The Perfect Life is a Perfect Lie
She had a successful career in a demanding profession. She had a great relationship and children she adored. On the surface, her life was an enviable portrait of modern success. But when psychologist Dr. Margaret Robinson Rutherford got the call from her client Natalie’s husband, the portrait shattered.
“I'm really worried about Natalie,” he said. “Something is terribly wrong.”
Guided by a gut feeling that eclipsed professional protocol, Rutherford drove to Natalie’s home. The house was eerily quiet, the living room perfectly arranged. Dishes were drying neatly in the sink. It was a scene of domestic order, not crisis. Rutherford calling her name, she walked down the hall and into the master bedroom. There, she found Natalie, surrounded by empty bottles of vodka and benzodiazepines, trying to die by suicide.
The shock was profound. “I never would have thought that she was suicidal,” Rutherford recalls. “She never talked about it. She never admitted it. She didn't reveal anything close to that.”
Natalie’s diagnosis had been anxiety. She was overworked and overwhelmed, traits common among high achievers. But there was something deeper, something hidden behind the facade of competence and control. This incident opened Rutherford’s eyes to a pattern she would see again and again in her 25-year practice: a dangerous link between the relentless pursuit of perfection and a profound, secret despair.
This is not classic depression. This is something far more insidious, because its victims do not look like they are suffering. They look like they are winning.
The Syndrome of Hidden Depression
Years after her experience with Natalie, Dr. Rutherford coined a term for this phenomenon: Perfectly Hidden Depression (PhD). She wrote a blog post about it an article which, to her surprise, went viral on publications like The Huffington Post. Her inbox flooded with hundreds of emails.
“This is me,” they wrote. “It's like you're in my head. How do you know this happens? No one's ever talked about this.”
What all these people shared was an external life that looked highly accomplished, coupled with an internal life of misery. They were surgeons, motivational speakers, and advertising executives. They were stay-at-home parents who ran their households with military precision. They were the people everyone else looked up to, yet they secretly felt like impostors, one mistake away from total collapse. Many had contemplated or attempted suicide.
Their motivation for speaking to Rutherford was unanimous: “I don't want anyone else to live the life that I've lived.”
Perfectly Hidden Depression is a syndrome, a constellation of traits and behaviors that mask profound emotional pain. Unlike classic depression, which can manifest as lethargy, sadness, and social withdrawal, PhD is masked by hyper-functionality. These are not the people who can’t get out of bed. These are the people who run marathons, lead board meetings, and organize the school bake sale, all while smiling and appearing completely in control.
The people Rutherford studied would never identify as depressed. They would say, “I'm not depressed. I've got too many blessings. I would be ashamed of myself to say I was depressed.” They believe genuine struggle is for people with “real” problems. Their own pain is dismissed, minimized, and pushed away.
The Hallmarks of a Hidden Struggle
In her book, Perfectly Hidden Depression, Rutherford outlines ten core characteristics of the syndrome. These traits, while seemingly positive on the surface, combine to create a prison of high achievement and emotional isolation.
The first and most central trait is a highly perfectionistic mindset, but not the kind that fuels creative greatness. This is a crucial distinction. As a creative, you might be driven to refine your work and pursue excellence, a process Rutherford calls healthy striving. It’s oriented toward learning and growth. Mistakes are data, not indictments of your character.
The perfectionism of PhD is different. It is fueled by shame and fear. It is a relentless, internal critic that whispers, “You’re not really good enough… Why are you on Chris’s show? You don’t have much to say.” This voice isn't a motivator. It's a controller. It operates from the belief that without constant, crushing pressure, you would become a failure.
As Rutherford explains, someone with this mindset fears that if they took the pressure off, they’d “turn into a slug.”
This toxic perfectionism is about the avoidance of shame and fear. The goal is not to create something beautiful; the goal is to avoid being judged as unworthy. For creatives, this leads directly to paralysis. The fear of confirming a parent’s doubt or a peer’s criticism becomes so overwhelming that you do nothing at all. You are frozen by the mirage of the “perfect project,” an impossible standard that guarantees you will never start.
This is tied directly to another core trait: a heightened or excessive sense of responsibility. People with PhD are the first to raise their hand. “I’ll do that. I’ll take it over.” This isn’t just about being helpful. It’s a strategy.
First, it’s a form of control. “If I do it, I know it’ll be done well,” is the underlying logic. It’s also a distraction. By focusing their energy on external tasks and other people’s needs, they avoid having to confront their own. They become defined by their roles: the committee chair, the go-to problem solver, the parent who never misses a detail. They don't know who they are if they aren’t doing something.
More importantly, this constant doing is a way to prove their worth. For many, this pattern began in childhood, where they learned that their value was tied to what they could accomplish, especially in chaotic or neglectful homes. Taking on responsibility was not a choice; it was a survival strategy.
The Analytical Mind as an Emotional Fortress
Perhaps the most defining characteristic of Perfectly Hidden Depression is the active, and often unconscious, detachment from painful emotions. These individuals live in their heads. They are highly analytical, logical, and adept at intellectualizing their experiences. They talk about trauma with the same dispassionate tone they would use to describe their workday.
Rutherford identifies this as a key diagnostic clue for therapists. “There is a mismatch between what someone is talking about and the way they are talking about it.”
She describes a young woman, a former beauty pageant contestant with eating disorders, who casually revealed a horrific trauma. “This really probably isn't a very big deal, but I was raped the week before I went to college,” the woman said, smiling. Rutherford stopped her. “You realize you’re smiling,” she pointed out. “You didn't even… there was no pain, there was no vulnerability, there was no connect with the horror.”
This isn't just burying an emotion. It is a sophisticated defense mechanism known as compartmentalization. We all do it to function. If you have a critical work presentation, you compartmentalize your grief over a personal loss to get through the day. It’s a healthy and necessary ego skill.
The problem arises when this becomes the default, unconscious strategy for all difficult emotions. For those with PhD, the emotional closet is packed with unprocessed pain. They aren't consciously deciding to put feelings away; it happens automatically. One woman told Rutherford, “If my feelings are too big for the box I've created, I'll build a bigger box.” This detachment is explored further in the context of personal narratives in How Words Shape Your Reality.
This strategy is almost always learned in a family environment where expressing vulnerability was ignored, mocked, or punished. Whether through active abuse or simple neglect, the child learns that emotions are dangerous and accomplishments are currency. The only safe path is to push feelings away and perform. Success becomes the armor.
Other key traits include:
- Worry and the need to control. This creates a vicious cycle. Worry prompts a need to take control, which leads to exhaustion, which creates more worry about appearing exhausted, which prompts an even greater need to appear in control.
- An intense focus on tasks. As Do notes, this means avoiding dealing with one’s own feelings and needs by filling all available time.
- A strong belief in counting one's blessings. This is used as a tool to invalidate their own pain, telling themselves they have no right to feel bad when others have it worse.
- Difficulty with receiving and giving affection. True intimacy requires vulnerability, which is the very thing they are programmed to avoid.
These traits are not exclusive to one gender. While women may be more likely to seek therapy, Rutherford’s research and clinical practice show that men identify with these characteristics in equal measure. The writer Terrence Real, in his book I Don't Want to Talk About It, identified a similar pattern in men he called “covert depression.” His central thesis is powerful: “If you don't feel it, you live it.” You will act out the very emotions you refuse to acknowledge.
This is the story of Don Draper in Mad Men. The brilliant, successful advertising executive who has everything but self-destructs at every turn. His shame over his true identity, born in a brothel, fuels a life of secrets and affairs. He can't accept his success because, deep down, a critical voice tells him he doesn’t deserve it. He must maintain the perfect facade, but the secret itself becomes another source of shame. It’s a trap with no exit.
Breaking the Cycle: The Imperfect Path to Healing
How do you break free from a prison you built to protect yourself? The answer is not simply to “do sloppy work” or abandon all standards. It’s about fundamentally changing your motivation. This requires a difficult but liberating shift in mindset.
The first step is recognizing the difference between healthy striving and toxic perfectionism.
- Healthy Striving for Excellence is process-oriented. It's about learning, growing, and accepting mistakes as part of the journey. The motivation is internal: a desire to do well.
- Toxic Perfectionism is outcome-oriented and driven by external validation. It's about avoiding shame, judgment, and the fear of being seen as a failure. The motivation is fear.
For creatives, this means detaching your self-worth from the outcome of a project. Rutherford herself faced this while writing her book. Paralyzed by the thought that it would be imperfect, she stared at a blinking cursor for days. She had to give herself permission for the book to be flawed. In the text, she wrote a paragraph admitting, “I know this will be an imperfect guide to trying to guide you to be okay with imperfection.”
It was a turning point. She had to model the very vulnerability she was asking of her readers.
The solution is to give yourself permission to be human. Accept that your output on any given day represents the best you can do at that moment. Tomorrow, you might be better. Or you might not. As Rutherford says, “Maybe I won't be better tomorrow… I will be who I am tomorrow.” Building a mindset that can withstand this uncertainty is key, a theme explored in Master Pricing, Attract Clients & Creative Blocks.
This acceptance doesn't come from intellectual insight alone. “Where I really think that people start getting hope is when their behavior starts to change,” Rutherford stresses. The black-and-white thinking that a project is either “totally perfect or it's just a slob job” must be confronted. The truth lies in the vast middle ground, where work can be good but flawed, strong in some areas and weak in others.
