thing that's come for me in terms of the podcast is this journey of really allowing myself to be exactly who I am. Mm-Hmm. <affirmative>, you know, nobody's ever stopped me but me. So,
Oh,
You know, like when I met Paulina, I was embarking on that journey and I was, I was ending a, a long-term relationship. I was, you know, there's a lot changing in my life. And this last 10 months of my life, I, I say it all the time, it's just, it's so obnoxious, but it's like, it's been the most freeing and the podcast is like so integral to that. Mm-Hmm.
<Affirmative>, you know. Well, I think, you know, I think I've read some of your reviews and that kind of thing that's obviously coming, coming across. It's just really coming across strong. So good for the two of you. Where do you wanna go with it? What do you wanna, I mean, the reason why I wanted to have y'all on primarily was to talk a little bit about millennials and mental health, but was also to really let people know about your podcast so that mm-hmm. <Affirmative> anyway. What, where are you going with it? What do you wanna create? Or are you already there? Do you or you know, whatever.
I wanna be a
Star Mom. You wanna be a star <laugh>? Yeah.
Yeah. Well, it's, it's a really funny question. That's why when you, when it came off your tongue, I, I laughed because when I s when I started with Victoria and I looked at her and I said, you wanna do a podcast with me? This is, this is so Victoria. Yeah, sure. Whatever. Sure. That sounds great. <Laugh>. And I'm like, I'm so glad you're in. But like,
Diver, can I,
Can I explain my vision to you? No. She's like, yeah, sure. What's your vision? I mean, I'll show up like, we'll do it. And I'm like, no,
But,
But my vision is like, I want this to be big girlfriend. Like, I want us to, I want to have a brand behind this. Are you in? She's like, listen, here's my boundaries. Here's what I can do, here's what I can't do. If you wanna make that happen, do it. She's not, she's not from New York, but she kind of is, you know, in her essence,
<Laugh>.
And that was so yes to, to make a long story short, you know, we really wanna be able to touch as many people as we can. We want the episodes to be fun and lighthearted and have humor, but also be really hopeful. Yes. And beneficial.
Yes. Tell, tell the audience a little bit about what some of your, the, the ones you like the best. What have, what have been the content of some of the podcasts you've liked the best? Yeah.
You go first,
Victoria.
I know obviously
This one, right? Obviously this, so Yeah, of course. Yes.
Our podcast with Dr. Margaret is number one <laugh>. I think the, so for me, the type of person I am, the, the podcast that I love the most are like our modern dating podcast. I think it's Oh, so f our mo or mo Modern dating episode. It's so funny. Our values episode is funny. I like humor. Right? So that's why Pauline and I work, is because Paulina brings, she brings the organization, she brings the joy, she brings the education. Right. And I just bring straight talking. Yeah, yeah. You know, well, it's the
Straight man and the, it's the word for centuries, you know? Exactly. <laugh>. Everybody
Needs. So like, my favorite episodes are the ones that are the most unhinged, <laugh>. And, and that's, and that's just what it is. <Laugh>,
You know, Paulie, I don't reference to you're wanting to be known. I live in a fairly, we're under a hundred thousand people, so fairly small. Where
Do you live in Arkansas?
Fayetteville, Arkansas. In the northwest part of the state. So we're a little liberal community in my very conservative (Woah), Arkansas. Yeah. Yeah. Interesting. So anyway, we walked into a restaurant and I said, you know, said, "Do you have reservations"? I said, "Yes, it's for two, it's under Rutherford." And she looked at me and she goes, "aAre you Margaret Rutherford?" And I said, "yes" "I recognize your voice. I love your podcast". We, we went to the table and my husband, who's very sarcastic, looks at mean, goes, "If this happens much more, I'm not gonna be able to stand living with you." <Laugh> <laugh>.
I love that. Did that feel good? What did that feel like?
Oh, it was, it was a, it was a brief passing moment. <Laugh> doesn't happen much, but anyway. Good. I hope you're both stars, like brightly shining stars. That would be great. <Laugh>.
Yeah. In my own mind. I am, I'm ready to do, there you go. Well,
You know, <laugh> people ask me all the time, how do you do something so serious all day long? And I say, because I'm not serious all day long, right. We find things to laugh about and we find things to, you know, see from a different perspective that adds a little more oh, I don't know. Just I mean, a lot of these people are incredibly demoralized and incredibly, they don't know what to do. They don't know what to say. They're hoping I know, but I usually don't. I'm just trying to help them and find their strengths or what I've learned from other people. So I'm just sort of this conduit. But anyway, I, I it, we do something very we do something that has a lot of seriousness to it in people's lives, but at the same time, like you said, you've both said in your own way, if we are trying to look like, you know, some kind of, and I'll use the term before immutable, or just unmoving or non-emotional. I mean, I, I, you could see what I'm feeling on my face, you know? Mm-Hmm. <Affirmative> I'm so glad y'all are going in that direction and have other, how have other therapists reacted to y'all or responded to y'all?
I don't, I I guess we're both pausing because I think, I think there has been a little bit of a,
You're nodding your head...
