027: High Functioning Depression Signs: Understanding Perfectly Hidden Depression with Dr. Margaret Rutherford

Episode Transcript
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Ananta Ripa Ajmera (00:02):
Welcome, Dr.
Margaret, to the True toYourself podcast.
It's so wonderful to have you.
I can

Dr. Margaret Rutherford (00:08):
truly say that I'm more than delighted
to be here.
Thank you so very much, Ananta.

Oh, thank you so much.
I really enjoyed reading yourbook, Perfectly Hidden
Depression.
It was an extremelyilluminating book, even though I
feel like I have been on thishealing journey for a long time
now myself, I still found somuch valuable content in it and
so much insight and I can't waitto introduce our readers to it

(00:39):
and help them to find a way toease into the healing journey
through it but before we diveinto the book I would actually
love to hear about a time inyour life when you were true to
yourself as the podcast titleproudly talks about and how that
impacted you

you know when when you you know you
you sent me the questions alittle bit early and i i thought
about that one and immediatelywhat came to mind um my husband
and i've been married for 33years but he was not my first
husband he was my third actuallymy my i had two weddings
marriages in my 20s both of themvery chaotic and very

(01:21):
destructive and not good andwhen we moved here this is a
small southern town we movedfrom dallas and i said i'm just
not going to tell anybody i meani you know i carried still a
lot of And I said, you know, Ijust, you know, I won't lie, but
I'm not sure I will offer it,you know, as information.

(01:41):
And at the time, Maya Angeloucame to my awareness as she was
poet laureate at Bill Clinton'sinauguration.
And I went to the bookstore andlooked through her books and
found a little book of essayscalled Wouldn't Take Nothing
from My Journey Now.
And in that book of essays, shetold a story about herself that

(02:06):
she had been elected or somehowhad been given the honor of
being like New York City'sperson of the week or person of
the month.
There's a big high honor.
And she went out to celebratewith a bunch of her friends and
she got absolutely snockered.
She got really, really drunk.
And she said she saddled up tothis table of men and sat down

(02:30):
and very sloppily questionedthem about why no man would love
her and how she had struggledand what was so wrong with her
and her friends had to sort ofdrag her off and say, Maya,
let's go home.
And she said it was one ofthose moments that you wish you
could change your name and moveto Canada.

(02:51):
I thought about that, Ananta,and I thought, you know, here
she is, poet laureate, esteemedauthor, writer, very wise.
And she's putting this veryembarrassing moment in a book.
And I put it down and Ithought, I'm not going to hide.

(03:12):
I don't want to hide.
I have lived the life I'velived.
I've made mistakes.
I want to be more transparentthan that.
And I was.
And I have tried to increase myability to do that from thence

(03:34):
forward because I was reared ina family where you just didn't
air your dirty laundry and youjust didn't talk about anything
that was, you know, not nice.
And so It was something thatreally changed me.
This was in my late 30s, early40s.
That's the moment that came tomind when I made that decision,

(03:55):
thanks to Maya Angelou, that Iwould share as much as I could
that I thought would be helpfulto my clients and then to my
friends.
It was like, okay, it's me.
Here I am.

Unknown (04:10):
Yeah.

Wow.
What a powerful story.
That's incredible that you wereable to connect with that and
that she had that experience.
I do remember reading that inyour book and being really
struck by that.
Like, wow.
I mean, she could have totallynot shared that with the world
through writing, but the factthat she did, I feel gives us

(04:32):
all permission to have less thanperfect experiences that we
actually own.

Dr. Margaret Rutherfor (04:39):
Exactly.
And I, I, why it's thatparticular moment.
I don't know why, but that'sthe one that came to mind.

It's really powerful.
Thank you for sharing aboutthat.
So what exactly is perfectlyhidden depression?

Well, the term itself is something
that I pulled out of the air asI was writing a blog post, my
normal weekly blog post one day.
And I was thinking about thesepeople that had come into my
office.
I'm a nurse.
And I've been in practice forquite a while when I moved to,

(05:15):
well, I've been in practice forseven or eight years when I
wrote this.
So not quite too long, but Iwas thinking about the people
who would walk in my office anddeny vehemently that they were
depressed, that they would say,oh, I'm not really sure why I'm
here, but you know, I'm a littleanxious or there's some
relationship issues or I've gotsome anxiety or I can't sleep or

(05:37):
whatever.
But what I noticed about all ofthem, Ananta, was that they
could not access painfulemotion.
And even if they were talkingabout something that would be
incredibly painful for most ofus to talk about, they would
smile or they would discount it.
They would say, Oh, you know,it happened a long time ago.

(05:58):
It's really kind of silly forme to even bring it up, but you
asked something like that.
And when I wrote this post, Icalled it the perfectly hidden
depressed person.
Are you one?
And it went viral and all thiskind of thing.
And that led to the bookeventually five years later.
But what it is, is whendestructive, there are several

(06:21):
kinds of perfectionism, but theone I'm talking about is a
destructive kind ofperfectionism.
When that is the camouflagethat emerges as someone's
survival strategy in theirfamily, as a child, whatever,
even as an adult, and that theycontinue living life like that

(06:43):
where it actually begins to hideor repress or suppress actual
painful traumatic memories orthings that you you put away
because either it's not safeenough in your family or your
culture to talk about it it'snot uh it's not okay to talk
about i mean there you getabused for it you get chastised

(07:07):
for it whatever it is and so youhave this storage of hidden
deep painful memories which youreally maybe you you may not
even be aware that they'restowed as entrenchedly away as
they are but you are you knowsomething's wrong because you're

(07:33):
constantly needing to be busyyou're constantly needing to be
on you constantly need to feelin control and it's what I call
perfectly hidden depressionbecause it is not going to be
like your typical depressionit's not going to look like that
it's not going to sound likethat and I it's an incredibly
important thing for us to talkabout because certainly in the

(07:57):
recent years perfectionism isway on the rise really amongst
many cultures internationally soas is suicide so there's a
correlation so that I mean it'sKind of a complicated question,
but that's probably the mostsuccinct answer I can give at
this point.

(08:17):
Hope that's helpful.

Yeah, absolutely.
And speaking of the signs, whatwould you say are the telltale
signs of perfectly hiddendepression?

the signs of it.
That's, you know, I, it is, itis a, it, what a lot of people
who have identified withperfectly hidden depression,
it's not a diagnosis, by theway, I call it a, I call it a
syndrome, which is a group ofbehaviors or beliefs that are
typically found together.
Codependence is probably themost well-known syndrome around

(08:53):
here.
And it is a mixture of thesetraits and beliefs that demand a
lot of perfectionism you'rehighly perfectionistic you you
carry but but that perfectionisminstead of being fueled by
curiosity or generosity orwhatever it's really more fueled

(09:15):
by shame I've got to provemyself as a person I've got to
I've got to make I'm afraidpeople will find out that I make
mistakes so I've got to dothings perfectly you take a lot
of responsibility in fact you'reuber responsible you do
discount hurt and any kind ofpain from the present or the
past you um you're very uhhelpful and loving toward other

(09:41):
people but you don't let anybodyreally know you uh you i mean i
can there are about 10 basictraits you're very you exude a
lot of gratitude and you talkabout being very grateful but at
the same time it has a toxicityto it meaning that uh you don't

(10:02):
even, I mean, you must begrateful for things rather than
seeing that even things that areblessings have underbellies
that can be difficult.
Um, and it's, it's just ageneral, uh, you're often very
successful.
Um, and you're well-likedyou're, you're, you're, you're

(10:25):
well-known in the community.
You give, you love, you care,you work hard, but at the same
time at the core of that you'reyou're very lonely very
despairing in your very quietsilent moments and unfortunately
that despair can reach canreach can reach dangerous

(10:53):
dangerous levels where suicideis an option

wow wow you said a lot of really important
things that I want to talk toyou about.
It actually brought up threethings in particular, so I'll
just go one at a time.
But how do you know whensomeone is pursuing excellence
versus perfectionism?

