We're Out of Time - Perfectly Hidden Depression Explained | Dr. Margaret Rutherford

Episode Date: July 7, 2026

What if you looked completely successful on the outside—but were silently suffering on the inside?Clinical psychologist, bestselling author, and TEDx speaker Dr. Margaret Rutherford joins Richard Taite to explore one of the most overlooked mental health challenges of our time: Perfectly Hidden Depression.Together, they discuss why high-achieving people often hide emotional pain behind perfectionism, how toxic positivity keeps people from healing, and what emotional transparency really looks like. Richard also shares his own recovery journey and what it took to stop hiding behind success.Dr. Rutherford is the author of Perfectly Hidden Depression and the companion workbook. Her TEDx talk, How to Recognize Perfectly Hidden Depression, has been viewed more than 2 million times.Learn more about Dr. Margaret Rutherford: https://drmargaretrutherford.comExplore more from Richard Taite and We're Out of Time: https://linktr.ee/richardtaite

You have to change your definition of depression. We have been so pummeled with the importance of the symptom checklist in the DSM and the Diagnostic and Statistical Manual of Psychiatry, that if someone doesn't fit those criteria, they must not be depressed, right? In fact, I have had people tell me their therapists, look at them when they say, I've got this perfectly hidden depression thing. this is me. So you're not depressed.

They're not depressed in the classic sense. That's true. Their lives are going to be full of energy, full of success, well-liked. People probably walk up to them and say things like, you know, how do you get everything you do done? I wish I had your life. I wish I had your energy. If someone has a problem with substance use disorder, please call one call placement. That's 888-8-3-3-3-3-3-3-3-3-3.

131-1581. And if we can't help you, we'll make a referral to someone who can. Please, we're out of time. One Call placement is affiliated with Carrera Treatment, Wellness, and Spa, and One Method Treatment Centers. Today, on We're Out of Time, I'm joined by Dr. Margaret Rutherford, a clinical psychologist and author who's brought global attention to something called Perfectly Hidden Depression, where people who seem to have it all together are actually struggling in silence.

Her TEDx talk has reached millions, and her new workbook is helping people recognize and break free from perfectionism that hides real pain. Dr. Rutherford, welcome. I'm delighted to be here. I want to read to you the short overview that I had done for me letting me know who you were. Oh, okay. Okay. I looked at this 20 minutes ago.

Okay. Which lets you know the level of preparation I do for the show. You should be able to, you know, figure me out in 20 minutes. That's okay. No, I figured you out in less than 60 seconds. Dr. Margaret Rutherford is a clinical psychologist known for her work on perfectly hidden depression. A condition where high functioning success,

successful people mask deep emotional pain through perfectionism and achievement. That's what you deal with. That is your specialty. Is it not? Yes, it is. It has been something Richard that, you know, I never intended to write a book. I never intended to do a TEDx. I never intended to do any of that.

But this topic found me. I was writing. I had started a website and I was writing about these people that I'd worked with over the years that were exactly that. They were very successful, high achieving. They'd come into therapy and kind of go, I don't really know why I'm here. I'm just kind of anxious and something. I mean, if I would ask them about depression, they would immediately say, oh, no, I am so lucky to be living the life. living. And yet, what I began figuring out was that these people didn't know how to express,

they didn't know to access emotional pain because of this camouflage that had protected them for years. The Y is multifaceted, if I can use a graduate school word. It could have been for a lot of reasons. It could have been because they were in an abusive home, alcoholic parents. It could have been that they, you know, their mother or father didn't take care of them. And so they took care of their siblings. So they became sort of a pseudo adult. That's because they grew up. What about shame? What about shame? What about the fact that these people are so excellent in their fields and what they've accomplished that it feels like shame to not be able to have a successful relationship or find a fit, right? That feels shameful.