...an uncomfortable response. Yeah. Like, you both have thriving private practices and businesses. You're both pretty well known in your communities, the clinical communities in Colorado and Illinois, and same with Victoria. Like, are you sure you wanna talk about anal sex?
Yeah. <laugh>, like,
Are you sure you wanna admit that, you know, you like to hit it from the back? Like
What <laugh>,
You know, there's like this, like uhoh danger. This is gonna jeopardize your brand, your reputation, your credibility. Right. And that is so deeply upsetting to Victoria and I, and we did a whole episode on the sexual revolution movement. And that was actually one of my favorites because if I want to be transparent as, as I embody, you know, being a sexual woman, that does not take away my credibility or my training or my expertise. No. And the fact that other clinicians have insinuated that it could tarnish who we are, that's very upsetting to me. Now, granted, there's a bunch of clinicians that are like, rah rah, we're your biggest cheerleaders. We love what you're doing. But there have been some where I'm like, oh, I'm disappointed in your response.
And, you know, one of my immediate responses to that is, and how many, especially older therapists don't ever mention sex, even if they're seeing a couple or, or, or just, I mean, they never ask about your sex life. I mean, ever.
They can't even say the words. I mean, I was literally taught intimate. Intimate, right? Intimate. Yeah. Oh, are you guys intimate? Are you guys intimate? But we don't have to go there. It's like yeah, we have to go there. It's a huge part of a relationship. <Laugh>. It's
What? It's like not talking about, you know, eating and sleeping. I mean, my co my God. Well, it's funny. I mean, I, I don't, I don't believe I've ever talked about anal sex <laugh>. I dunno. Maybe I have maybe some, some I have 300 and something odd episodes. I'm not sure I've, but even I have gotten you know, really? Do you want to, I mean, are you, you're just telling people all your secrets and one person you say to me all the time, your mother would just be so proud of you. And I said, my mother is turning over in her grave at this very point thinking that I'm revealing some of the things that I'm revealing about either my own life or about our family life, or just whatever. So, although respectfully cuz that's their lives, not mine. So I, I, I get it. I get it. And in fact, when I first started writing about Empty Nest, which was my first social media foray I would have friends go, are you okay? You sound like you've fallen apart <laugh>. And I'd say, I'm just talking about what I'm really feeling, you know,
But that, but that's, but that inherently makes me angry. Yeah. You know, and, and I know that we, we've just been, you know, having fun and laughing and talking and here, but that's, that's inherently problematic. Mm-Hmm. <affirmative> because the more that can clinicians... Right, right. Continue this persona that they don't feel that they don't struggle, that they're perfect. It is giving a false impression to everyone who we interact with. And that needs to change. It's, I'm not saying to be inappropriate, I'm not saying to not be professional or graceful or polished. Like we need to bring that to the field and we owe that to our clients, but there's, there's the ability to blend authenticity with that mm-hmm. <Affirmative>. And so when we are getting, you know, feedback of like, I can't believe you said that. Oh my God. It's like,
F... Off.
Sorry. I just, that's, that's how I feel ... f... off.
Right, right. Victoria yeah, you're,
I'm snapping
The hand gestures
<Laugh>. I'm making face gestures,
Hand gestures,
All of it, all the gestures. I, I mean, I completely agree. I think, you know, it it, I remember when I went to go open my practice and I got so much from older female clinicians. Really? I mean, yeah. Like, there is like a, I don't know, it's like that mom daughter jealousy where you like, see somebody's youth or you see like that they're thriving and you're like, see their flat stomach. Right. You see their flat stomach and they're perky boobs and they're, you know, like, I hate you. You know, but it's like I think, I think it's been, it's been an interesting process being younger, which I'm not that young. I'm younger in the field and like having a robust practice and now having an awesome podcast and like, there's this idea that I think is an old idea that we have to suffer in order to like, get the dividends that we deserve. Right. Like, you, you should, you should die for that. And I'm, I'm somebody who just fully believes in abundance no matter. Like, I don't think you have to kill yourself in this field to like, make good money and have a good lifestyle. Mm-Hmm. <Affirmative>, I hate that idea. Mm-Hmm. <affirmative>. Mm-Hmm. <affirmative>, you know, and so to the, to therapists that love it, I love them. And therapists that don't, I, I love them too, you know? Thank you. They leave really weird reviews and I love that
One of, they said,
The bad reviews are my favorite <laugh>. Yeah.
What, what was the, what was the oh, I remember it was like, I cannot believe the way that you spoke about Gen Z. You're off my rotation. And I was like, I am honored. I was on your rotation <laugh> to begin with. That's amazing. Yeah.
Mm-Hmm. <affirmative>. Oh my gosh.
So,
Okay, so we're kind of at the end of the interview. What, what else do you want people to know about, I mean, talking
Shrinks. Well, I guess, yeah, go ahead.
No, no.