Great question.
There's absolutely nothingwrong with pursuing excellence.
Absolutely nothing wrong.
I mean, in fact, you know, it'ssomething that we really admire
in people, you know, the oldsaying, if it's worth doing,
it's worth doing well.
And but here's an analogy I'veused in my teaching clinicians

(11:41):
about this.
Let's say you plan a hike foryour family.
And you really want to go seethese waterfalls.
And that's the purpose of thehike.
And you've packed well, andyou've really packed a perfect,
you know, perfect hike andperfect picnic.
But you know, little thingshappen along the way.

(12:01):
And, you know, somebody getspoison ivy and somebody gets
hungry before they're supposedto get hungry and, you know, and
but it's gorgeous and you enjoyit and it's fulfilling and you
still really enjoy the beingtogetherness of it, but you
don't get to the waterfall.
And so you turn around and youcome back and you think, you

(12:25):
know, that was perfect.
That was exactly what it wassupposed to be.
That is what's turned termed aconstructive perfectionist, that
you try to do things in a veryexcellent way.
You try to, but you alsorecognize that sometimes you
can't control everything, right?
Right.
Destructive perfectionism isthe same hiker of the same

(12:49):
family where the trip is gettingto the waterfall.
It's accomplishment oriented.
It's not process oriented.
Constructive perfectionism isprocess oriented.
What What am I learning fromthis process?
Destructive perfectionism isI've got to reach the
accomplishment or I will fail.

(13:12):
Okay.
And that is because, again, atthe root of destructive
perfectionism is this sense oftypically this shame and fear
of, I have to prove that wrong.
You've got voices in your headall the time that are saying, if
you don't make it to thatwaterfall, if you don't get the

(13:33):
promotion, if you're not head ofa nonprofit, and if you don't
make more money for them thanthey've ever made, if you don't
write a book, that somehow sellsa certain number of copies,
then you have failed.
And so your fear is that youwon't achieve versus the fear in

(13:56):
constructive perfectionism isthat you won't enjoy.
And so it's like the motivationis different.
The motivation is different.

Very interesting.
It actually sounds a lot likethe spiritual principle of karma
yoga, where it's about trainingyour mind to really focus on
the process and let go of theattachment to the outcome of

what you're doing.
And that has to make betterwork.
It's not that the outcome isn'timportant, but you can accept
that there are things that arejust not in your control, that
it, again, and that makes a lotof sense that you It's not that

(14:44):
you don't try, you do try.
But it's also about what youlearn along the way.
And a destructive perfectionistwill not, they will not believe
that.

Yeah, yeah, that's really important
distinction, because it isimportant to aim for the best,
you know, and to put effort intoa goal, because sometimes if
we're outcome oriented, and saywe don't get the outcome, there
could be a defeatist mentalitythat, oh, then I just won't even

(15:17):
try again, you know, we're onthe spiritual path.
Lord Krishna has said in theever goes to waste.
And I like how you said aboutwhat did you learn from the
experience?
Because if you can learnsomething from every experience,
then you are able to keep goingand build that resilience to be

(15:42):
able to apply that and to beable to still go with that same
intention.
Like maybe you try again to goto the same hike to see the

Dr. Margaret Rutherf (15:52):
waterfall, but you remember how much you
enjoyed it last time and whatyou've learned.
And so you can kind ofintegrate the two and just enjoy
the process again.
And also remember what may helpyou to get to the actual
waterfall.
Don't take all your children,probably.
You really want to get to thewaterfall.

Yeah, totally, totally.
So I love that.
And I also wanted to ask you,how do you know if the kind of
gratitude that you are feelingis toxic or if it's the kind of
gratitude that all kind ofresearch talks about uplifting
your mood and helping you copebetter and see more positivity

(16:39):
where maybe you've only seennegativity before I

mean you know I think the the
cognitive behavioral therapistwould say or the positive you
know activity therapistpsychologist would also say you
know it's a positive reframeyou're you're grateful because
you know it's It's, it's, you,you use, you make sure you're
framing things positively andyou're grateful for those

(17:02):
positive things rather thanthinking, you know, well, this
is a drag or whatever.
And, and I, I agree with thatso much.
Toxic positivity means that youcannot allow yourself to say
no.
this is hard.
This is harder than I thoughtthis is, well, just be grateful.

(17:25):
You've got the opportunity, youknow, or let's say, let's say
you're grateful because you'vealways wanted a big family and
you have a big family.
Well, you know, you, if you, ifyou got four children, you saw
also got four lunches to fix forhomeworks to, to help with for
weddings, you know, whatever fora name, that's a lot.

Unknown (17:48):
Yeah.

Speaker 02 (17:49):
And

so sometimes you go, wow, why
didn't we stop with three?
And that's okay.
You still want to, you'regrateful for number four, but
number four makes it a littlemore complicated.
Um, and so it's being able to,um, sort of swim in both sides

(18:16):
of the blessings and then the,some of the, you know, struggles
that those blessings bring inyour life.
I mean, I loved writing a book.
I love having a book published.
It was one of the hardestthings I ever did.
I mean, I, you know, my husbandsaid, how many more, how many
times did you go to the doctorthat year that you wrote the

(18:36):
book?
I mean, it was multiple,multiple, because I, it was
hard.
It was, it was hard physicallyfor me.
So, you know, you know, I wasgrateful for that experience,
but it also inherently, youknow, cause some issues in my
life that were much harder todeal with.
So it's, you can, you can beboth, you can be grateful and
you can recognize that things,you know, sometimes are hard and

(19:02):
it's those people that justwill not allow that.
They'll say, you know, theywill shame you for not being
grateful.
If you talk about something asbeing you know, having a hard
day or we'll just count yourblessings, you know, and
especially in the Bible belthere in the South, you know,
that's, that's very true.
So for a lot of people.

Wow.
Yeah.
I feel like that's somethingthat is good to be aware of is
the gratitude connected withshame.
Is it a punishing sort ofperspective to block feeling our
real feelings or acknowledgingthe paradox of life that the
biggest blessings can also bringthe biggest challenges.

Dr. Margaret Rutherfor (19:48):
Exactly.
Exactly.
And sometimes those challenges,you know, my dad, every time he
would get ill again and he was,he had, he had, you know, he
was glad to be alive and weloved him and he had a great
attitude.
But one day he said, you know,God's not supposed to give you
more than you can bear, but I'vegot to talk to God.
He's way overestimating myabilities.

(20:09):
he was kind of saying i'mgrateful and this is great but
whoa what are you gonna stop

wow that's funny um wow yeah that's that's
really helpful to be able to seethese traits because it sounds
like you're describing awell-adjusted person who would
be happy with life's blessingsand is grateful for them and
always helpful to other people.

(20:47):
But you talked about thepresence of this deep loneliness
within such people who seem tobe well-adjusted and are even
well-liked and are involved inthe community.
They have families, they havefriends, they have lots of
people around them.
No

one really knows them.
No one really knows what'sgoing on with them,

right?
Yeah, yeah.
So can you talk a little bitabout that?
What's causing that?
causing that deep loneliness inthe midst of being around other
people and how do you identifythat if someone is actually
really as happy as they seem orif they may be suffering inside

you know it's an interesting thing
when I was trying to get thebook published or my agent and I
were some large publishinghouses were very interested in
it and I got all excited andthought whoa it's gonna be great
and then when it got to thecommittee they said we don't
think I think these people willbuy a book on depression.
They need to look perfect.

