895 Upgrade Your Mental Health with Dr. Margaret Rutherford

This is episode number 895 on upgrading your mental health with Dr. Margaret Rutherford. Welcome to the School of Greatness. My name is Lewis Howes, former pro athlete turned lifestyle entrepreneur. And each week we bring you an inspiring person or message to help you discover how to unlock your inner greatness. Thanks for spending some time with me today. Now let the class begin. Berné Brown said, Shame derives its power from being unspeakable. Gloria Steinem said, Perfectionism is internalized oppression. And Michael Law said, As its root, perfectionism isn't really about deep love of being meticulous. It's about fear, fear of making a mistake, fear of disappointing others, fear of failure, fear of success. This is going to be a very powerful episode for so many people. You may not think it's going to.

Be powerful for you.

You may not think this is for you, but I'm telling you it is. If you are someone who wants to achieve great things in your life, you will have this fear of the need to look perfect, the need to look good, the need to impress people, the need to not feel like you're an imposter. All those things will come up at different stages of your life in trying to achieve great things, whether it be your relationships, your family, your career, your job, business, health, all these things, these ideas will come up with you. And Dr. Margaret Rutherford has been a psychologist in private practice for over 25 years now. She's the author of Marriage is Not for Chickens and also the host of a weekly podcast, which I fell in love with called Self-Work with Dr. Margaret Rutherford, where she offers compassionate, common sense directions, ideas and goals towards the changes listeners want to make in healing. And her latest book is called Perfectly Hidden Depression: How to Break Free from the Perfectionism that Masks your depression. And this is all going to be powerful because in this interview we talk about her own journey through depression, anxiety, and shame and how it informs her work today as a psychologist. What Dr. Rutherford believes is at the core of what plagues all her patients, the difference between mental illness and mental struggles. This is a big one. How perfectionism enables depression and anxiety and how to get to the root of your need to be perfect for all your perfectionists out there, and also how to begin to accept the things in your past that you are most ashamed of. I think this is going to help clear a lot of people of fear, pain, insecurity, doubt, shame, all these things that hold us back and really push us to being perfect to try to overcome something from our past or some fear from our past that we've carried with us today. So I'm so excited about this. Make sure to share this with your friends, lewishowes.com/895 and also text me. You can text me right now, 614-350-3960. Just put the word podcast in the text so I know you came here from this podcast. And tell me about anything that's going on in your life, your big goals for 2020. We can stay connected over there as every week I'm sending out inspirational audio messages. They are kind of like mini podcasts in a few minutes that I send out to help you in your week and in your life. So text me 614-350-3960 and share this with a friend, lewishouse.com/895.

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Big thank you again to our sponsor, and I'm so excited about this. It's all about how to upgrade your mental health with Dr. Margaret Rutherford.

Welcome everyone back to the School of Greatness podcast. Very excited we have Dr. Margaret Rutherford in the house. Thank you so much for being here.

You're so welcome. I'm loving it.

Excited about this. I started listening to your podcast Self Work and was really inspired by the way you deliver your message in your wisdom. You've got 25 years of experience as a clinical psychologist, but also you were telling me before that you just have lots of life experience.

I do.

So can you share?

I'm not sure some of the people that know me would call me wise.

I don't know if I trust people who've never been through adversity. You know what I mean? It's like, I don't trust them with advice, let's say. Like, if you've had everything perfect, if you are, you know, everything you do is successful and there's no downside to anything and you don't go through any hardship, you don't have the lessons to share. You can share stories from someone else's experience, but not your own. So what are some of just like a quick recap, the highlight reel or the blooper reel of your life that you would say that gives you experience and credibility besides 25 years as a psychotherapist?

My dad used to call me when he was alive and he'd say, maria, how's your practice going? And so it's going pretty well, Dad. He'd go, great. And he said, well, you know, you screwed up your own life so much, there's not very many problems you can't understand. And I'd say, you know, you're right. In a nutshell, I had a decade that was just really chaotic. I left college and, well, I didn't leave college, I graduated from college, and then was bound but determined to be a professional musician. And I was a professional musician. I was a jingle singer and then a jazz at night. I tried rock and roll, I was terrible. so I sang jazz at night and I had a successful career. I wasn't first tier, but I was second tier. But that decade also included two failed marriages. It also included a bout with anorexia. My panic attacks started in my late 20s, primarily because of the stress of how I was living. And so I, looking back on it, I now understand that. But I had no idea that I would end up becoming a therapist. In fact, I went to school I put all the money I had down in the world at SMU and started studying music therapy because I had done some volunteering and thought, you know, this would be a nice marriage of my interest in helping others and then my love for music. But the very last semester, my psychiatric internship was at a psych hospital. And I thought, oh, no, this is what I want to do. So I went back. I was not a psychology major in college. I was a French major. That has helped a lot. So I got psychology hours and one of my favorite stories is one of the secretaries in the program I got in, which was actually a very fine program, University of Texas, Southwestern Medical School. She told me like my third year there, she motioned to me like this and she said, you, know you were let in out of curiosity. I said, what do you mean? They said, who is this person? Sure. Who is a singer who fronts a big band at night. and then wants to be a psychologist. So that's in about nine years, I went from doing that to being a psychologist, seeing my first patient. So I took those years of confusion. I had two marriages. And I took those years of a lot of confusion and a lot of just feeling lost and a lot of the dangers of the music business for me. I had gone on and alcohol and drugs were very much a part of all that. And so it was hard not to stay away from that. And I just didn't like the person I was becoming. And so I switched and kind of started rowing my boat in another direction. And it wasn't easy. And I doubted myself a lot. I had been in therapy, I'd gotten some bad therapy and some good therapy. mostly good therapy. And I realized if I'm going to be a psychologist and to really believe in myself, I have to just fight through whatever doubt I have, whatever fear I have. I began talking openly about my panic.

Which people didn't talk about probably 20 years ago.

No, no. In fact, we had a mandatory group therapy among the first year students and we had to go and meet with an outside therapist and talk about ourselves. And I chose that group to finally walk in. Now we'd been together about eight weeks by that time.

People were opening up, they were being vulnerable.

A little bit.

After eight weeks, they weren't opening up?

Wow. No. And I walked in and I said, I have panic disorder and one of my colleagues who ended being one of my really good friends in the program looked at me and she goes, so you've been lying to us.

Wow.

