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The SelfWork Podcast

I'm Dr. Margaret, a psychologist for over 25 years and the author of Perfectly Hidden Depression. I created The SelfWork Podcast in 2016 to explain mental health treatment, and to give you the chance to consider therapy without thinking it's weird or somehow suggests you can't "fix" your own problems. My team is so honored that five years later, SelfWork has earned nearly 3.5 million downloads! Each episode features the popular listener question. And, once a month, you’ll hear a “You Get the Gist” segment - a five minute run-down of a current topic - as well as an interview with an outstanding guest author or expert, adding to the wide diversity of topics listeners so appreciate. Regularly rated as one of the top mental health/depression podcasts out there, I keep it short and casual - and I'd love to hear from you. Please join me.
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Now displaying: Category: Podcast
Dec 1, 2023

One of the reasons why many people suffer during the so-called “holiday” season is because it’s the first - or one more of many holidays - that they’re actively grieving a loved one’s death within the last year or even farther away – and they cannot seem to work through their grief enough to want to step back into life. Into living this moment that’s right before them.

I tuned into a Hidden Brain episode  this week that discussed a recently researched concept of grief in a very personal way, as resilience researcher Lucy Hone told the story of her own nightmare - the death of one of her children. So, I wanted to pass her ideas on to you – as you might be one of those people who are struggling with grief – and not knowing how to get out from under its shadow.

Our listener email is a from a listener who says he’s been diagnosed with what’s called “schizoaffective disorder” – and wonders if I know much about – or can help him with – intrusive thoughts that he can’t seem to rid himself of.

Advertiser's Link:

Click HERE for the NEW fabulous offer from AG1 – with bonus product with your subscription!

Vital Links:

Stroebe and Schut research in 1999

Resilient Grieving: How to Find Your Way Through Devastating Loss, by Lucy Hone, 2017

My own recent podcast on grief

Schizoaffective disorder symptoms

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 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!

 

 

Nov 24, 2023

Here at SelfWork, we focus on what you can do about it - right? I preach and I encourage all of you to figure out the one thing that’s in your control and make a change that will help you with your sense of wellness. Like all of you, I laugh at memes and try to take myself with a grain of salt. Usually, I think I’m pretty good at this… but not the last few weeks.

I’ve been in the dumps.

So today we're going to spend some time talking about being in the dumps and the slumps - as well as getting over the humps (the murky middle of a journey where you can lose sight of hope. And as always, "what you can do about it."

Our Speakpipe voicemail of the week is from a woman who checks in with my website and left a message there – which all of you can do at drmargaretrutherford.com! Love her question about whether to “let someone with apparent BPD” know that you’ve learned what they did in a fit of rage. It feels like you’re keeping a secret.. and a powerful one… But what makes it so powerful? That’s where my answer will lie – how does this voicemailer want to use that power?

Advertisers' Links:

We have a brand new sponsor of SelfWork - moonbird. What is it? It's the world’s first, tactile breathing coach designed to fit in the palm of your hand, which provides real-time biofeedback. Created for those grappling with stress, anxiety, autism, or insomnia, it's a compact device that aids users through soothing breathwork exercises. For their special Black Friday offer of 20% off (November 20-27th, 2023) or 10% off after Black Friday, click here and use the code SELFWORK!

Have you been putting off getting help? 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 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!

Nov 19, 2023

 

I’m so excited about this new SelfWork sponsor and I’m doing something a bit unusual and letting you know about it today! Because they have a Black Friday double discount offer that’s sensational – and I wanted to quickly pass it on to you!

The product is moonbird..

Used by over 25,000 people in Europe, moonbird is the world’s first, tactile breathing coach designed to fit in the palm of your hand, which provides real-time biofeedback (which I was trained in years ago and very much believe in!) Created for those grappling with stress, anxiety, autism, or insomnia, it's a compact device that aids users through soothing breathwork exercises..

It's the brainchild of Stephanie Broes (a PhD researcher) and her brother, Michael, and was created out of her experience suffering from insomnia and exhausting all other options

What does it do? Moonbird uniquely measures your heart rate and heart rate variability to guide you to change your own breathing patterns when you download their free app – but basically you hold device in your hand – and you can feel it moving in and out. And you follow it. Simple as that.

Just click here and enter the code SELFWORK for $20 off this week! It's for Black Friday week only! If you balk at the price, think of all the sleep aids you’ve bought over the years – I have a drawer full of them!

All I can say is – enjoy! And learn to breathe! It’s what you can do about your stress, your insomnia – and your life!

Photo Attribution: Tim Goedhart/Unsplash

Nov 17, 2023

As TikTok has taken over the world of social media throughout the last few years, many psychological trends have become increasingly popular, and could be more harmful than helpful. Glowing up, bed rotting, and lucky girl syndrome are only three of the harmful effects the so-called "psychological help" on TikTok and other outlets can bring - and we have a fantastic expert here today on SelfWork to discuss them.

Dr. Sanam Hafeez is an NYC based licensed clinical psychologist, and the founder and Clinical Director of Comprehensive Consultation Psychological Services, P.C. a neuropsychological, developmental and educational center in Manhattan and Queens. Dr. Hafeez masterfully applies her years of experience connecting psychological implications to address some of today’s common issues such as body image, social media addiction, relationships, workplace stress, parenting and psychopathology, and often shares her credible expertise to various news outlets in New York City and frequently appears on CNN and Dr.Oz.

Advertisers' Links: 

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!

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 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!

 

Nov 10, 2023

Out of curiosity,  l listened to an older voicemail this week. It was from "this time last year." How many times have you said that to yourself, "This time last year I... " Maybe the end of that sentence is joyful. Maybe it's sad. But it's an exercise in self-reflection - which is the topic for today's SelfWork.  This particular question is a  sort of time travel in your own head and heart.

Self-reflection isn't about over self-involvement: it’s what we humans can do to get perspective and learn ways you might be getting in your own way of creating the life you want. Show you how to move out of depression or anxiety. And when you pair self-reflection with action - it can lead to healing change. 

So here are the self-reflective questions that lead to action that we’re looking at today.

  • What am I needing to still learn? What have I learned?
  • When do I recognize that I need to put something new in place?
  • Where was I last year at this time? What did I learn? What did I find out about myself?
  • Why am I doing what I’m doing? What’s my purpose?
  • How do I want to put the answers to these questions in place in very real ways in my life?

Advertisers' Link: 

Have you been putting off getting help? 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 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!

 

 

Nov 3, 2023

Today we’re focusing on your choice to be transparent and how it can be important in your mental health. Self-transparency. Think of it like this – if you put a lot of energy into covering up – into not allowing anyone to see your own struggles. There can be repercussions from that. You’re living in fear of being known – of being seen. What are you so afraid of people seeing? And what would have to happen for you to risk transparency?

The SpeakPipe voicemail is from a listener who wants to know how she can determine her own diagnosis, if it’s CPTSD or BPD. She’s worried about her own kids – so I’ll do my best to answer her. But let’s just say – anyone who’s concerned about their impact on their children already may have my vote as NOT having BPD – but we’ll talk more about that dynamic.

Advertisers' Links: 

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!

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 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!

 

 

Oct 27, 2023

 

Talking about narcissism has become somewhat of a national pastime in the US at least. Everyone is calling someone who used them or who they felt manipulated by a narcissist. And perhaps they are – or were. But what exactly is narcissism and how is it different than healthy self-esteem? Is it on a spectrum or can it ever be helpful?  Is it necessary to have a bit of it to have self-confidence?  And how does humility play into this? Or is "humility" weakness?

I’ve seen some dramatic examples in the last few years of things going wrong for my clients– when the focus on self and the need to be and look successful has led to a huge escalation of depression (sometimes silent as in perfectly hidden depression) due to way over-the-top feelings of failure – rather than allowing that to be an example of making a mistake and learning from it. Or of life handing you some hard, even cruel, or tragic experiences.  In our self-focused world, this kind of acceptance can be punitively described as accepting failure -  instead of what humility truly is – recognizing your true place in the universe, not buying in too much to your successes, your desires, or your failings.

To me, humility is the moderating factor to prevent narcissism from becoming destructive, and instead promotes self-esteem and self-love rather than self-worship or self-centeredness.

The listener email today is about finding out about a spouse’s affair with a work colleague and how to discuss whether the spouse should leave that workplace or not. It’s a sticky discussion and one I’ve witnessed many times in my office as a couple tries to balance regaining trust with other factors, like financial stability.  People have tried some very unhealthy solutions which’ve only created more distrust, not less. Regaining and rebuilding trust can be a full-time job, but months of hypervigilance isn’t going to be helpful.

Vital Links:

Psych Central article written by Hilary Lebow on healthy versus unhealthy narcissism

Article by Dr. Dimitrios Tsatiris on the power of humility

https://drmargaretrutherford.com/005-selfwork-after-an-affair-the-essential-steps-of-regaining-trust/

Advertisers' Links: 

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product!

Have you been putting off getting help? 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 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!

 

 

 

Oct 20, 2023

I could think of no better way to continue this 8th season of SelfWork than to feature your questions and comments! Whether you communicate through email or voicemail or through my website contact form, YOU are the lifeblood of SelfWork. Yes, it’s true I often use what my own clients either have gone through or are going through as my “inspiration” for these episodes. Yet hearing from you means so much. It’s like turning up the lights in an auditorium so the person speaking can see the audience – it helps me see you. And your three topics for today are compatibility vs commitment, facing constant anger from your partner, and feeling abandoned by friends. So thank you!

All of these listeners are dealing with situations that have been ongoing for months if not years – so even though they don’t necessarily say “I’m depressed,” yet these kinds of relationship problems that drag on and on can certainly be a set-up  for symptoms of depression, like hopelessness or helplessness.  All three are about boundaries – the difficulty of setting them, of maintaining them, and  when you get hurt by or don't understand them.

Advertisers' Links:

Have you been putting off getting help? BetterHelp, the #1 online therapy provider, has a special offer for you now!

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product!

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 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!

Oct 13, 2023

Come celebrate with us! SelfWork is having its seventh anniversary so we're celebrating by bringing on the whole team! Please join me, Christine Mathias and John Crowley for a completely spontaneous conversation (which you'll be able to tell...) about our topic for today - the seven year itch! (Sounds appropriate don't you think?)

I'm offering seven ideas (keeping in the swing of things): three on how to avoid the itch altogether; one to use if you feel the itch to leave or to not act out what you know is best; and three more to help you keep on keeping on, growing in trust and intimacy with one another.

I'll announce the winner of Marriage Is Not for Chickens as well!

Advertiser's Link:

Have you been putting off getting help? BetterHelp, the #1 online therapy provider, has a special offer for you now!

Research Links!

Wikipedia's take on the seven year itch

Dr. DiDonato writes in Psychology Today about seven year itch

Your career and the seven year itch

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!

Oct 6, 2023

October is ADHD (Attention Deficit Hyperactivity Disorder) Awareness Month. SelfWork has never focused on this very difficult disorder, often affecting children who are what's now called "neurodivergent" but in the past, have been unjustly stigmatized as "lazy, stupid, or crazy" which was finally described in 2006 for the actual processing difference it is in the now classic book, You Mean I'm Not Lazy, Stupid, or Crazy?.

But ADHD contains hyperactivity as a symptom of the disorder; what used to be called ADD, or simple attention deficit disorder, is now labeled as inattentive ADHD. And these kids (and adults) often slip through the cracks of adult recognition, because they're seen more as daydreamers, or unmotivated, not causing the classroom behavioral problems that hyperactive kids can seem to create. But they still can truly struggle and... go unseen.

Cynthia Hammer has a new book, Living with Inattentive ADHD:  Climbing the Circular Staircase of Attention Deficit Hyperactivity Disorder, where she offers her own hard-earned wisdom of living with IADHD. I found the book at times chilling because of the dangers she could put herself in, poignant as she lives through tremendous sorrow of the accidental death of her first child, and hopeful, as - at almost age 80 - she shares what she's learned about surviving and thriving.

Advertiser's Link: 

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product!

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 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!

 

Sep 29, 2023

John Crowley, my audio engineer/editor extraordinaire, chose this episode this week as I'm getting back from vacation. My gratitude to him for many, many things! But he gives you some info on what this episode's message was for him and what I hoped it would be.

Today we’re focusing on the mind/body interaction – how your brain processes physical and emotional pain – as well as a brief touch on what are called somatic disorders. But what I want to focus on how your body might be expressing the pain or trauma you’ve experienced in your life. It's an intriguing topic and one I hope you'll enjoy.

The listener voicemail is from a daughter who believes her mom may have something to do with her being ill and not knowing how to leave or get other help. This could be something called “munchausen’s syndrome by proxy” which is a very complicated dynamic – but it might also be that this daughter’s mom has been part of her trauma. I’ll offer suggestions for both..

Advertisers' Links:

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product!

Click HERE for the NEW fabulous offer from AG1 – with bonus product with your subscription!

Scads of Important Links!

 

A recent Forbes article… discussing how your brain processes physical and social pain.

Depression Isn't Simply A Chemical Imbalance Part One (SelfWork Podcast)

Depression Isn't Simply A Chemical Imbalance Part Two (SelfWork)

An article on somatic disorders found on VeryWellMind.

How To Become An Emotional Grownup I don’t have time sadly to discuss all of it...

A recent Psychology Today article about different techniques that you can try to "get at" your body's holding on to trauma. And encouraging it to let go.

Article on FDIA. Facticious Disorder imposed on another

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 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!

 

Sep 22, 2023

I have such a fantastic production team in Christine Mathias, my communications manager, and John Crowley, my audio engineer. And so I want to thank them for pulling the next two episodes off for me while I'm on vacation with my family!

This was Christine's choice as one of her favorites, and she introduces this week's episode in this "second time around" listen. The focus is on how to interview a potential therapist, a task which stop SO many people from even trying therapy. I agree with her about how important this info is. So I hope - actually we hope - it's great info for you.

The listener voicemail today is from a woman who’d read one of my blogpostarticles on challenging or working through the shame that you've carried around, quite without rational or reason, because you felt invisible to others, and thought whatever happened to cause your shame was somehow your 'fault.'

Advertisers' Links:

Click HERE for the NEW fabulous offer from AG1 – with bonus product with your subscription!

Vital Links:

The podcast episode also talking about the problem of feeling invisible. 

An Unquiet Mind written by Kay Redfield Jamison,

My first podcast episode on What Is Good Therapy?

An Open Counseling article explaining licensure and training differences between therapists

My podcast on whether to terminate therapy

The different family roles that you can adopt and play

You can hear more of many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive one weekly newsletter including my weekly blog post and podcast! If you’d like to join my FaceBook closed group, then clickhere and answer the membership questions! Welcome!

My book entitled Perfectly Hidden Depression is available and you can order 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 here'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!

 

Sep 15, 2023

Trigger Warning: We're talking about sibling sexual abuse in this episode. The links for sexual abuse hotlines are below.

I’ve had so many guest interviews on SelfWork – really wonderful researchers and authors, therapists and thinkers. But there’s something very special about someone coming forth to share their message when they’ve learned something the hard way – and they want to help others either through what they went through or to avoid it in the first place.

Jane Epstein is this kind of person. She tells her story in this episode about how her life was dramatically impacted by her brother sexually abusing her. It took her years to put the pieces of the puzzle together, making connections between past and present that were difficult and painful to make – but also were freeing.

Many of you who are listening may have experienced something similar – and have tried, as Jane did for many years – to sweep it under the rug. A stepsister or stepbrother, an older sibling – and you’ve blamed yourself. Or felt a shameful heaviness.

Please know, you are far, far from alone.

Advertiser's Links:

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product!

Vital Links:

Jane Epsteins TEDxBocaRaton Talk:

Great sexual abuse website for sibling abuse:

The 501-3-C non-profit 5WAVES.org - Jane's (and others) website for support

International Sexual Abuse Hotline thru RAINN

I want to thank Jane and all other survivors of abuse who’ve come forward. It takes tremendous courage.

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!

Episode Transcript:

Speaker 1: Dr. Margaret
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.

Welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford, and we have a wonderful guest for you today. I wanna make sure you hear however, that this episode does discuss sexual abuse, sibling sexual abuse. So please heed a trigger warning and we'll have sexual abuse hotline suggestions in the show notes.

You know, I've had so many guest interviews here on Selfwork, really wonderful researchers and authors, therapists and thinkers. But there's something very special about someone coming forth to share their message when they've learned something the hard way, and they want to help others, either through what they went through or to avoid the experience in the first place.

Jane Epstein is this kind of person. She tells her story in this episode about how her life was dramatically impacted by her brother sexually abusing her for a six year period of time. It took her years to put the pieces of the puzzle together, making connections between past and present that were difficult and painful to make, but also were very freeing. And I want to quickly say, many of you who are listening may have experienced something similar and have tried, as Jane did for many years, to sweep the memories under the rug. Maybe it was a stepsister or stepbrother, an older sibling, and you've blamed yourself or felt a shameful heaviness. So that's what we're talking about today on SelfWork.

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Speaker 1: Dr. Margaret
I should tell you before we begin, how I met Jane Epstein. She actually did a TEDx talk for Boca Ratone and I watched it and we had the same coach. That's sort of a neat bond for us to share, but we talk about our TEDx experience a little bit here too. So please listen to this episode. Please click the link to Jane's TEDx talk, which will be in the show notes, or go to my website, drmargaretrutherford.com, and you can find it there. Another website that Jane has told me about, which is really wonderful is www.siblingsexualtrauma.com.

But just know you are far, far from alone.

Speaker 1: Dr. Margaret
I couldn't be happier to have you on SelfWork Jane, because I have listened to your TEDx many, many times. And we shared a coach, which was kind of fun. And so I, I looked at yours as to say, well, what would it be like to to work with Brian Miller? But I personally today wanna hear more about your story. About one of my questions as I looked at it is, how did you talk to your family about it? Or, or did you say, "No, it's my story to tell."  Just what and what made you, what brought you to TEDx in the first place?

Speaker 2: Jane Epstein
First of all, thank you for having me on your show. Of course, I, I have listened to a couple of your podcasts and I, I've listened to you and I've listened to your TEDx and you are very trauma informed, and you are very kind and compassionate and lots of wisdom. So I appreciate being on your puck. Thank you.

First thing, what brought me to TEDx and how did I tell my family? Me, I don't remember the exact timeline, but I started Googling sibling sexual abuse and trauma, and I couldn't find anything on it. And I, I had this feeling that I wasn't the only one. I thought, I can't be the only person. 'cause I found two outdated articles that stated that it's a silent epidemic, right? I was, okay, well, if it's an epidemic, I'm clearly not the only six year old little girl. My my sibling who was 12 at the time, is not the only 12 year old child who, who an abused a sibling. So I just was called to start talking about it, and I reached out to my sibling. It was very awkward. And I expressed to him, I said, "I feel called to start talking about this and sharing my story because no one's talking about it. And it's a silent epidemic." And he said he understood and that he would support me in whatever way he can.

Speaker 1:
I get chill bumps when I hear that.

Speaker 2:
Yes. He, I'm, I have a very unique situation. I've been able to forgive him. I can call him and ask him questions. I'll say, I had this memory, is this true? And he's very careful to not give me more information. Mm-hmm. , because he knows I have enough to work with. I don't need any more triggers. I don't need any more memories. Mm-hmm. . And I also think that because of what happened between us, that he's hypervigilant and that he's got his eyes on other families, and that he sees that there could potentially be problems and sexual abuse occurring. And because sibling sexual abuse is so prevalent and not talked about, I think we are seeing things and not always able to put our finger on it. In

Speaker 1:
Your talk, you quote in your talk, you quote statistics like it's three to five times - It happens three to five times more than father daughter abuse, which is incredible. It starts earlier. It lasts for years often. So you're right. And it, it is something I, I remember I wrote a post on sex, uh, sibling sexual abuse. I got all kinds of comments. So yes, you're exactly right.

Speaker 2:
Yes. I listened to your podcast on the sibling sexual abuse, and it was very well done. Thank you. You're, you're very informed, . Thank you.

So I started talking to my brother and I said, I need, we need to talk about this. We need to, we need to do this. Um, or I need to do this. And I had these great grand visions because there's so much work that needs to be done. Well, it's a marathon on its front . So I started pitching the media, it, my emails were either not opened or not responded to. One response was, "Well, we haven't ever talked about that, but if we do, we'll reach out". And I'm thinking, you're not gonna talk about it. So I come across a video with Brian Kenneth Miller, our joint TEDx coach. And he had gone through, what is a TEDx? What is a TEDx?

Speaker 2:
What is not a TEDx? Because I thought, "Well, I'll go on TEDx and I'll share my story and I'll raise the alarm bell." Well, TEDx is not sharing your story, but I thought, well, I'll book a call with him anyways. So I booked a call with him and he said, "A tough topic, but I think we could come up with something." So we started talking about it, and it is, it's a tough topic, it's a dark topic. And Brian was never told me this, but he was concerned, how am I gonna get on the TEDx stage? Mm-hmm. . So we started going down the path of how to support someone who's been through a traumatic event. And I was gonna slide sibling sexual abuse and trauma through the back door. Okay. Which would not have been a great talk because there's lots of how to support people who've gone through trauma. It would not have been

Speaker 1:
Not unique,

Speaker 2:
Impactful, not unique, not impactful. It might have gotten on stage, but not likely. So then I heard from TEDx Boca Raton, and I sat down with Eric and Eric said, look, you know, we like your idea, but we really wanna know more about the sibling sexual abuse and trauma. Can you talk just about that? And I said, yes, I can. And I pointed to all my research books and I started spouting off all these statistics. And he said, "Great, that's what we want you to talk about". And I said, excellent. And that's how it all started. And I didn't mean to be on the TEDx, it's just that's kind of where I landed. And I, you know, once I was approved and started practicing my TEDx talk, I started having all the anxieties of speaking in front of a large crowd, but practiced and practiced and practiced. And the day I got on that stage, I just, they basically, there's something magical about that red dot. Maybe it's true. I got on that red dot and all was okay. But I was shaking..

Speaker 1: Oh, I was perfectly calm. .

Speaker 2:
It's amazing what you can make, even though the camera, you know, the camera shows all, oh, it was done. Well, you did aYou did a really wonderful job.

Speaker 1: And, and one of the things that I thought was so powerful about it, again, you've already mentioned it, was that your, your brother had, he had apologized, but then he had, you had written to him years later and he said, "Oh gosh, I didn't know this was still a thing for you." So I'm sure this solidified for him, again, the seriousness of the trauma, the impact that that had had on you, uh, and that it had, it had, uh, impacted your choices as an adult. And when you left home and it was, it was a elegant story. Well, it's, call it elegant is missing the point of that. It was very painfully uh, impactful. So, um, yeah, I mean, you made, you made some career choices that were obviously you trying to get back in control, but it didn't work.

Speaker 2:
Right. Right. And I'm not sure he understands the full impact. We've never sat down and, and talked about it. It's, it's like, it's a, it's a strained relationship.

Speaker 1:
Okay.

Speaker 2:
Um, but it, it's friendly enough in that I can reach out to him. I haven't reached out to him for a while, but I would can reach out to him and say, "I had this memory, is this a false memory? Is this true? Is this what happened?" And he is very careful the way he answers it, because he does, doesn't wanna trigger me and give me more memories. 'cause I have plenty to work with. Sure. He understands why I'm so public. He's not exactly thrilled about it. But, you know, I was in the People magazine and I had to run that by him. And, and the pictures, I ran the pictures by him. And that, it's hard. Uh, it's hard because it's putting him in a, in a, in a tough situation. But in my situation, in my story, my sibling is not a monster. My sibling is not a pedophile. My sibling caused a lot of harm, caused a lot of damage, caused a lot of trauma. And I, I have forgiven him. Um, and I'm not telling every survivor, you have to forgive to heal. That is not my, that's not my thing. It's just that's what worked for me. And it started by forgiving the little girl first, my little girl myself. And then I was able to forgive him.

Speaker 1:
Well, an aspect of this that I wanted to talk to you about a little bit more was you opened the talk by saying that you were in marital work with your husband, and your therapist turned to you and said, "I, I just don't get where all this anger is coming from. It doesn't seem to fit the situation." And, and then ask the very astute question of, "Is there something that might be, is triggered by what's going on with your husband? And that's what's, that's what we're seeing". And you, did you, did you connect the dots right then? Or did it take you a while? It took a while. It was your sexual abuse that was getting somehow, maybe you can talk about that a little bit. What was getting triggered with your husband?

Speaker 2:
Right. Many years before, before we were in counseling, something happened in the bedroom that, that triggered a memory. And that memory would not go away. Usually memories would come and go and I could put them away. And I thought it was just two kids being curious. That's not my problem.

Speaker 1:
Okay.

Speaker 2:
I thought because I'd lost, I lost my first husband to cancer and I got remarried to my, my husband. Now I try not to use current husband 'cause he doesn't like to be the current husband. .

Speaker 1:
Well, my husband calls

Speaker 2:
Himself

Speaker 1: )
. We've been married 33 years, and he calls himself my current husband. So ,

Speaker 2:
He's a good sport then. Yeah. . Yeah. So I had thought, I knew we had two small children. He had a stressful job. I had, I was still dealing with grief. And I thought, that's why I'm angry. That's why I am upset. That's why I was not depressed in my brain. I was not depressed because no, I had survived burying my first husband, and I survived that. So there's no way I could be depressed.