(21:46):
Why would they buy a book ondepression?
And that's not a bad point.
These people are very investedin looking a certain way.
And until something clicks inthem.
In fact, I've heard some peoplereach out to me and say, I

(22:07):
heard that term perfectly hiddendepression.
And I knew you knew what wasgoing on with me.

wow

um and it is a very difficult undoing
or untangling or letting goslowly to recognize that you can
talk about that that lonelinessthat despair and that's not
going to cause you to becomethis person you fear becoming

(22:40):
you you you you are also and andyou are your competence and you
are your vulnerabilities thatself-acceptance is so important
these people do not have thatkind of self-acceptance the only
thing they accept aboutthemselves is that are their
accomplishments and that's whatthey're willing but but they

(23:03):
know their gut knows theirunconscious knows that they're
hiding and that there is abetter basic loneliness.
I cannot tell you, sadly,tragically, how many spouses
have reached out to me and said,you know, my husband killed
himself and, you know, it was ashock to the community or my

(23:25):
wife did.
And I didn't even know how badit was.
I had no clue.
Now that I look back on it, Ican see maybe that one woman,
for example, told me that herhusband had made some sort of
financial decision years agothat had been really bad and he

(23:50):
had had to work extremelydiligently to bring the company
back up he practically lost thecompany and she said about a
year before he died by suicidethat something was going wrong
with his business and shebelieved then that something was

(24:10):
triggered in him that he wasabout to go through the same
experience And he, quoteunquote, couldn't live through
it again.
And that was her best theoryabout why he took his life,
because the shouldering, theburden of thinking, I'm about to
fail, or I may look like I'mfailing, was so onerous to him

(24:33):
that he couldn't, as much as heloved her and his family, that
he couldn't tolerate the idea ofgoing through that.
He didn't know how.
Um, That's her best theory.
And so what I'm trying to dowith this book and knowing
wonderful people like you andhaving them ask me questions

(24:56):
about it is realizing that andhelping people realize that
there is a way out of that, thatyou are still living your life
by codes and laws and rules thatyou learned years and years and
years ago that don't have toapply.
And yet, and you're drawn tothat idea, but you're so afraid

(25:21):
of what might happen if youquestion or confront or begin to
massage those rules a littlebit.
Because it is, because again, Ilove to tell the story of a guy
named Steve, or at least that'swhat I'm calling him.
And Steve was a very successfulperson here locally in

(25:43):
Northwest Arkansas.
And head of a very difficultbusiness and retired.
And he and his wife actuallycame in at first because she was
having some struggles with himwith retirement.
And then we got into more someof her stuff, but he kind of sat

(26:03):
and listened.
He participated some.
But about four months later, hecalled me back and he says, can
I come back by myself?
And I said, sure.
And he said, I want to talk toyou about some things that have
happened to me.
I said, well, tell me aboutyour childhood.
He started laughing, Ananta,just laughing uproariously.

(26:23):
He said, well, my mother usedto throw rocks at me and scream
at me that I'd never amount toanything.
I proved her wrong.
He said, but I don't know.
I was looking forward toretirement and I don't

(26:44):
understand what's happening tome.
I'm drinking too much.
I don't want to do anything.
I've had this great career.
And you know, what's going on?
I don't understand.
And I looked at him and I said,don't you have a grandson?
He go, yeah.
So let's get him out in thefront yard.
Let's go pick up some bigstones and throw them at him and

(27:04):
say, you're not going to amountto anything.
Scream at him.
And Steve looked at me andwent, well, I would never do
that.
I said, why not?
Because it would hurt him.
I said, you are still thatlittle boy that was screamed at.
As long as you were working andgetting this, all this constant

(27:27):
affirmation, what a success youwere.
You could answer your mother.
You could say, see, you'rewrong.
I did amount to something.
And now with retirement, youdon't have that armor anymore.
And your armor is beginning tocome off.
And so you don't know what todo with yourself.
And he kind of looked at me.

(27:48):
I won't say he got tears in hiseyes, but you could tell that
something was going on.
He says, I think you're right.
And he began to do that workof, wow, I have been bound for
years to prove my mother wrong.
Now, how do I, how do I findand discover my true value?

(28:12):
It was incredible session.

Wow.
Wow, that's so powerful.
Yeah, we internalize so many ofthese things that happen in
childhood and don't even realizethe power that they continue to
have on us.
And as I was reading throughyour book myself, I remember
coming across reflection number35.

(28:39):
I love how you have all thesereflection prompts in the book
to help the readers go withinand see their own patterns and
things that had happened inchildhood or things they
learned.
It's

the hardest thing about the book.

It's the hardest thing, but it's the most
powerful part of it because wecan actually have a way to go
make that journey within that somany of us are avoiding
initially because of how muchcan come up.
I remember when I was readingReflection 35, though, and you
were talking in there about howwe need to look at any spoken or

(29:16):
in our childhood and how theymay have affected us.
And I loved that story that youtold about the cooking of the
ham.
That was hilarious where thewoman was cutting off a part of
the ham because she said hermother did it.

(29:37):
And she asked her mother, whydid you do it?
And she said, well, because mymother did it.
And so then she asks hermother, she would cut off that
part of the ham.
And she was like, oh, becauseBecause the container wasn't big
enough, so I just needed to cutpart of it off.
And it was such a hilariousstory.

(29:57):
Like, oh, there's actually areason for it that totally
doesn't apply to your context,but you're just doing it blindly
because that's what you haveseen modeled for you.

Right.
That's what the rule was.
When you cook a ham, you cutthe

end off.
Yeah.
Yeah.
It's kind of like an unspokenthing.
Right.
That

just

got passed down.
And it made me really thinkabout how in the spiritual
tradition of Vedanta, we learnabout how to develop the
intellect, which is differentfrom intelligence.
It's the part of the mind thatcan actually reason that can
think that can judge that candecide and that can also hold

(30:42):
the mind and the emotions and beable to process it and to not
be at the mercy of our mind.
our emotions and it's apowerful thing to have right on
the healing journey because ouremotions do tend to get the
better of us and the way thatwe're taught in Vedanta to
develop the intellect isactually to not take anything

(31:05):
for granted and to questioneverything which is why I love
that you have all thesequestions in the book because I
feel like so much of ourprogress in healing is actually
about asking powerful questions.
And I asked myself about that,like, oh, are there any rules

(31:25):
that I'm still kind of goingthrough?
And it reminded me of chapterthree in my book where I've
talked about igniting the fireof transformation and the first
time that I really looked at thedenial of what all went on in
my childhood and the masks thatI wore as a result of it and my
own eating disorders.
And now I would say my ownperfectly hidden depression that

(31:49):
caused all of this and how itwas so much around like
childhood and eating which madesense then that I had eating
disorders because I used to getpunished if I didn't eat
everything that was on my plateand there were certain foods
that really didn't agree with methat I found out much later

(32:09):
that Ayurveda validated areactually not good for my
particular constitution likeeggplant and I remember boy
every time eggplant was on themenu I was just like, want to
die, you know, rather than gothrough having to eat it because
it just did not agree with me.
And, and I would experience itbeing forced down my throat and

(32:31):
I had to eat it because it wasthe rule.
It wasn't even like children inIndia or Africa are starving.
So therefore you should eat it.
It was just, it's the rule andyou don't question it.
And it made me have a reallydifficult relationship with food
and emotions and as I grew up.
And I was able to confront thatand talk to my dad.

(32:52):
And I've shared about thatstory in my book, which is a
really powerful experience.

I remember that story.