Yeah, my worst fear, that people would see it as deception on my part or that I was somehow I've been hiding something, speaking of perfectly in depression. I'd been hiding something from them and, you know, masking and not telling the truth. And I looked at her and I said, I just was not ready to share. And I had to be ready in my heart and soul to share. So we worked through that. But that was really the beginning of me thinking that I wanted to be the kind of psychologist and the kind of person, actually, that would that would foster that kind of openness in other people. And of course, it's way before Brene Brown. And then when we moved to Fayetteville, Arkansas, I got my training in Dallas, and then we moved to Fayetteville, Arkansas, and Bill Clinton had just been voted in as president, and Maya Angelou was his poet laureate. And she's written a beautiful book called Wouldn't Take Nothing for My Journey Now. I was right out of graduate school, and I did not want to read a book. I thought, I've got to read a book by Maya Angelou. She's incredible. So I went to the bookstore and said, what's the smallest book Maya Angelou has never written? You've read so much of Maya Angelou. I can't read another book. And it was Wouldn't Take Nothing for My Journey Now. And there's a beautiful essay in that where she talks about that one week she had been named in New York, the outstanding something of the week. And everybody was very congratulatory in telling her how wonderful she was. And she got really drunk. And she stopped at this table of men and plopped herself down and somewhat with, I'm sure, a lot of slurring, said, what's wrong with me? Why does no man want to be with me? And just made an ass out of herself, basically. I mean, out of her sense of not belonging and a real confusion and hurt. But she even, she says in the book, that was a time when you wish you could change your last name and move to Canada. So, but I looked at that story, Louis, Yes, that's what I want to do. That's the kind of vulnerability and openness that I want to help people find in creating themselves and creating myself. So over the next 25, 26, 27 years where I've been in practice in Fable, I've tried to incorporate that. You know, I can't say that beginning as a beginning therapist, I didn't adopt the therapist stance. I'm sure I did. But I learned that was boring. Boring, boring, boring. So I brought more and more of myself into my work and not where I'm self-revelatory all the time. I don't talk about myself that much. But I try to find a way of getting at that place where people have the most shame and where they're holding a lot of shame.

And get them to share their shame.

Exactly.

Because when we hold on to our shame, what happens?

We continue our bad behavior. I thought shame for a long time. I grew up in a family where if you felt guilty for something that was the worst punishment you could have. You know, that look of disappointment in your parents' eyes. Right, right. And so I thought shame was helpful. I thought it was the same as a good conscience. But then I had a supervisor in Dallas. His name was Robert Beavers. He was swanky Texan boots and the whole bit. And I didn't like him actually very much, but I listened to him and he said, Shame is a helpful behavior if it lasts for 10 seconds and it leads to a change. And so I thought, okay, I didn't agree with him, but as I've learned through the years, you shame yourself for something and instead of it being a motivation for you to stop doing something, you already then say, I'm a horrible person. I've drug all this shame around. I've got all these secrets. I don't deserve anything. And so why not take another drink, or why not gamble, or why not have another affair, or why not whatever happens to you.

You're already a bad person.

I'm already a bad person. I've already screwed everything up. And so I'll keep one more secret, and I'll have one more shameful thing that I'm carrying around now.

Someone said, or multiple people have said, you,'re only as sick as your secrets. Is it the same thing, you're only as sick as your shame?

I think that's apt.

Because if we hold on to shame, we continue to beat ourselves up. We don't believe we're worthy of something, love or a career opportunity or people liking us, is that right?

Right, right, right.

So it doesn't do good for the world if we hold on to shame.

Exactly. And people will argue with me about this and have. I said, you,'re talking about not having any remorse or not feeling bad for what you did. That's not what I'm talking about. I'm talking about holding on to it. I feel remorse about the divorces. I hurt the people I married and they hurt me. But I don't feel good about that. I've hurt people along the way. I don't just forget that and say, well, that didn't matter. I was young or there's some justification for that.

You realize it matters, but you're not going to hold onto it to affect your happiness now.

I'm trying to live in today rather than the past. The past. And so you can learn from it and then have it be motivation for you to try not to do it. But at the same time, if it governs your present and if you're missing out on being with someone in the moment, either your spouse or your children or whatever, because you can't, let go of that. It's a huge part of perfectly hidden depression. It's a huge part of being comfortable with vulnerability.

What happens to us when we hold on to multiple things from the past? Secrets, shame, upset, hurt, frustration, regret, what happens to our life in the present?

You know, there's a quote. We were talking before the interview about an author named Terrence Real, who wrote the book, I Don't Want to Talk About It, back in 1999. '98. And I've quoted him because I love this quote. It's simple. He says, if you don't feel it, you live it. And what he means by that is if you don't allow yourself to connect with something, be it anger, be it fear, be it shame, be it disappointment, you know, whatever, then you are going to live that out. And you may not recognize that you are, but you're going to take that into your behavior today. And it may do it more covertly than overtly. I've had people as patients, both men and women actually, who've said, you mean that something that happened to me, or I did, or I said, or was done to me back when I was eight or nine or 10 or three affects me now? I just, that doesn't make any sense to me. I mean, I'm from Arkansas. People just kind of want to You know, the facts or the facts. And I'll say to them, yeah, and I'll start pointing out how there is a pattern that you can trace in their behavior. And just, it's, they're just wide-eyed. And when it's shame that is part of that pattern, they go, you know, maybe or maybe not, they may or may not cry, but there is a sense of recognition of, oh, I'm arguing with my wife. Because when she criticizes me, what I really hear is the voice of my stepfather. When I have to work until eight o'clock at night because I have to be the best person at my job, I'm really hearing the voice of my mother who said, you,'re never gonna amount to anything. You're just dirt. You know, you are carrying that around with you. And it is very much affecting your actions in the moment. And that's what you that's what you want to begin to undo to the best of your ability. Yeah.

What would you say in the 25 years of work that you've been doing with intimate therapy sessions are the three or four common things you see, the common challenges or problems that people have with themselves or with the situation they're in? I'm assuming a lot of couples, but what's the common thing? Is it anxiety, stress? Is it shame? Is it, What are they lacking? What are they needing? And what's the common theme that most people have? A challenge in a relationship. Interesting question.