When working with a man tormented by the mistakes he’d made, including three affairs, Rutherford asked him what he would say to a picture of himself as a six-year-old boy. He replied, “Don't grow up, because you will feel terrible about yourself because of the many mistakes you'll make.”
It was a devastatingly poignant moment, revealing the depth of a shame that had been compounding for decades. The work was not to erase the mistakes, but to cultivate forgiveness for the boy who would one day make them.
Empathy Is a Practice, Not a Demand
This internal work has external implications, especially in the workplace. Many creatives find themselves in environments that do not value or understand emotional vulnerability. They wonder how to foster more empathy in their teams and management.
The instinct is to try to change others, but this is a futile expenditure of energy. “People don't change unless they really are looking to change,” Rutherford states. Forcing empathy on a team that isn’t ready for it will only lead to frustration.
The better strategy is to model the behavior you wish to see. Start by having empathy for them. Try to understand what they are going through and why they might be resistant or closed off. As Do says, “Probably the best way to do is start with your own empathy.”
It also requires a degree of radical self-acceptance and courage. Rutherford made a conscious decision when she went on social media to be open about her own struggles: a panic disorder, a history of eating disorders, and a chaotic decade that included two divorces. She risked ridicule, but the opposite happened. People responded not with judgment, but with gratitude.
“I'm so glad that someone like you is saying these are things I struggle with all the time,” they told her. By modeling vulnerability, she gave others permission to acknowledge their own. For those building a career, understanding how this openness builds trust is vital, a concept central to building a personal brand.
A truly strong leader is not one who is always right, but one who can admit they don’t have all the answers. A manager who can say, “Gosh, you know, I’m just having a bad week,” creates a space where their team can be human, too. If that space doesn’t exist in your current workplace, the most powerful move may be to focus on your own well-being and seek an environment that aligns with your values.
The path out of Perfectly Hidden Depression is not a straight line. It is a messy, imperfect process of dismantling a lifetime of defenses. It involves looking at the childhood roots of your shame and making a conscious choice to write a different story.
It starts by allowing yourself to feel. It continues by sharing that feeling with one trusted person. It solidifies when you realize your accomplishments are what you do, not who you are.
The tragic end for some, like the woman whose husband found Rutherford’s book on her nightstand after her suicide, is a stark reminder of the stakes. The facade of perfection can become so complete that death seems like the only escape from the empty, lonely life it creates.
But there is another way. It ends with the powerful reframe that Rutherford offers as a mantra for recovery.
“Your vulnerabilities do not define you any more than your strengths do.”
TRANSCRIPT
happy Friday everybody congratulations you survived another week on life on lockdown today we have a very special guest and I'm gonna get right into it we're talking to somebody who's gonna tell us all about perfectly hidden depression or getting behind a mask of perfectionism I want to give you guys a little bit
of a warning here because this is a very serious subject we're talking about depression so if you're struggling with suicidal thoughts seek the media professional treatment ASAP and if you're younger I know there's some young people watching the show - please let an adult know that you're in big emotional trouble the purpose
of today's show help others become more comfortable with vulnerability in everyday life and to break free from the perfectionism that mask your depression I know so many creative people suffer from this so let's see if you are actually secretly hiding in depression here so today's yes is a psychologist she's been in private
practice for over 25 years she also has a podcast called self work and a YouTube channel please check her out she's the author of the book perfectly hidden depression she's written for numerous publications including Huffington Post Psychology Today the mighty psych central the Gottman blog psychologies stigma fighters the good men project this
is my brave and many others this is Margaret Rutherford and you guys can check her out at dr. Margaret Rutherford calm she's allowed me to call her Margaret Margaret welcome to the show sure of course hi Chris thank you okay I want to give a quick shout out to mo Ismail who made
this happen she's the one who connected us and you were so gracious to send me your books I'm holding the book here we'll give people information on how to get your book later okay it is same title perfectly hidden depression and I just want to get right into it the thing that you
had said in the book was that you see yourself as a conduit between those who've been hurt and found healing and those that are still lost and hurting tell me a little bit about how or why you describe yourself that way or your role well happy doing therapy for a long time now
and you know when I first started out Kris I thought okay I have the answers and as I was in graduate school and I knew what I needed to know and well sure I wasn't in practice for long before I figured yeah that simply was not true that I had was what was
in front of me as a psychologist was a lot of other kinds of cases other kinds of struggles other kinds of experiences that obviously in graduate school I had absolutely no experience with so what I feel like after all this time is that what what really therapists have to offer you we have
we offer a holding environment we offer a space where people can risk being vulnerable can risk stretching themselves can risk being able to look at things maybe they've been very afraid to look at but the idea of me being a conduit is this let's say someone comes in whose child has died and
so we worked through that and I tried to help them to the best of my ability and I watched their progress and watch what is beneficial to them and what is it and what they learn in the process maybe two years later someone else comes in whose child has died and so I
take not obviously it's anonymous but I learn from that experience and it's almost like what I learned there and what the patient learned I can offer to the next patient and say you know your your case may not be exactly like this and I don't necessarily say I'm quoting from so-and-so two years
ago it's just your face of experience the longer you practice it grows because you're simply learning guiding watching observing being a part of healing and that way you can pass on the wisdom that other people have learned the very hard way and you can help the next person perhaps have a little bit
of an easier time perhaps not but at least they know they're not alone when I say well you're certainly I've heard this before and let me share some of the details of it with you and so I think people feel often that what they are experiencing that no one else has a lot
of people go talk to them about it a lot of people shy away from actually people's lives getting control and so knowing that there was somebody else who was seated right in this office and talking with me that learned through the experience that obviously a death of a child is a horrible tragedy
but even through that experience there are things that I can offer because of working with that other person and it's almost as if it's a bridge it's a conduit that I can be that I'm very aware of all the time hmm I really connected to how you described that because in a business
term and I don't get to business because this is really like my work that we want to get into but if you look at it it kind of takes you away from the spotlight that you have seen people who have has have found ways to solve their problems and people who have just
discovered they have a problem and you're able to connect those stories and people together I have to ask you on a personal question as yours with a lot of people who are dealing with tremendous grief that are hurt that are in pain how do you process that and it's got to take an
impact on you I must guess here it does let me let me go back for just a second it doesn't mean that therapists don't have certain techniques and certain understandings of whether it's a diagnostic category like bipolar illness or depression or anxiety certainly we have techniques that are helpful but what you still
learn at the gut level you understand what it's like to be someone with panic you understand what it's like to be someone who's been sexually abused you understand because you've worked in a very deep way with this other person and that's what you can you build on and can offer anybody else personally
you know I'm a therapist because I got really good therapy I was the therapy was not my first profession psychology I was a professional singer in my mom and I I got a lot of therapy because I needed it and my life was pretty chaotic for about a decade and I got some
really wonderful I got some bad there appeals well but good therapy I got really helped me figure things out and begin to extricate myself from situations where I was I was actually pretty destructive so what I the way I handle that now I'll tell you a story I'm a storyteller my last year
in graduate school I went to my supervisor and I said I'm really bothered by something and she said what is it and I said all my colleagues have decided that they're going to be a certain kind of therapist they're gonna be a cognitive behavioral therapist or they're gonna be a Kohut Ian's therapist
or they're gonna be a family systems therapists I said I studied all those theories along with them and a lot of them make sense but I kind of looked for people's strengths when they come in and try to remind them of their strengths then we work on their vulnerabilities and she just started
laughing she said that's a pretty good approach so just because people are in front of me who are demoralized me obviously obviously people don't come into therapy that they're not struggling in some way because they're demoralized doesn't mean that I see that they have no strengths often they really do and so we
work together to help them sometimes accept their vulnerabilities that they even exist as in perfectly hidden depression but also so that they know that they they need to remember what kind of strengths they have and you know when is when is a time in their life when they have overcome something that they
can now link to this and say oh you know I did get through X and that's gonna help me through Y so you want to help people take their time and take the time that it needs to begin to really address what's going on whether there are roots in their childhood or rather
they're they're things that are going in their current relationships they're problematic or whatever reason you want to the way I take care of myself is yes of course sometimes I go home and I'm concerned about somebody who may be on the brink of something really pretty despairing and I'll reach out to them
and say how are you doing you know in two or three days and so it but I really believe that people are wanting to heal and people are wanting to grow and so the actually coming into therapy is a very courageous thing in and of itself so because you are risking your letting
in this perfect stranger into who you are and saying let's talk about this openly and let me help let me help you find your strengths and then yes I get my husband will tell you sometimes when I walk in the door he knows it's just not a good time to talk to me
for 15 or 20 minutes I need to dress and so I'll just go give me a minute and I'll go in the same sunroom or something and just kind of sit and think about all right you know what stretch does that person have do I need to reach out to not to them
in the morning or you know or do I just need to give them the message that they can do this and that I'm there for them if they can't mm-hmm I feel this way because I was talking to my therapist about this years ago it's that your job is to listen to people's
problems and if you listen to enough problems they can weigh heavy on your soul I have to imagine like I was saying my wife will and I will watch a documentary and it's hopefully presented truthfully and then we see the tragic stories of people and it breaks our heart like what's going on
in America right now all across America and the world yes and you find out about these stories and then just sometimes it can make you feel quite hopeless that we think that human beings are better and I'm a humanist and I want to believe in the good in the world but some of
the information you get out there is just bad and you're dealing with it on a very intimate personal level right I just like if it were me I'd just be in another room and I'm not a crier I would just be crying it's like I don't know how to deal with this is