It feels a little shameful to me. Yeah, it's not my central point, but it's a good point. I mean, the shame comes when you feel like you have this highly perfectionistic, again, successful persona and you don't want anybody to see underneath that because there's shame underneath that. Just like we all have shame. We all have things that we, you know, we've screwed up or whatever. So the perfectionist, this kind of perfectionist, which the researchers would call

destructive perfectionism, it stands that that shame is what drives them, what keeps them having to look busy and having to look like they don't have a trouble, trouble. whole in the world. You know what the thing about perfectionism is? You can say it destroys happiness and that's true. But what it doesn't destroy is excellence. So what you're doing is there's no work life balance because you're excellent here, right? You see what I'm saying? I say exactly what you're saying and there's a there's a line that gets crossed because some people you know maybe are again pulling from research calling that they would they would say they were constructive perfectionists that they were you know that their perfectionism was used in the you know as part of their

generosity or their curiosity or their just general wanting to make a difference in the world like make a dent in the universe I love that phrase but when it but it but it It crosses a line to where, I've called it in the workbook I just published last week, I've called it a prison of sorts where you're both prisoner and guard. The prisoner is the part of you who feels the shame that you've got to, you know, you've got to keep that pushed away and locked away or any pain of any kind. But then you've got to guard yourself from other people knowing that that's what you're doing. You know, you really must look like you are the.

that person that has life altogether. These people are so, it's hard sometimes to watch them try to change because they are so frightened of losing their status or losing their ability to look as if everything's great. What led you to create the perfectly hidden depression workbook and who is it really for? Well, I wrote the first book, The Perfectly Hidden Depression, eight or nine years ago, and that was published in 2019. You know, it wasn't a New York Times bestseller, but it sold well, and then it's been translated in a bunch of languages, so that feels really good. But what people were telling me was that the book, in some ways, there was like 60 exercises in the book, and that they were very hard. to do. I'm being a therapist for over 30 years. I guess I didn't see that or didn't recognize

maybe how hard it would be. I think it's a good book. I think it's a life-changing book, actually, if you do the exercises and it takes a long time. But I wrote the workbook so that people would have a more approachable way of looking at this. There's more guidance in the book. There's more and many of the workbook, there's more, it's simpler, it's not as past-oriented, it's more present-day oriented, and it's something that I believe

can be picked up literally and put down, picked up and put down. It's a standalone workbook from the first book. So the reason why I wrote it was simply to say there is another way and maybe a less strenuous way of taking this and you want to keep about that perfectionism what's worth keeping. You want to keep that.

But there's parts of it you don't want to keep. And it's very hard to let go of it. But I hope this is a very gentle guide in how to do just that. Do you know what I think the problem is? Because it's different, right? It's different when you have a 30-year-old, okay, a guy who, you know, is kind of a... You know, those guys that are completely cut off

and they hold out errors and they never show you who they are. There's a difference between that idiot and, you know, a guy who's 59 who has worked the last 30 years nonstop, finally stops and goes, I forgot how to have a good time. Yeah.

I forgot how to have a social interaction. You know, I'm at practice. How to play. That's exactly right. I forgot how to play. And I've always been really good at play. But then I got into my work life. And then there wasn't room for play.

And then there was room for work. But now there's room for play. And after two and a half days. decades, right, of work, it's like, come on, man. It's like, right? So what do you do? Obviously, there's a different, there's different interventions that you would make for a like the intervention it would seem for the guy who's completely shut off is to get him to

realize, okay? You don't need to be shut off. You can't be loved unless somebody knows you. You're afraid to let somebody know you, right? So you'll never feel loved, ever. Okay? That's a different intervention. That ain't my intervention.

What's my intervention? Well, if you were sitting in front of me in my office and we were thousands of miles apart, I would probably want to know. One of the questions I would have is, why did it take until you were 59 years old to figure out that you were, you know, what has kept this in place for so long that you very poignantly now see it as something that is getting in your way of truly connecting with someone else?

I would want to know. That's excellent. Let's do that. Let's do one at a time so that you have all the information. The reason is because I became a father. And so my only job in my world was to make certain that my kids were okay in the world when I was gone. So there was no time for outside good time. I was because I had children at a later time in life, at a later stage in life.

I was in a race. Okay. So that's why I did that. Then I, you know, I win the race, right? My kids are in their teens. They're like, they've got lots. And I'm like, oh, okay, life opened up. There's space now.

Okay, maybe I should take care of myself. That's true. So it was your role as a father superseded anything else. And it would be interesting to hear about where, if there's history there, I mean, what was your father like? What was your childhood like? My parents treated me as an accessory and my brothers. They didn't, they didn't know, they didn't know anything. There was nothing but beating.

and narcissism and devaluation. And so that's what that was. Like you were an object to be manipulated. When I wasn't being manipulated, I was being ignored or beaten. Okay. Just like my brothers were. Right? So, okay.