Because, you know, because I moved to a relatively small town, and I did my dissertation on pseudo seizures, which are seizures that don't have abnormal EEG activity. They're more psychological in nature. But I would have starved to death if I had moved to Fayetteville, Arkansas, and made my expertise in pseudo seizures. Sure, sure. There's not that many of them. So I've had a fairly general practice. where I've seen men and women and couples and for depression and anxiety and PTSD, I don't do learning disabilities. There's things I don't do. But when you say the common things, that's a really interesting question. I don't know if I've ever been asked it.

That's why you're on the School of Greatness. I think-- Look at the common traits, like why they all come in. Is there like one thing of the core of why everyone comes in or is looking for answers or looking for.

Support or a few things?

I think that they are searching. I think they're searching. And some people want to come in because they think a therapist is gonna provide answers and we don't provide answers. What we do is try to help the person see what they are feeling, but what they're not feeling, what they're saying, but what they're not saying. It's as if I'm gonna hold up a mirror to you. And from my own perspective, which is limited by me and my boundaries.

-Had a 60-minute conversation and what they revealed.

-Yeah, yeah. But I think that most people, if they're depressed, they want and they've tried to not be depressed, they're searching for, what can I do? I don't like feeling this way. if they're anxious, they're searching for a way to begin to manage that. One of the things that I stress is with mental illness, with many mental illnesses, you have to manage them. You don't get rid of them. You manage them, especially chronic mental illness. Now, if you have an acute mental illness where, let's say, you know, your mother died suddenly and you got very depressed, that probably has a beginning, a middle, and an end. However, you still have to live with the fact that your mother died. So you can have- those emotions for.

The rest of your life.

Yes, yes. So it's, there's some, I think what, you know, in graduate school, I was told that therapists are agents of change. And so I think if there's a common thread, and of course different therapists have different techniques of how they think that change is best created.

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I think it is through connection. I think that it is through having a relationship with somebody that has your best interest, that really truly cares about you, and that you can begin to let down these psychological defenses that you have and begin to look at your vulnerability, begin to look at things that you have not figured out before, and that are used the term intimate a few minutes ago, that truly feel intimate in a safe way, in an appropriate way. where you can display what perhaps you've never been able to in other relationships. Yeah. You know, there is so much more abuse than people realize. And people are valiant. I mean, they come up with strategies. That's what Perfectly Hidden Depression is all about. They come up with these strategies to handle whatever's happened to them. You had certainly some experiences early on that it took you quite a while to be able to say, I've got to look at this. I myself was a spoiled rotten child who was also kind of ill. I had some neurological problems and my mother was very, very smothering. And so I developed some behaviors that were in my adulthood pretty destructive. And so I think when you're searching and you're willing to be in a relationship with someone that is trying to help you those answers and you are trying to be open, then whether or not it's depression or anxiety or PTSD or an eating disorder or whatever it is, you begin to figure out what's underneath what the problem looks like.

What's underneath usually?

A metaphor I often use is that, let's, I'll take me as an example again because I never said no. That's why, you know, that was a reaction from my mother. and I was very rebellious that I wouldn't let people help me. And so my rebellion and that part of me that I believed was strong and independent and I didn't need anybody because I'd get smothered if I needed anybody. Let anybody know that I needed them. And so if you think of a rock and you're stepping on a rock every day and I stepped on that independent rock every day, every day, and I loved it. That's my strategy. that's my strength. Well, guess what? If you turn that rock over, it's got little worms in there, it's wet, and it's kind of icky. And that's where that comes from. And I had to understand how vulnerable I felt. Some of my anger, some of my sense of being encroached upon and intruded upon and enmeshed with my mom. As an adult, I had a lot to do with allowing that as well. I'm not gonna blame it on her. So I think you have to let yourself see both sides. You can count something as a strength and it often is a strength, but the other that you flip that coin over and it is a vulnerability. So therapy, I think, and what is trying to, a very long-winded answer to your question, is that people are searching for things that they don't see yet that are underneath the things they're doing that they like or that they're proud of or that they see happening and they don't quite understand what's the underpinning of it. So I'm helping people find the underpinnings of why they are who they are and how they make the choices they make.

It seems like everyone is talking about mental illness, anxiety, depression, stress, overwhelm, judgment, insecurities, body challenges. It seems like it's everywhere. Everyone's talking about it. This is what I feel like, right? That's what it seems like. It's probably not happening everywhere. But what is mental illness and do we all have some type of mental illness?

I think we all have emotional and mental challenges. You cannot because for one thing, there's the whole conscious, unconscious thing, which is about there are things I'm aware of, and then there are things that I'm not aware of that are provoking or causing my behavior. There's something going on in my unconscious right now in yours that is making you fold your hands and making me talk this certain way, and I'm aware of it. Maybe, would someone else who knows me well say, oh yeah, you were worried about your bangs or you were worried about some silly stuff to, gosh, you just talked about your mother and that would make her mad. And so, you know, we have things that are affecting our behavior. So I think that we all have some sort of mental and emotional issues. That said, they don't always get in the way. of your functioning. You know, your life is really good. It's what you want and what you feel good about, you work hard at it. And so it really becomes illness when it starts painfully affecting your life. Now, again, how much do you realize that? Or how much do people who love you realize that? And so your own awareness and mindfulness of that must be, you know, sometimes in question or is in question. You bring up that mental illness seems to be the topic. Yeah, it is. If I hear another post about narcissism, I think, you know, narcissism is, narcissism is the diagnosis of the decade. Last decade was bipolar. Decade before that was borderline. Yeah. So everybody's a narcissist. Everyone's a narcissist.

Do you think about yourself and care about yourself? And you want something good for yourself? back to self-love, you're narcissistic.

Yeah, exactly. So it's, you know, we have these kinds of favorite things and cultural things that everybody starts talking about. It's not bad for mental illness. I mean, I was delighted this week when I saw that 988 is coming out as, you know, you can now text that and you can, or call it, and you'll get a mental illness counselor. So that's fantastic. That means that our culture is moving much toward an acceptance you know, that depression and anxiety exist. There's some people in the world that don't even believe it exists. They think it's you're just feeling sorry for yourself, get over it.

So, so what is mental illness then? What would be the definition of mental illness versus a mental challenge or struggle?