Yeah, to be able to finally, you know, take
off those masks and have a muchmore authentic relationship with
myself.
And it led to a lot of healingand transformation with my dad.
And I'm so grateful for that.
And it was so unexpected, youknow, that he would initially it
was not pretty, but soonafterwards, it came around you

(33:19):
know I think it was just thatthe mask was on so tight for
everyone and the idea of anyonetaking it off was like no way
like no that's not happeninglike no like you've got the one
who got it all wrong but thenyou know my mom kind of stayed
in that place for a while butthen my dad quickly like saw
through his own stuff you knowand and was able to work with me

(33:41):
and we really transformed a lotand things have continued to
improve and improve beyond evenmy imaginations but it was very
scary to do that.
And I realized even recentlythat I had a lot of skin issues
because I went through atraumatic experience with some
spiritual teachers who were not,you know, the real deal.

(34:02):
They were like wolves insheep's clothing and they were,
you know, very manipulative andhad done a lot of abuse.
And I was just caught in thatbecause I was such a keen
student to want to learn thesedeep traditions.
And it's important to learn andstraight from the source you
know I

Dr. Margaret Ruther (34:20):
manipulated that

yeah yeah exactly it happens so much right
and and I feel like Iexperienced a lot of skin
breakouts afterwards because ofall the toxicity you know that
was involved in that dynamic forso many years and then the
stress of moving and changing mywhat I was going to do and just

(34:46):
figuring out a path out of allof that and being able to start
basically my life all over againbecause all the people I was
spending time with I no longerdid I moved across the country
so there's a lot of anxietyprovoking big changes that
happened within that year and Ihad a breakup also of a
significant relationship and somany breakups of friendships

(35:07):
even because of that so I feellike a lot of my emotions that
were probably hidden again inthat particular context came out
through my skin to makethemselves visible and I felt
like by that point I had healedenough to be able to recognize
that this is something toembrace the fact that my

(35:29):
emotions are coming out throughmy body and they're there to
teach me something and they'rethere to actually help me know
when I've really processed allof the trauma and all of the
lessons that are meant to belearned so that I can carry
forward only the pure teachingsand the good truth and wisdom
that I received and let go ofall the rest of it and really,

(35:52):
you know, put it behind me.
And that was really the originof my book, The Way of the
Goddess and being thatvulnerable because I realized
not facing all the patterns inmy childhood caused me to learn
from people who repeated themfor me to be able to kind of
close that cycle, you know, andthen my skin was my teacher to

(36:14):
know where I was at in thatprocess.
And I was as I was reading yourbook about that rule thing, I
realized, oh, wow.
So I've done a lot and why isit still not going away?
And then I made these small,small changes, right?
Like really micro changes whereI'm like, let me just pay a
little more attention to whenI'm actually full and not just

(36:37):
eat because I don't want to haveto deal with the hassle of
having leftovers, right?
Or eating the mind dullingleftovers because I know the
psychology of food right and ifyou eat food that's left over
it's going to cause morelethargy in the mind and more of
a you know kind of dullinginfluence then I'm like okay but

(36:59):
that's also maybe a story maybethe real culprit here is that
I'm still following the rule atthis really small hidden micro
level where it's not a big thingI'm not an overeater I don't do
those kind of binge eatingpatterns But I realized I let

(37:22):
the risk of leftovers allow meto make sure I finish everything
in the plate.
okay but whatever I'm eatingthat I don't need you know that

(37:52):
is beyond my body saying that'senough just beyond it it's still
causing some disruption in myskin because the skin is the
organ of digestion and I'm likewhoa and that was it and then
now they don't those breakoutsdon't come back anymore and

Speaker 02 (38:09):
like

wow that rule thing was a big revelation
wow

that's that's really incredible yeah
Bessel van would be jumping upand down right now with the body
keeps the score so he wouldhe'd go oh yeah that's what it
does all right

i really want to read that book it's on
my list of

oh it's

wonderful but it was very illuminating so
i really have to thank you forthat because i thought gosh i've
come so such a long way i'veeven written this into a book
and i'm going to share moreabout it with people but oh okay
no somewhere still there wassome stuff going on.

(38:51):
So I needed to clear that outcompletely.
And I think there's somethingso powerful about the reflection
questions and just asking theright questions, because maybe I
wouldn't have asked myself thatquestion about what rules am I
still subscribed to?
I,

you know, I have to thank my
cognitive behavioral friends forthat, because that's pretty
straight out cognitivebehavioral therapy, which some
of some of which I do, I don'tdo it as as you know rigidly as
a lot of people do it but umyeah and that that makes a lot
of sense and then you begin tosee just how intricate as you

(39:29):
did these um rules can go andhow they can seep into one level
and then another level andanother level so it's uh yeah
it's quite interesting so yeahi'm glad you know i i shared
with you there was a a review onamazon that said Yeah, I really
loved the first of this book,but then those reflections began

(39:52):
and it was like a therapysession.
And I thought, well, that's nota negative review in my book.
Luckily, there are other peoplewho said, yeah, the reflections
are, you know, thoughtprovoking and take some time,
but they're really worth doingso.

Totally.
And that was actually anotherquestion I had for you.
Often we hear that the healingjourney is not a straight line
path it's more of a spiral andalso I would love to know about
what do you tell people as faras the timing of it goes

That's one of the things when I
interviewed you for your bookthat I told you that I liked so
much about your book that yousaid, okay, you start and you go
from this goddess to thisgoddess and then you start over
again and you go from thisgoddess again to this goddess
and then you go back.
I thought that is such myexperience as a person and as a

(40:55):
therapist that is so true thatwe don't necessarily get quote
unquote finished.
So you know, some of the peoplewrote me and told me I couldn't
do the first month.
I couldn't do the firstreflection because it was a
mantra and I, I got stuck thatit had to be the perfect mantra.

(41:16):
And, and, and I even put thatin the book.
It, you know, if you get stuckwith this being the perfect
mantra, then just take, take aword or, but it has to be the
perfect word.
And so, you know, you can getstuck anywhere.
It's that's part of the workingof the book.
And, And as far as the time isconcerned, you know, I just

(41:41):
another mistake thatperfectionist especially will
make is that they think, oh,this this these exercises are
easy.
I want to go to the harderones.
And I had a woman tell me thatand she jumped to the trauma
timeline.

Speaker 02 (41:54):
Oh, geez.

And she said, oh, my gosh, it was
terrible.
I couldn't do it.
And I looked at her as kindlyas I could.
And said well of course youcouldn't because you hadn't it
was like being on a ladder orhaving to jump up three stories
to get on the rung you weresupposed to be on you know and
suppose or you might be readyfor so you the exercises are

(42:20):
designed to try to help youslowly jostle or juggle or
challenge or massage i've usedthat word before or begin to see
things i mean even from the oneof the first things I say is if
no one knows you, you know,you're not going to sit a friend

(42:42):
down and say, well, okay, Ineed to tell you, I'm reading
this book called perfectlyhidden depression and I've been
suicidal and I've done all thisstuff.
And you're not going to saythat where you start is to say,
I've been your friend for a longtime and I know you really love
me, but there are things that Idon't tell you about me.

Speaker 02 (43:00):
That's

where you start.
That is a start.
And they'll go, well, what isit?
I'm not ready to tell you thatyet.
This was my beginning.
Just telling you, it is notyou.
It is me.
I just struggle to say thingsthat are more vulnerable or more

(43:23):
transparent.
That's where you start.
That's where you can start.
There are many places you canstart, but you start very
simply.
And perfectionists, of course,want to go Well, no, that's not
hard enough.
Well, that's, you know, thatseems simple.
Seeming simple.
is not it's not simple um andso um you know somebody will

(43:47):
come in my office and say wellthis is really silly but and
i'll go wait wait just waitright there if this is a step
toward you going in anydirection that you feel like is
healing there's nothing silly orinconsequential about it you
know nothing and they'll kind oflook at me and i go so what was

(44:10):
it and And sure enough, they'llsay to me, well, you know, I
used to call my mother fourtimes a day and I only call her
two.
Good.
You know, great.
Or whatever it is that they'rewanting to change.