So was it, were you aware of that and what it was doing to you before you had children? Well, I'm probably the most over-themed. therapist human being on the face of the earth. So yes, I've always been aware of the horrific childhood that I had. But once I became a father, you know, I'm the dad. Yeah. Right. So I don't get, you know, I've, I've got quite a bit of tools. I don't get stuck in my child very often. And the second I get stuck in my child, I recognize it. I love him up. comfort him and move the hell along because I'm the dad and I would comfort him the same exact way I would comfort my son.

Mm-hmm. Mm-hmm. Right? No difference. That comes with 25 years of, you know, doing it. Yeah. And treating people. What is it that you're looking for now?

What I'm looking for is someone who I enjoy spending time. with that I'm actually curious about, that I care enough to actually care about what they're saying. Okay. Their goals, what they want in the world. Someone who I'm laughing with all the time. Okay. Somebody to travel with and see the world with. That's what I want.

Are there certain things that you are nervous about or that you, You know, I've told people, certainly took my own life, I've never felt healthier than when I was alone, that relationships are hard. Right. And that they bring out all kinds of things in us that we think are fixed or have been addressed or whatever. And then all of a sudden, you know, you're in another relationship. You go, you know, I thought this was going to be easier. So are there things that you were concerned about, that you want to keep, you know, that, you know, that. that whatever, you know, it sounds like that you're comfortable with beginning,

it's beginning to think about and seek out someone who will see your vulnerabilities and you will see theirs and that's something that you're ready for. Yeah. I mean, I'd like to try. You know, look, I love being alone. Love it. I love being with my friends. I love it.

But I want to go on vacation. Yeah. You know, that would be amazing to like experience like a good time with somebody that, you know, I enjoyed and was, you know, romantic with, right? That would be really cool. It would be really cool to wake up in the morning and have coffee with somebody. Okay. See what their days like.

Okay. Be interested in them. Right. And, you know, so that's where I'm at. You know, it's just, it's like I don't feel lonely. I don't feel lonely. Good. Right.

But it's not that there's loneliness. It's that I can do better. Yeah. And this is the one thing that I haven't really done. But in all fairness, it's the one thing that I've never been ready for until just now. Right. I mean, one of the things that you're trying to get your head around this. because it doesn't make sense.

I'm 59. But I lost 25 years to drug addiction and alcoholism before I built the finest treatment facility in the world. Right? So I got a late start. So without losing those, you know, 25 years, I'm 35. Sure. Right?

So that's why. Well, are you excited? I'm excited, but a little nervous. and let me tell you why I'm nervous because I'm 59 and I don't want a 59 year old woman. I know how that's house. Okay. But I don't. I'll want a 59 year old woman when I'm 89.

Okay. But I don't want a 59 year old. This is giving us more of material for therapeutic work. Whatever. Whatever. Hey, hey, no one's important enough to lie to and I'm not running for office. So, and you don't lie to your therapist. And right now you're my therapist, okay, for the show.

I'm not attracted to a 59-year-old woman. I'm just not. And, you know, I'm saying the same thing that every other 59-year-old is thinking. Well, I'm going to challenge you, though. I don't think every 59-year-old person is male. I understand what you're talking about as far as stereotypical stuff. Should we call it 90% and not? Um, maybe that's a little high. I'm hoping that the younger generations don't feel that way so much.

Okay. But today, it's the reality. Can we agree on 80%? Well, and as, as many women in their 50s and 60s who are divorced or widowed or whatever, we'll tell you that, you know, they, they get the message. And I'm, I'm 71. And believe me, I, I know. You're 71? I'm 71. Yes. And so. Yeah. So, but I feel it all the time. I, I, I, filled up, I was just turned 60 and I filled out this form for a doctor's office. They had, they had emailed it to me. I tried to fill it out online and it was working. And so I was their first patient of the day and I walked in and I said, you know, I'm Margaret Rutherford. And she said, well, did you fill out your form? I said, no, there was something wrong with your form. I couldn't do it. She got this look at her eyes, Richard like, oh, I know. You couldn't work it. You're 60 years old. see it in her eyes. And she got online and tried to work it. And it didn't work. I was like, you see, it's not me being 60 years old. So yeah, you have some preconceptions about older women.