so so heavy well I think what you have to remember is that if I'm gonna help someone deal with it then I I can have an emotional reaction I have certainly teared up during sessions and I have heard some awful stories about what human beings do to one another so those stay with
me there's some stories that I never tell anyone else because I don't want anyone else to have them stick in their memories like they're stuck in mind so but I also I have my job is to be there for them and I think that trumps that supersedes my need to express it in
that moment and so I may go home and I may maybe it may not occur to me until over the weekend that there's something that's that's nagging at me that I need to work through and so I'll go I want to walk and maybe I'll cry maybe I'll scream maybe I'll be really
angry but I my good job is to be there for my patient and if I lose it then that's not going to help them at all right right okay this I want to talk a little bit because you said that you love to tell stories and I think it's a great wait wait
to begin here is in the beginning of the book you talk about Natalie and how that led you to this idea of perfectly hidden depression PhD and and the reason why I'm holding this book in my hand could you tell us Natalie's story Natalie was someone that I saw many years ago in
fact by the way I asked Natalie if I could include her story in the book and she very graciously said I could I had not been practicing all that long and but Natalie had come in and she had some issues from her childhood which we discussed but overall she was a very successful
sort of a you know of one of the professions that you think okay you know you have to be really smart and really good at what you do do to succeed in that profession I won't say which one it is because I live in a small town but and she mostly came in
because she just said she was anxious a lot she tended to worry a lot and she wanted to work on that worry and how to contain that worry there's a whole technique about the work of worrying and how you can begin to encapsulate and honor it but also sort of fence it in
somewhat and that's what we were kind of working on we did do some family of origin work because she told me some things about her mom that were that were troublesome and so but all in all she said her relationship was great she loved her kids nothing was wrong with that then one
afternoon I got a call from her husband saying in fact we had beepers back then and my beeper went off and he said I'm really worried about Natalie there's something amiss something is terribly wrong and I said well because has she been talking about anything in therapy that is unusual I said no
he said she just told me to pick up the kids and take him to her mom's and and I'm concerned about her well I've never done this again and I not I had not done this before then butthis there was something in my gut that said this doesn't sound right and so he
said would you go check on her again very unusual right but I knew where she lived or he told me where she lived under the neighborhood and he gave me the garage coat just in case she wasn't outside she wasn't and I went in and I remember feeling like a bug burglar the
house was extremely quiet sort of eerily quiet and I looked around and her living room was perfectly set up little throws were over the pillows and or over the sofa and there were dishes drying in the sink and everything was quiet and I thought well what's going on of course I didn't know
her home but I began going down this hall that I sort of assumed was the master bedroom and I kept calling her name because I didn't want to frighten her and I walked in and she was trying to die by suicide she had almost an empty bottle of vodka by her side and
bottle of benzodiazepines that were also empty so i called 9-1-1 her saying no don't call no don't call you don't need to call and they came and got her and I remember this sense of just shock as she left because I thought I never would have thought that she was suicidal she never
talked about it she never admitted it she didn't reveal anything close to that and I just sat there for a second and then thought I've got to go home to one of those moments that I definitely had to go do some work on me um and obviously we talked after that and she
told me that you know she went for treatment for alcohol abuse unbeknownst to me she was also drinking heavily and when she came back we did some really great work but what it opened my eyes to was that her life looked perfect on the outside and I diagnosed her with anxiety she was
overworked she was tired she was overwhelmed and suddenly I began realizing wait a minute this is this is something different now I would love to tell you that at that moment I said oh I'm gonna write a book about this and I didn't not for years but I began watching for that in
my practice I was so much more aware that maybe I needed to ask some different questions and so when I started writing my when I went on social media back in 2012 now so this is a good 15 years after that I said I started thinking about the nataly's that I treated and
what it took to get them to open up and I entitled I just picked a term out of the air and called it perfectly hidden depression and I entitled the blog post the perfectly hidden depressed person are you done at that point I was really doing great if I got 50 shares I
mean I was like jumping up and down this went viral this went viral and when it was on The Huffington Post about two weeks later I forgot that I had left my email on the bottom of the post and Chris I got hundreds of emails this is me it's like you're in my
head how do you know this happens no one's ever talked about this so I was so struck by that that I thought okay I'm gonna go investigate this and find out what's in the popular literature about this perfect looking life and how it might be linked to depression and suicidality I found Rene
Brown which of course she her writing is incredible her research is incredible I found another book by Terrence real called I want to talk about it where it was it was written for men about what he termed covert depression but I didn't find anything about women I found work books on how to
not be so perfectionistic but no one was asking the question why not even run aground that I could find so I thought well maybe I should ask that question and in in many ways Cris this book found me I never wanted to write a book I was perfectly happy as a therapist but
I just decided this is too important to miss and I began researching and I really was formulating my ideas at the same time so I write a blog post and try to formulate it my for a better word in my own mind what exactly I was talking about so I came up with
this syndrome was what I call it off perfectly hidden depression okay I want to talk about that but first I do also want to compliment you as a therapist your lighting and your seat your background design is mmm it's very very nice we have professional people in the creative field you get people
take note this is you sound great I know I've done plenty of podcast interviews and I sometimes their background is just like weird and in fact I had somebody say well don't you want to turn your chair around so your so and I say no I want them to look outside and so
I got a light and I figured it all out so anyway thank you very much so that's very nice I've done a lot of theater so maybe you'll sing for us later today I tried that I went to a Zumba thing for yesterday and I say and I thought oh god I can
tell us in 15 years okay let's get back to the thing here that's sure the thing I hope everybody's tuning in for is that maybe you are suffering from perfectly hidden depression and so you you've written ten characteristics excuse me ten characteristics in the book and the first one is you know this
is how you can tell highly profession is stick ok there's pretty much everybody tuning in and have a constant critical and shaming inner voice that's the tricky part yeah can you expand on this sure let's make us let's make a distinction that's a very important distinction between striving for excellence being perfectionistic where
you see it as a process you see it as a learning experience I mean I'm her fection istic but I I don't I don't have to necessarily always be successful I can accept a mistake I can accept that well I just didn't study hard enough or I didn't do my research hard enough
and so it's a learning process where you are more you're more oriented toward the striving the process again to use that word again rather than the goal or the achievement the kind of perfectionism that is excellent in perfectly hidden depression is fueled by shame and fear and it's like you got constantly got
this voice in your head saying well you know you're not really good enough well why do you why are you on Chris's show you don't have much to say or you know blah blah blah blah blah it's constantly and so and in fact it's probably been around for years and it is controlling
your behavior to where you don't believe that if you don't keep the thumb in your back constantly that you don't have the innate character trait of wanting to do well you have to keep the pressure on and in fact I had a therapist ask me many years ago what if you took the
thumb out of your back and my response was I turn into a slug so you know my fear was that I would do anything I just sit around and sort of be and that's not you know the case at all so there's this huge distinction between striving for excellence which is process oriented
and then the kind of perfectionism that's very characteristic of perfectly hidden depression which is all about the avoidance of shame and fear so it has a lot to do them with your motivation for perfection is that the idea what's driving it yes we're striving now I'm I've talked about this too to my
audience I would love to get your take on this yes there's this illusion this Mirage that exists and you're the desert of life and you think that the Oasis is there and that Oasis looks like the perfect project the perfect social media opposed the perfect blog post that you put up and it's
crippling for a lot of creative people because we're it fearful we're fearful of people judging us by our peers confirming what our parents have said to us one one or both parents that you shouldn't be doing this you should have gone the route of being a doctor or an accountant a lawyer or
something respectable and selling something creative something respectable maybe that's what you should have done and so it causes people to freeze up in inaction and they don't do anything right so can you expand on that maybe give us your you know I heard a long time ago that another definition of procrastination was
imperfect perfectionism and so I think that it is a you can just be paralyzed by that because you you don't you're so afraid of allowing any vulnerability to show that you just simply don't do anything now that's you know none of us particularly want to do anything that we don't do well if
you handed me a pair of skates and said I want you to put on these pair of skates and skate around the room I'd say you know mmm don't really want to do that because I have a terrible balance so you know that's not something I would just jump up and down to
do but we've got as much farther than that and in fact even in the writing of the book I still have enough perfectionism left and enough shame left to we're right in the middle of the writing of the book I thought I can't do this because I realized that it would be imperfect
and that as soon as I turned it into the publisher I would think of something I hadn't said or I'd read a sentence and go oh my god why did I say that or I would learn something I didn't know or or whatever and I it it must paralyzing I just sat for
days staring at the screen blinking at me and finally I sort of looked at myself in the mirror and said what are you doing I mean you are trying to model for people that it's okay to be vulnerable and that you in fact what I've decided since then is what sort of one
of my mantras at this point is that your vulnerabilities do not define you any more than your strengths do and that's a huge leap from perfectly in depression but that is one of the goals of people who experience it that they want to learn and so I wrote a couple of paragraphs in
the book saying I know this this will be an imperfect guide to trying to guide you to be okay with imperfection and it was a huge breaking point for me and I just said okay there you go it's will be imperfect and that's okay right so it sounds to me like you gave
yourself permission and admitted it and revealed yourself in a vulnerable way to say this is the best I got for now and I even and I and maybe creatives just need to accept that and I think that's so liberating to say like you know what this represents what I can do at this
moment tomorrow I'll be better and the next day I'll be better than that but I'm not gonna let that be the thing that holds me back from expressing myself or maybe not maybe I won't be better tomorrow but maybe maybe I won't have learned anything I'll be I'll try to be better but
maybe I will maybe I want I will be Who I am tomorrow and I will I want to continue to grow and learn and hopefully some of that will seep in but it's not as me as all creators know it's not like you don't just get better and better and better and better