You, you want me? Okay. I want to well we are on Spotify and Apple and all of the platforms for Easy Access and you can also find us on our Buzz Sprout website. Oh. But the easiest way to do it is to, what's the easiest way to do it? Oh yeah. Type Shit Talking Shrinks into the Google search bar. Yeah. Thank you. Shit Talking Shrinks podcast into Google will all come up. We're on all the socials, we're on Instagram, we're on TikTok, LinkedIn Facebook, and it's Shit Talking Shrinks podcast. So you can find us easily,
You know, open up the conversation about you know, what therapy is, what their, who therapists are. And, and especially for this generation that just seems to be so overloaded with information that they're trying to sift through. And y'all are going now, wait a minute. You know we have the same kind of confusion, modeling that kind of confusion and modeling that kind of, not modeling it like you're doing something on purpose, but modeling it because it is really you. I've, you know, this is something that I, that I can, I, I know what this feels like and I can, I can try to help you with this. Mm-Hmm. <affirmative>
Good. Yeah. And to say we are beyond grateful for the opportunity to come on your show. Yeah. Like when when I got that email back, I was like, she wants us on our show. Really. Sure. I like called Victoria. I'm like, this is big. Yeah. We're so happy. Yeah, that's great. But thank you for, for seeing, for seeing the magic in us. Oh, yeah. I mean that,
I definitely see it and I hear it and I hear it in this interview and I'm proud of the two of you. Thank you. And so I think you're a great team and I really am gonna recommend this highly am recommending this highly to SelfWork listeners who thank you want this kind of, and are looking for exactly this kind of, oh, I don't know, just relief mm-hmm. <Affirmative> finding themselves somewhere just kind of a sense of, okay, I'm home. I'm home and I can laugh and I can cry and I can learn and all that kind of thing. So good for you.
Yeah. Thank you. If, if, I don't know if we have to end at this moment, but I, I do have to say one of the things that I, I always try and leave people with and, and what I try and bring to the podcast is I think life is inherently struggle, right? Like, there's so much that we get brought that is so hard, and especially in times like today. And so a big, huge part of why I am happy today is because I believe that the universe wants us to be joyful. I believe that the universe wants us to have abundance and laugh and, and be full of love. And so I think that, you know, what I bring to the podcast and what, what is a big part of our podcast is that, that life should be that and that it's wanted for us.
Yeah.
You know?
Love it.
Yeah.
You ladies are wonderful.
You can tell I had a really good time in that interview. <Laugh>, they are funny and I think they have a wonderful point. I decided a long time ago not to be one of those therapists that, you know, looked like she was always calm and never expressed feelings. In fact, you can read my feelings on my face, so that wasn't even gonna be possible. So I hope that this interests both you who aren't clinicians and some of you who are. As always, I appreciate your presence here on SelfWork. I hope this gave you a smile. Please take very good care of yourself, your family, and your community. I'm Dr. Margaret and this has been SelfWork.
Increasingly, I’ve noticed a trend in how people are describing “having fun” – and so much of that time, what they’re doing is scrolling thru TikTok or Instagram – Reddit or Quora – or any online communications app. Even people who are actively struggling with depression will tell me how the major way they “distract” themselves is through focusing on what they can find on their screens. This... despite all kind of studies showing that the more you interact or are “on” your phone, the more depressed you can become.
I’m not advocating that anyone get rid of their phone. But… I do think that a way out of depression is finding tiny bits of fun. I found a “fun” expert – science journalist and TED speaker, Catherine Davis.. We’ll talk about her work and research – and use it to wonder together about how you might be experiencing depression and still be able to find “fun.”
On a much different note. the voicemail today is from a woman who’d told her husband she was leaving him due to his narcissistic behaviors over 40 years. And then, he fell, broke his back and required extensive hospitalization and has become someone who needs ongoing care for a dementia that will only worsen over time. What would you do?
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"Happiness" article by Laurie Santos
Catherine Price's TED talk
Catherine Price's book How To Break Up With Your Phone
This is SelfWork. And I'm Dr. Margaret Rutherford. At Self-Work, we'll discuss psychological and emotional issues common in today's world and what to do about them. I'm Dr. Margaret and SelfWork is a podcast dedicated to you taking just a few minutes today for your own selfwork.
Hello and welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford. I'm a clinical psychologist and about seven years ago now, or almost seven years ago, I decided to extend the walls of my practice to those of you who might already be very interested in psychological issues or have sought therapy for yourself, to those of you who've just been figuring out some sort of problem or issue and you want some advice, and to a third group, to those of you who might be just a little more skeptical about mental health treatment and what you could do to help yourself with depression or anxiety, I'm glad for all of you to be here. I wanna remind you that my TEDx talk is out and I will have the link for it in the show notes. I'm very excited as I record this. We're closing in on 9,000 views and it's only been out for four or five days, so I'm so pleased that the message is getting out and you're part of that.
So if you've already listened or viewed, actually thank you for that. You can let me know by commenting. And for those of you who want to, it's about a 15 minute video on YouTube. You could also just go to YouTube and put in Dr. Margaret Rutherford and TEDx and it'll come up.