It's, it's, it's an attraction issue, but you just made me sad for a woman who's 60 years old. I just, you know, I got sad for her because this is the way it is. So that woman better find that 20% right? I mean, that made me her. Well,

that's right. And often, well, not often, but sometimes she does. So I hope that all changes

because it's a, as a woman and as a Southern woman, grew up in the 50s, then with a girdle wearing high heels and hose and girdle where my mother handed me a

girdle and said, don't take this off when I was 12. Luckily, I didn't follow her direction. But, you know, it's hard to know that you're losing your value or your attractiveness because you're getting older as a woman. Yeah, it's real hard. But, but doctor, the same thing's happening to me. I'm in the 20% category too. So it's funny that I felt bad for that woman, that fictional woman, but I didn't feel bad for me. Right? It's just, you know, I'm recognizing it's a small

window because you find somebody 20 years younger than you. Okay. You're looking for somebody who's stable, not in the chaos, not in the drama, right? Kind. Right. And old soul, you know, something you can have really great meaningful conversations with. And that's hard, you know, because you didn't grow up in the same stuff. Right.

She's not going to know who the band is. It's okay. I didn't know who the band was. I didn't know. Yeah. Well, you know, certainly May, September, as they're called, I think, relationships can sometimes work. My first husband was 20 years older than I was.

And that was a disaster. So, yeah, it was, yeah, it was ridiculous. when I turned 45, I thought about him and said, would I be attracted to a 25-year-old? And I thought, no. Maybe in certain ways, yes, but certainly not as a life partner. So, yeah, it was a mistake on both our parts. But sometimes they do work and they work very well. If someone looks successful, disciplined, and put together, how are they clinically depressed?

You have to change your definition of depression. we have been so pummeled with the importance of the symptom checklist in the DSM and the diagnostic and statistical manual of psychiatry, that if someone doesn't fit those criteria, they must not be depressed, right? In fact, I have had people tell me their therapists and look at them when they say, I've got this perfectly hidden depression thing, this is me. So you're not depressed. They're not depressed in the classic sense.

That's true. Their lives are going to be full of energy, full of success, well-liked. People probably walk up to them and say things like, you know, how do you get everything you do done? I wish I had your life. I wish I had your energy. Whereas underneath is this pain that they don't know how to express. They've either cut that off or never should.

shown or were told it was unacceptable to express pain or even stay in their feeling state for long. They would rather think, you know, I want to think about things. I don't want to be in a feeling state. So the depression looks different. You know, I got asked to do my TEDx in 2023 because I got a phone call from two women I did not know. Well, Ivy was LinkedIn, actually, but anyway, that better. And I talked with them, and one of their best friends had killed myself on Valentine's Day. She'd hugged herself in her home

with kids. But the point of the story was that her husband found my first book on her bedside table. So she had been looking for answers. So they called me and said, or reached out to me and said, you know, tell how old I am by saying, called all the time. they reached out to me and said, what is perfectly hidden depression? What in the hell is that? I say in the TEDx, we probably at this point, all of us know someone who killed in their life look great, or we know someone who knows someone that that happened to, because suicide rates are, you know, intensifying exponentially.

And so it is a problem. I think it's a problem as a culture. It's a problem in the middle health industry itself that we are sticking to this very rigid definition of depression. Yeah, don't get me going on the DSM. Oh, God. Don't get me going either. Yeah, it's ridiculous. I use the example when I'm teaching clinicians.

I use the example of cardiology and how when all the research was on men, women would go to a cardiologist office and say I had this particular symptom. And I think it's my heart. And the cardiologist would look at the research and go, oh, that's not a symptom of that you're about to have a heart attack. Well, duh, when they started using women in research, all of a sudden, here came these other symptoms that could ignite some fears that, you know, or could certainly show and indicate that this person was about to have a heart attack. It's worse than even that for women. Yeah. It's worse than even that. You go into the ER room, okay, with chest pain.

Yeah. Okay. And you're a guy. They're testing you for a heart attack. Yeah. You come in same symptoms for a woman. You're being treated for a panic attack. Yeah.

Well, listen, I know. I have panic attacks and I have a heart condition. And I also have an unusual heart condition called coronary vaso spasm, which doesn't look like the real thing. Yeah. It was like trying to convince my cardiologist that I wasn't making something up. That's right. It's crazy making. It's crazy making what I confronted her about it.