Speaker 1:
I have a, I have a book for you to read, . I know

Speaker 2:
You do. I am in that category. So we eventually went to marriage counseling and I went into the marriage counseling thinking, okay, he's gonna fix my husband, gonna fix him. Well, I had work to do too, fix too, when it comes to that. So we were in counseling for five years and we really had made a lot of progress. But I was still very, very angry. And I had asked myself, I had dug down and I thought, maybe it's something inside of me. I've tried to turn over every stone that maybe there's something inside of me that needs work. Mm-hmm. . So when the marriage counselor asked that question, I thought, well, there is this. My brother sexually abused me. There's that. And I approached it as, it can't be that because I participated. Right. So who am I to be messed up over that?

Speaker 2:
And the counselor, I kind of describe it as the deer in the headlights look. He's kinda like trying to sit still and kind of leaning in and trying to be very calm, realizing, okay, this is a big deal. No, what happened is a big deal. Right. And that it went on and off for six years. And that No, that was a big deal. And he said, "You're gonna need to tell Steve". And I said, huh. Steve's my husband. Mm-hmm. Current husband mm-hmm. . I said, oh, no, because then he'll be able to blame all our marriage problems on me. And he said, you need to be able to tell him to protect yourself in order and to, to be able to heal. So that's how that all started. And then I started a whole new healing process.

Speaker 1:
It's amazing. I've told a story on, on SelfWork about a woman. Um, and I already put a cautionary warning before we started. So great. Uh, a woman came in to see me who, um, it was the local community center. I literally had just gotten to Arkansas where I live now. And, and she said, you know, she told me about sexually abu abuse that her father had, um, had done to her. And then she, and there was this huge sense of relief. And then she came in the next week and she said, I've got something worse to tell you. So I sat back and said, all right. And she said, my dad made me do things to my brother . And she, she was a tough cowboy kind of woman. She had boots and, you know, she was farm girl. I mean, she was tough as nails.

Speaker 1:
And she teared up and, and we talked about it. And then she, she canceled her next appointment. And I called her and said, I'm, you've, you've shared so much with me, I'm a little concerned that you're not coming back in. Yeah. She said, well, okay, I'll come back in one more time. And she looked at me, Jane, and she said, I thought I would, I knew the look that would be on your face when I told you that I had done something to my brother. Because from her perspective, she had participated rather than being coerced herself. You know, it was, it was her doing something to her brother. And I said, you know, so, and she said, but the look on your face was not condemnation. It was, well, of course you did what your dad told you to do. Right. Um, and then there are other instances I I, uh, I mentioned before when we were just talking about a, a little girl who wore a red nightgown for her brother. Um, because she, she said, I enjoyed the attention. I knew something was wrong, but I, I didn't get any attention from anybody except from him. And so it was very complex and very complicated. But that whole idea of participation is so, um, is, is so confounding for any victim of sexual abuse, but especially with sibling sexual abuse, I think.

Speaker 2:
Yeah. And I, I wanna share with you that I've actually had some people who, when I, when I speak about the child who caused harm, there are situations where the child causes a lot more than harm. And I try and, and, and lower it a little bit so that parents hear me. Mm-hmm. , because if I scream your child, the pedophile or your child, the monster, your child, the perpetrator, they're not going to hear me. Right. 'cause if I talk about it in a more gentle as your child who caused harm, they're more likely to hear me. So that's why I approach it that way. But I understand that there are survivors out there where it was a lot more than harm. Yes, I understand that. Yes. But I have heard from people who have caused harm and they are suicidal. You're right. And so that's why we talk about this, because we don't want our children to be on any side of it.

Speaker 2:
Or I feel like if we raise awareness, if we educate our children, maybe we can lessen the numbers. You know, if we talk to our teenagers when they're 10, 12 and explore with them, say, Hey, you're experiencing a lot of changes. You've got a lot of questions. And I understand you may not be able to come to me as your parent, but you are at risk of harming another child, either a younger sibling or a cousin. And so we need to talk about this. What do you know when you have these feelings? And, and we need to talk about pornography. So that's why I I I am, it's an all encompassing, it's a whole family trauma. And, and I work very closely with the women of Five Wave, I dunno if you know anything about the Five Ways, but there's three parents and two survivors.

Speaker 2:
We've come together. And so the parents have shared their stories when they discover sibling sexual abuse and trauma in their homes and what the parents go through. Yes. What the survivor goes through, what the person who cause harm goes through. If we just talk about it and raise awareness and, and educate people and quit shoving it under the rug, maybe we can lift the numbers. Maybe we can get people help. Because you are a very, you're an informed therapist. You, you are very informed. A lot of therapists I've heard from survivors, they'll, they'll tell a survivor, well, you know, kids are curious. You are very informed. We need more of you . We really do.

Speaker 1:
Let me ask you something. Are there statistics? 'cause I'm not aware of them. If there are, and I'd love to know, um, about how many of the siblings be they girls or boys, we might point out it's not necessarily, um, and of course, or, or any gender identification. Um, absolutely. And how, what are the statistics on whether they have been abused themselves and then turn around and abused?

Speaker 2:
Unfortunately, we don't really have those statistics. We need more research. And the women of five Waves, we've actually had people, researchers are reaching out to us, asking us to share their surveys. So there is progress. Again, it's the marathon, not the sprint. So we are trying to gain more, more insight into that. And that's another thing is that I, I hear from survivors a lot. They reach out to me and they say, well, you know, my sibling did this to me, or my cousin did this to me, and then I did it to another child. And that there's shame on top of shame. Yes, indeed. And that happens a lot. Happens a lot. Mm-hmm. . But we don't have those statistics. Again, we need more research and we need more awareness and we need to be talking about it. And that, that's why I'm very loud.

Speaker 1:
What, what is the name of the organization that you Women of five.

Speaker 2: (20:58)
Okay. So it's called Five Waves Worldwide Awareness

Speaker 1: (21:02)
Wave. W A V E Ss. Correct.

Speaker 2: (21:04)
Worldwide Awareness, Voice, Education and Support. Okay. The way we came together, I've just been out there being very loud. And I am a moderator of a Facebook group for all types of survivors. And we kept having parents keep trying to join. And we're like, well, this is for survivors. So I went to find a parent support group, and through that I found a parent who had started a Facebook group for parents experiencing sibling sexual abuse and trauma in their homes. In their homes. So I reached out to her and I tried to join her group and she politely declined . And then I had a person reach out to me, Brandy Black, which is a pen name, to protect her family. Mm-hmm. . She said, look, it's been during Covid this happened in my home. I couldn't find any research, I couldn't find any resources on it. So I developed a website. Will you look at it? I promised my children to have a survivor look at it. And I said, whoa, this is amazing. Great. That's something I don't have to do. Was on my list. And I started looking at her website, Brandy Black.

Speaker 1: (22:03)
Oh, black. Okay.

Speaker 2: (22:04)
Black. I said, I can't get through this. I'm writing my TEDx. So I pulled in another survivor that I knew who was public, Maria Awa. And then I reached out to the woman who ran the Facebook group. And we all came together as 5WAVES. Oh, see. And the parents shared their stories. We shared their stories. So what we have through this organization, it's now 5 0 1 C three, is we are becoming thought leaders in this arena, or it's all out of a matter of, of, of caring. But we all have unique perspectives and we just wanna raise awareness. We want families to have support. We want families to have resources. We, you know, obviously one day we'd love to have this go away, but we aren't, you know, we aren't that optimistic. It, it's been going on forever.

Speaker 1:
Two cases come to mind that are the opposite. Um, both of them were difficult. One case, um, a case, one woman's story, um, was, uh, I was seeing the mother actually in therapy, and her daughter told her that her brother had sexually abused her. Um, the mother went to another state and confronted the, the brother. And he said, yes, he had, it took them probably it would took them years. I'm not sure how many, because the mother had to do her own work. The, the daughter, um, started working on herself. Um, 'cause she was definitely making choices that were very, um, tied to that, uh, that kind of abuse. So was the perpetrator the, or you go the person who did harm? He got his therapy finally. They got together and did therapy. But it was a long time before this family got together for Thanksgiving or, you know, anything like that, because the, the, the pain was just too real.

Speaker 1:
And, and yet I, they gradually worked toward that. It was marvelous to see the kind of healing that could actually take place when everybody was, and the mother, you know, had to take some responsibility for saying was I checked out. I mean, you know, maybe I was, maybe I wasn't. Um, and so they did great work. You know, I also have an example of a patient who I was seeing the daughter who was abused. The sister who was abused, uh, when she was a toddler, she had a twin. And she didn't remember it until the twin did. And then they confronted the family together. Actually, before she saw me. The family kind of nodded. It was an older brother. The older brother said, it wasn't me. I think it was a neighbor. Um, that wasn't true. And not a word was said about it again.

Speaker 2:
Yeah. It's very common.

Speaker 1:
And she was, she had the kind of family where they expected her to be there at every birthday, at every anniversary, at every holiday, at every religious event. I mean, and it was every time she was, she had anorexia still does. She would just not eat for days, um, after a home visit. So it, you know, those two situations are so contrasting and, and, and one of there can, there can be healing. Yes. It's hard, but there can be healing.

Speaker 2:
Yeah. And I, I think that the second scenario that you talked about, if you're a parent, I mean, parents experience a lot too when they discover this mm-hmm. . And if they go to Google and they can't find anything, if they aren't understanding, they may think, well, my, my child's the only person in the world who's harmed a sibling, or is my child gonna grow up to be a pedophile? And it's probably terrifying and probably easier to say, okay, let's just pretend status quo, and let's just, let's just go forward. Let's just shove it under the rug. That's what we're hoping to raise awareness. So if the parent, they, they got, I mean, wouldn't it be amazing if like, the Today Show covered this?

Speaker 1:
Sure. Wouldn't

Speaker 2:
It be, you know, sibling sexual abuse? Then a mom might think, oh, that's ho that's horrible. I can't believe that's happening. But then if, if she hears about it in her home or friend, she'll say, oh, but I heard this was a thing. You know, it's, it's at least in their subconscious, because if we don't get it out there, it's really hard for a parent to wrap their heads around. Of course. I mean, I can't imagine. I am a parent and I try to educate my children to the point where they run away from me. , . But, um, I, I can't, it's really hard for parents to wrap their head around. And that's, we're just trying to raise that awareness. But I hear from a lot of survivors that they're expected to just go on is normal, and, and you're asking a survivor to, to sit in the room with someone who abused them and possibly in the same home where they were abused. And that's very triggering. That's very difficult.

Speaker 1:
Yes, it is. And, and it doesn't get any easier. Another woman comes to mind who said, you know, that she sits by her brother every day or every Sunday at church, and she's always crying and people believe she's crying because she's moved by the service. And actually she's just, she's overwhelmed with feelings about the abuse that he has denied and continues to deny. So it's, it's, gosh, it's so painful. But there, there can be healing. Um, what, what did your mother, how did your mother handle it?

Speaker 2:
Well, I told her, I wanna say I was around age 24 when I was still pushing it off. It was just two kids. It just, it ha it happened. Uh, um, and I kind of said it in passing, and she cried. She said, I believe you, but where was I? Where was I? And then she started questioning. She said, but he's a good kid. He, he always knew right from wrong. There was a lot of confusion. And then I pushed it back. I put it back in its box, and we didn't talk about it for years. And then when it reared its ugly head in my current marriage mm-hmm. , um, she didn't understand. I said, I need to come forward. I need, I need to talk about this. I need to come forward. And she, she said, you need to forgive him. You need to forgive him.

Speaker 2:
And I said, I don't need to do anything. I will forgive him when I'm ready on my own terms. And she gave me the books on forgiveness, and I rolled my eyes. You can't, you can't force that. And she said, what about his family? And I screamed at her. I said, his family. Yeah, yeah. Because unfortunately, I took him, I was angry at him. I was angry at my husband. I was angry at my, my siblings wife. I was angry at my siblings children, and I pushed them all aside mm-hmm. . And they didn't understand why I was pushing them away. They didn't know mm-hmm. . So I did come to terms with it, and I did forgive my brother on my terms when I was ready. And then I reached out to my mom and I said, I forgave him. And there was relief in her voice mm-hmm.

Speaker 2:
. And then she realized, oh, now I've got my own journey of forgiveness. And she had to follow her own journey. And she was at the TEDx, she was in the audience. She didn't know what I was going to say. And, but by the time she was at the TEDx, I think she was in a good place. Um, she loves both of her children. It's, it's a very tough position to be in. And there were times when I said, I don't wanna be in the same room with him. And that was really hard for her. Mm-hmm. . So she seems to be on her own journey, and I think she's into the point where she's been able to accept it and, and sees why I'm being so public and understands why I am so public.

Speaker 1:
So what's been the changes in your life? I mentioned in the intro that you have over half a million views. What, how has your life changed since the TEDx and, and what are your plans for the future as this, as you, as you run this marathon?

Speaker 2:
Yes. It, it, I'm still running the marathon. Expect I, the finish line keeps moving. I, I actually heard from another survivor yesterday via email because it came across the TEDx. And so people are finding me through the TEDx and, and when they find me through the TEDx, I'm able to get them into Facebook support groups. I'm able to get them resources. So I know that they're in a community of people that's been, you know, I think when we can help others that help heal us mm-hmm. , um, I am, I'm still writing my memoir. It's so, so close. I have a children's book that I've, I've submitted. I'm waiting to hear back if they will publish it or not. That's what's on my radar right now. I am slowing down a little bit. I try and be supportive within the Facebook groups. I, I'm trying to, um, answer all my social media messages because I get a lot of social media messages. A lot of people on TikTok, unfortunately, a lot of my people are on TikTok. They're a younger age.

Speaker 2:
I'm slowing down a little bit. One, I'm tired. Two, I have two teenage boys who are in 10th grade, and they will be leaving me in three years. So I'm trying to be very, very present with them and enjoy them. Sure. And I just kind of show up wherever I'm needed and trying to, to support Five waves and, and keep that momentum going and, and just raising more awareness through five. Nobody's selling anything. We're not trying to, you know, obviously we're looking for donations, but, you know, we're not selling anything. We're not making any money. We're just trying to raise awareness and, and collaborate. We're having more and more people reach out wanting to volunteer with us, which is great. 'cause we're five people mm-hmm. . And yeah. I'm just looking forward to a day when there's more survivors who feel comfortable coming forward. And, and honestly, I I welcome hearing from those who caused harm too. Um, I feel we've received a couple emails. If,

Speaker 1:
If someone wanted to donate or volunteer or just, I mean, can you give the names of the Facebook groups or do they reach out to you? How, how is that, how do you want them to do that? Right.

Speaker 2: (32:14)
The 5WAVES.org website. Okay. You can email us there. You can contact us if you're, if you're, if you're a parent, if you're a survivor, if you're someone who's caused harm, you can email us there. And then also on that website, we have Facebook groups and, and we, we try and respond to every email that we can. Yeah. So that's where I'm headed right now. I kind of show up where I am needed .

Speaker 1:
And so I'm a great admirer of yours. And I, because I think you did this TEDx for a really good reason. Um, and I mean, and, and a very honorable reason. And so, uh, that I, I admire greatly.

Speaker 2:
Well, thank you. And I admire you as much. I I think that we, I I was looking forward to this interview and I told my husband this morning, I said, this'll be a great interview because she, she's informed and she knows what she's talking about. She's done the research, she's done the homework. So I really appreciate it.

Speaker 1:
Oh, well, thank you. Take very good care. Thank you.

Speaker 1:
I know you could tell from Jane's interview just how sincere and how passionate she is about getting this message out. And we at SelfWork wanted to help her do just that. The organization Jane refers to in the interview is the worldwide awareness, voice, education, and support. Better known as 5WAVES.org. And the five is not spelled out, is a numeral. So 5WAVES.org give if you can. It's a 5 0 1 3 C. So it's a nonprofit. And I wanna thank Jane and all other survivors of abuse who come forward. It takes tremendous courage to do so. Thank you for being here at SelfWork today. Please take care of yourself, your loved ones, and your community. I'm Dr. Margaret, and this has been SelfWork.

Sep 13, 2023

Hello my friends!

This September (2023) we're giving away two(2) copies of a little book Christine Mathias and I worked on called Marriage Is Not For Chickens. A post by the same name, when it appeared in HuffPost, earned over 200,000 views and over 50,000 shares... Wow! (Of course, I didn't get a call to be on a morning talk show... lolol)

This book may take you two minutes to read because it's meant to be a gift for someone who's getting married or deciding to commit to a relationship - or maybe to someone who's having an anniversary. The photos that fit all 24 statements of "what marriage is" and "what marriage is not" were either taken by Christine or my old high school friend Deborah Strauss. The images are breath-taking, poignant, evocative, or simply "right." We're very proud of it - and hope it will give you and yours joy.

So, all you have to do is leave a written review on the SelfWork page on Apple Podcasts to be included in the drawing! But I realized, you might need to hear what it's all about. So that's what today's quick YGTG (You Get The Gist) is all about!

Listen in, smile, and I hope you enter the contest - so you can give it away, keep it, or have fun with it in some way or the other.

Vital Links:

Dr. Margaret's TEDxBocaRaton Talk (now with 155,000 views!)

You can listen to Dr. Margaret's TEDxBocaRaton Talk on perfectly hidden depression and the Immediate need for greater transparency in talking about emotional pain and suicidal feelings.

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!

 

 

Sep 8, 2023

We certainly have had – and the world has had – our fair share of reasons to grieve. Wherever you live, you felt the fear and loss of the pandemic. Add on to that, the impact of hurricanes, tornados, drought, fires, floods,  war, racism, political unrest, violence… we’ve got it all - some countries more than others. But these events are also a backdrop for whatever happens in our personal lives – people who we’ve loved dying, losing a job, having to move or even to escape from where you’ve lived, developing a severe mental or physical illness or one that’s chronically debilitating, being abused… The list goes on and on.

And we need to grieve.

Yet, one of the ironies  is that the model we’ve been taught – in a very “this is how you should be grieving” kind of way – was created to help us understand what the person dying might feel and wasn't created to describe the grief of people who are alive and grieving loss.

What’s grief really like? How do the stages that Kübler-Ross help? How do they hurt? What are the effects of your culture or faith alter your experience of grief? How is the Internet changing the way we grieve?

The listener email for today is from a woman whose sense of emotional stability has decreased after the death of her father – and she has no relationship with her mom. She uses the term, “I feel orphaned.” So as always, we’ll talk about what you can do about it.

Before we go on,  I’d like to invite you to listen and watch my TEDxBocaRaton talk.. Here’s one of the many reviews… "Dr. Rutherford, what a beautiful talk. I watched it several times. We can all learn to recognize the signs and be ready to support those who might be silently struggling. This TEDx talk is a powerful reminder to be more attentive to the people around us, listen beyond the surface, and offer support without judgment."

Click here to listen!

Advertisers Links:

Have you been putting off getting help? BetterHelp, the #1 online therapy provider, has a special offer for you now!

Vital Links:

Heidi Bastian's article in The Atlantic

Article: It's Time To Let The Five Stages of Grief Die

Dr. Franco's article on cultural differences in grief.

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!

Episode Transcript: 

Intro:

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.

Welcome or welcome back to SelfWork. I'm Dr. Margaret Ruthford. I'm so glad you're here. I started this podcast almost seven years ago now to extend the walls of my practice to those of you who are already interested maybe in therapy or you were just interested in psychological stuff, to those of you who might have just been diagnosed or you're looking for some answers. And to those of you who might just be a little skeptical about the whole mental health horizon, so welcome, welcome to all of you.

We certainly have had, and the world has had their fair share of reasons to grieve recently. Wherever you live, you felt the fear and loss of the pandemic. Add onto that, the impact of hurricanes, tornadoes, drought, fires, floods, war, racism, political unrest, violence - we've got it all - some countries more than others, but these events are also a backdrop for whatever happens in our personal lives, people who we've loved dying, we lose a job, we have to move or even you, you have to escape where you've lived. You develop a severe mental or physical illness or or that's chronically debilitating or someone you love does or you're being abused.

The list goes on and on and we need to grieve.

And yet one of the ironies, and what I want to address in today's SelfWork is that the model we've had taught to us in a very "this is how you should be grieving" kind of way, was initially met or designed to describe the stages of grief for the person who is terminally ill or dying themselves. It's Elizabeth Kübler Ross's five stages of grief. It was never meant for the people who were alive in grieving a loss.

So that's what we're gonna talk about today. What's grief really like? How did the stages that Kübler Ross suggests help? How do they hurt? What are the effects of your culture or faith and how does that alter your experience of grief? How is the internet changing the way we grieve? That's an interesting kind of subject.

The listener mail for today is from a woman whose sense of emotional stability has decreased after the death of her father, and she has no relationship with her mom. She uses the term, "I feel orphaned." I've heard so many people say this, so we're gonna talk about it today on SelfWork.

Before we go on, I'd like to invite you to listen and watch my TEDxBocaRaton talk. Here's one of the many reviews, "Dr. Margaret Rutherford. What a beautiful talk. I watched it several times. We can all learn to recognize the signs and be ready to support those who might be silently struggling. This TEDx talk is a powerful reminder to be more attentive to the people around us. Listen beyond the surface and offer support without judgment. Together we can break mental health stigma and create a more compassionate and understanding society."

So I will have the link in the show notes or you can just put in Dr. Margaret Rutherford TEDx and it'll lead you right with my YouTube. And of course, if you like it, please say you do or check that off and even leave a review. I'm beginning to get asked to speak about perfectly in depression directly because of this TEDx talk. And so that's a wonderful and very helpful way you can help me spread what I believe is a very important message. Thanks, my gratitude to y'all.

Episode

Elizabeth Kübler-Ross, the psychiatrist who first developed and wrote about five stages of grief, gathered her ideas from conversations with dying patients. She talked to them and she watched the grief that they go through. And yet it was snapped up by others to describe what everyone who is grieving must go through. In fact, it doesn't make a lot of sense when you think of it and it's even becomes something you should be going through, which is really ridiculous. For one thing, the stages are interactive, but somehow people have felt bad that those stages weren't part of their experience.

In an article put out by McGill entitled, it's Time to Let the Five Stages of Grief Die. The author state and I quote while she was a psychiatry resident in New York, Kubler Ross realized how little attention was paid by hospital staff to terminally ill patients and how little medical knowledge there was regarding the psychological aspects besetting patients facing death.

She worked extensively with terminally ill patients throughout her medical school career and continued to study and teach about such topics. She was also criticized by academic researchers for not running a real study. Instead, she used conversations with a dying as her basis for putting the stages forth and wanting medical staff to be a better attuned to what was going on with these patients.

Now, what are those stages that she was describing? You may have thought I needed to know this way before now, but here we go. Denial, anger, bargaining, depression, and acceptance. She asserted that these stages weren't rigid. You could feel or express them at any time. Denial that you were dying or that you had a serious illness might make you not seek treatment or refuse treatment. Keep how serious your illness was out of your consciousness. Anger is the second one, anger that it feels unfair that you're not ready to die, that you have more life to live.

The third one is bargaining. If I can just get better, I'll never do X, Y, or Z again, or I'll start doing X, Y, or Z. Then there's depression, sadness over past choices, sadness over not having control, sadness that you're leaving the people you love, the life you've been fulfilled by and thus acceptance, realizing there's truly no more you can do. Acceptance that you won't see your grandchild born or your kid graduating from high school. Of course, how you grieve is shaped so much by the culture you live in or in the rituals, the religion you follow or that you have faith in general. Dr. Marissa Franco, who we've had here as SelfWork as a guest, she's really cool, writes in Psychology Today that research suggests that when we're helping our loved ones cope with grief, we should consider what they find.

Most supportive people in the Asian and Asian American communities for example, may prefer spending time with close others without talking about their grief. While people in the European American community may want more explicit emotional support. So she's pointing out that we need to understand and be aware of how a certain person may be grieving, how their culture influences them, how their faith influences them, and what you may need or want to do to be respectful of that because that's what's important. Even with the best of intentions, you may make someone's experience of grief more difficult or if they really want that kind of support from you, they want to talk about their loved one who's gone. Then you hold back obvious emotional support and you don't wanna do that, or at least most of us don't. <laugh> actually to know what's truly helpful. You could of course ask and not assume, how would you like for me to support you?

So what role does a belief in life after death have on grief? I looked at several different studies but was drawn to one whose results showed that people reporting no spiritual belief had not resolved their grief. By 14 months after the death, participants with strong spiritual beliefs resolved their grief progressively over the same period. And then people with low levels of belief showed little change in the first nine months but thereafter resolved their grief. So basically a spiritual belief seemed to increase the likelihood that you'll resolve your grief earlier and even a small bit of relief helped to resolve grief more quickly. That's important.

But let me quickly say that's not necessarily been what I've seen in my own clients, and I've watched many people grieve. Because so much of what matters is the timing or the way someone died. Did you have a chance to do what's called anticipatory grieving? Allowing yourself to feel what it's going to feel like to lose someone you love, whether you got to say goodbye, whether you feel to blame or partially responsible for their death or you were told that you were responsible.

Grief can often challenge your belief in some of these instances. If there's a God, then how did this happen? Now for those of you listening who say, if you believe in heaven, if you believe in life after death or if your religion is Buddhist or Hindu or whatever it is, that may of course be very comforting. I'm not saying that, but here's an example. I worked with a man years ago whose alcoholic parents had told him he was to blame for a sibling's death when he had been only a child himself. When it occurred they were inside drinking and this 10 year old boy was tasked with watching his four younger siblings and one of them got hit by a car.

So obviously when you're blamed, when you have a terrible time processing your own grief, or maybe you lose contact with others who you might be grieving with, you've got to go back to college or you've got a new job or you've quickly moved to a new home. So those that you might be grieving with are no longer there. Of course, our modern technology helps with that, but still, but there's also the possibility that you are not even allowed to speak of your mom who died because your father has remarried.