So today we're gonna be talking about having fun. Increasingly, I've noticed a big trend in how people who see me are describing having fun and so much of that time what they're doing is scrolling through TikTok or Instagram, Reddit or Quora or any online communications app. Even people who are actively struggling with depression will tell me the major way they distract themselves is through focusing on what they can find on their screens. This, despite all kinds of studies showing that the more you interact or are on your phone, the more depressed you can become.
I have a cell phone, which I use quite a lot, and I have fun on some of the apps I have. I get it. Yet.just this morning when my husband and I went out to a local diner for breakfast, we saw a couple. And then they weren't young, but they were older, both with one hand holding their fork with their food, while with the other hand ,they were scrolling through their phones. No conversation, no sharing, and they were definitely not having fun together.
So today I'm not advocating that anyone get rid of their phone, but I do think that a way out of depression is finding tiny bits of fun. aAnd I found a fun expert, Catherine Davis, whose Ted Talk will be in your show notes. She's a science journalist and has written a couple of very successful books and she's really fun to listen to.
We'll talk about her work and research and use it to wonder together how you might be experiencing depression or anxiety and still be able to find fun. It's also important to be aware that having fun itself is a way out of depression, even though that very statement may seem counterintuitive. How can you have fun if you're depressed? We'll focus on that and of course, what other things you can do about in this episode of SelfWork.
On a much different note, the voicemail today is from a woman who told her husband she was leaving him due to his narcissistic behaviors over 40 years. And then he fell, broke his back, and required extensive hospitalization and has become someone who needs ongoing care for dementia that will only worsen over time. I'll try my best to answer her question first.
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People ask me all the time, “How do you do what you do and not get down or depressed yourself?” My first answer is usually because I see so much courage and fight, although it can be hard to hear about the abuse that we humans and especially parents can force onto children. But I also have fun. I laugh all day long with my patients about various and sundry things and I can see a little bit of light in their eyes when they catch themselves enjoying a laugh or recognizing some amusing irony or another in their own lives.
So I wondered what I might find in research about having fun and I found Catherine Price. I found a reference to her first in an article by Laurie Santos about her work at Yale where she teaches an extremely popular course on happiness, and I'm gonna have that link in your show notes as well.
It's a great article. So she quotes Catherine Price. So I went to go look her up and I think her work's refreshing and more importantly, kind of fun to think about.
First, who is Catherine Price? Well, here's her byline. With a background in science journalism and an unshakable curiosity about the world. Catherine Price helps people question their assumptions, make positive changes in their lives, and see mundane things like phones and vitamins in a different more philosophical light. She's also the author of How to Break Up with Your Phone, which is a huge bestseller and I'll have that link for you. So that description intrigued me. I like to think of myself as a very curious person and I think that curiosity helps me to stay energetic and I love to laugh.
So, I was more than interested in what Catherine had to say. I watched her Ted Talk and frankly it was funny, she'd reached out internationally and asked people what fun was to them. She got some hilarious answers like roast a Turkey, which I guess could be fun. But what she mostly noted was that many of the answers, in fact most of the answers described doing something, I have fun when I cook, or fishing is fun, or watching old movies is fun. But she believes fun is a feeling, not necessarily an activity. And she goes on to talk about three kinds of fun: fake fun, true fun and activities that bring a sense of fun things that are enjoyable, like taking a bath or talking with a friend.
So let's first talk about fake fun. And this resonated so much with what I hear from the TikTok or Instagram addicted people I see as clients. These folks will say to me that they believe scrolling is fun until they realize that it's grown to be addictive. It becomes as Catherine Price calls it, a passive compulsion and one where social comparison happens in a negative direction, which isn't fun at all.
In fact, this kind of scrolling only increases self-doubt and leads to self-loathing because of what the scroller can then chastise themselves about wasted time being late because you were staring at your screen literally having to have a hit of TikTok before you do anything on your plan for the day, like waking up and smoking, you gotta have your hit of TikTok.
I might add that other addictive behaviors also belong here. Drinking can start out as feeling fun. For example, the alcohol breaks down whatever anxiety you might have about being social so you can have fun. Not so fun is what can happen afterward or the next day when you have little to no energy because you're so hung over. But then the fun can start again when you start drinking right, and this cycle of supposed fun becomes an addiction. This kind of fun sounds to me coming from a therapeutic perspective like distraction, like not wanting to or even fearing looking at yourself or your life honestly or procrastinating what may be a hard thing to do and doing an easy thing in instead, while also creating anxiety that will be waiting for you when your fun is over.
So what is real fun or true fun as Catherine calls it?
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Today I'm presenting the work of Catherine Davis, whom I've never met, but watched her Ted talk as well as an interview with her and was very impressed with how she talked about and defined fun. She says it has three components, flow, playfulness, and connection. She showed a Venn diagram, which is just circles in this case, and each facet - flow, playfulness and connection - are their own circle, but those three circles intersect in the middle. So there's a circle where all three were present and that constitutes real fun. And while I'm gonna talk about these three components, I'm also going to talk about how depression and anxiety can make it harder to create these but not impossible.