you have you know ups and downs and grow all kinds of things that go awry and then things that go very well so it's about knowing that you're you're okay with that journey and sometimes I'll never forget I sang for this guy really wanted me to sing for him and he had this
sweet gig and in Dallas and it would have paid a lot of bills and I auditioned and I sang the whole night and then I didn't hear from him for months and I called him back finally and I said you know what's going on I really you guys you sang flat all night
no way oh well that's kind of unusual he goes well you know you did so and I just kind of I just had to wrap around that and say okay that was an opportunity missed so that acceptance of sometimes you're going to be caught at your most vulnerable is is just part of
the creative process I think because it's there's so much risk of putting yourself out there great ok so here's another one here's number two here's one of the signs that you demonstrate a heightened or excessive sense of responsibility like every job is your job to do and do what's right that's right you've
got your hand in the air all the time you know I'll do that I'll take it over it is a way of distracting yourself in many ways it's also a way this ties in with the third trait which all these traits are really commingled with if if I do it I know it'll
be done well and so and especially for people who let's say their children are on soccer teams or something and so they'll say okay I'll crib I'll be the person who takes care of snacks and what they know about themselves they sense they have to do everything perfectly they know no child will
go without a snack in soccer season they just know that and they'll go to the nth degree to make that happen but it's also interesting to think about Chris is that these folks are also the folks that don't know what to do if they're not doing if they're not up and doing and
and so they've sort of lost when they don't have a role and and so they they assign themselves roles because it's easier to to handle life knowing yes I'm the chair of that committee or yes I'm in charge of this or yes I'm giving the dinner party and I'll cook everything because they
they really don't know how to do anything but take on that that responsibility and often of course they also grew up in homes where that was their big that was their responsibility these are kids who had an alcoholic parent and who had to take care of the kids or you know they were
they were they were natural responsibility takers so that was probably one of the strategies they devised it I'll just do it that's it's it's what makes me worthwhile right so in a way we're avoiding dealing with how we feel and what our needs are by all of our time and attention on sometimes
we're gonna find something else to do now I might be the weirdo here but I try not to do anything I just like I don't know you guys you guys have that you need to do that because I got to do my own stuff so this begs the question mm-hmm are men more
likely to exhibit these traits and women or is it just right down the middle or are women more likely to do this and then you know I've gotten that question in in other interviews and actually I didn't talk about that in the book and in the intro I say it has been my
observation through my own clinical practice that this does not necessarily it's not in the realm of women only or men only I've had just as many men come in that identify with this as women and but I think in general women certainly come to therapy more often than men do so you know
again how much do you trust those numbers you know it's always out there women are more depressed than men but women talk about their depression more than men or admit their depression more than men or you know how is that information skewed so I I would I would hold back from saying oh
yes this is a female problem in fact Terence realest book again I'll mention it I don't want to talk about it it's an excellent guide to man's depression that in fact I quoted one of the things he said in the book he said if you don't feel it you live it meaning if
you don't get some of those feelings out of the open and work through them then you're gonna live those feelings out without you even being conscious of them and so it may be that men are more likely to do that women are more supportive of one another in our vulnerabilities so as a
rule but again a lot of these women that have come to see me no not one of their friends knows you're in therapy not one of their friends knows they struggle not not they just don't reveal themselves so it is a very lonely experience I had I was so blessed to have as
I as I wrote these blog posts and try to figure out what I was talking about I would at the at the bottom of the blog post I would say if you think you experienced this would you reach out to me would you be willing to be anonymously interviewed and I had probably
about a three month period of time about seventy-five people contact me and say I would be willing to do this about Half Men and half women actually I filtered out some of them because they didn't really fit but I did interviews with them and for about an hour hour and a half each
sometimes two hours and really delved into their childhood in fact those are the stories that the stories in the book are are based on are people I actually talked to or I worked with myself personally we had brain a brain surgeon a motivational speaker and advertising exec I mean you name it all
these professions and sometimes stay-at-home parents so what I noticed was that to a tee when I asked them all why would you reach out I'm unknown to you in fact I'm not anybody time and you know but you're reaching out to help me try to explain this in what's your motivation and they
all said I don't want anyone else to live the life that I've lived we cannot tell you how many times I thought about dying by suicide or maybe I have attempted but I feel like nobody knows me nobody sees me I don't allow them to see me and I am miserable and I
fight I fight I fight just feeling like my life is although it looks highly accomplished that it's really hasn't it I don't feel the human experience I feel like as you said a few minutes ago I'm a doer I you know I'm just a doer I'm an accomplished ER that's what defines me
mm-hmm so I think there's an interesting align to draw here because there are people who have depression that you can tell right away they're the classic telltale signs okay maybe they're they're not very social they're they're kind of always inward and you can see that but the kind that you're talking about the
kind of we don't often recognize this masked by people who appear on the surface to be very successful to have accomplished lots of things to be all put together they could be like in your in your book you talk about the advertising executive all these busy successful people and what they're doing I
think is point three here which you've you've already dipped into which is they detach from these painful emotions by staying in their head and then shutting them off right yeah these are very analytical people in fact it's been interesting Chris because as as I've talked with people about the book I would say
at least two-thirds of them have revealed to me well no I haven't done the exercises and they're over sixty exercises in the book and I'll say why not well I wanted to get a mental picture of perfectly hidden depression first and I kind of look at them as kindly as I can say
so it scares you to do the feeling part and they said yeah it scares the heck out of me to do the feeling part so that is a real clue as a therapist if I had one thing to say to any therapist listening well how am I supposed to identify these people there
is a mismatch between what someone is talking about and the way they are talking about it there was a young woman who came in many years ago well five or six years ago she was a beauty pageant kind of person so she had eating disorders huh and she about the fourth session said
you know that first session when you asked me if I'd been sexually abused and I said yeah she said well like you know this really probably isn't a very big deal but I was raped the week before I went to college and no I never told anybody it was a long time ago
it just and it's so much worse happens to everybody else that you know and I stopped her and I said you realize you're smiling I mean she could have done the beauty pageant wage thing and and I said if I turn down the sound and could replay a video of what you just
said you would have looked like you were telling me what you did at work today I mean you you didn't even there was no pain there was no vulnerability there was no connect with the horror of waking up at three o'clock in the morning on the beach realizing your drink has been spotted
not spiced poisons but of drugs Mike yeah there you go and and that you know and you just get up and go home and start college the next week you know I I said what a terrible experience did she there was little tear that came to her eye and she goes well I've
never allowed myself to talk about it but it was interesting this very person had very superficial relationships with men and she found relationships boring and because she never really revealed anything about herself other than looked what looked really good and so it was really interesting working with her as she began to find
the courage to look at those things go ahead I was gonna say for some people have experienced trauma on that kind of level is it isn't it just a natural self defense mechanism to bury that pain because sometimes to look at that and to realize what has happened you've been violated it's it's
a violent thing that just happened to be able to look at that it's just too painful like our psyche is so fragile and we can't face it so we bury it we mask it we put a different label on it it's called compartmentalization and it's actually a healthy eco skill I mean if
your dog had died this morning and your beloved dog and you had this interview to do you would probably compartmentalize that and come to work and do the interview and then your grief is waiting for you so we all compartmentalize all the time it's an ego skill it's something we need to do
so we can function and the more trauma you have the more the more you have tried to compartmentalize the problem is with these folks is that they is almost become unconscious they don't think I need to not think about this today I'm gonna put this away it just automatically goes down and gets
stuffed in what's you know I guess their emotional closet and gets suppressed and never is gotten out again and looked at and connected with one woman told me if my feelings are too big for the box I've created all build a bigger box so you know the they are so frightened of their
vulnerability and of what's happened to them that they have just developed the strategy of pushing that away and again my theory is that they're they're all there could be cultural components to that there could be environmental components to that but there's also a big family component meaning that you were probably reared in
a family where that kind of vulnerability was ignored mocked ridiculed you you were a victim of abuse or trauma or you were you were just told that [ __ ] up stop stop crying or don't be angry maybe you grew up in a family where the only thing you really got attention was
for accomplishment are there all kinds of roads to Rome so to speak but that's the strategy of okay if it hurts I'll push it away and it becomes so automatic that it's unconscious I want to make a point really quickly the last thing I want people listening this to think is what I'm
saying is what are you talking about people in classic depression or just weenies that they walk around moping and despondent all the time you know I know a lot of people who who admit they're depressed to reveal they're depressed who are incredibly courageous and work very hard to manage their depression and there's
even a thing called high-functioning depression or smiling and depression which means someone knows they're depressed but they still put a smile on their face they still search for the right medications they still exercise they can't care of their kids they even though they know they fit the criteria for classic depression they are
still they're still putting on a happy face so to speak and those people will probably see themselves in practically hidden depression to a certain extent the people I'm really trying to reach are the people that would say I'm not depressed I've got too many blessings I would be ashamed of myself to say
I was depressed I can't you know that's the people have it so so much more so much more of a difficult life than I do and so it is that it's those people where this has become an automatic way of being that they just get lost in the persona they get lost in
what they are creating and then they're paying those unaddressed for years and years and years okay so for people who are just joining us late into this livestream I just want to let you guys know who we're talking to we're talking to dr. Margaret Rutherford and here's how you guys can get in
touch with her I'll leave this on the screen for a second I also want to read a question it's going a little bit off my plan where structure today but I'm okay with that a letting go control here this question comes in from Joanna and she says or she asks are there any