So many factors affect your grief, how you are encouraged to express it or how you're not allowed to do so again, faith, a certain structure of what happens after death. If you believe, that can certainly be helpful, but from my perspective at in my experience, that suddenly you just don't grieve. That's far too simplistic. Let's stop for a moment for a brief message and offer from BetterHelp where you just might turn in this kind of grieving situation or time.

BetterHelp Ad

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 betterhelp.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 surfaces.

Episode Continues

Sometimes when I'm looking into a topic like I did today, I realize that someone has said something born from their their own experience and expertise that I just can't say better. So when I read this Atlantic article by a grieving mother who's also a researcher, Heidi Bastian, I knew I was having that experience again. She went looking after her 38 year old son's sudden death for help. She found everything from you'll never survive This grief to the idea that there is a time period when grief will be at its strongest but will abate. I want to share this with you because it's the wisest thing I've read on my journey to bring you this episode. So I'm going to be directly quoting from Heidi Bastian's Atlantic article, and if you want to read all of it, I will have it in the show notes.

So I quote, "For most people, after most deaths, grief starts to ease after a few weeks and continues to reduce. From there, there can still be tough times ahead, but in most circumstances, by the time you reach six months, you're unlikely to be in a constant state of severe grief. Although most people will experience grief when they lose someone close to them, they won't be overwhelmed by it. For roughly half the bereaved grief is mild or moderate and then subsides among those who experience high levels of grief at the outset, distress will usually begin to ease in a few weeks or months to, it's not a straight line where each day is better than the one before, but the overall level of suffering does go down over time"

"Some bereaved people thought about 10% according to the research will be in severe grief for six months or longer. The risk of remaining in deep grief for more than a year is higher for those under socioeconomic stress or who experience the loss of a spouse and it's even higher still after the loss of a child or a sudden death via accident, suicide or homicide."

That's kind of what I was saying before. So for example, I worked with someone last year who lost her older child in a plane wreck and her husband was also on that plane  - and he survived. So where does grief get expressed in that family? Often grieve isn't a solo event others lived through. So again, is there a right way to grieve? No, no, no.

Also, to chime in with Ms. Bastian, I have found that grief sort of comes in waves and I've talked about this on the podcast. And you'll wonder and even be afraid what's happening when you get hit by what seems like a stronger wave than ever when your grief had been subsiding. "Oh my, I'm going all the way back to where I was in the first place." That's not my experience with grief. Grief comes in waves and some are stronger than others and then all of a sudden you can get hit by a rogue wave when you get triggered in some way. That's also grief.

But let's talk about when it becomes more severe in penetrating, and I'm gonna go back to Miss Bastian's article. "Adults who face this long-running, even severe distress are experiencing what many clinicians and researchers term prolonged or complicated grief. This increases their chances of having serious mental and physical health problems, including premature death and suicidal thoughts. Even if we don't personally know someone who died within a couple of years of a major loss, we've probably all heard stories of it".

So back to just me talking <laugh>, there is a new diagnosis called complicated grief and it's still very controversial 'cause it seems to be pathologizing really deep grief and they give it some sort of one year cutoff. If you're still grieving after one year, then you should be given a diagnosis of complicated grief. The Washington Post op-ed argued why set expectations on its pace or texture.

Why pathologize love? Now I'm back to Miss Bastian. Okay, so basically Adam was the name of her son, and I'm gonna go back to this part of her article. "When Adam died, I needed hope that a vibrant life was within my reach. The science showed me that it might be closer than I could even imagine. So I tried to look forward, forward as I did so I held onto a thought about my boy that helped me face a future without him."

And this is incredibly profound. So please listen closely. Ms. Baston: "He had loved me his whole life, that love is precious and it's for keeps. I will not waste it." So what she seems to be saying is she's reached a space or place in her heart and her mind where emotionally dying herself from the pain of losing her son would devalue his love for her.

I remember a woman I worked with many years ago or several years ago, lost her daughter in a tragic accident, completely shocking and a little more than a year after her death, she went to a wedding of one of her daughter's really good friends and they had a picture of her daughter there because she was supposed to have been in the wedding. And she came back into therapy and said something very similar to Ms. Bastian. She said, "I realized I was there because everyone there had loved my daughter and I loved my daughter, and I was there to honor her as hard as it was for her to go." Deciding you're not going to emotionally die along with your your son or your brother, or your mother or your friend is so important. I see this so much. It's a choice to continue living and in so doing, honoring the person who died.

I get a Christmas card every year, in fact, from a family I saw years ago, a couple who'd lost their second child days after his birth.One of them became very angry as his faith was temporarily shattered. The other focused on their living child while also grieving and they had a bit of struggle trying to understand and accept that their separate ways of grieving was okay, that neither had to give up or change their grieving pattern to appease the other.

I've seen this difference in grief often within a couple. It's not wrong, it's normal and natural in their card. I noticed immediately another child that had been born, I'm sure they still grieve the child that didn't live, but it doesn't seem to be stopping them from living and connecting to their life. Now, if you're struggling, then please do seek help. If you're stuck, you can get unstuck, but you may need someone who understands that there's no correct recipe for grief. You simply may need help through compassion and gathering hope.

Listener Email:

Here's our listener email for today. Hi, Dr. Rutherford. I listened to your podcast many times and I love it. I'm 49. I escaped my mom physically to be leaving Israel 23 years ago. I've done extensive work on myself and now I'm in the process of writing a book. Since my dad passed away three years ago also in Israel, I've been re-experiencing feeling wise, returned anxiety, depression, and I'm not as grounded and solid in my place in life. It's all subjective. I have a great family, friends and a husband, but I feel orphaned and guilty for being a bad daughter to my mom, feeling sort of lonely. I'm in California and would love to connect on better help. She didn't realize I couldn't do that. The book writing is obviously triggering, but at the same time I have to do it. I love writing.

So again, this was another message that was sent to me on my email, askdrmargaret@drmargaretrutherford.com and I  invite you to do so. But as I read this, the first analogy that came to mind as this listener was talking about how writing a book, I'm assuming about her struggles as a child in Israel is very triggering for her. Of course it is often when people tell me they don't want to journal, but I might be suggesting it. What they say is, "I don't know what it'll be like to actually see things in black and white." Or I also hear, "What if someone finds it?"

The first question I answer by saying they're absolutely correct. It's often difficult to see your feelings on paper to write down the painful experiences you had. It brings them much more to the surface. You bet it's hard. Here's the analogy I've used. So if your memories are held in a big iron soup pod on the stove and they've been simmering very, very slowly for years with the top on, so slowly they've barely even created any steam, but now you're opening the lid and you might get a huge cloud of steam that reflects those experiences and you have a sudden painful reaction, but you leave the lid off and the puddle settle down again, right?

It'll go back to a simmer. In fact, you might not be able to smell anything at all when you got a huge whiff when you first opened the pot. But what if you continue to stir the pot with every one of those stirs some of the smells of your past, the emotions and memories that belong to what happened will become stronger. Therapy's almost always about stirring the pot, talking with friends, however you communicated. However you begin to reveal yourself is stirring the pot and journaling, or certainly writing a book is also doing the same thing.

But there's one other factor. The death of her father and she doesn't describe their relationship, just says he was also in Israel. But that death may be very symbolically reminding her of the many losses she's experienced, maybe her dad's voice helped her feel that she'd done what she needed to do to protect herself from her mom. Maybe she's simply grieving that her dad is also gone. I'm not sure, but all of this sounds normal to me. Given the circumstance, estranging yourself from a parent or a sibling due to the damaging impact they had on you. When that estrangement is about self-protection, it's complicated. It can be a relief in many ways, but it's very sad as well. I hope this listener goes to better help or a local therapist to get some of the feedback that she seems to need.

Outro:

Once again, thank you for being here. I wanna remind you we're doing a little giveaway. If you'll leave a review, an actual written review on Apple Podcasts, then I'm gonna choose two of those reviewers to get a book. Marriage is Not for Chickens, and what I'm gonna do, I realize that many of you probably don't even know what I'm talking about. So in a YGTG coming up in just a couple of days, I'll actually read the book to you. It takes about maybe two and a half minutes <laugh>, it's a little book meant to be a gift or a little anniversary, something special present or a getting married present. And I know we have a lot of following winter weddings coming up, or like I say, just anniversaries. It's a fun little gift. My communications manager, Christine Mathias, who's also this incredible photographer, she and I did it and she did a lot of the pictures and certainly did a lot of the framing of those.

And I had a friend from way long ago also contribute to the photography. But the post itself, actually when it was in the Huffington Post, it earned 200,000 views and 50,000 shares. And of course, I didn't get invited on Good Morning America or <laugh>, any of those. I guess if you're writing about something happy, that doesn't happen, but I'm gonna give away two copies to two people who leave written reviews for the month of September. So have at it.

Let me know what you think about SelfWork, whether that's to say, oh, I wish you didn't do this so much, or you know, whatever I really need and want your feedback. Thanks so much and subscribe. Get onto my new website at drmargaretruthford.com. Look around. It's a lot of fun and if you subscribe there, then you'll get my weekly newsletter. That's it, I promise. But it has some interesting things that I'm doing or ideas I have things that you could be a part of on my Facebook page, that's facebook.com/groups/ self-work. Sometimes we get together for discussions, that kind of thing. But all in all, thank you for being here today. Please take very good care of you, of that family you love, and friends that you love, and your community. I'm Dr. Margaret and this has been SelfWork.

 

Sep 1, 2023

I was shocked to see this past week that I'd never done an episode on the four most well-researched communication patterns that can predict a couple will divorce or end their relationship.  And I talk about them in couples therapy all the time! These four have been written about extensively by the well-known pair of researchers John and Julie Gottman – and I think their work is right on target, given what I sadly see on a regular basis in my office. And I’ll offer the most recent ways these four distinct behaviors can appear in the modern partnership. Sadly, if you or your partner don’t see these things as problems, then that is a tremendous issue. But if you’re not aware of the danger of these, then you may not know the quicksand your relationship is in – and sinking fast.

The listener voicemail is from someone who was taught that everything in her life had to appear “perfect” – even saying that if someone comes over for dinner, there need to be five courses and the house has got to be spotless. That is truly a prison and she wants out! But… she lives in the same city as her mother – who taught her all this – and she fears moving away from those choices and what her mother’s reactions might be. I so love the questions y’all send in so keep them coming!

Advertisers Links:

We welcome back BiOptimizers and Magnesium Breakthrough as a returning sponsor to SelfWork and they have a new offer! Just click here! Make sure you use the code “selfwork10” to check out free product

Click HERE for the NEW fabulous offer from AG1 – with bonus product with your subscription!

Vital Links:

Article describing the original Four Horsemen of the Apocalypse

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!

 

Episode Transcript

Dr. Margaret: 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 or welcome back to SelfWork. I'm Dr. Margaret Rutherford. I'm so glad you're here. I hope you've enjoyed the last few interviews. I thought especially Dr. Priyanka Wali’s interview was really fascinating, a doctor and a comedian. She also just had some wonderful thoughts  - that was last week. Hope you get a chance to listen to that if you haven't.

I was commenting on an Instagram post the other day about someone giving their partner this silent treatment, which is something we all hear about. And I was looking for podcast episodes I'd done on marriage. I thought surely there'd be a whole bunch of them. And to my shock. I found ONE  on stonewalling, but not much else. I was really looking for talking about problems in marriages that cause maybe divorce or something like that. And there are actually very well researched bad habits. There are four of them that can predict divorce.

So that's the topic for today. These four have been written about extensively by the well-known pair of researchers, John and Julie Gottman, and I think their work is right on target, given what I sadly see on a regular basis in my office. We'll focus on the Gottman's four candidates and you can see what you and your partner may be guilty of. Sadly, if you or your partner don't see these things as problems, then that itself is a tremendous issue. But if you're not aware of the danger of these habits, then you may not know the quicksand your relationship actually could be in and you could be sinking fast.

Now, I'm not a researcher, but I'll also add a few more thoughts of my own about what these look like in the modern 2023 relationships.

The listener voicemail is from someone who was taught that everything in her life had to appear perfect.

Even saying that if someone comes over for dinner, there need to be five courses and the house has got to be spotless. That's truly a prison and she wants out, but she lives in the same city as her mother who taught her all this, and she fears moving away from those choices and what her mother's reactions might be. I love these questions that y'all send in. So please send a message over SpeakPipe, which is a voicemail, and I get to listen to your inflections and your voices and I love that. And the SpeakPipe option is in your show notes, but it's also on my website, drmargaretrutherford.com. It's right at the top. Let's hear first from SelfWorknsponsor Magnesium breakthrough.

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Body of Episode:

So let's talk about ways that you can really screw up your marriage,

Dr. Margaret – Speaker 2

Marital work or couples work. Any kind of couple really is something I love to do. It's very challenging to help both people feel heard and understood - not always agreed with of course, but as long as I don't have one or both people looking at me and saying, “Please help them see how wrong they are”. <Laugh>, I feel pretty hopeful  - in most cases at least. But sometimes that's exactly what's on one or both people's agenda. They've come to therapy way after they should have, it's really, it's not too late, but gosh, they've come in after multiple fights and threats of divorce or “I'm taking the children”,  after affairs or betrayals of some kind have happened, be they financial or emotional or whatever.

And they sit and argue in front of me at least for a while. I allow it to go on because I want to see the pattern that is as long as it doesn't get physically or verbally assaulted.

If it does, I have to cool things down and sometimes this is what I'll do. To cool them down. I'll ask them both, “What do you think are the four greatest predictors of divorce?” Usually I get answers like fighting or your in-laws or trust kinds of answers. And that's not wrong. But the best research out there, in fact, the most rigorous that  has been done is by Julie and John Gottman and what they call the four horsemen of the apocalypse  - in this case, meaning the end of the partnership or marriage, are well-regarded as true predictors in the field of psychology. So I look at the couple and by now they have kind of settled down, because remember, they probably wouldn't be in my office if they truly wanted a divorce.

So they're open to hear, “Well, okay, what are the predictors?” And I say very slowly in order of importance.

Stonewalling is number four. That's when one or both of you goes for hours or days refusing to communicate with the other. Usually someone looks kind of sheepish at that point. They may have even told me there are times, like even days, we barely say anything to each other because it's such a relief from the fighting. Or I've seen people kind of smirk like somehow stonewalling their partner is a really cool way to gain control works every time they'll say, which I would usually answer, “Well, if it worked really well, I don't think you'd be here.”

 What's number three..Blaming. And not to be mean, but to make my point. I'll repeat a few phrases from what I've just listened to that I would call blaming. Or when you don't take your share or the responsibility for whatever problems there are, you're focused on the other one you think you're not or never to blame or you're quick to blame, you don't apologize.

You're quick to angrily yell, “Whose fault is this? Who did this? “ So, your focus is mostly on other people and what they're doing wrong and not taking responsibility for yourself.

Number two, let me let you think, if you can guess for a second, what could be number two, it's close to blaming…criticism - and now the room is getting even more quiet. What's the difference between blaming and criticizing? They usually are wrapped up together, but you can have one or the other that predominates like blaming is this is your fault. “This wouldn't have happened if you hadn't X, Y, or Z.” Where criticism isn't as much about fault, but about correcting them saying they're wrong. And you're right, you can hear shades of gaslighting here. “Why didn't you pay that bill?” Or, “ Why do you change the baby's diaper that way?” Lots of why questions, which puts everybody on the defense by the way, and why questions that infer criticism or there's downright criticism – “ The way you did that was just dumb” or labeling your partner, “You're so lazy “or bringing in the kids, “The children are on my side” here, or “All our friends agree with me.”

Making sure you establish yourself as more right than your partner. More put together. You're like a healthier, more likable human being. So that gives you the right to criticize your partner.

I think the worst thing, no, not the worst, maybe the funniest in many ways was one couple came in and they have one of those strings that come down in their garage so when they pull in, they know when to stop, you know, it kind of hits their windshield. And she was saying that thing would hit the windshield. He had a certain timing that if she didn't turn off the car like two seconds after that or a second after that, he told her, “You just don't know how to park.” It was really a little trivial <laugh>. She wasn't running into the wall. So what do you think the last one is? Guesses.

The last one is contempt. Now what does contempt sound like? And I either pull from what they've already said or I make up my own examples. Like , “I can't believe I married someone like you. No one would ever guess just how disgusting you can be.” “How could you be so stupid?” Or it can be nonverbal stuff l- ike eye-rolling. But it's you have a disdain, a contempt, a huge disrespect for the other person.

So this couple is sitting in front of me now looking maybe a little ashamed, maybe a little surprised, maybe a little shocked. And a few seconds later, one of them might say to me, “We do all of those.” And I say, “So we've got our work cut out for us, right?”

 But guess what? Sometimes one of them will say, “Well, I never do any of those things”, or I” wouldn't do it if she didn't do it or he didn't do it or they didn't do it

Well guess what? That's blaming, right? <Laugh> or even contempt. And I point that out. Oh, so you just blamed her for all the problems or him.

Now before I go on, let me say that we probably all make these errors. We all have bad days. We say mean things. We may even know what criticisms to use that will really get our partner something like, you know, you're sounding just like your mother. Oh, I thought you told me you were gonna try to change that in Margaret's office. I don't really see it. That's contempt and we use it on purpose. But if a couple doesn't see these four things as problems or one of them doesn't or refuses to, that may likely reflect that there's true emotional abuse going on, which of course reflects another level of problem. It's not a bad habit that they've gotten into that's gotten out of hand.

It could be a choice to be in control and sabotage the worth and emotional stability of your partner and the absolute denial of blame or responsibility for any problem can be a destructive character trait that may not respond to therapeutic suggestion at all. Like in some of the personality disorders, borderline histrionic, narcissistic sociopathic, some of those problems if you are married to someone like that or partnered with them, it can take them some time to understand the impact they have on others if they can at all. But that's not the topic for today. We're talking about two pretty normal folks who've just gotten into some bad habits and may not recognize the horrible impact they can have.

One couple comes to mind immediately, but before I talk about them, let’s hear from AG1. Your support of these products helps us make and produce SelfWork. So remember that as you listen and if you think it might benefit you, then please go for it.

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Speaker 2:

Okay, so back to this couple. They came in only a few times together. She'd come to therapy to talk about feeling blamed for her husband's affairs that he'd had for years. “But he doesn't call them affairs,” she said,  “They're all prostitutes. He says he only goes once a month. Sometimes they have sex, but most of the time he simply wants to be held. But he says it's my fault because I don't make love with him the right way, but I do love him and I'm willing to try.”

I'd asked her if he'd come in with her and much to my surprise, he said yes he would. When he came in, he looked and sounded extremely depressed and sure enough he'd had treatment after treatment for depression. He tried all kinds of medicines. He'd even tried E C T, which is electroconvulsive therapy, and he was still suicidal.

Frequently. I won't go into all of his story, but there was definite emotional abuse in his childhood by his mother and in therapy he stated that he hated himself for going to these prostitutes, hated his inability to stop, hated himself so much that that's what was behind the suicidality. This is an interesting fact. He'd never told any of the other treating doctors about this self-loathing or this behavior around going to prostitutes and how it was likely tied to continued suicidal thinking. Instead, he opted to keep going and keep hating himself and blaming his wife who he said he loved. He was so sad to hear and watch these two people in these patterns. I tried to give them both as much understanding and support as I could while also not justifying the hurt he was causing. What he couldn't see was how his present, very painful behavior was strongly linked or at least could be strongly linked to his anger, never expressed against his own mother.

Just look at it. He could express disdain and contempt for a woman, his wife, while still receiving comfort from both her and the prostitutes. He hinted that there were other painful secrets he was keeping. He could almost see it. I could see it in his eyes, but then he looked at me when I suggested treatment like I was out of my mind. I even found a one week intensive program that served professionals like him. No one would have to know or suspect anything, but he was on a vacation. His wife looked hopeful. He never came back. His wife came in one more time. She said, “This is my last session. I think coming to you was the worst thing I could have done. All you talked about were the painful things in our marriage and we have a really great marriage.” I listened and told her I understood that I regretted if she felt that it only focused on their pain and she left.

Speaker 2:

You could hear the problems, the four horsemen of the apocalypse. They would go a long time without talking to one another. He blamed her for a lot of his behavior, but he also hated himself. He was very critical of her. And of course there was some contempt as well as he didn't understand why she just couldn't accept his behavior. And I do remember looking at her and saying, that is an option for you to just accept that this is what is going on. And she said, I'll try, but I don't know. But obviously when she came in and was angry with me or that's where she focused, her anger was on me, which is okay, you know, that happens. She needed to feel like they had a really great marriage and you know, they're probably still married to one another now in the community. This couple is considered a great couple, but neither of them were at a place where they could see or chose to look for what was underneath their very painful patterns with each other.

I said earlier that I was gonna talk about some other more modern versions of these problems, so I'll do that now. Stonewalling, for example, it's basic withdrawal in order to feel in control. Non-communication. I think this can take the form interestingly enough of an intense focus on children where your child's life takes up so much of your time, you quote unquote, barely have any energy for your partner. Or it could be about work - you stonewall through work. Your attention to work could be so dominant in the relationship and you can justify it, right? Somebody's gotta make a living around here. But you can see perhaps that both could be related to stonewalling or they have a similar effect. You are not available for your partner, which you justify by saying that the children or your work or your major responsibility, but all the conflict you might have arguing, the criticism, the blaming, none of that ever gets worked out.

You don't sit down and have a talk with one another about what's going on between the two of you. Now, it could also be in the form of absorption and video games or Instagram or TikTok. These can also draw you completely away from the relationship as you spend hours isolating from your partner and attaching instead to this virtual reality, which can seem so much more interesting than what's happening or not happening at home. T

he other three, blaming, criticism and contempt are basic bad attitudes or habits that I imagine have been part of every generation and every era. Sadly, they have also been culturally acceptable historically, especially men treating women that way in relationships. And I'm sure there are examples of women treating men that way. In fact, I know that in certain families that consider the woman more powerful, that it is culturally acceptable for her to treat him badly.

And then of course you can look for support for these behaviors, the blaming, criticism and contempt by socializing with other people who blame and criticize and show immense contempt for reasons they justify. This sort of blaming and criticism and contempt is destructive in a culture and it's certainly destructive in a partnership. The four horsemen of the apocalypse, stonewalling, blaming, criticism and contempt, they herald or predict the end of what was once treasured. Please think about them in your own life, in your beliefs and in your relationships.

Voicemail announcement

Speak pipe message from drmargaretrutherford.com.

Dr. Margaret

Let's hear from a listener from Canada.

Voicemail from listener:

Hi Dr. Margaret. So I am 37 and a mother of three kids and my question to you is, I was told by a therapist a couple years ago that I am a perfectionist and that's why it's stopping me from applying from jobs, which I always think I'll never be good enough for. I rarely invite people over because I feel like the house should be super clean and it there should be a five course meal. This was something I've learned from my mother. She's very focused on how our family appears to the exterior, to other people. I've been trying to <laugh> rewire myself, so I don't feel that. But however, inside I don't feel good doing those things. I feel it's like the people pleasing part. I feel that I will be judged if I don't make everything appear great. It's hard for me because my mother is still like that. And when I visit her, we live in the same city. I feel an internal conflict and it, it's anxiety provoking for me. How do I deal with that of being myself and kind of not doing

Dr. Margaret

This voicemail made me feel a very poignant sorrow for this mother of three who is struggling to get out of her fears about not seeming or being good enough. It's interesting that she can see what the problem is. Her therapist called it perfectionism. I'd clear that up and call it a kind of destructive perfectionism because again, it's based on fear of being found out that she's human after all. Maybe there's a closet in her home that's messy or a glass that's smudged or that in her thinking about getting a job that she won't live up to expectations and it doesn't sound as if she's even risking finding out what those expectations might be. She knows she learned this fear from her mom who sounds as if she taught it or demonstrated herself maybe unintentionally or maybe very intentionally. Certainly when I grew up, my mother had the table set for a party at least a week in advance.

She checked and rechecked. She had what she was going to wear all laid out way before the party. I saw that and much like this listener believed that I needed to do the same. In fact, I became anorexic because thinness was another one of those expectations. Luckily for me, or I say luckily, I moved away from home and saw life differently. I met women whose lives seemed very different, whose goals and directions were far from rigid and perfectionistic. I attended a very liberal college and feminism was being born, and I saw a way out even though at the time I didn't realize what I was doing, but this kind of perfectionism is still very, very prevalent in our culture. But I know very personally this inner struggle that this listener is talking about. In fact, for all my rebellion, when I'd go home, I'd still try to seem perfect, even when my real life was in tatters, the strain of that led to panic disorder.

So I certainly hope this listener isn't experiencing those.

So what can she do? I hope she's listening because I'd love to send her a copy of my book. Perfectly Hidden Depression. So listener, if you are listening, you can email me at askdrmargaret@drmargaretrutherford.com and I'll send you a signed copy because it sounds as if you'd find yourself there.

Okay, let's talk about what you could do first. Your mother seems to be highly unlikely to support you changing the message cut off before I could hear what exactly the rest of your struggle was when you visited your mom, but I guess is that you still get messages from her about things you should be doing or being that be done better, and those messages hold power. So two things need to happen simultaneously. Less contact with your mom for a while at least, and then beginning to take very small risks to tolerate and cope with your fears of being judged by others negatively.

I realize that's a lot to do all at once. So start slowly. Start with one friend, have her over and purposefully serve something not perfect like crackers and cheese instead of homemade something. In fact, I have my perfection seeking clients purposefully do something in a mediocre fashion, <laugh>, or what they would consider mediocre. Not an important thing, but something that they're making important and truly isn't that they kind of laugh about and go, I know nobody really caress. If I've vacuumed the sofa <laugh>, that's what I do. So I promise you most people are thinking about themselves. They are not thinking about you. We're all very self-conscious. Look for the small thing that you could try and you could risk. That would be not up to your expectations, but really just fine. Slowly look around your life and do something that you feared in the past doing.