Again, I think it's probably the extent to which it affects your life and maybe the lives of others. Yeah, I think that it It causes, you know, there's one thing to be anxious, for example. I'm better talking about specifics. It's one thing to be anxious. And I'm a little anxious right now. I have panic disorder, so I also help myself a little bit. But if I was so anxious that I couldn't do this interview, that would be getting in the way of my life and what I wanted and the choices I wanted to make, because I couldn't, I couldn't find my motivation to talk about the book as greater than the anxiety I felt. And there are many people who don't leave their homes because of that or have really very secluded isolated lives. So that to me is part of the problem. Now you add perfectionism into the picture. You know, I thought about the name of your book and the School of Greatness and I thought, I wonder if a perfectionist would actually see anything wrong with being great. And probably not. And you want to be great. You want to be great at everything. And the people you've had on and talked about the underbellies of being perceived as great in our culture might be tough for them. But the issue with perfectionism and this syndrome I talk about perfectly hidden depression is really that they don't think it's affecting their lives.

Perfectionism.

Perfectionism. They believe it's one of their greatest strengths.

Striving for perfection.

Yes. And it's like their best friend. That's what that's just, it's the key that starts their car in the morning. It's what helps them believe in themselves. They think. And so, but what I found out when I started writing about it, and we can talk about that in a second, is that they had no clue of the impact that it was having, the painful impact it was having on their actual vitality, their actual fulfillment in life, because they're on this treadmill constantly. either of their own making or believing that others need to be perfect or what's called socially oriented perfectionism, which is about trying to meet the expectations of others constantly.

So are people that strive for perfection more likely to have panic attacks and are more stressed out or more depressed than people that aren't striving for perfection?

They would. The people I write about in this book would never tell you they're depressed. Right.

They have success, they're happy, they have-.

In fact, they don't fit criteria for depression. If you look at the criteria for clinical depression, they don't fit it. And that's one of the dangerous things about it. Now, do they look anxious? To a certain extent. They will worry and be anxious, but they have a little bit of trouble with anybody knowing that they're that worried. Sure, because they want to look perfect then. Exactly. And so, but they can have anxiety disorders often co-occur with perfectionism. because it just sort of goes with the flow. OCD and generalized anxiety disorder, eating disorders, which are all about control. They're not really about food.

Body dysmorphic disorder.

So that's the problem with perfectionism. And it's sort of a, you know, it's called a characteristic or a character trait. Perfectionism is a character trait. But it's a character trait when it again, not modulated well, can very unknowingly and stealthily, is that a word? Stealthily? That's a good word. Creep up on you to where there's more and more research now coming out that actually it is a growing concern, especially with the suicide rates increasing so much.

What's the growing concern, the people with perfectionism or depression?

Well, the growing concern is that, again, that perfectionists don't have a warning signal that they are getting more depressed. No one is telling them, wow, you don't seem like yourself. No one is saying to them, you know, I noticed that when your mother-in-law got really sick, you talked about that it was hard, but you didn't seem to really, you just kind of kept on going. And I know you love your mother-in-law. No one is saying to that because they're so good that they're so good at creating this facade or this persona of someone who's got it all together. And they count on that. They depend on that to function. And it's their best friend. It's kind of like talking to an anorexic. And she says, or he says, I I can't give up not restricting my eating. I mean, I know what restriction does. I know how it feels. I know exactly what my body does. I do it because it's my friend. It's my best friend. You're asking me to say goodbye to my best friend. Perfectionism is very, very similar to that. So I have a lot of concern for these people because they are as a group, just that they're in denial, they discount whatever they suppress, they rigidly compartmentalize all psychological words, these traumas and memories and secrets that we were talking about at the very beginning that are literally weighing them down to the point where I asked many people who reached out to me why they had, and they said, Because I don't want anybody else to live the life I've lived. I've come so close to killing myself so often because it's the only way out.

That's why they're trying to be perfect?

No, they have adopted, there are a lot of roads to Rome, so to speak, where adopting this perfectionistic strategy is important. Maybe you were, as we said a few minutes ago, screamed at, you,'re never gonna amount to anything. Maybe you had to become a pseudo adult in your family because your mother was alcoholic. and maybe you were very enmeshed and you had to be the star of your family because and do everything extremely well because it pleased your mother so much and she was so proud of you. Well, whomever, whatever. Maybe you're male, as you talk about in the masks of masculinity. So maybe you just grew up in a home where they said, you know, we don't talk about being angry. We don't talk about being afraid. You know, that's not acceptable. and you even, well, that's being kind or they're told to go to their room until they can be happy. So these people have gotten messages that whatever is troubling them that they need to shove in a box and put that box in a closet and leave it there. Well, that's a problem. Because that's not healthy. Your closet gets too full. And what people said was that, why they are talking about it is because they fear that either they will end their lives or these people that are struggling with it will end their lives. And there's good research now to show that that's true. Yeah.

How do we start to overcome depression? If we feel like it's building in us, we don't know if we have it or not, but we feel like something's off. How do we recognize we have depression.

And how do we-- if you're a perfectionist.

Yeah, if you're a perfectionist, or if you just are depressed. How do we treat it? How do we realize we have it? How do we diagnose it? And then how do we start to treat depression for a depressed or for a perfectionist who's constantly striving for more?

Well, the best answer I can think of is that depression is on a spectrum. And a lot of times, if you have been chronically depressed for a long time, I mean, if these lights in this room Slowly went down. Slowly, slowly, slowly, slowly. And you didn't realize you were squinting to see? People who've been depressed a long time in a mild or moderate form don't realize until the lights are so hard, you know, you're squinting so hard that you kind of, something's wrong. And so their awareness is usually because they finally reach a critical mass or a critical point where they go, Yeah, I've got to admit something's wrong. More major depression, there's no way to hide it from yourself. I mean, or I guess there is a way.

You can't get out of bed for weeks.

You can't get out of bed. You're not going to work. You're not finishing assignments. You don't see friends. You have thoughts of hurting yourself. You are crying all the time. You have no feeling at all. You don't want to do anything that you've done before. I mean, those are symptoms of classic depression. and other people are saying, you,'ve got to get help. You've got to get help. You're not yourself. So that's not a good kind of depression to have, but it's more clear that something is terribly wrong.

What would be a few steps getting started, whether you have deep depression or mild depression, in terms of seeing some relief, treating it, and improving that depression?