First, let's take playfulness. Another word for this might be lightheartedness, not taking things so seriously, being spontaneous. She makes the point that when the world is so full of war and hunger and climate change, it can seem uncaring or even self-centered or selfish to have fun.
It made me think of the characters of Winnie the Pooh. There's Owl, Rabbit, Kanga, R00, Winnie, Piglet, Tigger, Christopher Robin and Eeyore I found an article about each character's relatability. Which character do you think wins that relatability contest? It might surprise you. It's not the fun loving Tigger or the adventuresome Roo. It’s Eeyore, the sad melancholy, the “if something bad happens, it'll be to me” character . In this series- created almost a hundred years ago - the writers were trying to make each of these characters lovable with their strengths showing as well as their vulnerabilities.
So why am I bringing this up? Because even Eeyore is capable of having fun. He has a malformed tale but says things like I”I's not much of a tale, but I'm sort of attached to it.” <Laugh>, What is Eeyore doing? Not to overanalyze poor Eeyore, but it seems as if he can see that his perspective is gloomy and depressing, but can also use a tiny bit of energy to care, to see things more positively, dare I say, to have fun.
Seeing the funny or the fun and things is more difficult obviously when you're depressed, yes. But if you challenge yourself to learn something new, to stay curious about how to do something, you are building steps to lift your depression or to soothe your anxiety. If you know that being around someone's a downer where being around someone else lifts your spirits, who are you going to choose to go to lunch with? Hopefully the second. Instead of doing the same things every day, which may become more of a trap for your depression rather than a way out, think of something that makes you smile. What if you had fun doing before? I can already hear someone listening to this and who's depressed saying, “Well, it wouldn't be fun now. Hell, I don't even have the energy to try my answer to that.” Depression is hard to fight, especially severe depression.
Yet realizing that all you have to do is find enough energy to try one thing that could be fun. Be around someone who is fun to be around. See how you're negating something's value before you've ever tried it. If you don't do those things, you will only stay depressed. So trying to look for what could possibly be playful in your world is so important.
The second facet of fun, according to Catherine. Price is connection - and that means connection with a real person, not a screen, not a task or a chore. Because realize you can feel connected without having fun. You and someone else might be grieving together or having an argument. That's connection. But remember we're talking about the three facets of fun. So she states that true fun involves another living being I almost said human being, but then I thought, I think you can have fun with a pet.
In fact, think about emotional support animals or the dogs that are regularly taken to see hospital patients. That's connection as well.
Isolating can be a huge part of depression. You pull away, you withdraw either because you feel that you're protecting yourself or even that you're protecting others. Nobody needs to be around me now, but that's a mistake, and if you do it regularly, feeling disconnected is very lonely and will wipe out any chance of fun. Think about the tale of Scrooge who spent his life isolating, not dancing, not attending social gatherings because he was too caught up in himself. He didn't take advantage of the opportunities for connection there were in his life, and then fear finally leads him to do so. So what opportunities could you be passing over if you look for them, if you look for a way out of your sadness, you just may find it.
The recent movie, A Man Named Otto did just this or told this story. Otto was grieving his wife's death and that's all he could think about until a neighbor needed his help and he got involved with her and her family and began living again. I realize that's a movie, but what opportunities for connection and fun could you be missing?
The last facet is flow. Now before you think, “Oh, that's some weird word that's all about meditation” and then dismiss it. Think about some time when you were totally engrossed in something you were doing. It could have been coaching your kid's soccer game or building a piece of furniture or playing piano or guitar where you lost your sense of time. That's flow. Sometimes when I write, I find that two hours has gone by and I'm not even aware of that time that's flow. Now, yesterday I binged on Netflix and my whole afternoon was gone. That was also flow, sort of escapism as well ; <Laugh>, some of those ways to flow are perhaps more constructive, but flow is the third needed component for fun. Think about the last time you and a friend couldn't stop laughing about something, whatever it is, that sense of timelessness for a few seconds or hours is flow.
There's a last tip that Ms. Price suggests, and it's on breaking the addictive power of your phone so you're more available to create true fun. I probably like these so much because they're very similar to the questions I ask my patients who are so enmeshed with someone else that I suggest they ask themselves these questions before they reach out trying to break that enmeshment. If I have a likely phone addict in my office, for example, what I'll see is they have to turn it over, but they keep it close by.
They know that they'll need to look at it if it's face up. Apple watches or whatever kind of watch you use can also rob you of fun. If you get addicted to how many steps you took, for example, your life becomes about checking or having to check. I stopped wearing mine for just this reason. I felt as if I was becoming hooked on reaching those achievements instead of flowing in my life.
Anyway, back to the topic of breaking up with your phone. She suggests using the acronym WWW - they are questions to ask yourself before you even pick the silly thing up. Ask yourself first, “What for, or what's the purpose of picking up your phone?” Are you avoiding something? Are you turning to someone else because you're anxious and need calming down? Are you looking for answers that someone else is going to give you because you've convinced yourself you can't do things for yourself?