But start with the easiest thing, not the hardest. Remember, there are no small changes. Every change, every risk, no matter how small or seemingly small is important. Now let's get back to mom. This listener's mom may wonder or question why those visits aren't occurring as often. Since this listener's been in therapy, I'd suggest working either with a great friend who knows about her struggle and is emotionally savvy or with that therapist or both, and write down and practice what you're going to say to your mom, what you're going to choose to reveal. You could try something like, “Mom, I'm trying to not be so afraid of what others think of me. It's really making me unhappy, but I'm not sure where you stand on this as so much of what you do seems perfect.” Something like that. Maybe even that's too revealing. You could decide what's right for you.

You can write it down and send it to her. You can email it, you can text it, you can say it to her face, but maybe you need to sort of help her see that, that you need to be around her less. But I also think that it is, that's a hard conversation to have and your mother may or may not be capable of actually having it in a fair way, in a healthy way. So that part of it is something you and your therapist are gonna have to talk about. There's so much life ahead of you and there's so much freedom in being able to decide whether or not you're going to strive for perfect or near perfect. And that's fine. And if you do enjoy that process or whether this time you're going to do what's more normal and easy and enjoy that as well, it's more freeing because it's a choice and you're no longer wrecked by fear and shame. That is what my book is all about. So I hope you'll email me and you can follow and do, it's over 60 exercises of reflections and read other stories to realize you're so far from being alone.

Outro;

So we're gonna do something fun in September. I'm gonna give away two books. Now, not perfectly Hidden Depression, I'm actually gonna give away a little book that Christine Mathias and I put together called Marriage Is Not for Chickens. It's a great little book to give somebody for an anniversary or they're getting married and I'm sure in the fall we're going to have some fall weddings and some holiday weddings. So I'm going to pick two reviewers who review on Apple Podcast in September who review self-work. And then I'll pick two, not the first two, not the last two. I'll choose them randomly and thank you. I hope you have fun with this. And of course, I hope you love self-work as well. Also, I have a really, I'm so proud of our new website. It's really beautiful. It's drmargaretrutherford.com and you can subscribe there.

You'll get my weekly newsletter, which actually gives you a rundown of everything I do. For example, my blog post this week was on Fobbing. Do you know what Fobbing is? <Laugh>? Well, it's the newest way to really alienate someone that you may or may not be interested in, and it has to do with cell phone use or looking at your screen, et cetera. So you could go over to Dr. Margaret brother for.com and subscribe, and you'd be able to get that link to that Fobbing <laugh> article. I write about all kinds of things that are either near and dear to me or something that I'm very interested in learning more about myself. You can also, in fact, recently, a whole bunch of people have joined the Facebook group at facebook.com/groups/ self-work. Thank you so much for being here. Tell your friends, we'd love to have more of you. Take very good care of yourself, your loved ones in your community. I'm, and this has been.

 

Aug 25, 2023

I’ve long been one to say to someone who’s paralyzed about the direction they see their lives going in or goals they want to achieve – experiences they want to have – to say, “Why not “and?”

After they look at me kinda funny, I’ll explain. “Why can’t you be a plumber and a painter? A mother and an ad exec?

That’s what this week's SelfWork guest has accomplished. She’s an internal medicine doctor and she’s a comic. A stand-up comic at that. Named by Refinery29 as one of the 50 Female Stand-Up Comedians You Need To Know", Priyanka Wali is a stand-up comic who also believes strongly in mind/body connection and the importance of fear in true transformation. I think you'll love this conversation!

She's also the co-host of HypochondriActor with Sean Hayes (yes the guy from Will and Grace…). I know you'll enjoy talking about her story and how you might use it as motivation for your own!

After all, why can’t life be an “and?”

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Episode Transcript:

 

Speaker 2: Dr. Margaret

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 or welcome back to SelfWork. I'm Dr. Margaret Rutherford. I'm a clinical psychologist, and I started this podcast just about seven years ago to extend the walls of my practice to many of you, some of you very interested in therapy or psychological issues, but also perhaps those of you who are a bit skeptical about the whole thing.

So, I have a great interview for today and before beginning, here's a message and an offer from AG1, the Greens mix I take every morning to get my day started on the right track. Okay... Occasionally I miss a day, gotta say that, but I try to remember every day 'cause it makes a difference.

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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.

Dr. Margaret

I've long been one to say to someone who's paralyzed about the direction they see their lives going in or goals they wanna achieve, experiences they wanna have... They always say, "Well, I've gotta have this or this, but I've gotta make the perfect choice. I've gotta try this or this." And my question to them is, "Why isn't it an "and"? And after they look at me, kind of funny, I'll explain, "wWhy can't you be a plumber AND a painter, a mother AND an ad exec?

We don't have to limit ourselves. We can be "AND",  not this or this. And that's what our guest has accomplished. She's an internal medicine doctor and she's a comic, a standup comic, by the way, who was named by Refinery 29 as one of the top female standup comedians that you need to know. Her name is Priyanka Wali. And she's the co-host of HypochondriActor with Sean Hayes, the guy from Will and Grace that probably a lot of you know, It's a great, great podcast and I'm delighted to have her on SelfWork as a true "And" - er <laugh>.

Here's one more sponsor message. This one from BiOptimizers and Magnesium Breakthrough. I use it every night just like I use AG1e in the morning. And that's my own AND,  I guess,

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Episode 356 with Priyanka Wali. 

Realize you can support self-work by supporting our sponsors. And now, Priyanka Wally,

Speaker 2: Dr. Margaret

I started off my morning by listening to your comedy routine <laugh>.

Speaker 3: Dr. Priyanka Wali

Oh, which one? Which bit did you check out?

Speaker 2:  the one on your Website?

Speaker 3: The one? Oh, yeah, yeah, yeah.

Speaker 2: And I laughed. I just thought, I've known some in and out guys.

Speaker 3: <Laugh> <laugh>. Oh man. Yeah, that takes me back. You know, I haven't, I haven't, you know, after the pandemic hit, you know, obviously comedy changed and performing in person totally changed. And I remember going back on stage in 2021, so, you know, we were kind of used to reentry, we were opening up a little bit, and the vibe was just really different. And so I've, I've slowly been getting my feet

Speaker 2: Thought about that. How was it different, Priyanka?

Speaker 3: Well, first of all, you know, having, it was an outdoor show and most people were wearing masks. But even if you're doing an indoor show, you, it's hard to see people's facial expressions if they're masked. Right? So that, you know, to me, standup has always been a relationship between the, the performer and the audience. It's a connection. And when you, you know, cover the face for obvious important reasons, safety reasons it, it sort of breaks that connection. And so what I found was that I enjoyed comedy, less enjoyed performing less after the pandemic.

And I actually took a break from comedy and I sort of went back to like, "Okay, what does bring me joy? Like, what is this really about?" And I went to France and I actually studied clowning with Philippe Goer, who's a world renowned clowning expert. And I went back to the basics of like, okay, physical comedy, like comedy with your body and not just your neck up mind voice.

And then I sort of came into singing parody songs. And that's kind of the new stuff that I'm working on now. Really? Yeah. So I'm taking my comedy and I'm turning it into more parody songs, and I've released a few small clips on Instagram. But I'm planning on releasing a longer video at some point. So that's kind of what I'm working on. And that's like part of the transformation as an artist, which is, it's an incredible journey.

Speaker 2: Well, you know and I wanna, I wanna back up and we, we kinda started in the middle, didn't we? Or I did. Yeah. Yeah. And so I wanna back up and, and talk about how you got to be, but you know, I'm a huge advocate of, of, AND kind of lives. I am this AND I'm that, and I'm something else. Mm-Hmm. <affirmative>. So I love that you're living your life that way. Oh, thank you. I also listened to the last podcast that you and Sean did. Mm-Hmm. <affirmative>. And I thought the story about your either great-grandfather or your grandfather was so touching that Wali is actually the Arabic name. Mm-Hmm. <Affirmative> healer or helper.

Speaker 3: Yeah. Helper. Helper. Or like friend, friend of man, helper of man. Yeah. Yeah. It was a name bestowed upon us. Yeah.

Speaker 2: Incredible.

Speaker 3: <Laugh>. Yeah. Yeah. When I, when I learned that for the first time, and it sort of changed my relationship with my own name, you know, I always thought I didn't really have a relationship, but then once I realized it was sort of like, gifted, I was like, Wow, that's, that's, there was an identity shift and you know, there's a sense of humility and gratitude as well.

Speaker 2: You know, when you hear stories like that. My grandmother was named Emma Clayton Robinson, and I remember asking one time why was, why was her middle name Clayton? And the story was that I'm from the south, I'm from Arkansas, and her mother and father's home was taken over by the Yankees during the Civil War by a General Clayton.

Speaker 3: Okay.

Speaker 2: He was so kind to them that they, when my grandmother was born, she was named Emma Clayton Robinson.

Speaker 3: Wow.

Speaker 2: And Clayton has become one of our family names, which is just so, I don't know, it adds something to your understanding of your family and what has happened, and of course,

Speaker 3: Right.

Speaker 2: It's just, I don't know, there's something about that kind of tradition or g legacy that's just fascinating to me.

Speaker 3: Yeah. And I'm curious, do you know what, what was the name prior to Clayton before that?

Speaker 2: Well, no, she had not been. She was born and then, and then they named her Emma Clayton Robinson.

Speaker 3: Wow. Wow. Yeah. There's so many complexities to that story, because on one hand, this, this person was the oppressor. They came in and they took, you know, your family home and your land. Right. And yet they were a kind, oppressor, kind enough for us to name them after them. It's like, there's so many nuances to that, that story. It's, it's very complex. It certainly could, would be totally justifiable to bring up a lot of different set of feelings around that.

Speaker 2: Yeah, I think so. So I wanna find out about your journey. You are a physician. Mm-Hmm. <affirmative>, you're an internal medicine physician. Mm-Hmm. <Affirmative>. And I think you also have training in OB obesity, is that right?

Speaker 3: Correct. Yeah. Double board certified. Mm-Hmm. <Affirmative> double board certified.

Speaker 2:  And so, and, and then, and you know, you, you've laughed with your co-host Sean, about I really wanna be just a doctor on tv and Yeah.

Speaker 3: <Laugh>, I just want a small rule on Grey's Anatomy. Is that too much to ask<Laugh>? I mean, come on.

Speaker 2: So I would love to hear you know, there's a lot of doctors in your family and you told that story, but Yeah. How, how did you decide to become a physician? And are you, are, are you American born? Are you, were you born in India or were you born in America?

Speaker 3: Yeah, great question. So I was born in the United States, so I'm Kary Pundit. So my family originates from Northern Kashmir, and that region was actually affected by genocide as recent as 1991. And so that led to a diaspora and immigration all over the world. And my family chose the United States.

And so I was born in Los Angeles, but I actually spent some early formative years going back and forth between India and the United States up until I was age three. And so, you know, my childhood upbringing you know, my parents were doctors, their siblings are doctors. Their kids are doctors. I mean, and, and the lineage goes further up the chain. So healing was really, we would not have normal dinner discussions. You know, like the, the dinner table discussions were about, like, the cases my dad had and like, you know, all this sort of preventive medicine stuff.

And so I joke, you know, like I sort of came out of the womb holding a stethoscope. It was something that I lived, breathed. It wasn't until I went to college that I was like, oh, people can do other things. You know what I mean? And I always had an artistic side to me. And so I always loved performing arts and creative writing, and that's always been a, a very big part of my sort of soul's energy.

And at the same time, the science had also would come to me quite easily. And so I found myself you know, going through the pre-med classes and I actually was accepted into a program coming out of high school called a Baccalaureate MD program. It no longer exists, but it was a program where you basically got accepted into medical school coming out of high school.

Really? It was a, yeah, it was a very competitive program. They only took, I think like 12 or 15 people all across the United States. And so I knew, I knew out of high school that I was gonna go to med school. Yeah. And I can't say honestly though, that that was what I wanted.

I think there was a part of me that really was you know, I loved creative arts. I loved performing. And I couldn't see a path if I were to pursue medicine. But I, I grew up in a very traditional Indian family. Like, I had a tremendous amount of pressure from my parents. Like, no, you have to go to med school. Like, that's gonna happen. Yeah. And so, you know, again, because the science would come to me easily, I decided to, to sort of give it a go and give it a chance.

You know, in hindsight I wish I had taken some time off in between undergrad and med school. 'cause I went straight through. And I, I don't necessarily recommend that. I think if I had had more time to sort of develop and simmer as a human being you know, I, I wasn't really a human being by the time I went to HU Med School. I was just this concept, you know, I was so undeveloped as a person.

Speaker 2: So you followed the structure that your parents wanted you to follow, and really hadn't had a whole lot of autonomy about

Speaker 3:

That. Totally. Yeah. And, you know, it would come out in these different ways. Like I, you know, when I was a med student, I joined this local improv troupe in East Los Angeles, you know, and I would have these little pockets of things that I would do to create balance. Sure. And it's funny now because the work that I do as a, as a physician, I, I am very passionate about it now, but I think it's because I've taken much more of a an an identity that this is part of social justice activism in terms of like, what is going on right now with the current medical paradigm and you, what needs to change. I feel like very compelled now to be involved with this and to be a part of this. Because at the end of the day, we're all connected.

And I feel like I was given a set of privileges by being born into a family that, you know, was all healthcare providers on some aspect. And I feel like it would really be a, a waste to, to squander those gifts essentially. Mm-Hmm. <affirmative>. And so it's funny 'cause now I, I really love what I do and the way I've sort of built my life. I mean, I'm definitely not working like a traditional medical doctor at like, you know, a major hospital or anything like that. I mean, I have my own private practice and I, the way I think about healing, I would say it's, it's more consistent with like a new paradigm as opposed to the older paradigm. You know, in terms of integrated,

Speaker 2: More holistic,

Speaker 3: More holistic integrative, you know, thinking about issues from a mind body perspective as opposed to the current, you know, the current paradigm is like, you have a heart problem, you go to a heart doctor, you have a kidney problem, you go to a kidney doctor, you have a mind problem, you go to the mind doctor. It's like that. It's very disconnected and, you know, there's no more like general doctors anymore. I mean, it's like, it's a rare dying breed. And so I am really trying to bring a callback to, Hey, let's look at the whole person. Let's treat the whole person. This is not just a mind issue or a body issue. This is a mind body issue. And essentially we are all mind body spirits. Yeah.

Speaker 2: Yeah. Couldn't agree more. So I was always interested, and I remember asking my sort of, she's my manager you know, why does Priyanka wanna come on SelfWork? I mean, why does she wanna come on a mental health podcast? And I, I wanna ask you that question. I was so intrigued that, you know, and it sounds like it's very may maybe tied into this, well, one, of course, you're an example of someone who is saying, don't be, don't be governed by, you know, what other people expect of you. But make sure that you're, you're zoning in and really expressing the parts of yourself that bring you joy and, and that kind of thing. Which I think is wonderful. I didn't know if you had any history with depression or anxiety or anything like that, but it also sounds like maybe it's tied in with more of this holistic view of things.

Speaker 3: Yeah, I think, I think you're hitting the nail on the head. So, so yeah. I, I actually, I've talked about this publicly. I think there was an article in Women's Health Magazine where I actually was very depressed in medical school. In fact, I didn't realize that I had the signs and symptoms of clinical depression until my psychiatry rotation in medical training Oh. <Laugh>. Where I was interviewing people. Yeah. I was interviewing people who were severely clinically depressed. And I was walking away from these interviews with individuals and I was like, there's really no difference between me and this person that like, probably needs to be hospitalized. And you know, I, it was then that I, yeah. So it was then that I realized that, you know, I had severe clinical depression and I needed to be on antidepressants for a period of time in medical training.

And what, what in hindsight coming out of that, what really was going on is that I was in a very difficult situation. The medical system, the medical training system, it's actually a very oppressive system. And I didn't have the best coping skills. I didn't even know what therapy was at the time. And fortunately that's when I learned about treatments, like cognitive behavioral therapy. And I started therapy. I saw a psychiatrist and was able to get the help that I needed. And then when I graduated medical school, my depression symptoms went away and I was able to get off the meds. And I haven't had a relapse of depression to that severity since then.

Speaker 2: So it was probably very situational and that kind of thing. It was

Speaker 3: Absolutely situational. Yeah.

Speaker 2: I have the fancy title of adjunct professor at University of Arkansas Medical School. Mm-Hmm. <Affirmative> Medical School of Medical Sciences, I think it's called mm-hmm. <Affirmative>. And I laughed and said, I don't even get a parking place with that. So <laugh>

Speaker 3: <Laugh>. Yeah. Yeah. And

Speaker 2: I, I teach a course that's, you know, an hour and a half in one semester or so, it's very little about psychotherapy to medical students. Mm-Hmm. <Affirmative> who are psych psychiatry rotation. And one of my major questions is, what do y'all think therapy is? And they just kind of stare at me. Oh, yeah. Like, what are you talking about? You know, and Oh yeah, well now we've learned that this is what you do with this person and this is, and I said, you know what? You gotta throw all that out. 'cause That's not really true. Mm-Hmm. <affirmative> mm-hmm. <Affirmative>. But it, it's fascinating how that the, unfortunately the medical school schools still don't really incorporate a whole lot of mental health knowledge and understanding to physicians.

Speaker 3: You know, I really appreciate you naming this because it's something I talked about. I think on one of the podcast episodes, you know, in medicine we are sort of taught that if you can't objectively identify the cause of someone's issues, like for example, if you can't get lab work Right. That can corroborate or a CAT scan or something like that, you we're, we're literally taught, or at least back when I was in med school, I was taught that you need to conclude that this is a psychosomatic issue. And once you label someone as having a psychosomatic issue, you kind of wash your hands of it and move on. What the deficit in education right now that's happening in the system, I think physicians especially need to be taught the next step. Right. If you're gonna label someone as having a psychosomatic issue, the next training is understanding, okay, well what is the emotion that's linking to that physical symptom?

Speaker 2: Well, the trauma or the Yeah, exactly. The, what's going on? Name what's going on with the patient. I, I love it. I did my dissertation yeah, my dissertation on conversion disorders,

Speaker 3: So, okay. Sure.

Speaker 2: I was, you know, bridging the gap between, for those listeners who don't know what conversion disorders are, they are disorders that are, that are psychologically based, but can can mimic mm-hmm.

Speaker 3: <Affirmative>

Speaker 2: Make true medical problems. And I did mine on Pseudoseizures mm-hmm. <Affirmative>, which was someone looks like they're having a seizure, but there's no actual abnormal EEG activity, so, right. Although they can be mixed anyway, enough about that. Mm-Hmm. <affirmative>. Yeah.

I'm always I'm so glad that more, at least there's a movement toward physicians moving there's a movement toward moving <laugh>,

Speaker 3:<Laugh>, a lot of movement, <laugh> a lot

Speaker 2: Of movement, lot of movement toward integrative, or that's kind of this kind of medicine. 'cause I just think it's vital.

Speaker 3: Oh, not only is it vital, Margaret, I I actually am at the point in my career where I am sort of, if anyone's gonna call themselves a physician or even a healer for that matter. Yeah. and they don't have a basic understanding of this type of education. They actually have an incomplete education of how healing actually works in human beings. And so what I would love to see more of is more education for medical students, especially helping them understand how to name emotions and the effects that that has on the human body.

Speaker 2: Sure. Sure. Because isn't there research, in fact, I've read some research that says the brain actually doesn't, can't tell the difference between physical pain and emotional pain.

Speaker 3: That's correct. Actually, yes. When we experience emotional pain, it activates the same receptors of the brain. This is through functional MRI studies, it activates the same receptors of the brain as if we were to experience physical pain. Fascinating. Fascinating. Yeah. Yeah. I mean, all we're naming here again, is this is more and more evidence of how we need to move towards a mind body model, a model in medicine. And I do believe this will be the next paradigm where we start to look at human beings as mind bodies and not just bodies with minds.

Speaker 2: Right, right. Bio psychosocial,

Speaker 3: Spiritual. Yeah. Right. Yeah. Exactly.

Speaker 2: Okay, so let's switch gears. Okay.

 Talk about the clown part of you, or the funny part of you, the comedic part of you. You have a wonderful podcast yourself that's very, very popular. It's called, let me see if I can not <laugh> This Hypo Dry actor Hypo <laugh>

Speaker 3:

Hypochondriac. <Laugh> hypochondria. I'm so

Speaker 2:

Used to saying the word hypori, called it <laugh>.

Speaker 3: Yeah, totally. We just call it hypo for sure.

Speaker 2: And your partner is, your partner in crime,

Speaker 3:

Is the lovely Sean Hayes, who you may know from a small show called Will and Grace <laugh> tiny little show. Yeah.

Speaker 2: In fact, my trainer, I was working out this morning and I was told him who I was, who I was interviewing. He goes it did you say that her co her cohort, you know, her partner is, is Sean Hayes. And I said, yeah. Oh, I can't wait to tell my girlfriend that you're interviewing someone <laugh>.

Speaker 3: Yeah. Yeah, Sean's darling. I love working with him. It's, it's been a pleasure. And I don't know when this episode's getting released, but he's currently on Broadway at the moment. So I do, I do miss him because he is, he's very, very busy on Broadway. But it has been just an absolute joy working alongside with him. Oh, great. He brings, you're, oh, thank you. Mm-Hmm. <Affirmative>. Yeah.

It's, it's so easy to work with someone who's so lighthearted as Sean, and he brings just a lot of joy and humor and, you know, in on the podcast we're talking about, we can talk about some pretty serious things, pretty heavy things. And, you know, that that lightness that he brings, it allows us to kind of go to places where maybe we wouldn't necessarily be able to go if this was a more serious kind of heavy podcast. Mm-Hmm. <affirmative>, you know, it's so important when you're interviewing celebrities or anyone who's willing to share something vulnerable about creating a safe space so that people feel like they can share. And so I feel really grateful to be working alongside him.

Speaker 2: And you answer questions from listeners about, is it only medical issues that they call in about? Or is it Yes.

Speaker 3: Yeah. So people like to call in and share their medical stories. And it's been also, that has been a very, very humbling experience. You know, the, the callers that call in and the, the depths of their shares, you know, as the show has progressed, the shares have been more and more vulnerable, which we so appreciate. And what I love about the shares is that people will many times call in and say, you know, I thought I was the only person that had blah, blah, blah, but after listening to this episode, I realize I'm not, and I have it too. And this is my experience. And that's, to me is what this is really about. You know, connecting us, reminding us that we're all one people. We're one species. We're human beings, and we, we feel the same things and emotions do connect us. And I think that's so important to remember in this time of such divisiveness

Speaker 2: On SelfWork. I also love to, to answer questions from listeners. It's one of my most favorite things to do. And so it's your right. I just feel like there's so many, you know, there's this, again, research will say that there's this explosion of loneliness, and it's true and right. Staring at our screens instead of talking right to another. And so there's this sense of, I must be the only one feeling this. So, so since, since the pandemic happened, what are you doing with you? You said you went to France and you, you're doing this clowning and that kind of thing. Tell us about that part of you.

Speaker 3: Yeah. Yeah. So, you know, I think in order for me to stay balanced, it is very important that I engage in some kind of play. Yeah. And it can be formal play, like going to study clowning with a renowned clowning expert. But on a day-to-day, like every day, you know, I can't fly to France to study clowning <laugh>. I do spend a, a significant part of my day. Like, I dance every day. I try and do some kind of movement, you know, especially before I start to see individuals in my private practice. You know, I may put on a song and just move my body and I get really funky and really weird, and I'll growl. I love growling and I love putting my yoga mat out and just like rolling on the floor and just like, moving and arching my back and acting like a total fool.

I mean, just like completely just like the, just an animal. But to me, I, it, it's important for me to do that every day. You know, I think we forget that we, human beings, we're animals and we're, we're, so we have to engage in somatic practices, otherwise we'll be very disconnected from our bodies. And in my own healing journey, I've noticed that the more I'm in my body, the more present I am, and the more I can give, the more I can share sort of the gifts that I have. And we all have gifts to share. And I've just noticed that the more I engage in somatic practices, it's easier for me to tap into that and play. I also consider rest to be a really important facet. I mean resting, going slow, taking naps, anything that just, again, keeps the body in flow. Mm-Hmm. <affirmative>. And so yeah, I'm, I'm generally a very silly person. <Laugh> and <laugh>.

Speaker 2: You know, people always ask me, well, how do you do something so serious all day long? And I think I laugh all the time with people, right?

Speaker 3: Yeah. I mean,

Speaker 2: There's a lot to not, we're not laughing. I'm not laughing at people. I'm laughing with people that I see. We find things too, to laugh about because it's so important for them to laugh. And it's important for me to laugh.

Speaker 3: Oh my gosh. Yeah. And laughing is so, you know, there's studies to show that laughter literally will lower cortisol levels in the blood. It'll lower inflammatory markers. I mean, it's, and it's, it's just a, a really great feeling. And I think that's why while I was a resident working 80 hours a week, sure. I gravitated towards standup comedy and performing comedy. 'cause It was this one thing that I could do solo on my own terms. And it, there's an immediate feedback. You make the audience laugh like you've done it. That's the feedback. And it's spontaneous. You can't fake it. Well, maybe you can fake it, but like a real belly laugh. Mm-Hmm. <Affirmative> really hard to fake, you know, that big old belly laugh. For those

Speaker 2: Listeners who are out there going, how do you, how do you get the courage to stand up there for five or eight minutes and try out these jokes? Because I know from, I've heard enough conversations with, with standup comedians that they, they go to hundreds of these clubs and try material and try out material, and sometimes it dies. I was lucky enough to hear Ellen DeGeneres when she was young.