I said, you're not listening to me. If you were a black woman, they get hose the worst. Right. Nobody gets hosed like a black woman. Nobody. Yeah, exactly. These unbelievable. All right.

And it's interesting. I have, sadly, Northwest Arkansas is not a very diverse community where I live, but I've had some minority clients who have come in because they've heard about perfectly hidden depression. And they'll look at me and they're black

and they'll say, barret, I wouldn't have gotten any opportunity if I hadn't looked better than everybody else and perfect and had done perfectly on this and perfectly on that. And I have to keep up that, that, that, that, that, that, that, that, way of being or I, you know, I get treated badly or I don't get chosen or I get, you know,

I'm discriminated against. So that's true too. Why can some people camouflage their depression better than others? I think that goes back to, I think that's an age thing, you know, when you, and correct me if I'm wrong because I want to, I ain't married to being right. Okay. When you, when you, in high school remember you're supposed to be cool and not say anything and just right because you're afraid uh to say something stupid right and for some people that keeps going and you can never really see who they are as you age it becomes less important for you to hold yourself out as somebody else or not show who you are.

Not always, right? It just feels like that to me. I agree with some of that. I mean, it doesn't, what other people think of you generally becomes less important as you age. I think the younger generations, though, are, in fact, the pendulum is swinging a little too far

because the people are using therapy speak to try to, you know, they're defining themselves by by some either panic or depression or and and even encouraging each other to dive more deeply into that that's the bad part of it the good part of it is that you know everything for the millennials down are beginning to say my mental health is important and mental you know i've got to pay attention to it and i want to i want to be honest about it that does not happen in all pockets of our society. I mean, I live in a state that's still way behind the times as far as mental health being something that's talked about openly.

What do you do about the guy who doesn't give a shit about what anybody thinks about him? Okay. Well, that don't usually come into therapy. No, no, no, that's not true. That's not true. Okay, I'm the most over-therapized person on the face of the earth. And I don't give it. what anybody thinks ever that's like i don't that's been me from the gate so when you're in therapy have you cared about what your therapist had to say to you that's different i'm there to take direction i'm there to be happier and more fulfilled and more strategic and to really live my best life that's what I'm there to do. But I don't give a shit what the neighbors think.

Okay. If like, like I was just asked a girl, a girl and I were doing a little something, right? And she said something to the fact that, you know, because I'm here.

And so it's long distance, right? So she says to me, you know, you know I was kind of seeing somebody else. Yes, I'm very attracted to you. But you're not here.

And I don't, I don't want to, you know, do a long distance. Right. And so I'm like, you know what my response was? Okay, doll, no problem. Be well. Right? That was it. Right. So what do you do with the guy who, I guess it's the polar opposite, right? It's like he doesn't really care. Like, I'm not looking for a woman to complete me. You know, I'm not looking for a woman because I'm lonely. I'm looking for a woman because that's a stage of life I'm in. and I want someone to add to my life and I want to be able to add to theirs. But what do you do with the guy that doesn't really care what anybody thinks? And he walking through life, not just.

Well, I guess where my mind goes is to think, you know, is he, quote, unquote, that way because he's really done enough inner work to divorce himself from, you know, having to keep up appearances or whatever? Or is it the mask? Or is it the mask? Right. And so it could be one of the other and trying to determine which is which. You know, I have to take my own. I can't project on to him what I think. So I have to let him sort of show me, you know, show me that.

And if I'm also sort of, you know, is this somebody I would know as a person or I would know as a therapist? And that would be, you know, obviously change my. It's someone who's sitting right in front of you. Oh. Okay. Remember we're doing. Remember, I am showing my. I today for the viewer.

Well, wait a minute. When do I get to send you a bill? You can send it anytime you want and I'll pay it. And if you don't think that's true, then you don't know you. I have a seeking sufficient. That's true. Yeah. You know, I think another fleeting thought I had or kind of came up to the top and I thought,

hmm, that might be interesting. You know, would you also need for the person that you, want to bring into your life to not care what anybody else thinks. I mean, would you, would you need that to be what of her traits too? Or what if, what if no, no, no, no, no. I need her to laugh off and not take it too seriously, right? But if she spun out or something, I could be there and turn that around in two seconds. But the problem is, is, and this is the problem I had in the last relationship and okay the last 10 relationships is I made the mistake of trying to fix it. Right?