So what for what's the purpose of me scrolling? What's the purpose of me texting? What's the purpose of me going onto YouTube? Maybe it's a very good purpose … but it helps to ask yourself what for.
The second question is, “Why right now?” wWhy in this moment are you picking up your phone rather than making another choice? I've heard from several Gen Zers that they pick up their phone the first thing in the morning to check their texts or their number of likes. Now I've been guilty of this as well, and I'm far from a Gen Zer. I've laughingly called it my “self-esteem” fix. But what's the other possibility that you didn't get any likes or there wasn't a text? Does that mean you're worth nothing, that your day off is off to an awful start? Or does it mean that you need to stop doing that looking externally for validation?
Yep, that's what would be best.
And the third question is, “What else?” What else could I do or say or be or try or be curious about? What are your other choices? What is it that Einstein said? Doing the same thing over and over and expecting a different result is the definition of insanity or something like that. All you're doing is dredging a deeper tunnel for yourself to get out of. So do something different. Even it's a tiny thing. Tiny is good, tiny is enough. So the three questions are, “What for? What's the purpose? Why right now? And What else?” What else could you do other than picking up that phone and staring at that screen? You know, even fun comes in tiny packages and that can be in making those changes, those tiny changes that can be where you find your joy and your hope and a way out of depression.
Speak pipe message from dr margaret rutherford.com
And now the voicemail of the week.
I told my husband of 40 years I was leaving him because he was narcissistic and abusive and a few days later he fell, broke his back was in the hospital for three months and diagnosed with precipitous cognitive decline. My adult children in their thirties want me to take care of him full-time. They're angry at me for taking any time for myself and they don't really wanna participate in it in a helpful way. I don't know whether to leave. I don't know whether to stay. I don't know what to do.
This voicemail was difficult to listen to as you can hear just how trapped the listener sounds. Her story reminded me of several people I've worked with through the years that found themselves in similar situations that their spouses or partners' lives had changed and not for the better. They'd just received a bad medical diagnosis or they'd lost their job. One person was in a coma, maybe they'd been arrested, whatever. But it had happened at a time when my patient had had plans to leave the relationship and they didn't know what to do. So this woman says the same. I don't know what to do.
There may be no good answers here. If her husband has treated his children the same way he's treated her, then it's understandable that they don't want to take care of him either. Perhaps they are mad because she can lose her divorce and they feel like they can't divorce their dad.
Perhaps one or more of them also share narcissistic traits and are thinking only of themselves. But it sounds as if she's stuck feeling like she told him she's had enough and then his life would have it. Her husband is now dependent on someone's care and she can tell herself it's her care. Yet he's not created the kind of relationships with his family and certainly not with her. That would act as a reason for her to be or likely remain his caregiver. He's not going to turn over a new leaf and not show narcissistic behaviors now, or at least that's not likely to happen. So she feels stuck. I announced I was done and now it feels like if I act on those feelings, I’m betraying my husband, I'm abandoning him. My children will be angry with me. Does that mean she would lose connection with them?
I can't tell from her words.
What I would wonder with her, if she's been with someone narcissistic for 40 years, she's likely someone who takes on way too much responsibility. Whether that's appropriate or not, that's a long time to spend when you're constantly or often intermittently getting the message that you are not enough, you're not supportive enough, understanding enough , that you fail often, that you're wrong a lot. How has that affected her? What has she done with her anger, with her own grief?
But as I've discussed with many people, as you make a choice like this to stay to go think about the things you predict that will be hard about either choice and ask yourself, how would I handle those hard things? Neither choice is likely going to avoid hardship, so which can you cope with better? I looked up precipitous cognitive decline and seems that it's a rapid decline.
Does she have the energy for that? Had she made plans to leave that she has then canceled. What she may need to do is sit down with a paper and pencil or whatever and actually write down what she thinks her steps could be or when she's already taken ones that she needs to take. Perhaps talking with a lawyer about separating some of the financial issues.
But I'm certainly sorry that this listener finds herself in such a difficult place. Going to a therapist in your local area could be very helpful as you sort out the myriad of feelings you're likely having and again, trying to organize the steps of what it would be like to stay, but probably stay in a different way or to go, you can ask them to help you organize and express those feelings so that whatever decision you make is one you can live with. No decision in either direction is going to be easy. Talk with your true friends about it and allow them to support you and good luck to you.
Thank you all for being here. I hope that this was helpful in you thinking about your own fun and how to create it. What I'd really love is for a few of you to leave some reviews on Apple Podcasts especially. It's really kind of funny. I was telling someone the other day, it seemed like they just kept rolling in, the reviews kept rolling in until I reached a thousand, and then it's like somebody says, “oOh, she's got more than a thousand reviews. I won't leave one <laugh>.” No SelfWork needs them in order for new people - people who might be considering listening in will have a sense of what self-work is now in 2023. So just take a couple of minutes to leave a rating or review and I'll be so grateful. You can also join my private closed Facebook group. It's at facebook.com/groups/ self-work. That's facebook.com/groups/ self-work.