Speaker 3: Oh, nice. Wow.

Speaker 2: And, and I can remember thinking, this lady's going somewhere. You know, I was

Speaker 3: In <crosstalk>. Oh, wow.

Speaker 2: And but I know it just must be grueling. And, and I don't know, how did, how did you, how did you rake up or whatever We would say the courage to do it?

Speaker 3: Yeah. Yeah. So, you know, I was a resident and I had just broken up with a long-term relationship. So I was really going through a process where I was really just re trying to figure out who am I at the coming out of this very long relationship. And I, I sort of took some time and I was like, what is it that I really need? What is it that I really want? And I, I, I searched in and the answer was like, I, I want laughter and I want to make people laugh. And, you know, to be completely honest, standup was a morbid fear of mine. You know, it was something that I could have never imagined myself doing, but I sort of wielded it within myself. I was like, you know what, it's just gonna be a one-time thing. It was supposed to be like a bucket list thing.

Like, I'm gonna do standup once, and then that's it. And I'm writing it off. But what happened is, I was in San Francisco training, and I Google searched good place to try standup comedy for the first time in San Francisco. And the first hit that came up on Google was a laundromat slash cafe slash open mic place where people, oh, fun. They have a, they have an open mic and people are like folding their laundry while you're like, telling jokes <laugh>. And yeah, the website said, this is a good place to try standup comedy for the first time in San Francisco.

So I go to Brainwash Cafe slash laundromat, and I, there were three minute sets, so I wrote three minutes of jokes. They were, I, they, now, in hindsight, they weren't funny at all, but they were all I could do at the time.

Mm-Hmm. <Affirmative> and I go to the laundromat, I do a three minute set, it went well. And just, it happened to be that, that afternoon in the audience was a local producer who produced shows locally in the Bay Area. And he came up to me after my set, he is like, you were really funny. Like, do you wanna do my showcase? Which is in a month? No. And I was shocked. And I was like sure. And he is like, I need you to do 10 minutes and it's next month. See you next month. And so I was like, I told him, yeah, absolutely.

But in my mind, I was like, 10 minutes, I don't even have 10 seconds of good material <laugh>. So, you know, what I ended up doing is I started going to other open mics so I could prep for that one showcase.

But then what happened is that at those other open mics, other comedians who had shows, they would see me and they were like, Hey, I want you to do my show. And so by the time I had that showcase a month out, I actually had all these other showcases lined up, and the next thing I knew I was, I was in it. I was deep in it. And, and the, the, it really just transformed. And then I, I was like, this is a lot of fun. I'm not gonna stop. And so I just kept doing it. And then years passed and then more opportunities arose, and then I started doing commercials. And that, you know, it turned into this whole other world. But it really originated for me wanting to face this small fear and just like seeing what would happen. I hope,

Speaker 2: I hope my listeners are listening to this because, you know, one of the things that I, that I say probably, I mean too many, too many times, is it doesn't matter where you go, it matters that you go, oh

Speaker 3: Yes.

Speaker 2: It sounds like you just said this is a fear of mine. I wanna confront it. You didn't have plans necessarily to become, you know, a standup comedian, but you just went where, you know, you went, you went in intersection and three minutes

Speaker 3: <Laugh>. Yes. And those three minutes literally changed my life. Yeah. And, you know, over the years, my relationship with fear has evolved. You know, it's, it's only years later that I realized, you know, when we experienced fear, and I'm not talking about the, the, the real fear. Like, if there's a tiger about to mall you or you know, a car gonna hit you or something like that, forget about that sort of fear, like actual real fear, but just sort of the existential fear that everyday fear to me. Now, when I experienced that in relation to a specific situation, I actually view that as a sign that I'm getting close to some area of transformation. Fear is a sign that you probably are doing something right.

Speaker 2: It's a flare from your unconscious mind going, pay attention, pay attention,

Speaker 3: Pay attention. Yeah. And so now when I experience fear, my relationship with it is such that I'm like, oh, it seems like this might be an opportunity for transformation.

Speaker 2: I Just love your story..

Speaker 3: Oh, thank you.

Speaker 2: What's the next?

Speaker 3: You know, yeah. So there's a coup, there's a couple of things in the pipeline. I mean I, I just wanna name to, to piggyback off of what you're saying, you know, again, when I first started doing standup, I never thought it would pivot to doing more social justice activism about better treatment for physicians treat. I never thought it would lead to educating the general public about complex medical issues in the form of a podcast that mixes comedy and medicine. You know standup really are, is kind of the trunk of the tree, but the branches led to other things. And for that, I'm very grateful. And so at this point, you know the, the podcast is taking up quite a bit of time. And we do have, it does butt

Speaker 3: it's a lot of work. It's a lot of work. And like I said earlier, I am working on a show with parody songs and singing. So I love that you sing because singing has, has also been, it's another way of performing that really uses your whole body. And so I, I'm working on that as well. And then a couple of other projects that I can't really talk about yet, but I, I'm excited to release soon.

Speaker 2:Oh, that's nice. Well, again, we'll have the link to your podcast, but say it one, because I'll probably crucify again. So <laugh>,

Speaker 3:

It's, it's HypochondriActor episodes are released every Wednesday on all of the channels Spotify, iTunes audible, you name it.

Speaker 2:Yeah. Okay. And way any other ways people can reach out to you. Yeah,

Speaker 3: Sure. You know, I'm available on social media, Instagram. You can find me at Wali Priyanka. That's w a l i, Priyanka, P R I Y Y A N K A.

Speaker 2: Okay. Well, I, I, like I said, I was up about five 30 this morning and I started, you know, and you made me laugh and you made me laugh hard.

Speaker 3: Oh, good. <Laugh>.

Speaker 2:That was really a fun way to start my morning. And I have loved our conversation. Likewise.

Speaker 2: If You ever wanna have a mental health professional on, just keep me in mind,

Speaker 3:

<Laugh>. Yeah. Yeah. I'd love to stay in touch. Well,

Speaker 2:

It's lovely to meet you. Likewise.

Speaker 3:

Bye.

Dr. Margaret Outro

I hope you enjoyed that. I could not have been more pleased that Priyanka wanted to be on the episode. In fact, we had quite a bit of schedules and reschedules and reschedules before we could get things planned. I really enjoyed talking with her. I hope I get to meet her in LA one time when I go out to see my son.

As of this recording, my TEDx has now had 112,000 views. Please go listen to it or watch it and like it if you do, I'm falling a little short on likes, 'cause I really want those to show that people are agreeing with the idea that we don't have to keep secrets. That we can be transparent even about things that are very, very hard to talk about. I hope that's what SelfWork is showing you, that I and other people can talk about things like depression, anxiety, sexual abuse, anything that happens to you with clarity so that we can act as beacons for each other.

So just go to YouTube, TEDx Dr. Margaret Rutherford, and it'll be there. You could watch it, listen to it, and if you do like it or even comment, that's even better. Thanks for being here, guys. It's always a pleasure. Take very good care of yourself, your family, and your community. I'm Margaret, and this has been.

 

Aug 18, 2023

When I received an email about this new book, I knew I wanted to talk with its author. The book? The Perfectionist's Guide to Losing Control. The author? Katherine Morgan Schafler, a psychotherapist and former on-site therapist at Google. She's worked with many high-achieving women who are told they need to find "balance" - as if they're doing something wrong! Katherine tells us instead that what's important is to learn about the five different types of constructive perfectionism so that it can work for you! As she says, "You can dare to want more without feeling greedy or ungrateful!"

She's an eloquent writer and speaker and it was wonderful having her on SelfWork as she helps these women exchange superficial control for real power.  Hope you'll listen in and learn!

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The Perfectionist's Guide to Losing Control: A Path to Peace and Power

My TEDx talk that today has earned 100,000 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!

Episode Transcript:

Speaker 1: Dr. Margaret

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 Self-Work 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 started this podcast now, almost seven years ago, to extend the walls of my practice to many of you who've already been in therapy and very interested in psychological and mental issues, emotional issues, to those of you who might have just been diagnosed with something and you're looking for answers. And also to a third group of you that might be a little skeptical about the whole mental health treatment thing. And even admitting to someone that you need help, that's a step in and of itself. So listening to a podcast, it's a real safe way to do that, right? Welcome to all of you. Y'all all know that I've written a book called Perfectly Hidden Depression, where we need to look at perfectionism as it serves as a camouflage for really a lot of inner struggle, despair, loneliness, and even sometimes suicidal thinking.

So I was very interested to see a book that's come out talking more about the positive aspects of perfectionism, what I would term constructive perfectionism rather than destructive perfectionism. So there's a new book by Katherine Morgan Schafler called The Perfectionist Guide to Losing Control. And she says, you know, you don't have to stop being a perfectionist to be healthy. She says, for women who are sick of being given the generic advice that they just need to find balance, her new approach has arrived, and she's categorized these constructive perfectionists in five ways: classic, intense, Parisian, messy or procrastinator. Which one could you be? As you identify your unique perfectionist profile, you'll learn how to manage each form of perfectionism to work for you, not against you. Beyond managing, you'll learn how to embrace and even enjoy your perfectionism. Yes, enjoy.

This book is elegantly written. I had to comment at the very beginning of the interview. I think it's one of the best books, at least self-help books that I've ever read, including my own. So Catherine's book is a love letter to the ambitious, high achieving full of life clients who have filled the author's private practice and who changed her life. Ultimately, her book will show you how to make the single greatest trade you'll ever make in your life, which is to exchange superficial control for real power, is what she says. So I was very interested to talk with Katherine, and we talked a few weeks ago, and that's our episode for today, Katherine Morgan Schafler.

So this episode is sponsored once again by Better Help, because when you are ready to ask for help, maybe that will be the venue that you turn to because it is so easy, affordable for many, and very, very conducive to whatever lifestyle you are living. So let's hear from Better Help.

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And now I want to introduce you to Catherine Morgan Schaeffler, the author of The Perfectionist Guide to Losing Control.

Interview:

Speaker 1: Dr. Margaret

Catherine, I I, I was reading your book and, and I will tell you that I, I think you're one of the most eloquent writers that I've ever interviewed and I've interviewed a bunch.

Speaker 2: Katherine Schafler

Wow, thank you so much.

Speaker 1: The way you use language, the way you approach ideas and the way you get them across is really, it makes the book not only very compelling, but it's it's just a pleasure to read. It's, it's a, it's the, it's very evocative and, and I just so enjoyed the way you think and the way you put things. So the process of the book was really good, I thought.

2: Thank you. That is so flattering. I will take that. Thank you so much.

1: Oh, good. So tell SelfWork listeners a little bit about you, who you are, how you get, you know, how you got to be an author, all that kind of thing.

2:

Sure. So my name's Katherine Morgan Schafler. I live in New York City, and I'm a psychotherapist and, and I, I think I always secretly wanted to write, but it was never in the forefront of my mind because I really do love being a therapist and, and my private practice was the soul of my work and still is. But I just noticed so many patterns as, as I know you have, because I've read your book as well, which is also fantastic. It was hooked on that intro story, which is every therapist's worst nightmare of Natalie and everything. Anyway, I digress. So, you know, when it is your job to listen to the most intimate pieces of someone's life, unfiltered, uncut and totally honest, that there's something special and sacred about that. And you kind of have your pulse on the zeitgeist in the way that other professions don't necessarily allow.

And for me, recognizing patterns across so many clinical settings, across so many de demographics, culturally, socioeconomically, and in all these kinds of ways, really compelled me to contain it somewhere. Mm-Hmm. <affirmative>, hence the book. Mm-Hmm. <affirmative>. So I wrote The Perfectionist Guide to Losing Control, A Path to Peace and Power, because that's, I noticed, universal.

1: That's my cue to show it. <Laugh>. Yeah. <Laugh>, yes.

2: So I, I really noticed universal plates around perfectionism that we are not talking about in commercial wellness. And not only are we not talking about them, we are talking about perfectionism. Like we fully understand it, like we know what it is, and you know, it's agreed upon in the research world that we're in the infancy of understanding this construct and that we don't even have a, an a formal clinical definition for so much of this stuff. And that really...

1: I noticed you call it an innate natural human tendency mm-hmm.Yeah. I thought that was interesting.

2: Yeah. You know, I think that it is natural and innate, and natural does not mean immediately healthy. Mm-Hmm. <affirmative> mm-hmm. <Affirmative>, you know, like anger is also natural. That doesn't mean that anger is always healthy, but it also doesn't mean that it's not that there aren't wonderful expressions of that impulse within us. And that if we can just harness our natural innate human impulses instead of trying to eradicate them and get rid of them, which doesn't work, it will never work. I'm glad it will never work, because perfectionism is so powerful. Anger is such a powerful tool. All these things that we think are bad. Mm-Hmm. <Affirmative>, they're not bad. They're powerful.

1: Yes. And they can be used in that way. You know, I, of course, I was thinking about my own writing and, and research and work when I was reading your book, and I really loved the juxtaposition of, of what your focus was and what my focus was. Which your focus is much more to a look at the, the beauty of perfectionism and celebrate it in many ways. And, and yet also look for when it's becoming something that, you know, like you said, all the five different types have their pros and their cons. Right. There are things that are great about them, and then there's things that are a little more vulnerable about them. Whereas my work is more talking about trauma and perfectionism and how that can, how perfectionism can at times, certainly not all the time be a camouflage of some kind, something that someone learns how to do in order to cope with the trauma that they have.

So they mm-hmm. <Affirmative> Anyway, enough about that. But I, I, I so enjoyed looking at this other side of it. And how did you come up with the five different categories? I mean, is that something just observation, clinical observation?

2: Yes. Well, first, let me say, I really resonate with what you just said, because my first job in this profession was working in residential treatment with kids in LA who had been severely abused and neglected so much so that they were no longer even in foster care because their family of origin had in some way not been fit to parent. And then they were abused and neglected in foster care, and then they became what was called wards of the state. Yes. And I saw so much perfectionism, maladaptive perfectionism of just shape shifting, of being around an adult and immediately trying to assess, "Okay, who do they want me to be?"

Speaker 2:

Who does this grownup want me to be? How do I, how do I best be whatever they need me to be right in this moment to stay safe.

1: Yeah. It's like a supervisor told me once, if you go into someone's home where you meet a family, always pay attention to the child that is quiet in the corner. <Laugh>.

2: Yeah. I put that in my book too. I had, I had similar advice from my supervisor who said, really specifically, pay attention to the children who are behaving perfectly. And I think that's a common adage in training and therapy, because, you know, kids have natural frenetic energy so often, and they're a little bit all over the place, and, and that's a good thing. But when they are trying to manage so much, they you know, fade themselves out. But to return to your original question, I came up with the five types because I was really trying to understand a phenomenon that I was noticing, which was, you know, I, I worked onsite at Google.

I had a private practice on Wall Street. I worked in a rehab in Brooklyn in all these different, you've been <laugh>, all these different settings. And I was able to take a client from my rehab and a client from my private practice on Wall Street and on, and see that they were both going to respond similarly to a certain situation. And those kinds of things started happening all the time. And I'm like, what is the tie that binds this true? Love it. And I thought for a moment, like, is it attachment theory? Is it this, is it what is happening? And how come I can predict with reasonable reliability, how people are going to respond to certain, you know, stimulus? And that's where the five types came from. I said, oh, it's perfectionism that is manifesting here, and it manifests in a patterned way.

1: So the, just to let the listeners know, the five types are: classic, procrastinator, messy, intense, and Parisian. And having lived in Paris for a little while I thought was, that one was very interesting. Oh, I think the French would love that they were some type of <laugh> perfectness.

2: Well, you know, I I came up with that title because, you know, the, the beauty aesthetic for French women is so, so understated and simple in the sense that like, simplicity is the greatest form of sophistication. Like, it's very much signaling a a subtext of I'm not trying too hard. And the Parisian perfectionist really is embarrassed about other people knowing how much they care about something. Oh, that's, you know, and so they wanna be a little bit effortlessly cool. I'm not trying too hard. I don't care if you like me or not.

Speaker 2:

Meanwhile, they care a lot. And as I talk about in the book, that's not a bad thing. It's not a bad thing to prioritize connection and relationships and understand the power of those connections that you have. And that is what Parisian perfectionists do. Every perfectionist is chasing an ideal mm-hmm. <Affirmative>. And we think of perfectionism in a one dimensional way, as in behavioral perfectionism. So I want everything to be organized and in its place when actually perfectionism is kaleidoscopic. And so perfectionism can show up interpersonally, I want to be perfectly liked by you, or perfectly understood, or I wanna be the perfect mother, the perfect whatever. And that doesn't look like I wanna act and say the perfect things. It's so much more nuanced. That's why I love this subject, because the person is holding in their mind a pie chart of what the perfect mother, let's say, okay.

Speaker 2:

Behaves like. Right. It's not that she never screams, it's that when she loses her cool, it's only to a certain amount. And then she's immediately able to make successful repair attempts and she's continually, you know, improving and getting better. And, you know, she's, and so when we think of perfect, we think of happy all the time, or never making a mistake, but perfectionism is actually very individualized. Mm-Hmm. <Affirmative>, and it's based on the own person's sense of what is, you know, this shows up another example of emotional perfectionism showing up is like, what is the perfect way to feel when you bump into an X <laugh>? Right? So it's like, I wanna feel 5% nostalgic, 20% just indifferent, and I don't care. And like 50% confident, empowered, and, you know, I wanna forget about it 10 minutes later. And so, you know, that's where we get to the nuance of perfectionism is those, those little pie charts that we walk around with our minds.

1: I, I think that's great. And, and I'm not sure what I would do if <laugh> my heads, I don't think it would be perfect, whatever it was.

2: We don't wanna find out. We don't need to find out. Right. <laugh> that can remain a mystery for us all.

1: It seems more targeted or focused on women. You talk a lot about misogyny, and I totally agree with you. And, and yet how would men be?

2: You know, you're the first person to ask me that question, and I've done so many podcasts. Thank you for asking that, because this is something I wanna talk more about. Unfortunately, like everything can't fit in a book, but perfectionism in men, typically, and I, you know, this is like a heteronormative version of perfectionism in men, typically shows up in like, the perfect response for a man is to be strong, to not cry, to know what to do, and to be able to pretty immediately execute on those actions.

Speaker 2:

Right? So there's no allowance for inaction. There's no allowance for more feminine qualities of, you know, I need comfort, I need guidance, I need counsel, I need love, I need all the things that men need, but feel unable to either access or ask for, or even recognizing themselves that they need because we've so polarized what it means to be a man and a woman in this, in this ridiculous way that we all know intellectually. But when we are in that position of, of feeling in need, you know, it's hard to be able to operate with a broadened perspective on all that stuff.

1: I was talking to one of my own clients yesterday about asking for help, and I quoted your quote <laugh>. Hmm. He said, asking for help is refusal to give up. And that's how I frame it. I loved that. So anyway, again, there are lots of little, no, not so little just very noteworthy and memorable.Is that a word? Memorable, <laugh> things things, quotes in your book.

2: Well, I'm glad that we're including men 'cause people have asked me that question too. And, and what I've noticed and I, I certainly have men, many men come to mind that I've worked with that Right. Fit into this rubric. So, I mean, I'm sure you've noticed the difference between what happens when men cry in front of you in a session, for example. Right. I mean, it's always vulnerable when clients go there. They're meaning like a very emotionally like live wire place when men do it. There, there is like a palpable sense of shame in the room, you know, of like, oh, I am really out of control right now. I am really losing it. Mm-Hmm. <Affirmative>.

1: Yeah. I, I I love to say to folks, I think tears are about intensity, not weakness.

2: Mm. I like that reframe. We believe.

1: So one of the things that I appreciated so much about your book is that you spend several chapters on what you can do about it, is what I say on SelfWork all time. What can you do about it? Yeah. And I wanna get there, but before I do, I think there were really in this kind of sense of celebrating, but also trying to understand what the underbelly of perfectionism is. You, you said there are two guiding questions mm-hmm. <Affirmative>, how am I striving and why am I striving? Can you talk about that a little bit?

2: Sure. So, you know, mental health and being healthy is not like a coordinate that you just plant your flag in and say, I've arrived. I'm healthy now. And healthy versions of perfectionism and unhealthy versions, like everybody always wants to know, am I healthy, perfectionist or not?

And I'm like, let me kill the suspense. You're both, I'm both, anyone who's a perfectionist is both Exactly. Mm-Hmm. <affirmative>. And so I encourage people to think of it on a spectrum, right? And so in instead of a categorical model of I am or am not, the questions of how and why help you really be a little more thoughtful about your level of awareness. So the how it am it skin, it's that, right? Exactly. Exactly. And so the how is like, how am I striving? Am I striving in a way that is hurting me, that is burning me out, that is exploiting people around me, that is, you know, costing me something that I value my integrity, you know, my health, my relationships with my family, whatever it is that's unhealthy perfectionism, maladaptive perfectionism. Conversely, am I striving in a way that makes me feel like more of myself, that helps me to feel alive, that increases my curiosity, that really energizes me and also, you know, tires me out because this is work, you know, but it tires me out in a way that feels satisfying, right?

That's healthy adaptive perfectionism. And the why am I striving is like, why am I trying to pursue the thing that I am in pursuit of? Is it because I think achieving that thing is going to enable me to then feel a certain way that once I, once I get my doctorate, then I can feel smart or know that I'm smart. Or once I get married, then I can feel like a grownup or lovable or legit or, you know, is it gonna certify my belonging in some way? Are you trying to get a ticket of admission into some club mm-hmm. <Affirmative>, or that's that's, that's unhealthy perfectionism? Or am I striving because it feels so good in the most, in the deepest way to find a pursuit worthy of a lifetime of striving, right.

1: And it's a process, it's a, yeah, you're enjoying the whole nine yards from A to z I mean, you may be tired when you get to Z but it's something that is, like you say, is feeding you at the same time that you are, that you are putting out that kind of energy and determination.

2: Yes, thank you. That's a great point. There's a level of reciprocation of energy, whereas when it's maladaptive and unhealthy, it feels like just hemorrhaging energy, just like, you know, such a cost. And so this most simple example is when people try to look their best, right? Healthy perfectionists might want to, some perfectionists don't really care about the way that they present, but if you're in a healthy place and you do care about the way that you present, you might decide to present, you know, as your best to look your best because you feel your best on the inside. And you wanna animate that and celebrate that and share that and let people know that. Whereas if you are in a maladaptive space, you do the exact same behavior, right. You're looking your best, but you're doing that because you already feel like you're at such a deficit and you already feel unworthy.

So the thinking is, I better look my best because I'm already coming to this meeting, this marriage, this whatever it is from a place of lack. And so I need to compensate for that somehow. So I'm gonna, you know, try to compensate by looking my best. So it's very <inaudible>. Yeah. I mean, it's what you're talking about in your book of it's hidden only, you know? Mm-Hmm. <affirmative> only, you know, whether you are focused on looking your best because you know, you truly feel that inside and you wanna animate that mm-hmm. <Affirmative> or because you feel a void inside and you wanna try to fill that.

1: I love that term "animate." I think that is very 'cause it does feel as if you are Disney your life in some ways. 'cause You want to, you're trying to, you know, Gordon Flett says, "The better I do, the better I must do."

 2: And so it's just this constant cycle of, of of animating that, you know that way you want to seem Yeah, yeah, yeah. In destructive perfectionism.

1: Right. I love those two questions. Help me understand, because I, I got puzzled a little bit about, you talk about balance in a negative way mm-hmm. <Affirmative> and I, I understood it. In many ways, it's, you, you know, you can't have it all. You, you just, you know, that's just not gonna happen. But you, you talk about balance is actually an energetic equilibrium. There's another one of those phrases that I loved, and because you've become, you've become being good at being busy. So can you sure. Yeah.

2: So that a little bit for us, yeah. Balance is a wonderful pursuit in its original definition, which is energetic equilibrium. Mm-Hmm. <Affirmative> right. Balance in its, yeah. You know, original form is about how you feel on the inside.

Right. Balance as we talk about it in commercial wellness has become a, about being good at being busy mm-hmm. <Affirmative> mm-hmm. <Affirmative>. And so we've really lost the inside of what balance means and we're operating with a shell casing. Yeah, that's an excellent point. Yeah. And so, you know, the people that are genuinely have found this sweet spot of their energetic equilibrium on the outside, they look like the opposite of balanced. You know, they're not able to juggle any task you throw at them. And, and they're not, you know, perfectly moving through their day with all of the, you know, it's not about that. And so it, that section was about the implicit sort of wild goose chase that we send women on, which is, you know what, you know what your problem is, you are not balanced enough. Yeah. Let me help you to be balanced.

Do this, say this mantra in the morning and buy this like Instapot so that you can make quinoa, <laugh>, and you know get this app that's gonna help you to learn French, because balanced people are really cultured and travel enough and all this stuff. And it's like, just becomes another another achievement. You must, but now I must achieve balance. Yeah. And you know, I talk about it in the book, like when we were all young girls, we were told that the story that a prince was gonna come and rescue us, right? And that if we just make the most out of being trapped or kidnapped or, you know, being an orphan or whatever travesty that we're in and do what is good and virtuous, then one day the prince will come and save us and we will live as this story goes happily ever after.

And now as adult women, we are being sold that same exact story. And the prince has been replaced by this idea of balance that is so superficial, it's not real, and it never arrives. It's like, balance is always, oh, after the holidays I'll, I'll find balance. Oh, this is such a stressful week at work. I can't wait till Saturday. I'm gonna, you know, what I'm gonna have, get level set on Saturday. And then it's always in the future. And it never comes. And, and we don't notice that it never comes because as women, we are too busy blaming ourselves for it's delay. And it is not our fault. The reason that we never come, that it never comes is because this fake notion of balance is not real. It's just an idea. It's not real. Mm-Hmm. <affirmative>.