And not just letting her vent and being present. Because I fix that's my job. I fix everything for everybody. So in a relationship, you know, I just didn't, I didn't get the right note. I'd be very interesting to work with because I'm like going, where did he learn that it's his job to fix everything for everybody? Because that's my job. I've given 10,000 people back to their loved ones.

You know, some people think I'm pretty good at this. So, you know, that's why I came back to work. I didn't need the money. I sold my first business. I guess that bleeds in, right? That work, that work life thing, okay? Oh, I'm, mine is almost inseparable. Yeah.

You know, you get, you get a relationship with me. If you're in a relationship with me, you get the therapist part of me. I mean, you know, I don't leave her behind somehow. You know, I've spent 34 years and five years of training. So, you know, I was a professional musician in my 20s. I was a professional singer. Yeah. Sang jingles during the day and in Dallas studios.

And then I had a little band at night and did all that stuff. So I led that lifestyle, which was not good for me, mind you. It was not a good lifestyle for me. Very chaotic for me. So, and then I went into music therapy, which then I thought, this is it. interesting, but I really want to be, I'm going to be a psychologist. And I'd had lots of therapy by that time. So it took me nine years to turn that boat around and from being a singer to all of a sudden, you know, seeing my first patient as a doctor. Is perfectly hidden depression,

essentially a self-defense mechanism? I call it protection, but yes, it could be also called self-defense. It's protectiveness. It's a protectiveness. It's a protection. It's a layering of, you know, I can't allow my hurt to show. And so I push it away. And again, that's a skill. If my dog had died this morning and I knew we were having this conversation, I would have had to, well, I might have called you and said, hey, my dog died two hours ago.

I can't do this. But, you know, if I truly could pull it together, that I would go get that grief. get it out and feel it after this is over. The perfectly hidden depressed person uses that skill rigidly. And it becomes they almost forget how to actually feel something deeply. Do they get stuck when they're perfectly depressed or can they move through it? Do they get stuck in the hiding or do they get, yes?

I'm talking about are they so sad initially that they blow off commitments and they don't show up for life and that kind of thing. Well, can you, can you burn out? Is that what you're kind of sort of? No, no, no. I'm talking about if I get shut down by a woman that I really, that I really cared about and now I'm, and now I'm depressed. Okay. Can I get up the, can those people get up the next day and go to work? Or are they on the couch in a fetal position for a couple days until they can get their probably if they have a fairly long history of hiding that pain, there's a term called high-functioning depression.

And my statement about that has been my understanding of that is high-functioning people know they're depressed, classically depressed, but they still have certain skill sets that lead them to be able to go to work or do whatever they do normally. People with what I'm calling perfectly hidden depression don't, they may not even know they are depressed. When my article came out in Huff Post now years ago, I got hundreds of emails about perfectly in depression. I got, it's like, I don't know what you're talking about, but this term is something that gets to me.

so they understand that there's something wrong but they would never call it depression at least at first i even thought about richard not calling it depression perfectly hidden pain perfectly hidden something you know because it does it's a little confusing to call it depression but it to me then when i finally kind of moved into the same space of thought space of well it's like that cardiology thing we are expanding the definition of what depression can look like and there are signs of it so now i realize that's a little grandiose of me to say that you know because and i've had colleagues say you know margaret we all know this exists you've just given it a name and um and i'm trying to make sure people know that that can happen

am i making sense i hope so No, that was beautiful. Some of the listeners are going to say, well, if they don't know they're depressed, why tell them? And you know where they're going to say that most of all? Where? Arkansas. You're right. Yeah.

In fact, I had some people very vehemently disagree with me on Facebook when I began writing up this. I used to be on Facebook. I don't really use it very much anymore. But they said, you're pathologizing resilience. You're pathologizing someone picking up and dusting themselves off and saying, well, yeah, it happened to me. And I, you know, I didn't have the best childhood. But by damn, I'm going to be successful and achieve and all this stuff.

And I said, no, well, that's great. But what are their options? Do they have the option to cry? Do they have the option to let themselves feel angry? Do they have the option to, you know. But they'll say. But they'll say, who gives a shit? Where's the injury?

Well, I do. No, no, of course you do. But what would we? I do. But what would you tell them? Because it's lonely. I interviewed about 60 people for the end. Stop.

That was breathtaking. Yeah. Because that was perfect. Okay. Because in what world is good, good enough? That's the answer. It's not. The idea of life is to keep getting better and better to live your best life, to be your best self.