ways we can inspire creative team and the management to have more empathy besides modeling it by ourselves empathy for depression is that what you mean I don't know so let me read the question Laura John yes are there any ways we can inspire a creative team and the management to have more empathy
besides modeling it by ourselves so I think she's looking for allies to to teach everybody to and to have more empathy sure maybe she feels alone in this sure well what immediately comes to mind Joanna is that it it sounds like sometimes you may be down or you may feel very vulnerable about
something and you may still feel like you have to hide it because it would not be something that would be welcomed on the team for you to say gosh I don't really know which direction to go now or whatever it is whereas maybe having a supervisor that you say I don't know where
to go I'm not sure which direction go and he or she would say well okay you know sometimes we're all like that we don't know where to go or what to do and you know how can I help you I've felt that way myself I can have empathy for that where you find
a colleague in realizing that you know that we're we're not always on we're not clicking constantly you know it's just you can try to look like that but even people who who might experience or identify with perfectly hidden depression have self-doubts they have insecurities but they have to hide it and so you
know when I went on social media back in 2012 I had a big decision to make because sometimes I would talk to my patients for example about I have panic disorder in fact I have performance anxiety I've had it since my late 20s I have a history of a severe eating disorder and
I still I don't obviously and anymore but I I still deal with eating disordered thinking and I've been I've been married now for 30 years but in that decade of chaos I was talking about a little while ago I married twice and divorced twice so you know what's not going to talk about
that and if I did would I get ridiculed am I so sphere I'll get ridicule up what are you doing being a psychologist on social media is your own life's been a mess and you know and you're still dealing with panic and you still deal with it eating sort of thinking but actually
quite the opposite has happened in fact more I don't know about the people who make almost she's a nut I don't want to you know listen to her but there have been plenty of other people who said I'm so glad that someone like you is saying these are things I struggle with all
the time and and I give you know in my blog post in podcast I definitely talked about not not constantly about myself but I will add in things about my own life that I know are hopefully can model and so I don't know if you have a supervisor like that sometimes we don't
and sometimes they're just not open to that because you know why probably they cannot be open about their own insecurities it is a strong person and a person that doesn't have to be right all the time or does it have to pretend that they feel more secure than they do to say gosh
you know I had I'm just having a bad week or whatever it is and and giving you permission to do that too I hope that's a good enough answer to your question I'm not sure it is but it was my best effort that's good enough for us but I do have a question
related to this which is yeah I see this a lot I I see young people especially who have a very ideal way of living their life and how they want to be and they're in a workplace where people don't share those same values and beliefs and they feel really out of place right
my feeling is you know it's a lot for you just to manage your own emotions let alone try to get other people to change and be just like you and I often advise people Amen just focus on job here just take care of yourself and then if you're in a bad place look
for other employment but you're gonna spend all your energy trying to change other people and it's a very difficult thing to do and and you're gonna wind up I think spending energy in the wrong place that's just my opinion what's your take on that yeah I would agree with that Chris I think
that people don't change unless they really are looking to change they don't change for other people they may change to please for a little bit of time but that change is not maintained it takes the person saying I like this change I like myself better as this person who's changed and I'm getting
along with my life better so I don't think you can change other people now it's interesting that they would hire you and and your diversity is known and they seem to welcome that but maybe they get a little scared by that or something when they're up close and personal to it so you
know I I think that you modeling acceptance of them maybe they will then turn around and be more accepting because you accepting that they're not going to get some things about you maybe you don't get some things about them either so then you sit down and you know if you if you had
that kind of relationship which is you know in many workplaces not the case where you can say you know you can have an open conversation about that yeah but I loved what you said there which was your thinking you want to change them and for them to be more empathetic probably the best
way to do is start with your own empathy and kind of try and understand what they're going through I love that oh that's good okay let's let's keep going cuz we got to get through the year ten and then all the other stories that we need to talk about Right see ya 90
minutes is gonna go by fast so here's the next one is the worry and need to control yourself hey there it is and your environment yeah well this one is again again all these are really commingled it was a little hard to disentangle them in fact but this one is different because there's
actually a cycle to the worry what do you do what are these folks tend to do when they're worried they then to be responsible and take control and then the more they're in control the more they feel exhausted and then the more they think their exhaustion is going to show so the more
they worry and so then the more they just look like they're in control Wow so you know it's this vicious cycle of worry and a need to look in control because these are not people for example who will tell you they they suffer with panic attacks or that they tend to stay up
at night not worried about the virus or whatever it happens to be they'll say oh you know yeah I'm worried about it but not any more than anybody else and if because they don't want to look that out-of-control so you know I worked with a man one time he was it was very
some of these people who are very eloquent and he had really struggled with the mistakes he made in his life the things that made him look out of control and one of the things that he'd had three affairs and other than that his his life was a cookie cutter I mean he gathered
he had the perfect wife he had the perfect family had the perfect job begat the perfect house but then he would get sort of this urge and he would have affairs well the third affair he got so suicidal but what was so poignant he came in one time I asked him if he
had any pictures of himself as a little boy and he brought in a picture and he was about 6 in the picture and I said so what do you want to say to this little boy thinking he would say you're gonna be okay you know you know you're gonna make mistakes it's gonna
be okay and what he said was don't grow up because you will feel terrible about yourself because of the many mistakes you'll make and it was so poignant and his eyes filled with tears and I said is that what you want to say to this little boy in your healthier place or is
that where you he goes no that's not my healthier places so we really worked on what he would say to that little boy given that some of the things that he'd figured out and it was that non forgiveness that harshness that shame me and we talked about the shameful critical voice it's shame
that he'd made the mistakes that he had and so it's really about trying to quiet that need to always look in control and realize you're not gonna look in control all the time you're not gonna be in control all the time you're gonna really make a fool out of yourself sometimes and that's
that's something that's just about being human your story just triggered something in my mind do you watch you have time to watch TV madmen have you seen madmen out of curiosity I have seen a couple of episodes okay so that's probably good enough I just want to throw this out there just to
bring us the pop-culture land a little bit here sure so Mad Men Don Draper he's he's a bastard he grew up in a brothel and he seemingly has the the perfect life the perfect wife the perfect job and he's climbing the career ladder really really fast but he has super self-destructive behavior he
can't stay committed to his relationships and every time something good happens in this life he'll do something to totally mess it up and your story just reminded me of this this person who has seemingly everything lined up goes out and has an affair like they feel like they don't deserve it and they
want to go back to the place of chaos right well remember that voice of shame it can be saying to you you don't deserve all this like Don Draper you don't we know who you really are we know what you're really like and if anybody found out you know you you lose everything
and so these are the people that have to hide that part of themselves rather than saying gosh I get I guess so overwhelmed trying to make my life look so perfect and and really let that lapse I mean maybe they don't love the wife that looks perfect the husband that looks perfect maybe
you know there's some things about it that they wish they could change it but rather than doing that they go about secretly having this other life and so it's what perfectionism does is it and this kind of perfectionism fueled by shame is that it tells you it's not okay for you to look
like you make any mistakes it's as long as you can keep it secret it's okay but still then I'm gonna turn around and shame you for the secret you're keeping so you can sort of never get away from the shame right and it really takes going back to where you learned that you
had to again in that brothel where you develop the strategy of I will not look like any the people around me I will look successful I will look like I have everything put together and that's where I'm going to build my sense of security but it's very this foundation is way too shaky
no in fact you know just a month ago I had some people from Boca Raton Florida contact me and one of them had a friend who had died by suicide recently and she literally she has three kids she was successful loved by the community loved by her family it was it was devastating
people just came out of the blue and this happens a lot in fact I bet we can all think about someone that we know who who looked like they had the perfect life and then we fear out other we hear they died by suicide and the next thing out of this woman's mouth
just I I gasped and just couldn't breathe for a second she said her husband found your book on her nightstand and I couldn't breathe I mean I was like I it made me even more determined that these people who feel like there's no way out but to leave the life that they have
created that is so empty and lonely for them that they don't realize that they could take apart that life or or change it enough to where they could have some sense of true security and true connection with people and it's just this it is it is devastatingly tragic when this happens and it's
happening more and more Chris it's perfectionism the the rate of perfectionism and the rate of suicide is going up concurrently in our culture and in fact in the international culture so we've really got to address this there's this battle that creative people go through all the time which is so are you saying
just do sloppy work and put whatever like just not a care or to the opposite end of the extreme which is I gotta get every little detail just perfect otherwise I'm not going to release something this is a conversation that I'm not talking in a theoretical way I'm having this conversation with the
team all the time from young people to my managers we're fighting this all the time yeah well when I hear that where my mind goes is to say you know inside I've learned as a therapist that insight is wonderful I mean insight connects the dots inside gives you a context you understand oh
you know my stepmother or my stepfather or whomever threw away all my artwork and said that was a stupid thing to do and so by damn I became an artist and I'm gonna be extremely successful and so here comes the perfectionism of needing to create something that is astoundingly perfect and then as
we said a few minutes ago then you get caught up in the well what makes it astoundingly perfect and you know you get you get paralyzed there where I really think that people start getting hope it's when their behavior starts to change you know when you do this black and white it's either
got to be totally perfect or it's just a slob job right you know that's where the the irrational thinking is that that you have to confront you know there is a vast middle that there's going to be things that are really really good about a piece or a sculpture or painting or a