1: Yeah. It's a really intriguing thought. And I, I think it, it certainly I'm glad you said it and brought it up in the conversation in your book. 'Cause I, I think it's, it's something that maybe people, as you say, have swallowed a this com.

2: I used the term commercial a few minutes ago, this commercial version of balance. And, you know, you see people meditating on commercials and you know, making sure they take their, you know, all their medicine 'cause another medicine is going to fix that. Right? So medicine and yoga pants, the right outfit, <laugh>, and a quick vodka martini perhaps. Oh, that too. Sure.

1: You said there are 10 changes in thinking that you can have and then 10 changes in your behaviors. So I would, I would love for you to just pick one of those maybe that you don't get to talk about very much. Mm-Hmm. <affirmative>, I just wrote a few of them down. Counterfactual thinking Maintenance and is triumph, difficulty versus challenge. And what I can't read my own handwriting, the getting connected Simple isn't easy, which I loved that one.

Mm-Hmm. And then some of the behaviors are restoration, reframe, explain, and express. Do less than, do more. Those are just a few that I wrote down. But what do you not get to talk about that you'd like to talk about?

2: Oh, thank you for that. So I think strike when the iron is cold. Like one of my favorite strategies it's a phrase that comes from the Dr. Irvin Yalom who is, you know, a celebrated psychologist and writer. And the idea here is that the best time to address a conflict or something that is really challenging to you is not when the iron is hot. It's not in the moment that you're in the conflict, right? It's when the conflict and you have some distance between themselves. So the strategy that, you know, the way I applied it in the book is like, the best time to work on your maladaptive perfectionism is when it's not showing up.

Yes. For you. It's when you're in a great space. Because when you're in a healthy space, that's when you feel most solutions oriented. That's when you feel confident enough to ask for help. That's when you feel, you know, that you have the most energy to maybe set or adjust a routine such that you are able to encounter, you know, your deepest self every day or your goals or whatever it is that you, you know, if you're anything like me can lose sight of really easily, you know, I have to remind myself of like my basic values every day just because otherwise we get so distracted and so striking when the iron is, is cold applied outside of managing perfectionism might look like, let's say you and your partner have a real hot button issue going on. Mm-Hmm. <Affirmative> the time to talk about that is when you are feeling very connected to that person.

Exactly. And when, when you and that person are laughing, you're having a good time, you feel safe together. And that's when you wanna say, listen, I, I've been thinking about something that I'd like to have a conversation about. It's important to me. Do you have time? Mm-Hmm. And energy to listen to that right now? Or are you up for that right now? Mm-Hmm. <Affirmative> and the person will probably be able to receive that versus, you know, let's just say for argument's sake, the, the issue is one, you know, one person comes home late and they don't say that they're coming home late and the other person feels dismissed and disrespected and blah, blah, blah. Okay. So striking when the iron is hot would look like noticing it's seven o'clock. My partner said they would be home at, at 6 45, 0, 15 minutes. You're building resentment, you're, you're, you know, you're just having an argument in your head and then seven 12 rolls by and your partner comes home and you're just like, why didn't you tell me?

We have talked about this. I wanna talk about this right now. You either respect me or you don't. And you just engage in this very unproductive back and forth, which creates immediate defensiveness. Nobody feels really safe and nobody feels open. There's, there's such a tiny, if not invisible or, or not even invisible, but just like doesn't exist opportunity for solution in those moments. You're just doing damage control at that point. Sure. Of course.

1: Strike when the iron is cold. That's a great, great way of putting it. And I've never heard it before. So that's that's, that's another one that will stick with me. I have sneaking suspicion. And then again, some of your behavioral suggestions are also really, really good. Which one do you not get to talk about <laugh>? Well so I mean, I think that if people understood that asking for help looks like not just asking for emotional help, that's actually a reframe of of perspective.

2: It's not one of the behavioral strategies, but I think it applies to behavioral strategies. Because if we're talking about the behavior of asking for help, being able to understand that, so often we don't ask for help because we think of my, of help in this myopic one dimensional way, which is asking for help means being emotionally vulnerable and having to tell someone something that feels private or scary to acknowledge. And emotional help is one version of help. I identify six in the book. There are many more. And so other versions of help include informational help. Mm-Hmm. <Affirmative>, right? So if you, if you just started a business and you are really stressed out with the mechanics of filing your taxes under, you know, this a new P L L C as opposed to the way you've always filed your taxes in life, you are stressed and you need help and understanding, wait a minute, I don't need necessarily a therapy session about this.

I need to talk to an accountant and ask them two specific questions. I need informational help. And so just being able to organize the kind of help you need and create buckets in your mind. There's tangible help, there's physical help, there's financial help, there's emotional help, there's informational help and there's community help. And again, that's just the intro class, right? <Laugh>, they're all different kinds of help. And so asking for help doesn't have to look like bearing your soul to somebody.

  1. You know, I, I'm thinking laughing to myself about this past weekend. I, I'm short, I'm like five three and I am too. Oh, <laugh>. And I was at the grocery store and the thing I wanted Creme Fraise was way at the top. And I was standing there and trying to hold on and I thought, I'm just not gonna ask for help.

And I knocked the hole, the shelf off, <laugh>, it all kept rumbling down. Oh God, didn't I just ask for help? So <laugh>

2: Yeah. I know there are so many moments where we don't ask for help for no good reason. And then there are other moments when we don't ask for help for reasons that we think are good, but other people, you know, they, I was just talking about this to a friend where it's like, you don't ask for help because you think you are burdening someone. Mm-Hmm. <Affirmative> when actually asking for help is an invitation to connect and let people show up for you. And it also gives other people license to ask for help from you. Love to ask for help. Yeah. Be asked for help. It's like, oh, you see me as someone that can help you? That's very flattering to me.

1:  Right. A lot of people do. So well the, the book's title is again, the Perfectionist Guide to Losing Control, A Path to Peace and Power by Katherine Morgan Schafler. And I'm also curious, and I saw that one of your certifications was from the Association for Spirituality and Psychotherapy in New York, and, but your afterward is very interesting. Mm-Hmm. <affirmative>.

2: Yeah. I put that in in the last second 'cause I was scared to put it in because I was like, it it, it has God in it. Yeah. It has God, God language, <laugh>. And I was really raised, not, not religiously and so to me, but I've always believed in God. Mm-Hmm. <affirmative> and it felt like a really intellectual book.

And it also felt incomplete without that afterwards. So I just snuck it in there, <laugh>.

1: I love it. I thought, wow, what, this is really revealing another part of her. Yeah. So it was and the way you feel about that kind of connection, how you feel about connection. Yeah.

2: Well, I'll tell you where that came from. I remember being in my apartment before I even had a book proposal and just having a ton of index cards. 'cause I'm old school and I like to write stuff on index cards and lay them out to organize my thoughts. And I was like, what is this book gonna be about? What is it not gonna be about? How am I going to structure it? And I just had that, you know, I call it in the afterward Waking Dream. I was sitting there and I just saw what I wrote in the afterward and it was just like a ten second thing.

And I, and I was like, that is the spine of the book. And at, when I finished the book, something about it didn't feel complete and it was not including that little, you know, half a page afterward. And then I put it in and I felt such a peace in heart and mind, and I really love that part too. So thank you for, for sharing that.

1: Of course. Well, if for SelfWork listeners who are going to actually pick this book up, which I would highly recommend, I'm not gonna spoil it by reading it because I think it's just very, oh gosh, it, it evoked curiosity. It evoked gentleness. I don't know. It was just very, it was very interesting that you would, and I, I, I felt like you were letting us in a little bit to who you are and, and what makes you tick.

So that's, that was really a beautiful thing to write. Hmm. Thank you. Anything else that you would like for us to hear about you or about your work?

2. Well the book is a conversation starter, and I could, you know, I think we all could talk about this in so many different directions and ways. And I continue the conversation on my site, which is Katherine Morgan Schafler.com, and you can find me on instagram@Katherinemorganschafler.com. And and I just wanna thank you for having me on. This has been such a thoughtful conversation and I also wanna Thank you. I have your book here. Oh. And I wanna, I wanna thank you for laying the groundwork. You know, you and so many other practitioners, you know, Dr. Brene Brown comes to mind, Flett and Hewitt, obviously, you know, all these people that really cemented how perfectionism can go wrong and how much we need to be mindful of that and understand that we need bumper lanes on this thing mm-hmm.

<Affirmative> or else we are going to crash. Mm-Hmm. <Affirmative>. And, you know, the crash for perfectionism is very serious. And I talk about those serious risks in the book. And the reason that I was able to write a book about a sort of broader perspective was because the, you know, part about how maladaptive perfectionism can go wrong was so clearly laid out. And so I appreciate that and it gave me license to really explore. And I never get a chance to tell the people who wrote books. I mean, isn't that the best part of being an author is that you get to talk to other people who write other authors and about being a podcast host as well, so <laugh>. Yeah, right. But man, being a podcast host looks so hard to me. It look, I mean, it looks easy on the surface, but just by being on all these podcasts, even just as a guest, I'm like, God, the level of technology, <laugh> alone, <laugh>.

  1. Well, that's when you, thank God for your team and your audio engineer <laugh>. Mm-Hmm. <Affirmative>. Thank you Catherine. So very, very much. My pleasure. Thank you. Of course.

Thanks to Catherine for a wonderful interview. I'm so appreciative of her work and the fact that she also actually in the beginnings of the book does talk about how perfectionism can be destructive. So we're really more on the same page than I initially thought. Thanks for the reviews you're leaving for SelfWork. Wherever you listen, keep 'em coming. Thank you for your support and for being here today. And please take very good care of yourself, your family, and your community. Of course, our hearts are broken by what has happened in Hawaii. And so if you know someone there or if your life is affected by that tragic wildfire, please know that we are helping and we want to help. And I urge everybody listening, give whatever you can to the American Red Cross or the organization of your choice to help out these Hawaiians who have lost everything. I'm Dr. Margaret, and this has been SelfWork.

 

 

Aug 16, 2023

During my research on last week's episode on post partum, I learned that my own state of Arkansas holds the #1 spot in the US for maternal mortality rates. I'm interviewing Dr. Zenobia Harris today, whose accolades in this field are numerous to try to understand what's not happening in Arkansas that needs to happen - and what states are doing it right and how. Dr. Harris heads up the Arkansas Birthing Project, and is an incredible force and national advocate for health equity and for improvements to family, child, and maternal health. The program as well as the national organization Every Mother Counts is reaching out to minority women and their families, who are much more likely to suffer severe medical problems both during and after pregnancy.

Thanks as always to MagBreakthrough for their sponsorship of this episode!

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Vital Links:

Birthing Project USA

Dr. Krystal Caschetta as a victim of severe post partum depression

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!

Episode Transcript

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.

Speaker 2: Dr. Margaret

Hello and welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford, and I'm so glad you're here.

This week, we had another reminder of the seriousness of post partum depression - or the potentially fatal mixture of new motherhood and suicide.

Dr. Krystal Caschetta, an oncologist, is reported to have killed her 4 month-old daughter and then killed herself in New York.  Current evidence seems to support that she was suffering from the most severe type of post partum, or what's called post partum psychosis, where the new mother is besieged with delusions or hallucinations that can govern her behavior and lead to violence against her baby and her self. It's another set of gruesome tragedies that demands our attention because these deaths can be prevented with the right care and understanding.

I'm sure there will be more to report. And our hearts go out to that family and others who've experienced such a harsh reminder of the mental and emotional toll pregnancy can take.

During my research on last week's episode on post partum, I learned that my own state of Arkansas holds the #1 spot in the US for maternal mortality rates. I'm interviewing Dr. Zenobia Harris today, whose accolades in this field are numerous. She heads up the Arkansas Birthing Project, and is an incredible force and national advocate for health equity and for improvements to family, child, and maternal health. The program as well as the national organization Every Mother Counts is reaching out to minority women and their families, who are much more likely to suffer severe medical problems both during and after pregnancy.

What's amazing is that those statistics can be reversed with support for that mom during pregnancy - provided by who Dr. Harris calls "sister friends."  Here on SelfWork, we talk about what you can do about it. Dr. Harris is doing just that and creating a network of sister friends that are saving lives- and we want to support that mission here at SelfWork!

We want to welcome back Magnesium Breakthrough as a sponsor of SelfWork once again! In fact, Mag Breakthrough helped me avoid a side effect of another medication I needed to take for a few days simply by helping my colon function better. I love this product!

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Speaker 2:

So now I'd like to introduce you to Dr. Zenobia Harris, head of the Arkansas Birthing Project, and a highly respected advocate for improving the care and support that all mothers receive, but especially moms of color who are the most at risk.

Speaker 3: Dr. Harris

The Arkansas Birthing Project is located in the main office is in Little Rock, but we do have birthing projects in various counties around Arkansas and primarily in southeast Arkansas. We primarily work with African American women and women of color. Yes.

Speaker 2:

So, but tell me about how long have you been the head of the birthing project and what do y'all do and talk about some maternal mortality issues.

Speaker 3:

Well, the Arkansas Birthing Project is an affiliate of Birthing Project, USA, which is a 40 year old black maternal and child health organization that originally formed in California Uhhuh <affirmative>, but it was founded by a woman from Arkansas. Really? Her name is Catherine Trujillo, and she was from Moscow, Arkansas. Yeah. But she was actually working for the California Department of Health and Human Services and was spending a huge amount of money as a fiscal agent on preterm Babies Care. Okay. And so she decided to do, conduct a social experiment with several of her friends. They decided to provide support to pregnant women during their pregnancy. There were, were 10 of them, and they each got a mentee, a little pregnant woman who they provided material and physical supports to during pregnancy and social supports, and they were astounded by the outcomes.

Speaker 3:

Traditionally statistically, the young women that they partnered with should have had really poor outcomes, and they didn't. The babies were born close to term or on term, the baby's weighed more than 5, 6, 5 and a half pounds at birth. Wow. they had a non-eventful delivery, and they did quite well after birth. And so they replicated this in that community several times and ended up at one, at, at later time, actually establishing a health clinic in a really at-risk community in the Sacramento area. And this kind of just sort of spread through informal networks. The, the idea of doing this well I, I saw Catherine when she came to Arkansas about, oh, about 10 years after she had founded the birthing project. She did a, a program for the March of Dimes, and I was mesmerized by the work she was doing. And so I became involved with the birthing project at that time. Yeah. And have been, had been working on it part-time until I actually retired from my work as a administrator with the Arkansas Department of Health and have been doing the birthing project full-time now in Arkansas since 2016.

Speaker 2:

I should add, you have your doctorate in nurse practitioner,

Speaker 3:

But we what we do is we go into local communities and train community women to provide support to women during their pregnancy.

Speaker 2:

What did those in initial mentors do? Or what is that? What does that support look like?

Speaker 3:

Well we primarily focus, of course, on social supports because many of the women that we interact with are women who identify as people who fall through the cracks. Perhaps they don't have a, a permanent place to live, or they have food insecurity, or they don't, they're not seeking prenatal care for various reasons because they don't know how to access it or they don't know have transportation, all those kinds of issues.

Speaker 2:

Too Expensive. They don't have insurance. Yeah, exactly.

Speaker 3:

Exactly. And some of them don't have family members to support them. They don't have close, you know people in their lives that will provide that support during this really special time in their lives. And so, our sister friends who are our mentors, we encourage them to become really familiar with the resources in their local communities. Okay. And to work with their little sisters to access those resources that she needs to have a good outcome. Okay. We require that the sister friends work with the little sisters to make sure they get a source of prenatal care and that they keep their prenatal appointments. If they have need transportation, help them work on identifying that we encourage our sister friends not to make your little sister dependent on you, but to encourage her to be independent.

Speaker 2:

That's an important point, isn't it? Wow. Yes.

Speaker 3:

Yes.

Speaker 2:

So what about postnatal care? Because I mean, you know, last week I did this episode on postpartum depression and found out that suicide and drug overdose is accounts for about 25% of the mortality deaths. Is that right? The maternal deaths? Is that correct?

Speaker 3:

Maternal? Yes, that's correct. Mental health related issues certainly have a huge impact. And unfortunately, some physical health issues also impact our maternal mortality issues such as undiagnosed health conditions such as diabetes, right. Cardiac disease, hypertension, which can lead to eclampsia, preeclampsia, and eclampsia, and which can be very fatal. And unfortunately for many African American women it is,

Speaker 2:

I'm so sorry. And the, the couple of articles, 84% of those deaths were preventable.

Speaker 3:

Yes. That is a, that is a huge tragedy for our communities. Huge, huge, huge tragedy and a huge loss of potential of human potential that could you know, be at work in these communities helping to improve the status of our communities. So it's a, it's a huge loss that we experience when these things happen.

Speaker 2:

Yes, it is. And as well as the children they bore, you know, so Yes.

Speaker 3:

Right. And unfortunately, sometimes we lose the babies as well. You know, we have the fourth highest infant mortality rate in the United States as well.

Speaker 2:

Do we really,?

Speaker 3:

Arkansas.

Speaker 2:

Wow.

Speaker 2:

Which are the states that are doing it better? What are the states that are doing it better and, and how are they doing it better?

Speaker 3:

Well as you, you may or may not be aware many states, over 30 of our states in the United States have extended the coverage for Medicaid for women postpartum. You know, in Arkansas, their postpartum coverage cuts off for women who are Medicaid eligible after the second, after two months after delivery. Oh my goodness. Well, many states - about 30 states - have extended that coverage for the first year of life because these deaths can often occur during the postpartum period. Many of them occur during the postpartum period when women don't have coverage. And what we, what they have found is that women will put off going to the doctor because they don't have money to pay for their care. And so they put off their symptoms and they'll deny their symptoms or delay, you know, seeking care until it's unfortunately too late.

Speaker 2:

What do you know for the mental health aspect of things?

Speaker 3:

Well, I think we, we do have a real acute shortage of mental health providers in our state, as you probably are very well aware mm-hmm. <Affirmative>, and there's some parts of our state that are worse than others. And so dealing with that, in addition to some of the stigma that is associated with seeking psychological care and support is something that we've got to address as a society.

Speaker 2:

Now, if I read some of the articles disagreed with one another about this, so let me ask you... I read in one article that the mental health problems, suicide and drug overdose were more prevalent in minority women than white women. And then another article, it said, no, they're about the same.

Speaker 3:

They're about the same. Okay. In my experience. Okay.

Speaker 2:

Okay. Yes.

Speaker 3:

Yeah, yeah. You know, we have the first trimester, second trimester, third trimester is, you know, when during the time the baby is born. Sure. And then, of course, that fourth trimester, which is the period, the immediate period after birth, actually that first year after birth of the baby. I think something that we need to make some distinctions about, or what we call baby blues. Have you heard that terminology, baby blues?

Speaker 2:

Oh, yes, of course.

Speaker 3:

Have, mm-hmm. <Affirmative> versus postpartum depression. And I think sometimes people get those things confused. In the baby blues, you know, a little bit of melancholy and uncertainty and perhaps a little depression after birth because of all this tremendous hormonal and body changes that are occurring. If it lasts longer than two weeks, then we're really talking about postpartum depression.

Speaker 2:

And speaking of that, there is a, a, a medication that has just been FDA approved for postpartum depression, specifically for postpartum depression. Now I'm real excited about that. But, you know, my, my podcast goes well, I have listeners from all over the world, but certainly all over the United States. What, what could a woman do or, or a friend of someone who's pregnant? What are all these, is it called the Tennessee Birthing Project? Is it called the Mississippi Birthing Project? What, what are the, or the California, whatever it is, how can people plug themselves in or plug people in that they, that they know and love into these kinds of programs?

Speaker 3:

Well, the birthing project is just one of many opportunities I think we have available in our local communities to provide support to women during this really critical time. You know, there's been a lot of discussion about community doulas as well, and the supports that they provide. Yes. And I think there's room for everyone. The birthing project specifically, we identify people who are lay people. They don't necessarily have to be trained medical people, and they don't necessarily have to have any kind of certification, but we work with them and support them so that they can in turn, feel free and empowered to support a, an individual person basically like becoming a, a good friend of that person. Okay. A reliable and trustworthy friend. And Birthing Project USA, which is based out of Albuquerque, New Mexico is sort of the hub where people go to get information to establish birthing projects in other states. There are even some international birthing projects in Cuba in Ghana and other foreign nations.

Speaker 2:

Can you tell the audience what, what a doula is?

Speaker 3:

Well, a doula is an individual who is specially trained and experienced to provide to women at doing support during very critical times, either during their pregnancy, during labor and delivery postpartum. And there are even some some bereavement doulas who actually provide specialized support to real, recognize important needs that women and their families have as well. Mm-Hmm. <Affirmative>, and to provide those supports to them to make sure that they have good pregnancy outcomes. So they are right there with women in the delivery area. They're that other voice in that other set of eyes and hands in that area and space that women need often when they're going through this real critical period, because as you know, it's very stressful and often, sometimes decisions have to be made pretty quickly, and it is good to have someone there who is very focused on the needs and the desires of the woman involved Right. During this real critical period.

Speaker 2:

Right. So if people wanted to either volunteer or donate, they could go to the Birthing Project, USA

Speaker 3:

Or the Arkansas Birthing Project if they're in Arkansas.

Speaker 2:

Sure, sure, sure. Mm-Hmm. <Affirmative>. Well, yeah. Most, a lot of my listeners are New Yorkers and California people. So <laugh>

Speaker 3:

Birthing Project USA. it's listed they do have a web, there's a website Birthing Project USA, and we'd be happy, they can indicate that they're interested in more information, and we'd be happy to get in touch with them. Arkansas has been asked to do some of the training for Birthing Project U S A because they appreciate the model that we have in our state. We're the only state that has multiple birthing projects in different counties compared to some of the other, you may have just one birthing project in one particular area in their state.

Speaker 2:

I have a sneaking suspicion that's about you, <laugh>

Speaker 3:

<Laugh>. Well, I'm, I'm very passionate about this work. I'm very committed to it. And I just want to make sure that our next generation is prepared to provide supports that women need during this really important time in our lives. We're building our communities and we want to make sure that we get the full benefit of every person, the full humanity of every person in our communities safely delivered into this in our communities, and safely ensconced in our communities empowered to achieve the goals that God has set before them so that they can be full functioning citizens in our society.

Speaker 2:

I, I couldn't, well, very well said and eloquently said, by the way, so I'm so glad you could come on. And I hope to, again, it's Birthing Project USA or in if you live in Arkansas, it's the Arkansas Birthing Project. This is Dr. Zenobia Harris, and I'm delighted, absolutely delighted that you've joined me today. Thank you so very much,

Speaker 3:

Dr. Margaret. Can I do one more plug You regarding Every Mother Counts. Every Mother Counts has been very generous working with us. They actually have produced a film called Giving Birth in America, Arkansas. Oh. And we are encouraging people to access that film. It can be accessed on Every Mother Counts website to schedule viewings of the, of the film. And if you are interested in having a discussion groups set aside, we can certainly arrange that for you too, because we want people to talk about this very important issue of maternal mortality in our state and come together on solutions for this very important issue.

Speaker 2:

What is the name of it again? Because I will put it in the show notes.

Speaker 3:

Giving Birth in America, Arkansas, and it's on the Every Mother Counts website.

Speaker 2:

Okay. I got it.

Speaker 3:

Thank you. And thank you to Every Mother Counts too, for their support.

Speaker 2:

Yeah. They seem like an incredible organization.

Speaker 3:

Well, thank you so much, Dr. Margaret.

Speaker 2:

Of course. Of course. Anytime.

Speaker 3:

All right, let's stay in touch.

I'm sure you were as impressed with Dr. Harris as I am and was. Please reach out to her and all the organizations. Most states are gonna have some sort of support group like this as well as Every Mother Counts. That's a national organization, and I bet there are others. I know that not everyone who listens to SelfWork is from the United States, so please look around for help that you might need and benefit from. As usual, thank you for being here. It's an exciting week. My TED Talk has reached a hundred thousand views and many of you are probably those who have viewed it. So I want to thank you very much. We've got a lot of plans for the fall, and I can't wait to begin to introduce them to you. Thank you. Thank you for being here. Please take care of yourself, your family, and your community. I'm Dr. Margaret, and this has been self work.

.

 

 

Aug 11, 2023

There are many times that work with my own clients sparks a podcast episode – and this time, I needed to look at what had been discussed in the literature since I saw my last client with postpartum depression. Because I had another – and her depression was severe.

The moms I’ve seen with PPD have all been different. Some highly anxious but unable to function due to that anxiety along with a bad depression. Some who had histories of depression and some who didn’t. Some who had had previous children with no problem and some who’d prepared for PPD since they’d experienced it before. And some who were almost dissociative – meaning that they were going through the motions of motherhood but felt very little about it. They “loved” their baby but having one seemed unreal – as if it hadn’t happened.

So today we’re going to get the facts out about postpartum depression and of course, what you can do about it.

Our listener voicemail is from a woman whose mom was an alcoholic and got sober, but who also appears to have borderline traits or BPD. – and who is viewing her daughter’s choice to set boundaries as cruel and punitive. You can hear the poignancy in this mom’s voice as she wants so to protect her children – but is she really protecting them by setting the boundary and thus, from her perspective, “creating” her mom’s reaction and other difficult family dynamics. The point is she’s NOT the one creating the dysfunction – or it certainly doesn’t sound as if she is.  What would you say?

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Symptoms of Post Partum Depression

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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!