Again, I appreciate you taking the time to be here today with me. You can always email me at ask Dr. Margaret@Drmargaretrutherford.Com and let me know what you'd like for me to talk about. Or you can use the SpeakPipe function that is either on my website@drmargaretrutherford.com, which by the way is new and I think it's really nice <laugh>. So I'd love for you to go look and there's some new ways to subscribe as well. That, again, is dr margaret rutherford.com. So thank you for being here. Please take very good care of yourself, your loved ones, and your community. I'm Dr. Margaret and this has been SelfWork.
You can hear more about this and many other topics by listening to my podcast, The Selfwork Podcast. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook!
And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
Today I’m offering something different for you. No commercials. Just me and you talking. I’ve said before on SelfWork that I’ve seen so many people become paralyzed in their decision -making about what course or direction they should follow. Hopefully, through my own story of discovering my own potential, you’ll get a taste of what I’ve learned works – which is to simply “go.” Go in a direction – any direction that puts itself in front of you. At least that’s healthy and productive. Learn from that. And keep going. Sometimes you have to pick yourself up from disappointments. But you learn every time.
And you'll hear at the end my own exciting announcement of my TEDxBocaRaton talk now being available on YouTube! I'll hope you can watch!
This is SelfWork, and I'm Dr. Margaret Rutherford. At SelfWork, we'll discuss psychological and emotional issues common in today's world and what to do about them. I'm Dr. Margaret and SelfWork is a podcast dedicated to you taking just a few minutes today for your own selfwork.
Hello and welcome to SelfWork. I'm Dr. Margaret Rutherford. I'm so glad you're here today. I am offering something different for you. No commercials, just me and you talking. I've said before on SelfWork that I've seen so many people become paralyzed in their decision making about what course or direction they should follow. Hopefully, through my own story that I'll tell today of self-discovery, you'll get a taste of what I've learned works, which is just simply go, go in a direction, any direction that puts itself in front of you, at least that's healthy and productive. You learn from that and then you keep going, and I have an announcement to make of something I'm more than honored to tell you is now available.
Potential. It's one of those words that would come up, especially for my mom when my life wasn't going so well. "But you have so much potential.," she'd say to me. At least at that time, it felt like I was being chastised, certainly not supported. But I think I was wrong. I was the one who felt so bad about me that I couldn't see any potential. So today is a story about me being open to discovering potential in myself, and hopefully my story will make sense for you.
You know me as Dr. Margaret who does this podcast. Maybe you know, I'm the author of Perfectly Hidden Depression. What you may not know is that I never actually wanted to write a book. Never dreamed of hosting a podcast. I'd never had ambitions to be known for something. Well, you know, that's not quite true. When I was much younger, I thought I'd be a famous opera star, but that wasn't in the cards for me.
But I've come to love being a therapist and a mom and a wife, <laugh>, and my husband would quickly note the order of those things like, oh, I'm last <laugh>. And you know, I was quite happy doing that. I'd found my potential, at least I thought I had.
I began writing online when my son had gone to college because I had time on my hands and my husband was undergoing a medical treatment. So that was really new for me. I'd always liked writing emails and things, but I'd never considered myself an author. But I needed to do something while I was being with my husband and a woman here locally that I knew Jeanette is her first name. She's basically a coach for inventors and entrepreneurs taught me about online stuff. I didn't even know what a link was when I began. That was back in 2012.
That's when I started a blog about empty nest and then pretty quickly started writing about mental health. The writing was fun. So I thought, "Okay, this fills my time." And hopefully, as I say on the podcast, I was extending the walls of my practice to those who wanted to read what I had to say and maybe learn a little bit more about therapy and mental health treatment. But in 2014, I was sitting and thinking about the people I'd seen who'd walked into my office, not telling me they were depressed, but saying things like, "I'm not sure what's wrong. I probably don't even need to be here." Or some such story. What they all had in common was an inability to express painful emotion. In fact, they might be telling you about something that was even traumatic, but they'd be smiling as if they were telling me what they'd had for lunch.
They were completely detached from their pain, like they had their anger or sadness or shame stuck so far back that it was as if that pain didn't exist. It was weird to watch, and I had to begin to tune in very closely to what these people were saying and not pay as much attention to how they were saying it. So again, on that afternoon in 2014, I literally grabbed a name from out of the air when I was titling the piece and called it the Perfectly Hidden Depressed Person, are You One? And the post went viral after it appeared on the Huff Post. I received hundreds of emails. "How do you know about this? It's like, you're in my head.". So I got curious, and I looked around at the popular literature and I found Dr. Brene Brown. The Gifts of Imperfection is an incredible work on perfectionism, vulnerability, and shame.
And of course, now she's world famous and has written scads of truly great books and has a TED Talk that is one of the most watched talks ever. But I also found Terrence Real's book. "I don't wanna talk about it" on what he termed Covert Depression, but it was written only for men, and I was finding this in my clients, were both men and women.