piece of music and then they're gonna be things that are flaws in it I'm sure I will watch this very recording and think well why didn't I mention that and so you know I watch it go you know why didn't I think about that so it's really beginning to try to approach it
and the task whatever the task is or the joy or the the goal is that a new creation is realizing that it will be both again if I'll go back to what I said in a few minutes ago your strengths don't define you anymore than your weaknesses do anymore than your vulnerabilities do
so in your creations your strengths will show and your vulnerabilities will show right that's part of the artistic process that's part of the creative process so it's part of any process and so I I would I think it's hard to learn how to approach that especially when you're younger because you're hungry you're
literally and figuratively sometimes and you're you're wanting to create a niche for yourself and so understanding that something that you think is a piece of shock you know somebody else may go this I love this and you kind of go in what and then something you think is outstanding people just pass by
you know that's that's part and parcel of trying you know realizing that I don't get to judge what other people see as wonderful or as perfect or it was just what they wanted to hang in their living room you know that's really not up to me to decide what I can do is
I'm okay as I can't as much as I can be with what I produce and then I don't let the achievement of producing that define who I am i defined the process it's the process of creating that defines me I may create or versus I'm defined by what I create how about that
okay I'm looking at the time here you see it's already been an hour season by now I have to read a couple more things and so we'll kind of do these in bulk and you said before they're inter wolven so okay race so here's another sign that you might be suffering from perfectly
hidden depression that you're intensely focused on tasks using accomplishments to feel valuable we've really talked about that already yeah we did so the focus on well-being of others but don't allow them into your inner world yeah this this is important because you know some people have asked me what does that mean that
their focus is insincere absolutely not often these people have been through a lot of hurt and pain and they they are they they want to help someone who's in a in a fix or who's having pain what they don't do they don't allow you into what hurts them or what they they'll say
something like oh if I started crying I never stop or or I'm just not a crier or you know oh I tell you if something was wrong when really they don't have any plan to do so so right okay here's another one is to discount the person I hurt or sorrow struggle with
self compassion no self compassion they don't know what that word means what do you mean I'm supposed to feel sorry for myself no you're supposed to have the same kind of empathy and understanding for yourself that you have for other people okay yeah you mentioned this already and you shared some of your
own struggles with an eating disorder there's an anxiety disorder obsessive compulsive disorder or addiction yeah the clinician in me Chris said I don't want to write this book without mentioning that I want the last thing I want to do is have someone read the book or hear about it read the list and
say oh I have perfectly hidden depression period you know certainly there can be other not real because from my standpoint perfectly impression Israel but to have a clinical diagnostic category that you actually fit criteria for and just call that perfectly in depression because there could be some real treatment that would be helpful
to you and so I wanted to put that in there because and actually talked about that in the book and how you know what about how how that's different from perfectly in depression and how it may feel similar right and you also said in the book that some of this in in doses
is actually really good it's just when you go too far with this that's when it gets into the dark side sure right sure some of all of this can be I mean you know respond being responsible is great focusing on others sincerely is wonderful even sometimes discounting you know well I'm not gonna
treat myself like I'm the center of the world and because my feelings got hurt doesn't mean that I'm you know need to make a big deal out of this that's being humble and that's keeping perspective and all I can't think what you're right what happens is the the there's not a balance at
all right okay so here I think are the last two and we already talked about this which is to believe strongly and counting your blessings as the foundation of well-being so there's never an opportunity for you to acknowledge it sometimes it's tough and it's done you don't always have to be grateful for
the some of the best stuff that happens in your life right or even for the good stuff I mean okay for example um you know I wrote this book I consider that a good thing I mean I consider it I'm I'm happy about it on but you know has it brought some stress
into my life yes you know it's brought these interviews which I love but also I get nervous about remember that performance anxiety you know it's if there's some struggles that come along with it so although I'm grateful in and really happy about the book it's also brought some things that sometimes I have
to fight against or struggle with and that's just part of blessings they have an underbelly right okay so this is number ten here rounding out number ten is enjoy success we didn't gain professional structure but struggle with emotional intimacy in relationships yes that's the big one the big one right yeah it's you
know these people are what do we do we were more perfectionism we were we reward people who stay like and come early so these people are usually very very successful professionally and yet they've chosen partners they've even maybe she chosen friends who are fairly superficial or perhaps they've chosen a partner who's fairly
narcissistic and really wants them to take a lot of responsibility because the narcissistic one doesn't want to take responsibility or they've been attracted to an under function ER and the under function er says you go for it you over function all you want to do I'm fine with that but I will tell
you that some of the most poignant emails I've gotten are from people who said I've been married to my husband or my wife for 12 years and I've never seen them I've never seen them cry over anything that said I've never seen them let down I've never seen them integrate loss into their
lives and we I try to talk to them about what's really going on and they pushed me away or they isolate I you know and so they say so how do I approach them and my answer is tell them what it's like for you to watch them do that tell them I I
get I get scared about whether or not you're going you're gonna be okay because I never see you be sad I get I get lonely because we don't talk about anything other than what's for dinner and in the vacation we're gonna take the friends in two weeks so or the kids or whatever
so you know it's not always that they're attracted to people who are not capable of intimacy but often they are as well okay so now we have an opportunity to talk to some of the people who've been watching this live with us perfect almost 300 people and there's been a lot of positive
reactions thinking us bringing you on your wonderful articulate and the feeling the feels as though as a young people say so Mariana this is a statement I think that's a question but maybe I can get your reaction to this she's saying when everything keeps going wrong in your life especially things that are
out of your control it's hard to keep being positive negative thought just pours in and don't know if this is depression well okay my first reaction that Mariana is that when negative things happen things that are unexpected things that you can't prepare for that are sudden sort of a sudden loss or you
think you think one thing is going to happen in something else does and it's disappointing or frustrating to you there is a what normally happens is a sense of disappointment or sadness or frustration or helplessness or confusion agitation whatever it's not classic depression until you can't shed that feeling that that feelin stays
with you and makes you not want to go to work and makes you be surly with your kids or makes you want to isolate or all of a sudden you lose your appetite or you want to sleep all the time classic depression has these criteria that you know we can all have times
when we're down or when things aren't going our way I mean look at what this pandemic we're all living through or every patient that I have including myself we're having days where it just seems so overwhelming to try to manage and that we're sort of having this communal kind of depression or sadness
or frustration in that because everything is out of whack but I think you know at the official criteria for depression is that you must have those symptoms for a certain amount of time with dysthymia or moderate depression it's six months even to a year for major depression which is much more severe you
have to have that for at least two weeks and then you are really the dive is noticeable to other people that's also a huge difference between classic depression and perfectly hidden depression because no one sees that you're any different than you normally are so hopefully that's helpful thank you I would encourage journaling
about it I would encourage trying to honor it by journaling what are you disappointed when have you been disappointed like this before how did you handle that how did you get yourself through that to try to you know if you've been around from the beginning which might I salute you if you have
you know what are some of your strengths that you can call forth you know are you talking to a friend about it um you know try to work through it on your own and then if you are getting depressed clinically then you know sometimes you have to decide I need to go to
the doctor or I need to go to the therapist yes and in case you're joining us very late in the livestream I'm talking to dr. dr. Margaret Robinson Rutherford and she wrote this book perfectly hidden depression and there are a bunch of exercises in this this isn't just a book about reading it's
a it's a book about doing and putting into action the things that you've learned so I just want to highlight a little passage here and this is this is on page 13 and and reflection number one creating a mantra for confronting shame and perfectionism you give the prompt ask yourself this question what
do I need to remind myself about I'm sorry let me read that correctly what do I need to remind myself of every day about my healing work with perfectly hidden depression play with creating a mantra a mental reminder a positive goal or experience you want to have and it seems like there's a
bunch of these things in in the book so yes they do and apply right you know the funny thing is it's not really very funny it's actually very poignant several of my own patients who are reading the book have said I couldn't do the first exercise because I couldn't come up with a
mantra that was going to be absolutely correct and absolutely perfect and I said so that's your mantra your mantra is I want to be able to create a mantra that isn't perfect I love that that's your mantra so you know you just take yourself where you are and that becomes where you want
to go I want to be able to create a mantra that I know isn't perfect there you go center yourself where you are here's a couple of others in the book whatever time it takes is time well spent because there's a lot of that there's a lot of people who say how do
I know I'm doing the right thing or this is taking too long or it's taking or it's going too fast well it's just gonna take what it's gonna take that's right another one in the book I'm going to relish discovering what I write that's also very beautiful well thank you I've done a
fair amount of journaling in my lifetime so it's been very very helpful to me too it's sometimes very jarring or upsetting to see in black and white how you really feel and some people say I don't want to do that because it makes it more real but it also actually helps you track
where you are in your progress and helps you move through things instead of being stuck in one place actually you get tired of writing the same stuff over and over again so you you you say well that's what I said yesterday what else what else do I think about this and so you
it helps you move through emotions and experiences oh that's nice I don't share something with you when I was a teenager I was just an emotional roller coaster very different than the way I am today and I remember I did write in a journal but I had some strange dark thoughts about my
journal I have to share with you which is I wrote it in a way that I almost wanted my parents to read it yeah because there's this thing like this feeling that teenage angst like you just don't understand me how could you do this to me the kind of victimization self-pity and I