Episode Transcript/Intro

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, welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford. I'm a psychologist. I've been in private practice for 30 years now and have decided to extend the walls of that practice to those of you who might be very interested in hearing more about mental health topics, maybe you're in therapy, maybe you've just been diagnosed with something or you have some kind of problem that you just want some help seeing through different eyes... and of course to a third group of you - those of you who think mental health treatment and maybe even therapists are just a little wacky and a little strange <laugh>. So we're here together and I'm so glad we are.

There are many times that my work with my own clients sparks a podcast episode, and this is one of them. I have someone with pretty severe postpartum depression, and so I wanted to look more into it, especially the recent research.

The moms I've seen with postpartum have all been different. Some have been highly anxious and unable to function due to that anxiety along with a bad depression. Some had histories of depression, some who didn't, some who'd had previous children with no problem, and then some who prepared for postpartum depression since they'd experienced it before. Some were almost dissociative, meaning that they were going through the motions of motherhood, but felt very little about it. They loved their baby, but having one seemed unreal. They sort of felt dissociated from the whole experience. Detached is what that means  - as if it hadn't happened.

What the general public doesn't realize is just how many miscarriages actually occur or how many problems there can be with pregnancy. For example, in 2020, there were 21,000 stillbirths that occurred in the US and the majority of those occurred among non-Hispanic, native Hawaiian or other Pacific Islanders and non-Hispanic black women.And this rate is more than twice the rate for non-Hispanic white women.

So today we're gonna get to the facts out there about postpartum and of course what you can do about it.

Our listener voicemail is from a woman whose mom was an alcoholic and got sober, but who also appears to have borderline traits and who's viewing her daughter's choice to set boundaries as cruel and punitive. You can hear the poignancy in this mom's voice as she wants so to protect her children. But is she really protecting them by setting a boundary, and thus, from her perspective, creating her mom's reaction and other difficult family dynamics? The point is, she's not the one creating the dysfunction, or it certainly doesn't sound as if she is. What would you say? We'll delve into that more later.

As always, we wanna thank our generous sponsors. And if you've noticed, there's a fairly new arrival in SelfWork's queue of podcast listens, and that's an announcement about the Jordan Harbinger Show. You can support me and SelfWork by listening into my intro on Jordan's podcast. It'll appear second in your feed, as well as hearing a short message from Jordan himself on how he shapes his podcast. I actually listen to him on my walks. It's very different from SelfWork, but I like his style. Give it a listen when you can because it will support SelfWork..

The Episode

For now, let's get into a discussion about what is a very painful subject when you're not supposed to be depressed -  'cause you just had a baby,

It seems that finally postpartum depression is getting attention and that attention is long overdue. Some celebrities have been talking about it through the years revealing what an extremely tough time they had for the months after their child's birth. Marin Morris, for example, the country singer says "You're trying to become a new mother and good parent and do everything right". She added of the drowning feeling, "You just feel like you suck at every level".

The actress Reese Witherspoon gave testimony to this kind of depression sneaking up on you. She said she felt completely out of control after the birth of her first child. And now I quote, "We don't understand the kind of hormonal rollercoaster that you go on when you stop nursing, and no one explained that to me. I was 23 years old when I had my first baby, and nobody explained to me that when you wean a baby, your hormones go into the toilet.I felt more depressed than I'd ever felt in my whole life. It was scary."

And there's another, Serena Williams had her baby in 2018, and she said, "Honestly, sometimes I still think I have to deal with it". Her daughter was born by emergency cesarean section, and the athlete also had a near death experience involving pulmonary embolism. So you can see why that is really trauma and that happens. So I quote her again, "I think people need to talk about it more because it's almost like the fourth trimester. It's part of the pregnancy. I remember one day I couldn't find Olympia's bottle and I got so upset I started crying because I wanted to be perfect for her."

If you wanna hear more celeb stories, I've got a link for you in the show notes.

So what are the most recent statistics and facts about postpartum depression?

Here's what a New York Times article had to say. "In recent years, mental health struggles have become the leading cause of maternal mortality in the United States, primarily due to suicides and drug overdoses. It's estimated that one in eight new moms experience postpartum depression and some research has suggested that the prevalence climbed as high as one in three during the early days of the pandemic. Yet roughly half of the women who are struggling with their mental health after pregnancy don't receive treatment. Barriers to care include a lack of awareness about symptoms and treatments and inability to access resources and of course stigma."

So now I move away from that article to say there's increasing awareness that maternal deaths don't just happen during pregnancy or within the first few weeks after birth. This is going to surprise you. It was a stunning revelation to me. The new figures come amid a troubling rise in deaths of pregnant women and new mothers in the United States, which has the highest maternal mortality rate in the industrialized world.

The figures soared during the pandemic to 32.9 deaths for every 100,000 live births in 2021. Rates for black and Native American women are two to three times higher than those for white women. It seems that the rates for black and native American women may be more equivalent to white women when the deaths are about depression or suicide.

So now we know that there's danger to mom and baby for quite a long time. I'm going to quote one more article, summing up the findings from the CDC and I quote, "A fuller extent of the problem came to light in September when the Centers for Disease Control and Prevention took a more expansive look at mother's deaths analyzing them for a full year after childbirth and including deaths resulting from mental health conditions based on data provided by 36 states on 1018 pregnancy related deaths from 2017 to 2019."

The CDC concluded that about a third of them occurred during pregnancy or on the day of delivery, and roughly another third before the baby turns six weeks old. But a full 30% occurred from that point until the baby's first birthday, a period that had not been a focus of maternal mortality research. I mean, I think this is incredible.

Of note, most pregnancy related suicidal deaths occurred in the postpartum period with 62% of pregnancy related suicides occurring between 43 and 365 days postpartum, followed by 24% during pregnancy, and 14% within 42 days postpartum. So we don't have to just worry about postpartum in the first few weeks. We actually have to be very tuned into its presence even a year after the baby is born. The data have led to calls for closer follow-up care and more support for new moms during what has been called the fourth trimester, as Serena Williams called it, with special attention given to the women most vulnerable.

I love this quote from Allison Stuby, an OB GYN professor at the University of North Carolina School of Medicine. She says, "Our approach to birth has been that the baby is the candy and the mom's the wrapper. And once the baby is out of the wrapper, we cast it aside. We need to recognize that the wrapper is a person. Moms are getting really sick and dying."

Just to let you know, the other deaths that were not mental health conditions, the most frequent is hemorrhage, cardiac conditions, infections, thrombotic embolism and cardiomyopathy in that order. And they accounted for over 75% of pregnancy related deaths. And actually the figures show that 84% of those deaths were preventable. Let me say that again. 84% of those deaths were preventable. But people aren't paying attention. Moms don't wanna complain. Families are in denial. They don't know about this information.

That's why it's so vital, and we're featuring it here on SelfWork. So is it that women didn't complain or that somehow mothers signs of illness were overlooked, somehow seen as weakness or that pregnant or new moms weren't counting their blessings?

In fact, I will remember that when I finally became pregnant through I V F, that's in vitro fertilization. I was in my OBs office complaining about how much my feet had swollen. Now, I liked my OB, but he said, "Now, Margaret, you're so lucky to be pregnant. You shouldn't complain" in this kind of patronizing voice, I looked straight at him and said, "I couldn't disagree with you more. You're right. I worked hard to get pregnant and I am lucky. But that hard work gives me all the room in the world to complain. This was hard from the very beginning." He apologized, which was one of the reasons why I liked him so much.

But somehow, women are supposed to handle the very difficult and at time frightening aspects of childbirth while either parenting other children or working full-time for a salary or whatever, without complaining, without receiving support, or more importantly, without being listened to for what are very real problems.

In my research for this episode, I also came across a story about just this attitude toward women that truly shocked me to the core, at least rationally as a woman. However, I sadly got it. After we hear from BetterHelp who can help you through depression of any kind, I'll tell you this story and talk more specifically about the symptoms of postpartum depression.

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 Betterhelp.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.

Okay, first, let's talk about the symptoms of what's called PPD or postpartum depression. It's very different than the baby blues. Baby blues are very, very common, similar to what things are going on in other life transitions, they are mood swings, anxieties, sadness, irritability, feeling overwhelmed, crying, trouble with thinking and concentration, trouble sleeping. But that tends to go away when the new mom or maybe the mom with two or three other children settles down. But if the baby is sick or colicky or is born with some kind of problem, who knows what will happen. And yet, even if the baby seems perfectly normal, postpartum depression can happen and you can place huge shame onto yourself because somehow you're not grateful or happy. It basically is the same as a major depressive episode. In fact, that diagnosis has to be there with huge hormonal changes occurring.

I worked with a woman who developed major depression after an adoption, not because there was anything wrong, but 'cause she'd gone through years of infertility treatment and failed adoptions and had never grieved the loss of those dreams. Her grief was waiting for her, and her experience was that she had very strong depression after she got her child. And let's say the mother herself had serious medical trauma during the birth or the pregnancy, and now she's supposed to be able to snap back from that and parent or nurse. Maybe she nearly died herself, but there's no time to grieve... or so she can tell herself and others can feed her that line as well. So in that instance, talk about complication!. She may be dealing with post-traumatic stress alongside trying to care for a child and becoming depressed herself.

Now, what are postpartum depression symptoms? It's very similar, if not the same with major depression, except there are unique things that have to do with hormonal changes and being a mom. You're depressed, you have severe mood swings, you cry too much. You have difficulty bonding with your baby. You withdraw from family and friends. You can't eat, you can't sleep. Or sometimes you sleep too much. You don't enjoy what you used to enjoy. You can be very angry and irritable. You fear that you're not a good mother. Feel hopeless, helpless, worthless. You can have severe anxiety and even panic attacks. You can have thoughts of harming yourself or your baby and recurring thoughts of death or suicide.

So who's more at risk for postpartum? One, someone who's had depression in the past. Two, if you have a partner with an untreated mood disorder or substance abuse and three, lack of social support. Now what does that last one mean? Maybe you have little to no maternity leave. Maybe you're on your own with no friends or relatives to help you adjust. Untreated postpartum depression may last for many months or longer.

Now, there is a thing called postpartum psychosis. Just like in any depression, a deeper depression can devolve into psychosis where you feel confused and lost. You hallucinate -meaning you see things that aren't there or hear things that aren't there. You have delusions. You can feel paranoid, and you may even hear voices telling you to harm your baby. You've got to tell people if that's what's happening. It requires immediate treatment.

I'm gonna touch on the fact that fathers who are young, have a history of depression, experience relationship problems, or are struggling financially are also candidates for a certain kind of postpartum depression, sometimes called paternal postpartum depression. It can certainly have the same negative effect on the mother and father's relationship and their child's development. So we must become more aware of this. And if you have a daughter or a sister or a friend who's struggling, what's the best thing you can do?

Before I answer this question, I wanna bring up perfectionism. Just think what happens when a woman who's perfectionistic and needs a lot of control has a baby. Everything that was in her control suddenly isn't. This can be a highly dangerous time for her. It can be a pressure cooker, and friends can really help out by affirming what is a difficult transition for anyone, but especially if you need a lot of control.

So I told you about a story I was gonna tell you that I was shocked by. I discovered a podcast called The Retrievals that is a part of the Serial series. Now, I haven't listened to it all, but what I heard was shocking. Basically, an employee, a nurse from the Yale Infertility Clinic stole pain meds that the women undergoing egg retrieval procedures were supposed to get in their IVs, pain meds that would normally have made the procedure perhaps uncomfortable, but that would be it.

And yet, several of the women having these egg retrievals, which is an operation basically were screaming that they could feel everything and that the pain was unbearable. And this happened to multiple, multiple people and went on for several weeks. But the women just bore the pain because they were told, "Well, we've given you all the pain medicine we can." The producer of this program stated that they did what women often do, which is to make up a story that would somehow lead them to blame themselves for their horrific experience. And that's what women tend to do. We tend to find fault with ourselves.

But listen to this... Even after the facts were discovered, the crime was discovered that the nurse had basically replaced the pain meds with saline solution. So some women only got one to 10% of the pain medicine needed. Even after that had been discovered, all of the women got a statement from Yale that basically said, "We're sorry, but you know, there was no harm done." What?No harm?

So the women felt relief that their realities were validated but also very disrespected. I'm anxious to hear the rest of the program. Maybe they did something about that. I'll have the links to the entire podcast for you in the show notes.

So women's pain is often overlooked. We are seen as complaining or whining when it's really very real. And this has just got to stop. Postpartum depression is a very real and dangerous form of depression. So we must make sure we listen and pay attention. And rather than saying, "Well, I don't wanna tell my daughter who's about to have a baby that this might happen to her, you know, I don't want to worry her. I don't want her to be afraid." Myself. I'd rather someone know that this is what to watch for. In fact, that would be a wonderful gift to give someone who's just discovered she's about to have a child - Sso they can prepare and be alert. That's what you can do about it. And then support them getting the help that they need.

You'll be excited to hear. I'm excited to say that later on this week, it will be a midweek episode. I'm gonna have Dr. Zenobia Harris on who heads up the Arkansas Birthing Project. My state of Arkansas leads the nation in maternal mortality rates. And Dr. Harris is gonna talk to us about that as well as what's going on in the field so that we can prevent those deaths. So tune in again this week to hear more about that

Speak pipe message from dr margaret rutherford.com.

Listener Email

So now let's get to our weekly voicemail.

Hi, I'm looking for some advice on how to manage my borderline mom as a grandmother to my six and four year old children. I've been putting in boundaries with her since I became a mom about six years ago. So it's very new in our relationship and she hasn't taken it well. She's playing the victim and that since she's stopped drinking, which she abused alcohol for nearly 20 years of my life, she thinks all the issues are resolved and that I'm being selfish for not forgiving her and that I'm being making things very hard and treating her badly by having boundaries. I'm getting to the point of thinking there's no way forward. But apart from struggling with being labeled as difficult and a problem and not compassionate and attacked by family members for treating her this way, I'm very mindful of protecting my children from this dynamic in my family. But it feels like going no contact and having to explain that to my children is me bringing that dynamic to my children rather than protecting them from it. So how do I navigate this while protecting my children from her, but also from the story of her? I really am lost and worried. So any advice would be so helpful.

You know, there aren't many more problematic family issues than when a family member, whether it's a parent, a child, a sibling, a grandparent, whatever, denies the impact of their behavior on other people. I've often talked with one of my very dear friends who happens to be a psychologist. Think of it like this. Imagine a a fairly small party or gathering where one person doesn't talk, doesn't say anything, doesn't say why they're not talking, just walks around or sits and stares. You can imagine what kind of impact that's likely to have on the others. Some people will try very hard to engage them, some will get mad, some people will ignore them or at least try to, but they have a lot of power, don't they? It's like someone refusing to own their impact on others. So you can have a family member like this mom, who is refusing to own the impact of her past behavior, and in fact wants credit for having changed, which is great that she's quit drinking, but she's still not taking responsibility for the impact of her past behavior and perhaps other characterological issues.

What they don't realize is that they've been hurtful and must earn back the trust of their family members because the family is not supposed to turn the page and pretend it didn't happen. No, that's not the way it works. And especially to call someone setting boundaries, abandonment when the trust hasn't been earned back, isn't fair or right. In fact, from what I know, from what this listener talks about, it seems that the mom just wants her daughter to ignore what has happened and trust her. And yet, I've heard many, many times in my office with people or mothers or fathers, whomever that have had abusive parents, they've said to me, "I can deal with them hurting me, but I'm not gonna let them hurt my child or my children." So that can seem pretty clear, right? The boundary's drawn, the mom gets mad, family doesn't understand, but it's still about," I'm not gonna let you hurt my children."

Yet this listener brings up another difficult point: Is not being involved with her mother going to confuse her children or even more greatly expose them to the pain in the family, especially if it sounds like other members of the family are moving on? Both her mom and some of her family are seeing this as cruel and they may make a big deal about it.

So this is my somewhat painful answer. Yes, it is a difficult issue and in fact, there's probably no total win in this situation, or at least what I've heard from this listener. Being estranged from a parent or a grandparent is going to need an explanation, at least an age appropriate one. But you can prepare yourself for that conversation.

I'd highly recommend that this listener read some Al-Anon literature or join an online or local group. Al-Anon is a group that was formed years ago.They help each other to see how their own behavior or choices could what's called enable the drinker. And remember, stopping drinking alone doesn't fix the problems created when someone was drinking. That's naive and even entitled. But the people who are involved in Al-Anon have a lot of wisdom to share. I've been told their motto is something like "detach with love." I've got the Al-Anon link in the show notes, and there are meetings all over the world in 133 countries. And of course you can join in online.

Perhaps they will give you their own versions of what they said to parents or family and how they explained it to their children. But you must remember as well that children learning that there is a natural consequence to their behavior and others, that's a really important thing for them to learn. I hope this has been helpful.

Thank you so much to those of you who are regular listeners, welcome to new listeners. I got a wonderful review from a listener in South Africa. She happens to be a therapist, so thank you for that. I read that. I appreciate it very much. People ask me all the time, how long have you been doing that podcast? And now in October it'll be seven years. It's just become a part of my life. And I appreciate all of you listening, reviewing, rating, commenting, and sending in your questions and voicemails. Thank you so much. Please take care of yourself, your family, and your community. I'm Dr. Margaret and this has been SelfWork.

 

Aug 4, 2023

I wanted to offer you the advice and very creative teachings today of Becky Blades – she founded and sold an award-winning communications firm, she’s basically run from the board room to the home room, she’s an artist herself, and she’s an inspiring and highly creative author of two books;

Her first book, Do Your Laundry or You’ll Die Alone, Advice Your Mom Would Give if She Thought You Were Listening, which she wrote and illustrated, was named a Best Books of 2014 and one of the Top 100 Indie Releases by Kirkus Reviews. It received the prestigious Kirkus Starred Review and was an Amazon best seller for six consecutive years.

Now she’s written another wonderfully illustrated book (her own drawings and illustrations) entitled Start More Than You Can Finish. And I wanted it to be a real fresh-er-up-er for those of you wilting in the heat of the summer or fending off one more winter storm – dependent on your hemisphere. And the Next Big Idea Club  has selected it as one of  “the most essential nonfiction books of the year."

She calls herself a bad cook, a hopeful gardener, a passionate tree hugger and a licensed private pilot – and I’m delighted not only to have her on SelfWork...  but to call her a friend.

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Have you been putting off getting help? BetterHelp, the #1 online therapy provider, has a special offer for you now!

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My TEDx talk that today has earned 72,000 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!

Episode Transcript

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.

Speaker 2:

Hello and welcome or welcome back to SelfWork. I'm Dr. Margaret Rutherford, and I'm so excited about bringing you a friend of mine and someone that I truly, truly admire. Becky Blades. I wanted to offer you the advice and very creative teachings of Becky today. Not only has she founded and sold an award-winning communications firm, she's basically run from the boardroom to the homeroom. She's an artist herself, and she's an inspiring and highly creative author of two books. Now, the first one was, do Your Laundry or You'll Die Alone, <laugh> subtitle being Advice Your Mom Would Give If She Thought You Were Listing. She not only wrote and illustrated that book, it was named a Best book of 2014 and one of the Top 100 Indie Releases by Kirkus Reviews. And it received the prestigious Kirkus starred Review and was an Amazon bestseller for six consecutive years.

Speaker 2:

That is a long time. Now, she's written another wonderfully illustrated book. Again, her own drawings and illustrations entitled Start More Than You Can Finish. And I thoroughly enjoyed it. I wanted it to be a real fresher upper for those of you who are wilting in this heat of the summer, or if you're in another hemisphere, fending off one more winter storm. Her point in this book is that we can get so afraid of failing, we don't start and starting is so important. In fact, she advocates being a startist. And this book also has high praise. It's been named a Must Read by the Next Big Idea Club, which by the way, the members of that club are Malcolm Gladwell, Adam Grant, Susan Kane, and Daniel Pink, not bad company. And they call it one of the most essential non-fiction books of the year. It is truly inspiring.

Speaker 2:

She calls herself a bad cook, a hopeful gardener, a passionate tree hugger, and a licensed private pilot. And I'm delighted not only to have her on SelfWork, but I'm lucky enough, like I said, to call her a friend.

Before we hear Becky's interview, let's hear from BetterHelp. So many people start or go back to therapy when their kids are starting school. And that's not too long from now. So everyone's starting something new. I'd recommend calling very early for a therapist in your locale, but with better help. You don't have to worry about that. They're ready to see you when you are ready to be seen.

Speaker 2:

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 Betterhelp.com/self work, you get 10% off your first month of sessions. So just do it. You'll be glad you did. That. Link again is better help.com/selfwork to get 10% off your first month of surfaces.

Speaker 2:

And now I'm delighted, absolutely delighted to introduce you if you don't already know her. To Becky Blades. I was trying to remember when you and I met, was it at a midlife bloggers

Speaker 3:

Associated? It was at, it was at BlogHer that in San Jose.

Speaker 2:

That's right. Yeah, that's right.

Speaker 3:

And it was my first one. Do did you go to a lot of those? No,

Speaker 2:

I think I went to two. I went to the one there. I went to one in Chicago, I think, and then I went to that one I didn't go to anymore.

Speaker 3:

And who invited me were Mary

Speaker 2:

Mary Dell Harrington, and Mary

Speaker 3:

Darrell Harrington and Lisa Heffernan. And I had just put out that first book. And I, you know, gosh, I am, I'm, you know, everybody I met there was so nice. And I just have still loved maintaining those relationships.

Speaker 2:

Listen, I was so glad that I took the time to read all of your book because I just laughed and I smiled and I teared up a couple of times and you had me from the very beginning. Your artwork is just incredible. A line is a dot that wasn't, this is what you say, a line is a dot that wasn't afraid to get started. I mean, that's like,

Speaker 3:

I loved that. Yeah. And a dot can be a splatter. I mean, dots don't need to be neat, perfect little dots. They can be <laugh> little cuddles.

Speaker 2:

I didn't remember that until it, then I refreshed my memory and I wrote it that you are also, you're an author, but you're an an artist and you're, you're, you really love combining those things. And can you, why don't you tell SelfWork listeners a little bit about you?

Speaker 3:

Okay. Yeah. I had a career in public relations, which came out of a degree in journalism. And so I've always liked writing. I didn't like being poor. So journalism wasn't, you know, the job that I wanted out out of school. I grew up poor. So I, I chose to find a way to make money in an, the agency business, the journalism public relations agency business. There were a lot of opportunities for creativity. So I started my own firm in when I was 30. Wow. And ran that for 13 years. And then when I, kind of parenting was at a, at a pitch that I wanted to be home and in, in my creative space at home more too, sold the business and started building what what we now call a portfolio lifestyle. So I had the business oh, I like

Speaker 2:

That name. I've never heard this

Speaker 3:

<Laugh>. Yeah. And, and, and then I had the, I had an art studio and I remember  - to kind of jump over to this book  - when I one time my soon after I sold the business, my daughters were talking, they came home from school and they wanted it an identity for me. 'Cause you know, kids talk what your mother do, you know, what does your mom do? So my youngest said, "Mom, what are you, are you an artist? Are you a business person?" And I said, "Honey, why do those labels matter?" And her sister from the other room said, "She's a startist" <laugh>. 'cause I was starting some other businesses and you know, they got confused by how I dress different days. So, so during that time, I, I went through my first and second midlife crisis. First that empty nest crisis that, you know, and have been such a great expert on my first book was do Your Laundry or You'll Die Alone.

Speaker 3:

And that was the subject line of the email I sent my daughter of all these journal entries with advice that I was kind of afraid to give her in person. So after she left for college, I sent it all to her. And, and then, you know, after that, I'm, I, I don't mind saying I'm 64 now. And those, these past 10 years of being kind of all, you know, almost the entire time empty, nested has given me the chance to really see how what I love and what I, who I love spending time with. And I've realized it's, it's people like you who when they think they wanna do a podcast, they'll just haul off and start it, or people have ideas and act on them. So

Speaker 2:

No, and the, the name of this book is Start More Than You Can Finish. And, and I so agreed with it. I, one of the things that I say to patients all the time is, it doesn't matter where you go, it's that you go Exactly. Just go, just make a choice. Just go. And I, I was just humming along with your book Thinking <laugh>, I agree. <Laugh>.

Speaker 3:

And it's been fun to think about the mental health aspects, of course, you know, to, to make the case for something that seems as contrarian as this notion of start more than you can finish, you know, kind of in defiance of what our parents may have said. But the mental health aspects of creativity, we're learning more and more as you know about how creativity makes us flourish and thrive and, and the and then we have other things we can talk about, anxiety, depression as I studied the neuroscience of it, I, I decided, you know, I discovered hidden benefits that I didn't know I had been partaking in.

Speaker 2:

Wow. What are those?

Speaker 3:

Well, starting with self-discovery, self-esteem, getting out of anxiety and depression. I'll, I'll tell you a story that I haven't, it didn't make it in the book and I haven't told many people because it seems like kind of a downer, and we wanted the book to be upbeat. But part of my catalyst for writing the book was I was taking art lessons to domestic violence shelters. I did this for a few years. I, I didn't call it art therapy. Now they did because mm-hmm. <Affirmative> All art is therapy, but I'm not a, I'm not a licensed therapist. Mm-Hmm. <Affirmative> or an art therapist. But what I discovered in my time with those amazing women is that the thing that, that spectrum of creativity, I used to think it was started with, oh, oh, I'm not creative, and ended with, oh, I can start anything on a dime.