Well, there are, you know, my particular feelings about that is that usually there's something situational. You have to look at a genetic component. You have to look at, is there sort of a spiritual component? Is there a biological component? I mean, if you are drinking 10 beers a night, you know, there may be, you know, you got to look at that behavior. So you have to look at family, individual issues, you have to look at all kinds of different things. And some people do use medication to help them feel better and to help them give them some fresh mental energy. Some people really don't want to use medication. As far as what you can do, exercise is huge. So where you are on the spectrum, and the closer you get to true danger, the closer you get to losing your job or the closer you get to having suicidal thoughts or the closer you get to your marriage ending in a divorce or you're losing a relationship. Those typically are motivators for people to say, I can't let this go on. I've got to look at this myself. A lot of times people grew up in families, like I said a few minutes ago, that they were taught that especially in the flyover states, as I like to call them, the Midwest. that they were taught that mental illness is just a, it's a myth. And so people in those states, in those cultures, in those regions really have to begin to be more conscious that it is a problem. So the treatment for it is very reflective of where you are in the illness. The thing we haven't talked about is recurrent depression, which literally comes in sort of waves. and you don't have as much control over when it happens, you can be triggered. And so that work is involved, you know, definitely looking at your triggers. Is it weather, is it stress, is it not getting enough rest, is it, you know, a relationship you're in, is it, what is it that is beginning to... So it's kind of, it's a journey, it's a discovery, you know, with everybody.

It's like, how about a quick answer?

No, there's not like, I can't get out a worksheet and say, well, now you do this. Now, we also have different therapists have different techniques that they like, you know, cognitive behavioral, emotionally focused, acceptance, commitment therapy, I mean, all these kinds of different therapies that are, you know, have been proved to really help. But I go back to the fact that the meta analyses show that, It's really the, if you believe that the therapist understands you, if you believe that whatever technique they're using, that they know how to use it and they use it consistently and that they are helping you make those changes, then that you want to make, then I think the therapy goes much better and is much more of a place where that change can occur.

Yeah, when you trust the person who's got experience with it and stuff like that.

Yeah, yeah.

There's lots of strategies to anything in your life and to switch a belief and to heal and to forgive and let go of all these things. I've tried lots of them, workshops, therapy, screaming in the ocean, whatever it is.

I have people throw glass.

Yeah, exactly. Just like the different techniques, the strategies, there's so many things you can do to try and I think it's helpful for people to try lots of different things and don't stop trying until you start to feel a sense of inner peace.

I worked with a woman who had major recurrent depression. She had a father who died by suicide years before and she struggled with the same kind of depression. And she fought me and fought me and fought me about, I said, you need to exercise. She tried medicine, she tried therapy, she tried going to groups, like you said, she tried all kinds of things. She changed her relationships, she did all this stuff. Once she started swimming, She walked in one day, I said, what's changed? She said, I'm swimming. And so, you know, she found a haven in getting that kind of repetitive, you know, and also it helped her self-esteem because she had some body image issues. So I wish, Louis, that it was as easy to have some sort of checklist of if you do this and this and this and this, you'll feel better. It's a little more complex than that. So that's why I think you have to spend time with somebody and try to understand how you feel.

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You add to their perspective?

A holistic approach to yeah, relief. What would you say are three to five things that every human can do to arm themselves from being susceptible to mental illness, depression, anxiety attacks, a lack of self-worth, those type of things that tend to hurt us and hold us back? What are some strategies that can be very simple and basic? It's just like work out every day or eat clean. get eight hours of sleep, you know, what are the things that you really recommend that you've seen work well for people when they start implementing this? Like, she just had to swim and she was better. What are three to five things we could all do to improve that for ourselves?

You know, a young man comes to mind that had actually come to therapy because of his, he had lost his best friend, his best friend had been killed in a car accident. And he had a lot of grieving to do. And we did that work. And then he came back in, which often happens in therapy, and was ready to be honest. And sure enough, he was drinking a lot. And as we looked at, there were some family issues. He'd been in a family where one of his siblings had almost died, and so because of that, his parents had focused much more on that sibling than they did him. and he really felt invisible. And so then his friend died, and so he was carrying around that sense of I'm not important and I don't know how to heal that. And so basically what I had him do was talk to his family, talk to his parents about it. It was very hard for him.

Tell him how he felt.

Exactly. And so when you asked me the question, The first word that came to my mind was engagement. Connection with other people.

You mean isolating yourself and that's nothing good.

That's not quite a good idea.

It's a way to heal.

Nah, nah, it doesn't work.

It's a connection.

And in fact, therapy, when you think about it, the whole gist of therapy is for you to create a change in someone, help them create it, that they then take outside of the therapy environment and begin to implement it. Implement in their own lives. And so they're open with me. Well, gosh, you can go be open with Joe Blow or whatever, your mom or yeah. And so, so it's engagement.

Okay.

I think that-- Engagement through connection.

Connection with people, sharing how you feel.

Yeah.

Connection, yeah.

There's no way that exercise or having a good relationship with your body and with sleep and all that kind of thing is important. So you've got to do that. so other oriented, self-oriented and then the third thing I would say, people reach their spiritualness in lots of different ways. For some people, it's Faith. For some people, it's just a sense of how they find their well-being whether that's through laughter, whether that's through Hobbies or activities they enjoy. Maybe their work is very purposeful for them, but a sense a sense of purpose, a sense of knowing why you're doing what you're doing and why, what is important, how are you unique? And beginning to understand and value that, you know, when you mentioned self-esteem, a lot of times when people struggle with self-esteem, it's because they don't know their competencies. I can't hand you a piece of paper and you'd say, you put Lewis on the top and I ask you, okay, so what are your- what are my skills? What are my competencies? What do you do well? There are a lot of people that can't write anything on that piece of paper. And it can be simple things. And so engagement, taking care of yourself, purpose, acceptance. Self-acceptance, I think, no matter what issues you have, is a huge key. And it's different from self-esteem. because self-esteem is something that you find or you discover. Self-acceptance is more, it's not resignation. It is accepting both your strengths, the things that you have esteem about, the things that you value, but also these vulnerabilities. And when you can accept those things, whether it be sometimes I struggle with depression, Sometimes I get anxious. Sometimes I get jealous. Sometimes I'm impatient. Sometimes I get way too angry than I'm supposed to. You don't resign yourself to that and go, well, you know, that's just me. You say, all right, I can accept that and then I can move toward change. Again, that whole discussion we had on shame, which is if I can accept it and I don't shame myself for it, then I can move ahead and say, so what do I want to do with it? Create a new commitment for myself. When I moved to Fayetteville, Arkansas from Dallas, Texas, I told my therapist at the time, there is no way that I'm going to tell anybody in a small town in Arkansas that I have been divorced twice. I will get railroaded out of town. What is she doing? You know, why is she helping people? She can't help couples. She can't help herself. I can't help myself. Now I have been married almost 30 years now. But all that said, and he just kind of smiled and looked at me, you know? And I was obviously not in self-acceptance. And then when someone was across from me, I remember who it was, obviously I'm not going to say, and she was getting her second divorce and she looked at me and she said, But obviously that's not something you know anything about. And I like that. Just made the decision. I looked at her and I said, you,'re about to join a club that I've been a member of for a long time.