wanted to write these dark thoughts even though I think I was just being very dramatic in case somebody would read it yeah what's going on with me there well obviously you didn't feel that your parents were very attuned to you and so you were coming up with these scenarios of well if I
really look out of control if I look really dark if I look really despondent then maybe my parents will tune in to me enough and they'll read this journal and I don't I mean if you really felt that way or even if you felt like you needed to act that way you know
that'd be something that with a more open kind of should get between you and your parents you could have gone you know mom sometimes I want to make up a problem because I get frustrated that you're not paying more attention to me there you go so you know the fact that you were
hoping that this would happen is it's very poignant it's very meaningful because I still would I would contend that if you were sitting in front of me as a as a patient I would say so tell me the things that they were missing about you that you knew they were missing about you
and and go from there and then you almost had to make that worse but why did you have to make it worse you know probably it was bad enough for what it was and they still just weren't tuned in or they were too busy or they were maybe they were working three jobs
to put food on the table I don't know they tried throwing their parents under the bus but something was happening to where there were parts of you that you didn't feel like they saw so you had these fantasies about making it worse you know you don't diagnose a teenager with a lot of
diagnostic or diagnosis because being a teenager is in itself very chaotic and very emotional and so but you know I think that I don't know if that rings true with you that there were things that your parents weren't tuning into or maybe they expected you to be better than you were or somehow
they had a lot of they wanted you to accomplish a lot you were trying to say no I'm really suffering I'm not sure what the end message was and you spill your guts and tell us you know so look between the ages of 13 and 16 I'm not gonna lie to you we've
talked about this in smaller intimate circles but I've had thoughts of suicide I was fantasizing about how to kill myself and I was just I mean I obviously worked through I have a loving relationship with my parents but the thing that you said about mom sometimes I feel like I want to act
up so that you can pay attention to me that would have a level self awareness emotional maturity and communication that just did not exist at that time you know I'm obviously Asian American the idea of therapy that's not even a word that you say at home men being vulnerable crying that's not a
good thing there's so there's a lot of things that were already in place for it not to happen I'm a middle child of three boys I mean yeah I love my parents everything's fine now but back then it was like it was rough you know it's interesting because I didn't find this out
until last week but I guess my publishing company has been selling the foreign rights to translate the book you know the place I've had a bidding war on the book so far is Korea and it was sold for thousands of dollars where the other ones are just a thousand because you know they
said oh this is going to be a highly popular book in Korea because that's that Asian environment you have to be exactly what we need you to be and who you tell you're gonna be it's very prominent so I need to learn more about Korea sure have you been this have you been
to Japan before I've not been to Japan I've been to China but I've not been to try in all right I've been to Japan a couple of times I love Japan but Japan I've gotta imagine that there's gonna be a bidding war there too because that's a structure or society that's just all
about doing your part and what we what we saw and what we witnessed were men who would go to work like all day like we're talking about like 12-hour days and afterwards they are just hating their life and they would just drink themselves crazy the bars in the streets vomiting pass out on
the floor in a full three-piece suit and it's a horrible life and then what they do is they don't go home they check themselves into these capsule hotels where they can just sleep in their clothes their work clothes and just get right back and do the grind they're called salarymen they just show
up every single day yeah there's even a term for them and when we walk by and my friend who is a Taiwanese originally but he's lived in in Japan for a number of years is fluent he said how you look at them and he's like shaking his head it's so sad and there's
thousands and thousands of people doing this and that's why he said to me to kind of explain a little bit of Japanese culture why some of the men are doing too into some really kinky weird stuff because they're just no joy there it's just going through this whole thing and it makes me
sad for their families as well not just them but yeah I had heard about the drinking issues in Japan and so but supposedly the suicide rate is very high in Korea said Arthur look into that as well okay so this is a comment from a guy Franklin Andrade I think that's his real
name what's a good way to appear vulnerable and being okay with not being always in control or having every answer in front of people at work that don't value and even punish any kind of vulnerability whew well you know my husband who works in a corporation said I would last three hours for
the environment if I tried to work there so frankly I don't know if there's a very good answer to that question because if the if the policies and the in the zeitgeist of the environment is so rigid and that none of that is allowed then you trying to find it there establish that
there is probably not even safe for you I would you know some of the corporations are beginning to get more empathic toward this I live in I live in Fayetteville Arkansas in just 30 minutes from us is the international headquarters of both Tyson and Walmart so I get a lot of people from
those two huge organizations as patients and certainly they've talked about this that you know you don't let them see you sweat and the rigors of what it's expected of you are are incredible and so you know I'm not gonna give you the glib advice I will just quit your job because obviously you
can't you know you may have all kinds of financial reasons that are very serious to be there but I I would definitely try to find relationships outside of work that do meet that need in you and that desire and you so that at least you have enough of it until perhaps you're in
a place where you could consider changing your environment and your work environment because at least you'll be getting that you know at home or with friends or with family or just somewhere where you get those needs met I love that you said that in ideal world our personal life our relationship our spiritual
life and our work life would all be in perfect alignment we know that's not the case there's hope for us in the future that this is actually more accepted in by talking about it by sharing the stories that you have in the book and talking about it openly hopefully we remove some of
the stigma around being vulnerable and I think everybody needs at least one person in their life that you can just say here's who I am see me for who I am and we accept each other we grow together but it doesn't always happen have to happen at work or some other place but
you do need to find somebody and if you don't have somebody you got to reach out to somebody like you right well hopefully yeah I I think that I mean I've had a I've had a lot of people who are in that world come to me and say you know this is this
used to fit exactly who I wanted to be and who I needed to be and it just doesn't anymore but I'm having a struggle because I'll have to give up you know there'll be sacrifices financially or I need to work with my partner about this and that those are tough life-altering decisions but
you know you deciding how important it is in your own life and I'm here to remind everyone not in a dire way or well I don't know I don't want to distress it I just don't want to sound like I'm being dramatic but suicide rates are going up and so in in every
age group except 65 and older so and not to make anybody feel guilty but remember that your children are learning from you as well and if you aren't vulnerable if you aren't talking about what you're struggling with or what is hard for you or what you feel joy about I mean if you're
not yourself to show your emotions as they occurred your children appropriately appropriately then your children will model their lives after you and so when they get depressed or when they feel overwhelmed they won't talk about it either so you know you have to mete out what what are the gains you're making financially
or instability but what is that costing you and remember that that cost you know the emotional cost of being in that kind of environment also has it has a price it has a very tangible price and so I would encourage you to look at that and think yeah I'll never forget these people
came in one time and they say first thing we want to tell you is we're downwardly mobile and they had run this huge advertising agency and they took it apart because their family was falling apart because of it and they really wanted to change the whole feeling and their family and what they
were teaching their kids was important and I mean that was their decision and of course we've all got to make our own but it's really you know that sense of meaning and fulfillment it may seem like Oh meaning and fulfillment will you know that's not going to put food on the table but
the food you actually have at the table with your children will be more joyful if that's if you can know that you spend a great deal of your day doing things that truly are valuable to you and teach your children what you want to teach them I have a confession what mm-hmm okay
I'm gonna just confess here right now all right I I struggle with this that I am I have an allergic reaction to people who are super needy who had this this hole in their life that they're always seeking approval from other people and so they're constantly needing it to be other validated and
I find that to be it's overwhelming for me so and there's a lot of people I know in my life in my world both intimate and and and relationships are from afar like I just can you just tell me my work is good enough and that's like uh if you're always seeking that
you'll never there's that whole will never be filled you have to learn to love yourself so when I feel that about other people and then I internalize that as my own dialogue to say I don't want to be that person to other people I don't want to tell him everything I'm going through
and I'm like I think most men pretty good at compartmentalizing I would come home from work back when it was super stressful for me and my wife could tell you know there's something going on behind those glasses of yours or mine and she's like hey how's your day but instead of telling her
I would just I like you I just need a minute I got to deal with some stuff internally and I'll stare at the TV screen for a while and then I'll process what I have to go through and the reason why I do this is because when I tell her the emotions get
stirred up again the toxic energy goes back up and not only being a very good partner she starts to feel the anger the frustration and then she goes into problem-solving mode like ah it's too much I don't want to live work at home I could process us I can get through this and
then she starts to feel you're getting really distant like who are you where are you in there and then when you said this whole thing about what kind of model are you making for your children and I have two little boys I have the 16 year old our 14 year old I'm processing
it I think I'm fine but I don't want them to go through their life thinking this is the way that men behave you bottle everything up there's no vulnerability there's no struggle there's no pain what should I do here this is a complicated thing well the first thing I notice is the either/or
nests of what you're saying Chris is that I've got to spill everything and you know and then I'm I will look like I'm highly needy rather than saying you know you get home you're if you had a language and um and so you know if you come home and you start crying and
you start going on Campbell or not crying maybe just being angry by what I suppose Ben will do and just say I had a stupid day I can't believe my supervisor is just as ignoramus and all these people wanting something from me and you know blah blah blah blah and so you know
instead of saying and beginning to practice with your partner that there is a way of saying I want to talk to you about what happened at work today now it's not the time can we talk about it after we get the kids to bed and and so you honor the fact that there's
something you want to share with her that was difficult for you and you begin to practice what it's like to take apart something that you're afraid sounds needy you're telling something I'm gonna look needy rather than saying I'm going to change this cycle between me and my wife because as soon as I