Speaker 3:

Well, the spectrum really starts way over in a place where we feel totally powerless. Totally. devoid of even knowing what we like. Right. What gives us joy, what our idea of beauty is, and our inability to make a decision. So this book is about starting, it's taking that first step, like you said, it's not where you go, it's that you go. And the example is, in the very first class, these women, all of them could not even make that first initial decision. I, I would kind of lay out a little project, very simple. I had all these enticing art supplies, but they literally needed my permission to choose a color. Like, what should I start with purple? Yes. Purple would be a great place to start. They had lost, I mean, they had literally had mm-hmm. <Affirmative> the creativity beaten out of them because creativity is, it's trusting our own ideas and owning them, and then also having the, the courage to experiment and say, okay, you know, what? If purple doesn't work well, when we're terrified, when we're traumatized, when we're stuck, I don't think we have the courage to know that the stakes aren't that high. You know, if I choose color, if I choose purple and I don't like it, I can paint over it. Sure, of course. Or as I said, I'll give you another piece of paper <laugh>.

Speaker 2:

That's a great point. It's that shutting down of, of risk of any, even, even how what, even no matter how tiny the risk, or seemingly tiny, it's not seemingly, it's not tiny to them. It's like, oh, right. I'm gonna make a choice and it's gonna be out here for other people to see. And yeah, it's right. But, you know, I, and you may

Speaker 3:

Not know, you know, I think when we're beaten down, we don't know what the risks are. There's this free floating sense of, I'm taking a chance, I'm doing something I haven't didn't do yesterday. So what might happen, because, you know, life doesn't treat us rationally. And for those women who had been, you know, abused, they, they had been abused for much less things than making a wrong color decision. Right. So the healing so to, you know, get back to your first big question was the, the ancillary benefits of acting on our ideas and following that creative process are things we don't even know we need, I think. And, and yet I could really see it dramatically with those, those women who, and this was another really fun thing, is that they came out of that so fast, so joyfully really, that just a few weeks, you know, just, you just give that affirmation that Yeah, purple would be great, and that looks great, and you know what, this other color might work too. And then they start with the self, with their own self-talk. And I mean, they just, those, those stays and those shelters aren't that long. So I only got to see 'em for a short period of time, but it was, it was fast and miraculous.

Speaker 2:

That's incredible. You know, I got my start in this business by volunteering at a domestic shelter. Oh.

Speaker 3:

So you get it.

Speaker 2:

Love so much so, so, so much. Anyway. Mm-hmm. <Affirmative>, you know, I, I'm gonna quote you again. It's not that finishing isn't vital and great, but not finishing is not failure. And I, I love that because you know, how many times have I heard the phrase, well, that didn't work out like, that says something bad about me. I mean, you asked in the book to, to make a list of, you know, the things we've started and didn't finish. And to make, I mean, my first two marriages came to mind immediately,

Speaker 3:

<Laugh>,

Speaker 2:

I finished them, but <laugh>

Speaker 2:

Not in, not in the way that I thought I was going to. And, and I mean, I carried those around with such shame for so long mm-hmm. <Affirmative> that that wasn't okay. And and it's not ideal, perhaps, but it, you know, I learned something along the way. And then, but I, I love the fact that in the book, you also take time to say, all right, stop reading or, you know, whatever. And, and let's apply this. Let's, what can you do? Mm-Hmm. <Affirmative>, what can you do with, with your, and you have four stages, you imagine, think, decide, and act. Which, you know, I, I think when people, a lot of people hear the word well, just imagine, just imagine mm-hmm. <Affirmative> mm-hmm. <Affirmative>, that feels like real shaky ground to just imagine. Mm.

Speaker 3:

Mm-Hmm. Mm-Hmm. <Affirmative> mm-hmm. <Affirmative>. And if we imagine and some people are really good at that part mm-hmm. <Affirmative>, but some people, that is the toughest part because they imagine very small. They only imagine with the reality that they can touch and hold Right. Then. some people are great imagining and they imagine backwards, you know, they only pull from what they've already been able to do. So what, what I do with those four steps was research and find out how to do them better to, to start better and start more. So imagining it really comes down to imagining more and bigger the, the more we noodle and think about how things might be a future reality, which we're all gonna have, you know, we're gonna have a future anyway. Yeah.

Speaker 2:

<Laugh>

Speaker 3:

<Laugh>. So why not imagine it in all the, and it's all, its glorious colors and possibilities.

Speaker 2:

You know, I'm, I'm thinking about your work on Dreams with Start. I love that book. That, that's a great word. You, you, you should thank your daughter <laugh>, because it says to write down your dreams, but then you very quickly said, but I don't have enough something. I don't have enough. Mm-Hmm. <Affirmative> time. I don't have enough money, I don't have enough talent. I don't how whatever it is that you convince yourself to, to stop dreaming.

Speaker 3:

Exactly. It's, it's the, the answer to the question. The answer to the question. Why haven't you started that thing? And I asked actual people, art students of mine create very creative people after they told me something they wanted to do, I asked them why they hadn't started. And the answer was always, I don't have enough blank. They, they would word the answer many different ways. Sure. It could be confidence, like, I don't think I can do it. You don't have enough confidence. Right. enough permission, enough validation, you know, space and permission could be just from your family to think that you could take the time away for yourself. Mm-Hmm. <affirmative> to do that. I call that enough permission. You know, and, and obviously money and time are the big ones. Sure.

Speaker 3:

But we do have enough to start those things. That was the big learning. I think the big aha in the research was if you've started anything, like you probably didn't know that you'd be doing a podcast for this long pss I can, I've decided I can never do a podcast. I <laugh>. So respect the ability to all the skills that come into this. But when you started your first one a start only thinks, thinks mostly about how I will start it, how I will do the first step. Yeah. And that is the healthy way. If you think your finish, if your finish was to get it produced and get it picked up by a big syndicate, you would not think you had enough of whatever to do that. And

Speaker 2:

I was determined to do at least eight podcasts because I was told in my class that that was the average number of podcasts that people do before they finish <laugh> before they start

Speaker 3:

Really? Eight. Eight. Wow.

Speaker 2:

Eight. And so when I got to nine, I thought, oh, why <laugh>?

Speaker 3:

See, there you go. And what if you hadn't known those numbers? That's fascinating. Yeah.

Speaker 2:

Yeah. So I I just, the support you give in the book and the humor and the asking people to look at themselves, I you know, you, you sort of break down these four parts, the imagine, think, decide, and act, and you <laugh> you said, thinking brings ideas to life, not overthinking. What do you mean by that?

Speaker 3:

Not overthinking? Well, you may be familiar with, you know, all the research that mm-hmm. <Affirmative> says that when we, that we are programmed, how would you state it? That we are, we are engineered for security as, as species, we're engineered for survival. So there's an, a natural avoidance to risk, which is healthy. Mm-Hmm. <affirmative>. So if we let ourselves to think, think too long, so we go to that imagining place and we're very successful and imagine something wonderful, then the next step is we think about it. We think about how that future state looks into reality. How would we do it? Where would we start? How long will it take? Who do I need to, you know, kinda warn about this? Sure. In that it is that process where we talk ourselves out of it, and we really do a number on ourselves be, and the more perfectionist a person is, the better or worse they, they do that part. So I, you know, I say imagine more, think less. Because the truth is that even if you plan, if you're thinking involves this elaborate detailed plan, the minute you start something, that plan changes. I,

Speaker 2:

I wrote that reality,

Speaker 3:

Circled it. Reality is a big old truth pill. And we cannot, we cannot predict it.

Speaker 2:

Mm-Hmm. No, we cannot. So like I have that in red, circled in red <laugh> plans change as soon as you start. And you also talked, there was a section that I, I maybe 'cause of my theater experience, but you talked about how they're tenets of improv improvisation that are really important for start. Mm-Hmm. <affirmative> and I, I've done a little bit of improvisation, and it is, it's not easy <laugh>. 'cause One of these things that you brought up, you, you know, you have to just say yes and yes. And it's a rule of agreement. And then you Oh, don't tell. There are no mistakes. And you stay in the moment, like you said it, it's like somebody can just start, an audience member will say, okay, we're gonna talk about diaries and cowboys.

Speaker 3:

Yeah.

Speaker 2:

Somebody has to start something about a diary and a cowboy. And it may not make any sense. It is like, you have no idea where they're going, but you, you, you say something and you bring along. And then, oh, and then there was a, there was another cowboy, but he had a black horse, but he wanted a white. I mean, it's just, it's, it's, yeah. Then the story evolves. And so it's, I I loved that. Maybe, I don't know, is it an analogy, a metaphor that this

Speaker 3:

Yeah.

Speaker 2:

Creation is like improv.

Speaker 3:

And you know, the best quote I heard in my interviews with those people is it's about what we do, but mostly it's about what we do with what we did. So that first step, again, the stakes are reduced. You just gotta do something. It's throwing the mud on the wall. It's on an improv stage. There are like five actors, somebody has to say the first thing mm-hmm. <Affirmative>, that takes courage. But really the hardest job is the person that says the second thing. Sure. <Laugh>. Or maybe it's easiest because then you have something to respond to. So we need to give ourselves something to respond to, to really flesh out our ideas. And I mean, I also learned that all kind of comedy really works like that because, you know, finding out what makes other people laugh is an exploration. You think, oh, this might make me laugh, but you don't know. 'cause You're hearing it on your, in your own head. So <laugh> Exactly. My husband's taken to doing open mic nights. And

Speaker 2:

That's brave. That,

Speaker 3:

That is brave. It's also brave to be in the audience of those because it's, it's usually young men who <laugh> who have, have lost their mothers laughing at them. So they're, you know, they don't know what's funny, but they're willing to, at, at late night climb on a stage and tell jokes and for taste. But what happens is that's how, that's how comedy's worked out. And even the, even the best joke writers, you know, go on stage over and over again before they will go lifetime Yeah. And tweak this and try that and shorten this. And, and that's, you know, that is the creative process. It's iterative, it's exploratory, it's curiosity. And I mean, I think mental health wise, I too believe when you, when you, when I am mentally healthy, I am my most curious Exactly. When we're shut down, we're, we're not curious.

Speaker 2:

But it's also an external energy. It's, it's going energy from internal traveling externally. When you're curious because you are either, whether it's how you make a good glass of iced tea. I'm sitting here looking at my i d or whether it's gosh, I, you know, I'm interested in what those green books are behind her. You know, it's, it's, you are, you're engaging with something. Maybe it's an idea or a person or a thing that's not, but you are, you, your focus is outward.

Speaker 3:

Yeah. I never thought of that, that way. That's, that makes sense. Which is a

Speaker 2:

Antidote to depression for sure. Hmm. And in many ways, anxiety, because you have to be in the moment. You have to be, whereas anxiety puts you into the future. Hmm. So what, tell me what you learned about yourself in, in writing this book.

Speaker 3:

Oh gosh. I learned that the very beginning of the research was learning that all of my unfinished business, and I'm doing air quotes visually here was were treasures. And that when I, you know, we rarely let ourselves dig back into the things that didn't go forward. You know, even things I didn't consider failures or unfinished, I just forgot about them. Mm-Hmm. <affirmative>. I just saw the link to how they made me who I am. And the big finishes in my life, the big finishes always had some roots and some unfinished business from, I found my college art supplies. As when you're, when you write and make art, you have all these records back there. Now, you may not have, in other types of curiosity, in other types of creativity like gardening or cooking, you may forget those things you tried. And so I think what I learned is I need to memorialize and celebrate my starts more.

Speaker 3:

And I do now. The, the rationale for this book was to to help other people that don't act on their ideas and make those people more fun companions, <laugh> in a way. <Laugh>. And I had, and one of the things I found is after I sold my business, people were saying to me like, what are you, what have you, what are you doing now? What have you finished lately? They didn't use those words, but I could hear that people thought I had a lot of plates spinning. I do have a lot of plates spinning. That's something I'm good at. I'm good at starting things and, you know, maybe I could be the world expert because I have <laugh> all the failures, and now they're documented. I do probably have a d d there are maybe not the, I

Speaker 2:

Was just about to ask you about that. Mm-Hmm.

Speaker 3:

<Affirmative>. Yeah. but I no longer, I do not let people shame me about things that I started that are in a pause button. Mm-Hmm. <affirmative>, you know, because when we, like, the, the big lovely lesson or gift I hope this book gives people is that there is every benefit and very low price to, to trying something and setting it aside for another day for trying it and finding out, Hey, I don't really like that. I have a couple of big things I could have totally not what

Speaker 2:

I thought it would be, or would've

Speaker 3:

<Laugh>, or I scratch that itch and I'm good. And oh, what a, just a, it's just a glorious way to live. And that's how I wanna live the rest of my life. And I wanna do it with people who feel the same way and are not, and, and, you know, that feed off of me and I feed off of them. So after my first book, you, you may have experienced this too. People will come to you who have the same kind of dreams. Maybe they wanna start a practice, start a podcast, start a book, and they'll say, you know, I have, "I saw your book. I, I, you know, I think I could write a book like that." And so I would say, "Oh gosh, you should1"  You know, advice is personal. Everybody could write an advice book and about one in 10, and, and this bears out in other research, about one in 10 people will actually act on an idea that's even fully formulated.

Speaker 3:

And, and I would try to help them. And, and you could just see that they ditch the others that were not gonna act on it. They had taken it as far as they wanted to go, and there was not a whole lot you could do for them. So that's what I wanna change. They had, they had, you know, is that mindset that says I can't start it unless I have made room in my life mm-hmm. <Affirmative> to be an author. I can't start a book unless I've made room in my life to add a writing practice, find a publisher, whatever they think writing a book is. Yeah. And, you know, so

Speaker 2:

And it's funny, I, I had lunch with someone that was interested in the TEDx process and was asking me about it. And she's starting to write a book and, and, or she wants to. And she was asking me all about that. And this is a very I, I feel like I'm having the same conversation twice this morning or this afternoon, Uhhuh <affirmative> because she is kind of at that place of, well, I don't know how I'm gonna make room for it. I wanna do it. And I have had this idea for a long time, but, and I looked at her and I said, "you know, start this afternoon."  You know, make, did you

Speaker 3:

Good for you. I

Speaker 2:

Said, if you've got 10 minutes, just take 10 minutes.

Speaker 3:

Exactly.

Speaker 2:

Just start jotting down some ideas and you don't have to what's the word I'm looking for? You know, you, you don't have to corral the time or say, okay, I'm gonna have gonna do this in on it. It's like, if you just put some consistent energy into it, it, it's gonna grow. It's just a, it's just exactly watering the idea every now and then so that it, it has, it can sustain you with time away from it. But you also, when you get back to it, you go, oh, oh, I hadn't thought about that. And

Speaker 3:

Exactly.

Speaker 2:

It, it's, it's, it's kind of refreshing. It's, it's like having a, starting a conversation and realizing the more you have it, the more you really value it. Mm-Hmm. <affirmative>. Mm-Hmm. And that's adding something. So

Speaker 3:

It's like such sort the Nik effect which I wrote about a little.

Speaker 2:

Yes. I had never heard of that.

Speaker 3:

I mean, it's just that, it's just what you said. Once you make it real, once you tell your brain, we're gonna do this, or I have a problem if, if we accept it and don't say like, those nine out of 10 people said, I'm probably not gonna do this. If you're one of the ones that said, "Okay, I'm writing a book" -  whatever you declare as starting maybe that's writing your first two sentences, our brain tells us, our brain gets the message that they're on the job. Yeah. And subconsciously we are homing devices to pieces of information, to problem solving help, to meeting people. You know, you meet somebody and you think, oh, like, did they just say something about a book? Are they an author? You know, we are, we're, we wonder, we think there's new information coming out, we're just zeroed into it. Sure. And that we, you know, that happens all the time in our lives. And that effect it's also responsible for the thing that happens after we're done with something. Like we're done studying for tests. We take the test, it's over, and all that information just dumps out more <laugh>. Yes.

Speaker 2:

It just goes away.

Speaker 3:

Well consider the opposite of that true for something that we've started and we haven't finished. So if you, if you take that fall smallest first step, declare it started, the world gives us a bling bag full of gifts. And that's, that's really why I say that the more we start the better and the, even if we start things that are very short term and finish 'em, start a limerick, start a, a soup <laugh>, things that we, but declare that muscle in ourselves that says, you know, just like it was your instinct to say, start this afternoon. Very few people would say that, but it's that instinct that gets our ideas out and flowing. Mm-Hmm. <affirmative>,

Speaker 2:

I, I just, I, I really felt very supported. And I, I think if, if you're interested in this and you, you wanna get Becky's book, it is, it is, it is an, it's not, it's not a hard read at all. What is, what is compelling about it to me is that it does go against so much of what many of us are taught that mm-hmm. You know, you don't wanna start something and not finish it because, you know, that means that you're wasting time or you're wasting energy. Mm-Hmm. <Affirmative> shame yourself for that. And, and rather than saying, well, what did I learn when I started that I learned this. And so when I start the next thing, I may start it a little differently, or I may, I don't know. I mean, it just gives you information. One of the things that I, I have people say to me all the time when they're trying to make changes, they'll say, well, this isn't really a big deal, but I go, wait, wait, wait. Yes. It's, it's a big deal. <Laugh>.

Speaker 3:

Yeah. What you're just

Speaker 2:

About to say is a big deal. Yeah.

Speaker 3:

And, and you know, a clarification on the finish start more than you can finish. What, and you, because you brought up di divorces in that example of something that wasn't finished or could have been called failure mm-hmm. <Affirmative>, because what's the finish? What, what I'd like to say, it doesn't make a very pithy title, but start more than you can finish just exactly as you plan to everything has its finish. But great

Speaker 2:

Point. What

Speaker 3:

We don't start because we don't think we can finish as planned. If somebody said, "You're gonna have eight years with a person who you love for six of them, and you learn all these things for each other from each other" you know, maybe you can make that decision to not start because you didn't like that finish. But that's not how things work. And relationships are very creative undertaking. So in many ways, a relationship is a very good example. Yeah. a courageous creative start. So anyway, it's not, it's not don't finish. Finishing is always the end game. We wouldn't, you know, you don't start something you don't want to finish, but it, it's just a, it's just trying to trick that. Because I think when our parents said, "Don't start more than you can finish, don't bite off more than you could chew," they did not make us finish more. They only made us start less.

Speaker 2:

Right.

Speaker 3:

They just didn't wanna mess left out <laugh>.

Speaker 2:

Right, right. Wow. I wonder how you think this affects the newer, the younger generations. This don't start because they, you know, one of the things that I read a lot about, and then I have a 28 year old, so I'm somewhat in touch with what's hopefully in touch with what's in his world, is that they have not, there's been so much comparison with what other people have started around the world where I knew maybe somebody in Little Rock, you know, in Arkansas, and I was in Pine Bluff and oh, well, you know, I, I didn't know what somebody was doing in Bangkok or, or Toronto or California. I knew my little group of friends and that was it. And, and yet, so maybe some of this don't start anxiety is also about, well, what am I spo, you know, how do I compare what I'm starting to, what somebody else is starting or mm-hmm. <Affirmative>, whatever

Speaker 3:

The biggest learning I had about that and this generation, and remember this was, this book was pretty much done when Covid hit. And the data then on business starts, particularly by young people, was on a 25 year decline. Really. And the research showed that that really came from how we're raising our kids. We no longer say, "Yes, Joey, you can have a lemonade stand. I don't have time to help you, but go for it". No, now we are, we are over parenting. We are trying to get kids in the, in the right schools. So my kids didn't do a lemonade stand after they were four because they were on club soccer teams because, or the debate team, because maybe they could get a scholarship. It was we have very structured instead of free range childhoods. Right. So how do you, you know, it just, it's a subliminal message that there's not time for your ideas. 'cause You have to follow society's schedule. Mm-Hmm.

Speaker 2:

<Affirmative> mm-hmm. <Affirmative>.

Speaker 3:

That's my hunch. And I think it's tragic. So, but then now there have to, and, and then Covid necessitated this boom in business starts because a business start is also, you know, your son starting a freelance business because he has to in Covid. Now, you know, it, it remains to be seen whether those starts will be sustained or whether they were just out of necessity. But that is a good, that is a reason for this rally cry, is that our kids are gonna need to start whole careers for themselves. Mm-Hmm. <Affirmative>, I mean, we know things aren't going back the way they were. So that statistic, energy and confidence needs to be nurtured. And they've, they've gotta reduce their risks of trying something, not liking it and then trying something else. It's

Speaker 2:

Pulling on your face. I mean, you know, it's just, oh, well this didn't work out quite as way, I thought. Yeah,

Speaker 2:

Yeah, exactly. And then again, start something else. <Laugh>, so mm-hmm. <Affirmative>. Yeah. Well, I I love your book again. It's called Start More Than You Can Finish. I created Permission Slip to unleash your Best Ideas. The art is absolutely delightful in it. Oh, I'm so glad. I'm as to the enjoyment and pleasure of the book. You know, I told you that I couldn't, I I didn't want to interview you ne last week because I had not had a chance to actually read all of it. And I was so glad that I took the time. I'm too, I just had this real excitement about it. And I, and I hope self work listeners will check it out and and see what it holds for you. And Becky, I couldn't thank you more for being on self work. Thank you so very much.

Speaker 3:

It was so fun to reconnect. Thank you, Dr. Margaret.

Speaker 2:

You betcha.

Speaker 2:

I know you enjoyed that interview. Isn't Becky absolutely fantastic?. I wanna remind you that we now have episode transcripts at the end of every episode of Self Work. I don't know why I haven't done that in the past. It's really been far easier to do do it than I imagined. And so I apologize in many ways to those of you who may struggle with hearing like I do because I have tinnitus. And if I can find a way to add in other episode transcripts, I will. But at least for now, each episode of Self-Work has its own episode transcript. I also wanna remind those of you who maybe haven't subscribed to my website@drmargaretrutherford.com, you can get a free ebook called The Seven Commandments of Good Therapy. But most importantly, you get one weekly newsletter from me, just one, and it offers to you both my weekly blog posts, which some of you may be interested in reading.

Speaker 2:

I write one still every week, or sometimes we revamp an old one to bring it up to speed and make it applicable to today. And then of course, this podcast and any other news or information that I think you might be interested in, love to have you join, you can subscribe at the website. So now the subscription or the subscribe now is basically embedded when you scroll through the website. It's much easier than it was and I hope far less irritating. But I'd love to have you as a member of my newsletter, thank you to those of you who've listened to my TEDx talk as I record this. We are right at 63,000 views and wow, that's incredible. So keep 'em coming if you can. If you haven't watched I'd so appreciate you going to YouTube, Dr. Margaret Rutherford and TEDx, and you'll get the talk. Or you can go to my Instagram page and you'll see it in the links. That's instagram.com/dr. Margaret Rutherford. Thanks so much for being here. Again, my immense gratitude to you, and I hope this in every episode is helpful to you. Please take care of yourself, your family, and your community. I'm Dr. Margaret, and this has been self work.

 

 

Jul 28, 2023

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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Vital Links: 

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!

Episode Transcript: 

(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):

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(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.

(11:18):

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.

 

Jul 21, 2023

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.

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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!

 

Episode Transcript

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.

  • Have a strong therapeutic alliance: feel that the two of you are working together well.

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.

  • Know how you’re moving toward positive change; be able to say how you’re getting better in a tangible way.

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.

  • Have a therapist that is attentive in session.

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.

  • Believe your therapist knows what they’re doing. And you know their basic treatment strategy.

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.

  • Expect reasonable business practices.

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.

  1. You should sign a well-written statement concerning your consent to treatment and a confidentiality agreement. That agreement should include information on what the therapist charges and what occurs if you miss an appointment without calling within an appropriate amount of time.
  2. HIPAA documents should be made available to you. Or a form that states you have seen the document. Online therapy has its own HIPAA requiremends and you can ask questions about how confidentiality is being kept when and if online therapy is occurring.
  3. You should know about how insurance or payment is being handled. Many therapists do not file insurance at all. Some do. You should know whether or not your insurance is through "managed care" or not. That means whether or not your therapist is free to make all clinical judgements or whether your treatment might be modified by your insurance company. This information is available through your insurance company.
  4. There is huge variety about the way therapists deal with financial matters. Some will reduce their fee. Some will not. You can ask questions about these topics as you are contacting mental health professionals as a potential therapist or certainly in an initial session. Also, bills should come regularly and as stated initially and costs should not change unless you’re notified well ahead of time.
  5. Confidentiality in the case of treatment of children, adolescents and in marital work should be outlined. The boundaries of that confidentiality should be understood by all.
  6. Your therapist should be very clear with you about whether or not they provide emergency or after hours coverage. You need to know that going into the relationship. You and your provider need to have a plan on what you should do in case of emergency.
  7. There are several different mental health degrees that allow people to practice as "therapists." The training is very different between them. Psychiatrists are medical doctors. They prescribe and sometimes offer therapy.  The rest are psychologists, social workers, licensed professional counselors, marriage and family therapists. Perhaps even other designations. When choosing to educate yourself about the training in the different professions so that you can choose well for your particular condition. Feel free to ask how much experience he or she has in working with patients with your particular issue. Ask what specific techniques they will use to help you get better!
  8. The profession of life coaching has greatly increased. But it should be made clear that a life coach is not a licensed mental health professional. It’s my understanding that there are certifications you can obtain by going through courses offered by life coaching platforms. But please realize the two professions are very different. That doesn’t mean better or less than. It means different. I’ve referred a few patients to qualified life coaches I know and it can be very helpful – as they help the patient deal more with pragmatic things.
  9. If you do not feel you are improving, look elsewhere! Ask a medical doctor for other referrals. Frequently, family physicians, pastors or gynecologists have a referral list of mental health professionals. Remember, the "fit" is extremely important!

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.

 

Jul 14, 2023

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.

Advertiser's Link:

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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!

Episode Transcript

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.

 

Jul 7, 2023

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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Other Vital Links:

"Happiness" article by Laurie Santos

Catherine Price's TED talk

Catherine Price's book  How To Break Up With Your Phone

Episode Transcript! 

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!

 

 

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