Wow.

And I felt this, you never told anyone.

You never told any of your clients.

No. No.

Wow.

That's the level of shame I had. The level of, you know, I was not in a self-accepting place. And as soon as I began to just breathe through that and think, well, you know, she may walk out of the room.

You met, you had your own therapy session.

I did. It was more about me than you. Would you Would you like to sit here and I'll sit there? Which I hope she didn't realize. But I gave a huge gift to myself because it was at that point and it was a journey, but it was at that point that that journey began of, I have to accept this. I don't like it. I'm not proud of it. I have remorse about it. But I can accept it and then make damn sure that I don't make those same mistakes again in the relationships that I'm in now.

How do we accept something about our past if we're ashamed of it and we know it was wrong or we are just frustrated we did it or you're not proud of it, like you said, how do you come to accept it?

My answer to that would be because you have to also accept, or you can accept, that that doesn't define you any more than your competencies do. The fact that I have a PhD after my name is lovely. It is a means to an end. I get to help people. and I'm given a license and I get to sit in front of people just like you and I are talking and I get to hear and try to help.

But that can be taken away.

But the fact that I was divorced twice or that I struggle sometimes in my own marriage, we all do, doesn't define me any more than those three letters. And so that's sort of just sitting with that and okay, you know, it doesn't. Now, Will it matter to other people? Yeah, it might. I can't control that.

Sure.

But what I can have control over is whether I accept it in myself. That's four. Trying to think of my fifth, I'm probably living out some glaring thing that people listening, oh my god, why did you say this?

I think four is good.

Yeah.

Yeah.

Yeah.

One of the things that Most of us learn from childhood that typically hold us back from adulthood, that we are hard for us to let go of.

We absorb sometimes through modeling, sometimes our parents model things for us that they never tell us, but they just model it. And we absorb that as reality. That's what life is like. that's what marriage is like, that's what being a man is like, that's what being a Baptist is like, that's what being a woman is like. I'm going to get the definitions, and if those are erroneous or if they are destructive, then that's what you've absorbed. And so you'll go on and live that out again without being very aware.

Unconscious of it.

Unconscious.

So how do we become conscious of these patterns or beliefs we've been mirroring our whole life? When we think it's the way it's supposed to be, or we think it's the truth, or we think this is the right way, how do we become conscious besides a tragic accident, a death in the family, a breakup or divorce? It seems like there has to be some big breakdown in our lives.

Sometimes there does.

A near-death experience for yourself, a car crash, for you to wake up and become conscious and evaluate everything. How do we get to that place without nearly dying or going through divorce?

Yeah.

Is it possible?

I remember a night that I had an old player piano. It had been a player piano and it had been modified to be a regular piano, but it had this huge shelf with the keys. And so here was this big thing and then these keys. But I could sit under it. And I remember after my second divorce, I was sitting in there just bawling, thinking, what's going on with my life? And then all of a sudden I thought, All right, you're the thread. This is, you know, it's- you-'re the common denominator. I'm the common denominator, and I need to start looking at either how I'm choosing or what I'm looking for or how I'm acting or whatever, and I have to look at that. And yeah, it was a damn hard way to find out about it. I hope that things don't have to be that way for people, but just like AA says, sometimes you have to reach your bottom. That's so true. But the other way is to begin to question. There's a wonderful study that Dove did when they started many years ago now doing these commercials about true beauty and moms and stuff. And they did it over in Great Britain and it was a study that they took mothers and daughters and the mothers were asked what they hated about their bodies and they said, oh, I hate my knees, I hate my nose, I hate my ears, whenever it happens. Yeah. But I would never say that to my daughter. I don't ever say that to her. I tell her how beautiful she is, how she's achieved so much, and blah, blah, blah. But at the same time, they were asking the daughters to write what they didn't like about their bodies. And maybe it's already evident.

It was a mirror.

When the daughters read to their mothers, it was significantly the same.

And lumps are probably in tears.

And yeah, you don't have to say it. Say it for it to be absorbed by your child. And I'm sure that's true for men. I know it's true for men. So I think you have to become aware if you are, if you want to be an aware human being, and some people don't. So the answer is to say, you know, let me question why I do what I do. What rules am I following that I don't, do I really want, do I need to follow this rule? Do I, I mean, people have said to me, your parents would be so proud of you for writing this book. And I look at them and then say, my dad would be proud, but my mother is turning over in her grave. Because one of the things I absorbed from her is you don't share your, your true experiences. Yeah. No, no, no, no, no. And so, Anyway, I think that you, you know, was I aware of that growing up? That I had that, I was living by that rule? No. Did it affect my life? Yes. Was it one of the reasons I developed panic disorder? Yes. So, not blaming her, but just acknowledging that impact on me. So, I think that when you want to be aware, and that's a choice, when you want to be aware, than questioning yourself, asking yourself, why do I do what I do? And why do I believe what I believe? And then finding answers to that.

Yeah, before the breakdowns.

Yeah, but it would be nice.

Yeah, yeah. Are you a parent?

Yes.

What is a few things that every parent, if they could control this and give this to their kid, or their kids growing up. What are a few things that they could give them that would set them up for the potential best life they could have?

You're obviously not a parent, are you? Not yet. I gotta research.

I gotta research from wise people. Like if you could wave a magic wand and say, you know, it's never talking bad. I don't know, modeling something that's positive. Like, what are three things that parents, if they could give to their kids, they should try to do? Obviously, it never gonna be perfect, but what could they try to instill in their kids? So they have, you know, powerful, thoughtful leaders in their own lives.