Unknown (44:26):
Wow.

It's amazing.
You know, another question Ihad for you, just given my own
experiences, what do you feel isthe role of anger in perfectly
hidden depression?
Would you say that a lot ofpeople who suffer from it feel
averse to feeling or expressinganger, which leads to this

(44:48):
excessive amount of shame and alot of suppressed emotions that
end up building up so muchinside that then the person's
can't deal with it anymore?

Really good question.
I don't know if anybody's everasked it.
I think probably for a lot ofthe people that at least I had
in mind when I wrote the book,they more than likely grew up in
homes where anger was notallowed.
Because if they'd been able tobe angry, they would have said,

(45:19):
well, what, you know, the factthat dad drinks himself to sleep
every night makes me mad or henever comes to my games or she
mom you never you know you'retoo busy on your phone i mean
it's like i feel neglected imean whatever it is it's that's
not an emotion they feel safeenough in that family or that

(45:42):
culture and environment againit's not always it's a to
express and nor probably is fearbut they're probably more aware
of fear so anger is somethingtypically again with these folks
now I have I have had somepeople tell me that in the work

(46:06):
environment that they feel likesometimes they can be overly
aggressive and so because theirneed for things to be to go
perfectly yeah and then whenthey they begin to heal that
anger with others, um, begins tosubside because their own

(46:26):
standards begin to notnecessarily lessen, but soften.
And, and they realize that, youknow, you get more, what is it?
You get more, what was that oldphrase?
You get more something withhoney than you do.
I don't One man, for example,told me that, I mean, he was

(46:51):
very much identified withperfectly hidden depression and
he'd been married three timesand he said, you know, none of
my wives knew me.
Absolutely none of them knewme.
I didn't let them know me.
I needed to be in control.
My children don't know me.
And he said, I've got to dosomething because, and so he
really worked hard and he wentback to his, and people were

(47:14):
asking to get off his team atwork because he was so difficult
to work with.

Speaker 02 (47:18):
And

he asked his supervisor to retrain
him, which happened.
And I'll never forget, hecalled me and he said, Margaret,
I was so afraid when I wasworking with you in your office,
that if I became lessperfectionistic, that my job
would suffer.

Speaker 02 (47:36):
What

I found is that people are asking to be
on my team now.

Speaker 02 (47:44):
And

so, yes, I mean, I'm not trying to
make this into a Disney to Imean, these are actual stories
of what people have said,because, you know, he began to
try to get to know the peoplethat worked for him, worked with
him.
And that led to a better workenvironment.
And then he wasn't, you know,writing people so hard and

(48:05):
writing himself so hard.
So it can really, um, it canchange someone.
And, but as you are pointingout, and I think it's very apt
to point out, this isn't a onemonth fix, you know, uh, This
may be transformative in manyways, which is a word that I
think is used too much rightnow, but it takes time.

Absolutely.
Yeah, I totally agree withthat.
And I feel like I definitelyhad this.
And I definitely was notencouraged to feel or express
anger ever.
And I actually was reallyafraid of anger.
And I feel like I've had achallenging relationship with

(48:47):
anger because seeing my dad notbe able to control his anger and
be on the receiving end of thatas the most vulnerable person
in the family you know andincidentally the smallest person
in the family I reallydeveloped such a aversion to
anger you know that I wouldn'teven admit that I felt it ever

(49:13):
because I thought I'm notsupposed to I'm taught that I'm
not supposed to in the Indianculture a woman is not supposed
to have these feelings and evenjust as a woman I feel like
we're all about nurture rightand we're about caring and we
have to do that whole prescribedrole but then we get taken

(49:34):
advantage of so much right thatanger would be the appropriate
response anger would be thething to kind of burst through
those like those layers of shamethat cause you to be inactive
right that that depression islike unlived life right it's
like you you are just under thisheavy spell of something that

(49:57):
doesn't allow you to moveforward and so I feel like for
me that was really huge on myjourney to give myself the
permission to feel that for onceand I think that's why my skin
did its whole thing because it'slike look we're red we're angry
we're gonna just show you thatwe do have this emotion and we

(50:19):
do have to deal with it becauseif you don't deal with it we're
just gonna keep coming back youknow like and they were red and
they were angry and they were inmy skin and it would be hot and
I had to do a lot to deal withit.
But what I realized so muchright away was that I know what
you are.
You're my suppressed anger thatis coming out after years of

(50:39):
trying to run, but not reallybeing able to hide from what's
going on inside.
And for me, I found a lot ofrelief actually in exercise and
not the crazy kind of exercise Iused to do when I had eating
disorders as a teenager.
where it was a self-punishmentkind of strategy, but really

(51:00):
like owning my physical powerand being able to channel that
anger into martial artspractices was really empowering
for me.
And it's really interestingbecause in the Eastern
tradition, we have a system ofastrology, which is different
than the Western system.

(51:21):
The Western is based on theEastern system.
It's the oldest system, butit's fascinating to kind of like
see your chart and to see theinfluences of different elements
and different planets on yourmind, your body, your
relationships, your work andthings like that.
And I always thought I'mtotally a good person.

(51:44):
I'm compassionate.
I am a kind hearted person.

I am never angry,

never angry.
Like I'm like, I'm just like afeminine energy, right?
Like I write about goddesses.
I wear pink anger doesn't haveany place in all of that so sure
enough you know the chartitself was a huge revelation
because in the chart it kind oflike shows you a blueprint of
your personality and youroverall sort of purpose or what

(52:14):
sort of role you play in societyand sure enough the second
strongest planet after theplanet of wisdom and spiritual
teachings which makes sensebecause I'm so very much drawn
to that is Mars, which is the

Speaker 02 (52:31):
planet.

Adventure and anger and potentially
violence.
And I'm like, oh my gosh, likeaccording to my chart, I'm like
double Mars because I have aAries moon and an Aries rising
sign, which is like the leader,the fire, the warrior, right?
And it says that my role is tobe a warrior, that I'm not just

(52:56):
here to spread wisdom.
But the way that I even spreadwisdom is by being a warrior for
truth and a warrior for peaceand a peaceful warrior.
But that warrior part, I didn'teven know I had within me until
I uncovered it through leavingthat situation of the crazy

(53:17):
teachers and really owning mypower.
And it's so interestingbecause, you know, they were
still my teachers and I willnever not call them that because
I learned so much about myselfand about how to apply these
teachings in dark situationsfrom what I went through with
them.
But I remember that one thingone of them said that really

(53:38):
stuck with me is that the way Iwould get moksha or spiritual
liberation is not by continuingto develop qualities that I
already had, like the humility,like the gratitude, like the
selfless service, like theability to feel compassion and
empathy towards other beings butactually by owning my power and

(54:02):
I not owning my power was thething that was actually blocking
me from being liberated and Iwas like whoa okay I really need
to do that you know and Ireally need to put that anger
with the wisdom and create truesoul power from that and that

(54:22):
was an equation I learned fromstudying that also stuck with me
that when we bring angertogether with wisdom, we can be
a force for powerfultransformation within ourselves
and then be an example for otherpeople.
And so for me, it's like awhole new relationship with this

(54:43):
fire element and this abilityto burn through what doesn't
serve me or other people and tobe able to find that courage
also that I think it takes toeven get onto a path of healing
and a path that can lead togrowth.
So I personally have felt ahuge change in my life from just

(55:06):
giving myself permission toaccept that I have this and then
to really channel thatconstructively to be able to get
out of my own comfort zone tobe able to take risks to be able
to be vulnerable and to getmyself out of this whole pattern
right of pretending thateverything is perfect, even
though it wasn't inside.