back off and withdraw and she gets angry because she can tell something's wrong she feels abandoned she feels like I'm turning away from her help and here we go down this cycle so if you want to change your part of the cycle which is only the part that you have control over is
to say is to begin to practice not telling yourself you're needy saying you're human and something has really stirred something in you and so then you give it some time you know you go through your night and then either the next day or that night or whenever the two of you decide to
talk about it you pull it out again that's reconnecting with that thing you've compartmentalize and you say alright this is what I experienced yesterday I'm really scared that I'm gonna you're gonna think I'm really needy by talking to you about this hmm and I hate the idea that I might look needy and
she's gonna go Chris I just want to know you mean we women loved we'd love to be known we want to know our spouses our partners and so you say no all right and then this is what caused this and then you just and just say you know I don't want you to
saw the problem I just needed to let you know that that's what was wrong with me when I walked in the door can I do anything for you yes you can rub my back or give me a hug or whatever it is and then what you've done in that moment is you've broken
this cycle that you just identified you know I tell people I see a lot of couples and I say I bet you can tell me that switch roles and you you do what you're say what your spouse says and you do what the other spouse says I want to hear you have this
argument of this discussion but take the role of the other one and they can do it oh that kid can keep on and keep on oh yeah this is when he says and this is when she says and you know Bob a boss so you know you you're risking changing that cycle and
when you begin to practice that it can get easier and easier not that it's easy but you have to quit judging yourself that somehow you're like those terribly needy people and just say well I'm scared that I'll look like this but I'm gonna risk this and she she doesn't go oh my god
Chris I can't believe you're talking everywhere it says but something like that is she wouldn't say that it and so that's what you're telling yourself she'd say sure so you know you admit what you fear and you don't project onto the other person what you think what you tell yourself you're scared of
hearing and then she gets a chance to be there with you and then you all get a chance to cry people maybe not go perfectly but you know you'll begin to change the cycle and then guess what happens the next time she has a day when she feels overwhelmed she's gonna much more
be able to say can I talk to you later about what happened this afternoon I mean yeah you know I could tell something was wrong well and so you begin to have these moments of connection that are and you're getting out of the habit of avoiding what you fear and what you're projecting
onto the situation I love that so let me summarize what I heard the first part is if you need a minute speak that or take a that to say hey you know what there's something I'd love to share with you that's happened I'm going through some stuff but now's not a good time
why don't we find a moment when I'm in a better mental place to talk to you it might be tonight it might be tomorrow but it will be sometime I promise you and then the second thing that you said which was I want to share this with you but I don't want you
to feel like I'm needy or I'm desperate or any of these things and no you can't determine what she feels she could say I'm scared you're gonna think I'm needy okay so I'm scared that you're gonna think that I'm needy or desperate and I what would be most helpful for me is for
you just to listen and I'm not looking for a solution per se a hug would be more than what more than enough for me right bingo did I get that right you did okay now my only question for you is where have you been all my life [Laughter] five years I'll never forget
standing in the kitchen one time I named my husband is not the most cyclic in fact he's not psychologically oriented at all which is an interesting choice of mate from me but that said one time we were having our unusual not women knock-down drag-out but he was definitely I mean you know kind
of thing and he stopped the conversation and all of a sudden he looked at me and said what are we really fighting about I was floored I was like oh my god living together has not it's actually made an impact on him and I said well I'm not sure but let's figure it
out well sure enough we were like we were really fighting about trust or control I can't remember now what it was but you realize that there's a there's a lot of stuff underneath you make how many times have you heard somebody say I'm not sure what we were arguing about it doesn't matter
anymore that's because they were arguing about something that was under the surface so you know having those kinds of conversations and moving your relationship toward that that ability is something that is land so much more depth to your relationship you know I'm I'm not somebody who thinks every time you come home you
got to bury your soul to your mate and you know sometimes we got to take out the garbage we're gonna do the dishes and there's epic you know algebra homework and there's laundry and blah blah but it just has to happen enough it has to happen where there is a connection that intimate
connection that I said Berkeley and depressed people don't have I I realize now here we are past the 90 minute mark so I'm gonna ask you for one one quick question and one deeper question he said okay children what we're gonna say thank you and goodbye so the first question is this is
if you can't afford to see a therapist are there any other options of course I mean they're all kinds of self-help books I will say that with the on the onset of online therapy it's much less expensive than normal talk therapy it's not covered by insurance I think but I bet that's about
to change actually I'm and so there's there's there's online therapy there are graduate schools that have programs that literally you pay two dollars a session because you're getting experienced for a graduate student and I saw I don't know how many clients I saw in graduate school hopefully I did no harm but but
you know you could get it for relatively nothing there are community health centers that have mental health I volunteer in a community health center where people can see me for nothing so there are things that are out there but you can you can try to build a network of friends where y'all don't
just talk about what's superficial was on the surface I can't tell you how many people I've asked okay I want you to really tell one person that you're in therapy oh I know I can't do that well just try well sure enough the person will say oh I was in therapy last year
and I'm still on antidepressants but it was really helpful or you know I didn't like my therapist do you like your therapist and here comes this conversation about oh it's okay for us to admit we had problems um but and there are a lot of self-help books um - one of them but
you know if you have a history of trauma you really have to be careful because you're trying to unearth a lot of things whose roots are very deep and there are there's a there kinds of therapists down it's EMDR eye movement desensitization reprocessing therapy it's known to be a fairly brief solution-oriented kind
of therapy for trauma so you might look for an EMDR therapist and look for therapists who will work with you about money not all therapists will a lot of therapists don't even take insurance me more but there are people out there who will say listen you can pay me ten dollars a week
for three years to finish paying off this bill you know it's okay with me just so you do it a lot of resources there I didn't know that there were that many okay this is fantastic so here's the last big question I'm gonna ask it take as much time as you you need
you to think about it and if you don't like the question you can say never mind and we'll end the show okay but then I want you to look right into a camera and to deliver this because I think this is going to be one of many cut-down so we're gonna have I
personally believe this that perfectionism is a self-destructive belief that creative people have forget about depression and all this other stuff because they're always trying to pursue this thing the negative self-talk that comes out of this the the paralysis that happens this idea that you will never put anything out there as part of
your progress versus like your final result that thing is probably the number one thing that's messing up a lot of creative people so I would love to get your thoughts on that to look right into a camera and speak to that person who's feeling this like I don't want to put this out
I'm not gonna finish that thing I need three more weeks to do this thing I would love for you just to speak to them right now I've never known anyone who didn't feel like a new behavior was risk it takes a lot of courage to take a risk and if part of your
issue is as chris describes it that I have to I have to be able to tell myself that something is the absolute best I can make it before or I I just trash it I don't do it I put it off I missed the deadline I you know and encouraged to risk takes
a lot of courage and so what I would say that you know when else in your life have you discovered that you had courage you know maybe your best friend's father died when you were in the fourth grade and you were the kid that went over to your friend and said you know
you want to go for a walk or where did you find your courage and how have you found it in the past I bet you can find something in your life where you have found courage and I know having been a singer myself in my lifetime that you don't get a lot of
steady unless of course you're very successful you don't get a lot of steady affirmation from the world and so you have to find it yourself you have to you have to surround yourself with people who are more positive who aren't also you know find someone find a mentor who can help you find
that courage to say it's more important to put out the work and to to be a creator than is to always be completely sure that your creation it's going to be exactly what it needs to be for other people because you cannot control that you cannot control what other people are going to
think is going to be wonderful all of you out here who have listened to this some of you will go I really enjoyed it other people she talked too much about X Y or Z I no control over that and yet I've risked and I would I would challenge you to risk and
begin to think about the idea that is more important to create and be in the process of creating than to achieve some goal that you've got in your head that must be met for you to be accomplished and if you keep on with the process of creating and you find the courage to
do that and you risk then then you I don't know where that will lead you but you won't be paralyzed that's what I would have to say Wow Wow okay how do people get in touch with you or find out more information about the different things that you're doing progress sure my websites
dr. market Weatherford calm not very creative but to the point again my podcast is the self podcast with dr. Martin brother for what it is is usually about twenty five minutes long and it's me picking a subject I always read a listener email so I've been doing it for about four and a
half year almost four years now so I love doing I'd love to have you there I'm on instagram at dr. Margaret Rutherford my I have a Facebook page Facebook you know calm slash dr. Margaret Rutherford and I have a closed group which is facebook.com slash groups slash self work so that's facebook.com slash
group / self work and my email my infinite my infamous email asks dr. Margaret at dr. Margaret Rutherford column and I do I'm the only one who sees those it's quite confidential I'll do my best to answer you as quickly as I can I I thank all of you for being here thank
you Chris and Mo Thank You mo for setting me up with Chris I really appreciate it and I'm very honored that you had me Chris you are delightful and I love the fact that you're willing to share yourself that means so much to people and to me I'm delighted to have been here
and whatever we have created is a perfectly perfect way to end thank you so much thank you for your generosity and thank you for everybody that's tuning in watching live we hope you got some value from this and on behalf of the entire team dr. Margaret Rutherford thank you very much for doing
this with us thank you welcome okay Jonah get the music ready here we go let's get out of the show and this is all the information that you need in case you guys couldn't fully understand everything that that Margaret was saying it's dr. Margaret Rutherford comm and she's active on Instagram dr. Margaret
Rutherford and shockingly she gave you her email address which being prepared for the onslaught the Avalanche it's about to happen Joe to get the music here we go don't forget to Like comment subscribe you guys hit the bell for notifications thanking everybody for being part over 1 billion mission you know what we're
trying to do change a billion lives on planet Earth thank you very much everybody I'm out here hope you guys have a great weekend
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