Sure, sure. I can't remember the name of the man right now, But he spoke at a graduation in an uppity up school, I can't remember what it was, one of the best and brightest. And he said the thing he regretted most in his life was not being kind. And I think that if you're kind to yourself and you're kind to other people, that if you instill a sense of kindness in your children, that that is a huge factor. They'll be able to make friends. So, I always want to throw a pillow at the television when somebody, tragically, that's not why I want to throw a pillow, but when a teenager or a young person dies by suicide or struggles, they trot out the usual signs of depression. And one, of course, in my own research, that's not the only thing, but that's not what's really important. What they don't say, they say what to look for in your child. What they don't say is what to look for in yourself.

The parents, or what?

The parents, meaning are you talking about, sometimes I get really sad, sometimes I get so angry I don't know what to do with it, sometimes I'm haunted by something in the past, sometimes it's hard to forgive myself. How vulnerable are you being with your children? Where you're modeling, we talked about absorption stuff, where you're modeling, it's okay. to talk about, I'm not going to say what it was, but my son made a mistake in college and he called me. He knew I had made similar mistakes. And he called me and at first I had the mom response, which was, you know, and then he goes, Mom, I called you because you've talked about it. And I went, oh yeah. And so I was able to get out of that mom response and just be there for him because he was calling me because he could be vulnerable. and I loved that moment. I mean, I'm sure there are others that are not quite that great. But anyway, so I would ask parents to, if you want your child to talk to you about being depressed, then open up to them about not some of your secrets necessarily, but about who you are and how you've learned to function and how you've learned to handle disappointment. Maybe you were bullied and how you learned to handle that. Just talk to them about real stuff, not what they made on some test, and not, you know, this stuff that we can get really bogged down by.

Yeah, that's a question I ask a lot of people towards the end. It's called the Three Truths.

Okay.

So I'm curious your thoughts on that.

I should have listened to more podcasts.

So I want you to imagine it's your last day on earth many years from now. You get to live as long as you want to live, and you get to achieve everything you want. Your book reaches millions of people. You're helping more people. You're doing your clinical work. You're doing whatever you want.

Okay.

And for whatever reason, you've got to take everything you've created with you when you go, when you leave this world, right?

So you've got to take a million books. I have to take a million.

You take all your work with you.

Okay.

All your written work, all your audio, podcast, everything you've ever done. It's got to go with you to the next world, wherever you go. But you get to leave behind a message, three things that you know to be true from your whole life experience. that you would share with everyone. And this is all we have to remember you by, are these three lessons that you would share with people, or three truths, what I like to call them. What would you say are your three truths?

I would say first that it's important to find what is bigger than you. That in your own life that you feel gives your life purpose. And that could be a lot of things. Everything from the sublime to the ridiculous, but it just gives you a sense of something bigger than you. I would say that there is no shame in struggle. And in fact, if you don't struggle, that you learn more from struggling than you do, or even failing, than you do from success. and I only get three. I would say that having laughter and again a sense of connection with people is so because having laughter and a sense of connection with people is so important because that is how you know that whether or not all the evidence of your existence is gone, that the people who love you and who you've loved, more importantly, will always have that in their hearts and their minds. It's not your accomplishment. You know, what is it that Maya Angelou said? It's how you treat people that they'll.

Remember, not what you said or did. They'll remember the way you made them feel.

Exactly. And so I'm not as eloquent as Maya Angelou, but that is what I would say that that that kind of internalization of your gifts to others is.

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Period.

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Hey, everybody, it's Rob Lowe here. If you haven't heard, I have a podcast that's called literally with Rob Lowe. And basically it's conversations I've had that really make you feel like you're pulling up a chair at an intimate dinner between myself and people that I admire, like Aaron Sorkin or Tiffany Haddish, Demi Moore, Chris Pratt, Michael J.

Fox.

They're new episodes out every Thursday. So subscribe, please, and listen wherever you get your podcasts.

What's so meaningful about life? Because no matter what your spiritual beliefs, then that means that those things, but accomplishment.

Yeah.

Yeah.

I love those. Those are great truths. Your podcast has been really helpful for a lot of people including me. It's called Self-Work and people can go listen to that right now. And this book is going to help a lot of people. Perfectly Hidden Depression: How to Break Free from the Perfectionism that Masks yous Depression. Who's this book for? And what's the main thing they'll get out of this?

It offers... Well, let me answer the first question first. The book is for People who, when they see the term perfectly hidden depression, something in their gut goes, oh, you mean I need to listen to that? I have tried hard not to listen to it. I have discounted it. I've denied it. But when the lights are off and it's everybody's asleep but me, I know something's wrong. It could also help people that are very aware of what they're doing, something called high functioning depression or smiling depression. And that's fine. And there are strategies for them as well. But really the people that I want to reach are those people that are walking around just knowing that their lives are emptier and lonelier than they want, but they can't let anybody know that. that I used the term with you before the interview, they have stayed silent about secrets that they have kept or shame they have felt or confusion or whatever because they must look so successful. That's who it's for. How does it help?

That was probably 20 years of my life.

I have none of this actually myself. Yeah, I've been very perfectionistic. optimistic in my life. How it's gonna happen, you know, when New Harbinger, who published the book, they were looking at accepting the book. And they said, well, this is great, but right now this book only describes this syndrome. It doesn't, there's no treatment. And so they said, In two weeks, we'd like you to come up with a treatment. And I just went, what? In two weeks? But what I did is I sat down and I thought, okay, what are the steps that I do with really everybody? We've mentioned some of them or we've by inferred some of them. And those steps are, and it's going to sound kind of hokey because I had to come up with something very pop, you know, the five C's of healing, because woo-hoo, you know, consciousness, commitment, confrontation, connection and change. And what I mean by those is you have to become aware of the problem before you can do anything about it. That's consciousness and mindfulness and all the stuff we've been talking about. Commitment means that you have to look at the hurdles to the actual change itself, or with a perfectionist, your perfectionism can get in the way because you have a relapse and all of a sudden you go, oh, I don't wanna do this anymore. This doesn't make me feel good. So there are all kinds of specific hurdles for perfectionists, but there's hurdles for everybody. The confrontation is something about that's a very CBT or cognitive behavioral kind of approach, which is more about, again, we sort of mentioned it, it's the rules that you're following and which ones are helpful to you and which ones are hurtful to you. And there's a specific kind of guidelines. They're like 60 exercises in the book. It's more of a workbook actually. The fourth one, is tough. The fourth one is connection with these emotions that you have been afraid to connect with. And since it's a self-help book, I mean, I say all over it, if this gets too hard, go to therapy. Find a therapist. But the technique that I use or I suggest them using is what's called a trauma timeline. Whereas you really look back at all your life and you think, okay, what were the good things that happened to me? when I was two or 12 or 22 and what were the difficult things, the painful things or the secrets I've kept?