(55:26):
so I wonder what are some otherhealthy ways you might
recommend other people who mightrelate to what I'm saying to
safely connect with that angerwithout hurting themselves or
anyone else in the processbecause obviously suicide I feel
like that must be anger thatthey're directing into
themselves right to hurtthemselves in such a way oh

well

could be part

of it yeah it could be it could be and
there are you know actuallysome of the suicides that are
most associated with anger thatI know about are the more
impulsive suicides where they'reangry and then they express
that anger through dying but youknow what what what I kept

(56:17):
thinking as you were talkingthat if if I were trying to talk
about this it would be that wewe pigeonhole ourselves into
thinking well I am x yeah mustbe x I must be selfless I must
be I want to be I aspire to begiving I aspire to be you know

(56:43):
whatever it caring.
But rather than it being an or,I'm either that or I'm this,
it's that and I'm angry.
Or I have angry feelings.
I am caring and compassionateand I can be angry.
You know, that those things donot obstruct one another.

(57:05):
They can coexist actually verybeautifully.
If you're only angry, thenyeah, that's a problem.
Yeah.
You know, if everything makesyou angry, if that's your sole
way of expressing emotion, thenthat can be a problematic, kind

(57:29):
of a characterological problem.
But if you are, you know, ifyou're funny and you can be
angry, if you're caring and youcan be angry, if you're caring
and you can be funny, I mean,it's just sort of this, we are
complicated human beings and wedon't have to pigeonhole
ourselves um you know thishappens a lot in families i at

(57:52):
least in the united states iknow it does that people will
tell me all the time oh i wasthe smart kid in the family yeah
it was the funny kid my sisterwas the spoiled kid or my sister
was the whiny kid andunfortunately you get called
that enough yeah and you startgoing okay that's who i am
that's all who i am i'm justfunny i'm smart i'm i'm a good

(58:15):
athlete i'm you know that'sthat's That's where I need to
head.
That's where I'm going to getmy needs met.
But actually, we're all ands.
So, you know, that's what cameto mind when I was listening to
you talk.

Yeah, yeah.
And again, it's accepting thatroom for paradox and that

Speaker 02 (58:36):
room for

nuances and the complexities of life and not
vision-holing ourselves.
Because in a way, I feel likethe perfectly hidden Depression
is a pigeonholing.

It is.
A

role.
And we have to get ourselvesout of that.
So would you please share aboutthe five stages of healing from
perfectly hidden depression andalso how someone who's
listening might take their firstbrave step on this journey?
Because that's the hardest one,I think.

I have to tell you the funny story
about the stages of healingfirst.
I submitted the book.
to my publisher and they saidokay we really like the book but
the book didn't have anytreatment strategies it was just
describing this syndrome Ithought that was good enough

(59:29):
thank you very much and theysaid no we need a treatment
strategy and we need it in twoweeks I was like whoa okay and
so I really sat down by thattime I'd been a a therapist for
24, 25 years.

(59:49):
And I thought, what do I dowith people?
If there was a, if there was acompartmentalization or if there
was, you know, stages of what Ido with people, I don't care if
they have bipolar disorder.
I don't care if they havedepression.
I don't care if they haveborderline personality disorder.
I don't care if they haveanxiety and eating disorder.

(01:00:10):
What do I do in my own, if Ihad to segment it, which I don't
typically do, I But if I had tosegment it, so it made sense to
somebody who was trying tolearn it, how would I do that?
And they wanted it marketableas well.
So it was the five C's oftreatment, you know, I hate

(01:00:31):
that, but you know, that was,they said, make it marketable.
I was like, oh gosh.
So anyway, so I thought, youknow, the first, the first route
that I think is important isconsciousness, especially, well,
really with anything.
you have to accept thatsomething is a problem before
you are willing to say or it'sdestructive or it's a part of

(01:00:55):
you that is getting in your wayyou have to accept that first
and see it as a problem oryou're going to kind of look at
someone and go well that's not aproblem you know so I get angry
that's not a problem so I can'tleave my home that's not a
problem so you know I think thatkind of consciousness awareness

(01:01:19):
again with mindfulness I wrotesome about the book that in the
book and you know that sense ofpaying attention to what's
happening around you, not toanalyze it, but to just see it

(01:01:42):
and be aware of it.
That's not a very gooddefinition, but anyway.
And so that's where you have tostart.
The second one is commitment.
therapy is just like any kindof healing journey takes some
commitment it takes some and andyou actually that commitment

(01:02:05):
can be challenged in many manyways um it can be challenged in
financial ways it can bechallenged in pragmatic ways it
can be challenged in um timeways it can be challenged in um
but but often it's oftenchallenged by you know this is
just hard and i it's scares meto do this it's you have to face

(01:02:27):
your fear you have to sometimesyou your family doesn't want
you to change um they say i kindof like you the way you are
what do you mean you're notgoing to do x y or z anymore

Speaker 01 (01:02:37):
um

Dr. Margaret Rutherford (01:02:39):
what do you mean you're going to
therapy um so it can be you canget pushback you can get in you
can struggle yourself and thatkind of commitment is important
the third one is what we weretalking about a few minutes ago
which was the confrontation partlooking at your rules, both
spoken and unspoken, and howyou're following them now.
And is that a good thing?

(01:03:00):
I mean, are you following rulesthat you're glad you follow
now?
But what would happen if youstopped following that rule?
And what are you scared wouldhappen if you did?
And if you begin risking that,what does it feel like to not
live by that rule anymore?
What did it feel like to say,it's okay that I don't eat all
this food?
And so that's the third step.

(01:03:24):
The fourth step step in someways is it's not the hardest.
But if you have trauma in yourlifetime, which many of these
folks do, you may not be able todo this by yourself.
You may need to go into atherapist to do this because

(01:03:44):
it's very difficult work.
And I use what's called atrauma timeline with people.
That's a very specifictechnique about going back and
recognizing in your childhood,what were the things that
happened to you that affectedyou in a painful way?
What were the things thathappened?
to you in a productive way andbeginning to then either through

(01:04:08):
your art through music throughwriting through journaling
through talking through justlooking at it you can begin to
see the patterns that existed inyour life and how maybe things
that you had not even been awareof were traumatic actually were
because you begin to say youknow if that hadn't happened
when I was three I probablywouldn't have chosen that when I

(01:04:32):
was 23.
I But that can be verydifficult for people.
People will say, oh, I'm justgoing back and blaming my
parents or I'm going back.
And, you know, no, you're notdoing any of that.
You're becoming aware andyou're acknowledging.
There's a huge differencebetween blame and
acknowledgement.
Fifth change is something orfifth segment or stage is

(01:04:57):
something I think is veryimportant.
And a lot of therapists, youknow, I don't know, some
therapists is do not stressthis, but I do.
I think you get hope not frominsight.
Insight's wonderful.
Lots of aha moments.
That's great.
But where you get hope is whenyou see your behavior change.
And so I take each one of those10 traits in the book, 10

(01:05:22):
traits of perfectly hiddendepression, and I have you pick
the easiest one to begin to say,well, what if I didn't do X
anymore?
What if I challenged numberseven.
Um, and what would that looklike operationally in my life?
What would it look like to, um,let's say, this is a true

(01:05:44):
story.
I think it's in the book of awoman who said, I'm going to
choose number two because she,she was busy, busy, busy all the
time because she constantlytook the responsibility for
getting things done.
And she went to a committeemeeting and she did not
volunteer for one single thingto do.
He said, she literally sat onhands.
I think, do you remember thestory in the book?