Then I turned to the academic research, and there were so many researchers shouting out the dangers of the combination of perfectionism and depression saying that perfectionism alters the presentation of depression and makes it very hard for a therapist or clinician to really see what's going on. Yet the pain is very real and very active, but it's active underneath an armor that's worn as camouflage for those often traumatic memories.
Recently, we were all shocked by the suicidal death of the incredible dancer, entertainer, and producer tWitch. He wrote in a suicide note about something from his past that it had to do with his death by suicide. I don't know any more than that. But back in 2014, there wasn't too much about this link between having a perfect seeming life and suicide. It just wasn't being talked about.
So what was I to do? Well, I've told clients through the years, "If you believe something should exist and it doesn't, then create it." So that's what I did with luck, support from many, many important others, very, very hard work by me and the fantastic team I'd built over the years. Five years later, Perfectly Hidden Depression was published. Then the pandemic hit. So no face-to-face interviews, certainly no book tour. So basically I thought, okay, I've reached my potential, and that's the end of this journey.
But there's one more twist to this story.
Three years ago, right at the beginning of the pandemic, a woman I didn't know, a stranger, Cindy Metzler, reached out to me on LinkedIn. She said a friend had told her about the death of another friend. We'll call that friend Jane. Jane was a wife and mother of two, a highly respected and successful person in her community, and she died by suicide on Valentine's Day using a means that was very planned, and there was no doubt she'd chosen to die. Everyone was absolutely shocked trying to absorb this tremendously confusing loss.
But at the funeral, Jane's husband walked up to Cindy and her friend and said, "I found this on Jane's bedside table." It was my book.
Tears came to my eyes when I heard this story in 2020, and Cindy and I became virtual friends along with her other friend, Tricia and I volunteered a couple of times to speak to groups that Cindy ran about this kind of hidden depression, and that all went very well.
What I didn't know was that Cindy was and is a co-organizer of the Boca Raton TEDx Talks. Now, if you don't know what a TED Talk is, TED was begun years ago by a man who believed in giving people a stage to talk about what he termed "ideas worth sharing." The TED or the t e d part of it is technology, entertainment, and design. All kinds of people auditioned from scientists to students, to artists to creators. And what happened after that? TED became a huge platform for people to share those ideas. Then cities and communities around the world wanted to host their own TED Talks, so they were termed TEDx talks. Now, TEDx follows the same guidelines created by big Ted, like what the stage looks like, how long the talks are. They can't be more than 20 minutes. And then the famous red dot that the speaker stands on, well, seems like the universe thought I had more potential.
Cindy asked me to submit to her city's TEDx committee. TEDx spoke a ratton. They didn't host anything in 2021 due again to the pandemic. But I submitted in 2022 and I didn't make the cut. So once again, I thought that was that.
I played around with the idea of submitting to other TEDx venues, but somehow I just couldn't find the energy to do it. I was pretty deflated actually, after submitting and getting turned down. And this journey through the last decade had had its share of disappointments. My book was published, yes, but 39 Count 'em, 39 other publishers had said no. Some I got interviews, which was great, but it was still a no, and there were two reasons. One, no one knew who I was, and two, those publication houses didn't think people hiding depression would buy a book on hiding depression. <laugh>, you can see the irony.
So when I got turned down those 39 times, each one of those 39 times, I thought, "Okay, this is the end." I was disappointed, but I was happy to have gotten the chances I had, and sure enough, New Harbinger came along and said, yes. Again, lots of luck and hard work.
But back to the other story, Cindy and I stayed in touch, and this year, 2023, she asked me to submit again. I took a big breath and I did, and my talk was chosen. Then the real work began as I hired a great coach, but we only had nine weeks to create a talk that would be about 14 to 15 minutes long that would share not only the idea of perfectly hidden depression, but give a solution to its core problem, and that talk had to be memorized. <laugh>. I've always had trouble with memorizing; even my band used to kid me in my twenties, that I kept song lyrics in front of me when I'd sung the same songs night after night after night.Memorizing was simply not my forte.
So I gave the talk on May the 20th this year, and I was incredibly nervous. But I think the message comes across, it's not only about perfectionism and depression, it's on transparency. It's on learning to trust. It's on how we as a culture can change to stop talking about suicidal thoughts or feelings as if they're only a symptom of depression. They're not. Pain is at the core of suicidal thinking, and we can all feel that kind of pain given the right circumstances. All of us. I can't tell you how many times people have shared the fact that they've thought about dying, about taking their own lives because of what's happened to them in the present or in the past.
But I'm not gonna give you the talk here. I'm asking that you go watch it on YouTube. The link will be in your show notes or you can go to YouTube, put in Dr.Margaret Rutherford and TEDx and it ought to come up. That's it. Again, the link will be in your show notes and please like, comment and share if you can.
Now, I don't know if this is the end of the journey or not, but what I hope you can see, if you keep curious, if you keep open and if you risk, you never know what might be in store for you or what potential you have that is within you just waiting to be discovered. Thank you so much for listening. Today's shortened self-work. I always appreciate you taking the time to listen. I'm Dr. Margaret, and this has been SelfWork.
You can hear more about this and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook!
And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!