The moments.

The moments and their impact on you. And so you can begin to see this pattern that starts evolving.

That's cool.

You can do that. So the last one is change. And I'm a huge believer after, gosh, after doing this for, I saw my first patient in 1988 in graduate school. time. Insight is wonderful. Insight gives you context. You can look at those patterns and go, wow, I didn't realize that. That's why I always have troubles with, with, gosh, it could be anything, with selfishness. Because I never, I was never concerned. My parents never did anything for me that was all about me. So I become kind a selfish person because I'm gonna get mine before anybody gets theirs. So you can look at this pattern and see it, but where you get hope is from behavior change. So the change chapter is all about how you begin actually making changes in your behavior. We already talked about changes in your thinking. So you do things like learn how to play, you do things like how to find your value in something other than accomplishment. you find things that you, perfectionists have a very difficult time just actually feeling their emotions. And so you find a piece of music that helps you do that and you sit and listen to that music, whatever. Because where you get your hope is from changing your behavior. And the strategies itself in the stages are applicable to anything, but I've just, specific for perfection.

I love it.

Thank you.

Make sure you guys get the book Perfectly Hidden Depression. I think your podcast is great. I don't listen to many of them, many podcasts out there, but I like yours. Self-work. I want to acknowledge you for doing this work because not many people talk about this stuff. The depression linked to being perfectionism. And I think that's something that a lot of people feel like they need to live up to this. perfectionist point of view with social media and all the comparison that's out there and seeing their friends have this perfect life and them feeling like they have to have a perfect life. But that links to a lot of anxiety, stress, overwhelm, depression and things like that. So I think this is a powerful book for a lot of people. So I want to acknowledge you for writing this, for doing the work and for allowing you to share all your vulnerabilities as a therapist over the years. so you can help other people with your shame too.

Sure, there are plenty of stories about me in that book. Yeah, because if I can't talk about.

It, then you know, I can't expect other people. Exactly, exactly. So we can find you on the podcast, the book, where else can we find you?

DrMargaretRutherford.com, it has a very creative name. DrMargaretRutherford.com, my website. Okay.

And the book is on Amazon and Barnes & Noble and Indie books and.

All that kind of stuff. Okay, cool. Final question is, what's your definition of greatness? First thought, putting my head on my pillow at night and thinking, I did something today that has made me grow, has helped me grow as a person. And that's been a great day. Maybe I learned how to cry about something I haven't ever cried about. Maybe I helped a friend. Maybe I wrote a post that did well. Maybe I just simply remembered that it was the anniversary of one of my friend's spouse's deaths. And I called him. You know, when I put my head on my pillow and kind of say, all right, you know, I feel like I've grown today or I've helped someone else grow, that to me is a great day. And that's to me is greatness.

Dr. Marko, thank you. Appreciate it.

My friend, I hope you enjoyed this episode and interview. And I was actually under the weather a little bit, so I had to stop a couple of times in the middle of this interview to go to the bathroom. I had a stomach flu, and that was the first time I ever had to stop in the middle of an interview. So hopefully my questions were powerful enough for you and hopefully I was still able to deliver the way that I expect myself to. And even though we did an episode on letting go of perfectionism, I had to just surrender and let that go. So I hope you got some great value out of this. If you did, please subscribe to the podcast. Just go to Apple Podcasts right now, click subscribe, and leave us a review. We've got over 6,000 five star reviews. We'd love to see more of those because those help us fuel the fire to to make this even better and get the message out to more people. So subscribe to the podcast if this is your first time here. Leave a review if you've been here 10 times, 100 times, or if this is your first time, I'd love your thoughts. And share this with a friend, lewishouse.com/895. If you've got a girlfriend, a guy friend, or a buddy that you know could get some support with upgrading their mental health or if they're dealing with any mental challenges, send them this episode. I think it could save people's lives. It could help people with suffering, with depression, with anxiety, and really just help people get to the next level in their freedom in their life. So again, share this with a friend and have a connection with them. Support each other. Reach out to them and say, what did you gain from this? What was the lesson you learned from this? Let's keep each other accountable. That's what this is all about. And I love these quotes at the beginning. Bernice Brown says, Shame perfectionism derives its power from being unspeakable. And Michael Law said at its root, perfectionism isn't really about a deep love of being meticulous. It's about fear. Fear of making a mistake, fear of disappointing others, fear of failure, fear of success. When we let go of that need to be perfect and the to please other people, that's when we can get into the flow and do our best work in this life and in this world. And we can truly start to let go of that pain and inner suffering we once might have had. I know that I dealt with a lot of internal suffering and it doesn't matter how much you were given or where you were born and what your family situation was like or how much money you had or didn't have, we all face different internal battles that most.

People aren't aware of.

And I was going through a lot of internal suffering.

Hey, everybody, it's Rob Lowe here. If you haven't heard, I have a podcast that's called literally with Rob Lowe. And basically it's conversations I've had that really make you feel like you're pulling up a chair at an intimate dinner between myself and people that I admire, like Aaron Sorkin or Tiffany Haddish, Demi Moore, Chris Pratt, Michael J. Fox. There are new episodes out every Thursday. So subscribe, please, and listen wherever you get your podcasts.

For many, many years growing up. And so I know the challenge and the suffering, how much pain that can cause, and I don't want that to happen for anyone. anymore because I know how much pain that causes and how destructive that can be in that person's life. So just know that you are loved, you are here for a reason, you have a beautiful gift inside of you, and I can't wait to see you.

Share those gifts with the world.

I love you so very much. You know what time it is? It's time to go out there and do something great.

Hey, everybody, it's Rob Lowe here. If you haven't heard, I have a podcast that's called Literally with Rob Lowe. And basically it's conversations I've had that really make you feel like you're pulling up a chair at an intimate dinner between myself and people that I admire, like Aaron Sorkin or Tiffany Haddish, Demi Moore, Chris Pratt, Michael J.

Fox.

They're new episodes out every Thursday. So subscribe, please, and listen wherever you get your podcasts.