Ananta Ripa Ajmera (01:06:06):
Yeah, I remember that story.

And then she came into therapy and
she said, I almost went back inbecause who was I to not,
everybody in that room was busyand who was I to not take a
role?
And she said, I had to fightback tears because I just felt
like I was disappointing ineverybody.
And as we talked about it, whatwe realized is that she had
learned that, that she had shehad been adopted as a child

(01:06:32):
again here we're going back sortof the trauma timeline she'd
been adopted as a child and herparents adopted parents had
unfortunately told her all thetime you wouldn't be who you are
if you hadn't been adopted byus and so she had internalized
that and thought i have to provemy worth And she proved her

(01:06:56):
worth through constantlyvolunteering.
And she, I remember her face inmy office and she said, I don't
know how to feel okay aboutmyself if I'm not accomplishing
something.
And if I'm not working harderthan everybody else.
And yet she could see the rootsof those feelings in what her

(01:07:16):
adoptive parents had told heragain and again.
hopefully not hurtfully or onpurpose, but it had been
hurtful.
So you go back and you try tochange some of these things.
And that's what you really canget this sense of almost giddy
freedom from that, you know,like throwing the food in the,

(01:07:40):
you know, in the, in the,

in the compost,

Dr. Margaret Rutherfor (01:07:45):
compost.
And so it, those little changesin your behavior and no matter
how inconsequential seeming arenot inconsequential and you can
feel your life beginning to takea deeper breath than you could
have before and um but and againyou you do this over and over
and over all these all thesestages are interwoven and

(01:08:09):
interact and you know you changeyour belief and then all of a
sudden you see something fromyour past differently and then
you deepen your commitment oryour commitment gets shaky you
know and all of them in Sothat's it's consciousness,
commitment, confrontation, uh,Connection and change.

Wow.
You know, I know it's amarketing thing to have, but it
actually does help to rememberto have the alliteration because
it's like, oh, you know, like,and then you can kind of connect
with each of these steps moreefficiently.
You know,

there's a reason why people do it.

Yeah.
Yeah, exactly.
Then if it were explained adifferent way.
So

yeah.

Yeah.
I appreciate that.
um I think a lot of timesthere's a fear of floodgates of
emotions pouring out when theyhave been suppressed for so long
I certainly went through thatand I think it's easy to wonder
if we allow ourselves to finallyfeel if the emotions will ever

(01:09:15):
stop so how do you recommendconfronting this to be able to
start the process of feeling toheal

it's it's a it's a normal fear and
it's one that um i often talk tomy clients about i have a young
girl right now who's a newpatient and she has never looked
at some of these things and mysuggestion to her was well leave

(01:09:46):
it here and then when you walkback in the office it will be
here waiting for you so thereare some mental tricks there's
some emotional tricks that youcan use tricks But I will say
this, some people will say tome, well, if I started crying,
I'd never stop.
I've never seen somebody not beable to stop crying.

(01:10:06):
And if they can't stop crying,then I will see them again and
find out what's going on.
I mean, is your grief, are yourealizing something that you've
never realized before?
And let's talk about it.
But you then I need to teachthem some calming techniques.

(01:10:29):
So I understand the fear, butone of the analogies I've used
as well, and maybe this is notthe way many other people clean
out their closets, but when Iclean out a closet, I pull
everything out and then startputting stuff back in.
When I pull everything out, Iusually look down and think, oh

(01:10:52):
my God, I'll never get all thisstuff back in the closet.
Yeah.
I don't want to put all thatstuff back in the closet.
So I recommend that people bothgear what they feel personally
ready for and And they tell me,again, I'm a therapist.
So I say, you know, I'm not incharge of what we talk about.

(01:11:16):
You're in charge of what wetalk about.
If you're not ready to tell meabout something, if I ask you a
question, then look at me andsay, I'm not ready to talk about
that.
Okay, fine.
So you have to monitoryourself, but at the same time,
suppressing it, stuffing it,whatever word we want to use,

(01:11:38):
has not worked.
And it's coming out, it'sseeping out underneath the door
and through the, you know, likethose, you know, those movies
you see where there's vaporcoming out from some hidden, you
know, storage.
And it's, it's, it's, you don'twant it to burst out.

(01:11:58):
So if you let some of thepressure off, I begin to talk
about it a little bit, thenyou'll probably be more in
control of it.
But I understand the fear.
I I remember telling atherapist of mine years ago,
when am I ever not going to beangry?
And he said, yeah, you'll beangry for a while here because

(01:12:19):
you've never been angry before.
Yeah,

yeah, exactly.
And I feel like I went throughthat with my skin for sure.

Yeah.
And he said, yeah, well, just,you know, okay, you're angry.
It's

a new thing, right?
It's like, yeah, you've neverallowed yourself something.
You got to really be patientwith it.
And let

it seem like a long time to me, but
probably wasn't all that long.
I just was uncomfortable withit.

Yeah.
Yeah.
Same here.
Same here.
It takes a while to integratelike, oh, okay.
I can feel this and I can dealwith it and channel it into
different ways, but be awarethat it's there and not try to

deny.
I want to tell you, these arereally wonderful questions.
You've given so much thought tothese questions and I so
appreciate it.

Oh, my pleasure.
I loved your book.
It was so insightful andamazing to read about.
So, and I have more questionsfor you.
And if we don't have time to doall of them, let's definitely
do an interview with you on theblog and we can address them
that way so that we can dojustice to everything that to

(01:13:29):
share.
But I feel like, you know,we've uncovered so many amazing
things and I definitely wouldlove to have you address one of
the biggest obstacles that Ifeel a lot of people face in
making big changes in our livesis how those currently in our

(01:13:50):
lives will react to that.
So would you please alsoaddress this fear of what others
would think or say if we startto be more vulnerable and real
with them after years of hiding?

I had half a chapter to talk about
this book.
I could have written a wholebook about this.
I mentioned this before, but Iwill say, well, I didn't really
mention this before, but it canbe very difficult.
Yeah.

Unknown (01:14:23):
Yeah.

I think it's one of the most difficult
things.
I feel like it's one of thefirst resistances.
But I'm married.
What will my children do?
And even for making Ayurvedalifestyle changes or diet
changes, those are the firstkind of resistances that people
have to making changes.
How will the rest of the peoplein my life fare with that?
And even the guy in the job,right?

(01:14:45):
Like, will I lose my job?

Right.
Will I lose my job?
Exactly.

Sick.

So...
Everyone in your family isgoing to have a different
response.
I think that...
Well, let me say this first.
People in this particularcategory who have identified

(01:15:13):
with perfectly hidden oppressionmay have, I don't have an
exhausted list, obviously.
They may have been, they may bepartnered with somebody that
literally for the last 12 yearsthat they've been together have
said, you know what?
I don't know you any betterthan I knew you when I'm the day
I, we started living together.
We got married, whatever.

(01:15:33):
And I really want to know you.
So, so where are you?
I mean, they, they may be, theymay, divorced because of that
they may say i'm still heretrying to get to know you and
they might write to me and go ithink my wife is this person and
you know what can i do how cani reach her and that has

(01:15:53):
happened it's also likelyhowever that you've either
attracted someone who also is ahider also wants to avoid
painful emotion and y'all justdon't do that

Speaker 02 (01:16:10):
yeah

you don't get angry the two of you
kind of you know you look youlook like you have the perfect
life you people tell you we justwe want to be just like you um
you know and so that may be partof the problem because he or
she or they isn't ready to makethat change with you.

(01:16:36):
And they don't like it that nowall of a sudden you want to
talk about things or expressthings that you want to
introduce something into thepartnership that has not been
there in the past.
So that can be a hurdle.
The second thing is that youmay have been attracted to
someone who really needed you tobe overly responsible,

(01:16:59):
especially someone withnarcissism because you you're
the first one to say oh this wasmy fault or I should have
worked harder or I should haveunderstood this better or you're
accustomed to taking a lot ofresponsibility to the point

(01:17:19):
where it may be something evenpathological in you or certainly
destructive in you and thenarcissist is going to say yeah
this is your fault and orsomeone who has those kinds of
traits.
So you may have attractedsomeone like that.
They also are not going towelcome a change.
The third thing is that you mayhave attracted someone who's

(01:17:43):
under responsible because you'reoverly responsible or you're,
they are a, they, you know,they're underachieving and
you're overachieving.
You're the primary breadwinneror you're the, and all of a
sudden you decide I'm not goingto work three jobs and anymore
or I'm gonna take somethingthat's for a pay cut because I'm

(01:18:05):
tired of working this manyhours and they're gonna freak
out so you know I that is toughit's definitely tough and uh uh,
it, you know, if, if you'relucky enough to be partnered

(01:18:28):
with the first kind of person,they're going to be delighted.
Although you're probably goingto be the one that says, oh my
gosh, you know, you're, youreally want me to talk to you
about me being angry with you.
Yes, I do.
You know, um, the other threekinds are problematic.
And just like when we make,like if an alcoholic gets sober,

(01:18:52):
if, uh, if someone who any kindof major change, as you say,
developing an Ayurveda lifestyleor even going vegan or
something.
I mean, we change somethingthat, that alters our social way
of being with one another orour familial structure.

(01:19:12):
Then all of a sudden that thatcan cause problems.
So it, I'm not going to try togive a glib answer here.
It is definitely one of thetougher things.
I think I learned this yearsago.
and I was a music therapist orI actually studied music therapy

(01:19:33):
and one of the things we had todo was we had to shadow an
ancillary therapy and I shadoweda physical therapist in the
summer.
This woman came in, I'll neverforget, her name was Harriet.
Harriet was so out of shape.
It was a spinal pain clinic andher back hurt and we managed to

(01:19:56):
get her on the bike and shecould bear pedal like two or
three cycles.
By the time Harriet left thatclinic, she was coming around
with a towel around her neck andshe was like, all right, I'm
ready to work out, you know, andit was this huge, phenomenal
change in her.
Well, I saw it.
Then she went home and I sawHarriet about six weeks later at

(01:20:18):
the very end of my tenure atthat job.
And she was back in awheelchair.
And I said, what has happened?
She said, we see this all thetime.
they go back to their familytheir family wants them to still
get disability or their familysays no you know you can't do
that and they'll they'll becauseof the pressure of the family

(01:20:41):
dynamics they'll go back to theway they were before so it's
really tough wow

Wow.
Yeah.
It's very brave, I think, tomake this journey because you do
take these risks where it's alot safer, maybe feeling to stay
where you are.
And yet the risk of notchanging means staying
inauthentic with yourself andmeans staying stuck.

(01:21:14):
And so there's kind of a highprice for it.

And again, not to be overly dramatic
but I'm not being overlydramatic when I say sometimes
the price of this rigid, aperfectionistic stance.
And then you get, you feelyou're more despairing.
You're more lonely.
You're, you're, you getoverwhelmed by something.

(01:21:39):
The, the correlates ofperfectionism and suicide are
going up and they're both.
So, you know, this can lead toa suicidal gesture or actually
suicide.
And I, That's terrible.
So, and tragic.

Yeah, absolutely.
Absolutely.
And speaking of which, I reallyloved the story you shared
about the maze of life.
Would you please share thatwith our listeners?

You're talking about the maze that I
went through?
Yes.
Yeah.

Unknown (01:22:15):
Yeah.

Dr. Margaret Rutherfo (01:22:16):
Sometimes I cry when I tell this story,
so I'll see if I tear up thistime.
I had been at a...

It's a good example of being very authentic
and vulnerable

if it does.
I had gone to a residentialpsychiatric program.
They wanted me and severalother therapists to go through
their program as if we were aclient and to experience what
they taught.
They were very experiential.
I did a sweat lodge and I didseveral other things that were
really cool.
The first night we were thereand I was so tired and I just

(01:22:49):
wanted to go back to my hotel.
They blindfolded us and said,we're going to lead you into
this maze.
And there are several rules.
One of the rules is you hangonto the rope and you can't let
go of the rope and you need tofind the exit to the maze.
And all you have to do is, isfind the exit.

(01:23:15):
And if you need help, let usknow.
Raise your hand or somethinglike that.
I said, okay.
So there were about 30 of usand I was anxious and my ego got
all involved and I was tryingto track in my own mind.
Okay.
I went to the right and then Iwent to the left and then I went

(01:23:37):
backwards and, and, and thepressure was growing and the
soft music was playing and thenthey would clap when somebody
got out of the, found the exit.
And, and I was getting more andmore nervous feeling like I'm
the, I'm going to be the stupidlooking person with my hand on
the rope, still walking around.
So I raised my hand and I saidsomething like, okay.

(01:24:01):
And so the person came over andI said, so I need to just go
under the rope.
He said, no, you can't go underthe rope.
That's not the answer.
And so I said, okay, that's notthe exit.
But I was getting more and morefrustrated thinking I'm a smart
person.
I should be able to find thisexit.

Unknown (01:24:21):
Okay.

So I raised my hand again and I said,
okay, is it letting, is itbreaking the rules?
Is the exit breaking the rules?
No, Margaret, that's not theexit.
And so I kept going.
And Ananta, I just remember, Istopped in my tracks and I

(01:24:45):
raised my hand for the thirdtime and I said, I need help.
and they said that's the exitand i will tell you that i
changed at that moment um Allmy, well, I hope most of my

(01:25:12):
defensiveness or guard dropped.
And I realized that I couldonly get everything out of that
weekend if I kept my guard down.
That I wouldn't be Dr.
Margaret Rutherford fromFayetteville, Arkansas.
And that I just needed to...

(01:25:34):
And I don't ask for helpeasily, never have.
And I hope I've gotten bettersince that experience.
So it was very, very meaningfulfor me to include that story in

(01:25:56):
the book.

wow that's such a perfect place to close
this part of our session I feelbecause it's really you living
what you're teaching and writingabout and leading other people
with in the book so that's sucha powerful example of what we

(01:26:21):
need to do and that's thehardest thing to do it's the
simplest thing to do it may seemlike it's easier for other
people to do but once we do it,it's really life changing.

It is.
It is.

That's beautiful.
Thank you so, so much for

Speaker 02 (01:26:39):
being

so vulnerable and authentic and
sharing this message ofperfectly hidden depression and
how to take the brave journey tostart to take off these masks.
And where can people find outmore about you and about your
book and your podcast?

It's drmargaretrutherford.com.
The podcast is on there, theself-work podcast, which I've
done for now eight years andlove doing it.
The book is there.
You can get the book anywhere.
It's in e-book form, audio bookform and then paperback.
And my TEDx talk is on TEDx oryou can put in TEDx.

(01:27:21):
Actually, you can find it on mywebsite too.
You can subscribe to my websiteand you'll get a newsletter
once a week, only once a weekthat just has my blog posts and
my podcast on it and sometimessome fun things and pictures and
challenges and whatever happensto come into my head.
And so that's me.

Amazing.
Thank you so, so much for beingwith us.
I know our listeners arereally, really going to benefit
from your sharing.
And I'm so excited to talk toyou more about how we can
collaborate to be able to joinforces and helping more people.
I

think that's just an outstanding idea.

Thank you so much again.

Okay.
Thank you.

We will.
Go ahead and stop.

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027: High Functioning Depression Signs: Understanding Perfectly Hidden Depression with Dr. Margaret Rutherford

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