And you're not, you're not, you can do better. And that's why you're not pathologizing. Okay. Resilience. It's nuanced. And that's, this is why education is so important. And when people don't understand the nuance, okay, we can try to dumb it down for them so that they understand. But if you don't, okay, we can lead horse to water, but you can't make them drink.

That ain't the problem. That was beautifully said. Well, thank you. But that's what I learned from the people that I had the courage to reach out to me. And I said, why in the world are you doing this? I'm this person you don't know from Fayable, Arkansas. And I would say, again, I don't have a percentage, but most of them said because I would not wish my life on anyone. brain surgeon,

advertising accountant, motivational speaker, you know, all these people said, I've been so lonely. I'm just so lonely. Yeah, that's sad.

So it's, yeah. That's sad, man. Loneliness, loneliness is sad, but I got to tell you for me because I'm not lonely, but that doesn't mean

I don't have bouts, right? Moments. And, you know, you just got to be gentle with yourself. Yeah, that's right. And take care of yourself. And, you know, for me, I like repetition. I like waking up in the morning, getting quiet, doing my stretching, getting the shower, right?

Take, do all my morning stuff, right? Sit down with a nice cup of coffee and a cigar. You were fine until you said cigar. Sorry. Don't mean to deny the importance of your ritual to you. Listen, they're Cuban cigars. It's sorry. I spoke to cigar in high school and I've never thrown up like that in my life.

How much of someone's identity and self-worth gets tied to achievement? My perhaps somewhat cynical answer to that would be, sadly, maybe the more achievement you have, it is harder to not be governed by that achievement and to start saying, so I've got to achieve more and I've got to achieve more. Because it's kind of like, it's like drinking, you know, when you have that first drink and, oh, wow, it settles you down and it's great, you know, and you're constantly trying to relive that moment. And so on your fifth drink, you don't have that feeling.

You know, in fact, it makes you sick or it makes you go to sleep or it makes you throw up, whatever. You know, it's like that initial, oh, wow, this is really great. Now, maybe drinking stuff. I mean, I'm not talking about addiction stuff. I'm not an expert in that at all. But it's kind of like you're trying to recreate that, oh, this is fantastic. You know, I want to live this. moment and then the second success doesn't have that kind of excitement. In fact, there's just,

you know, a guy out of Canada that I admire a lot, Gordon Flett, says this kind of depression, this kind of perfectionism better. He's a perfectionist researcher. It's like being on a treadmill where you have no control over the speed or the incline. And what I would, what I've added to his definition of this kind of perfectionism is, and you don't know how you're being evaluated. Are you being evaluated because of how fast you go for how long you run, for how steep the incline is? You know, how are you being evaluated? And everybody, you know, when you're trying to meet everybody's expectations, you have no idea

of, I mean, if I had been trying to meet your expectations during this interview, that is what would have been in my mind. What does he expect me to say? And there would be so much anxiety to it instead of just listening and, you know, responding how my gut and heart and mind tell me to respond. How often does this show up as addiction? I think that when I began formulating these ideas, thinking through things, feeling through things, I realized that probably what would be a likely trait probably would be a likely

would be real psychological illnesses or. or things like that that have to do with control, panic disorder, social anxiety, OCD, all those things that have anorexia, orthorexia, that have to do with I have to stay in control. And if I don't have control, then I greatly fear losing control. And addiction goes along with that,

where it is, you know, if you need a substance to hide your confusion or your, to escape it or to relieve yourself from it a little bit, then that is something that can turn into a problem. So actually it is listed in this trait that involves problems with disorders or illnesses, mental illnesses or substance abuse that have to do with control. Do you know what we see? What? Just in this little realm of perfectionism, we see that people with perfectionism have a higher rate of substance use disorder.

And the reason they do is because you always, when you're part of perfectionism, is always moving the goalposts. Yeah. Right? And so you're never satisfied. And if you're never satisfied and you always feel like you're not enough, you have to medicate. That's what we're finding.

When does gratitude cross the line into toxic positivity? Yeah. Toxic positivity is a huge issue. has been for at least a decade, if not more. Can you tell the viewers what it is? It's when you get so stuck in feeling like you need to feel grateful that, and gratitude is a great thing. Don't get me wrong.

I'm very grateful. I want people to be grateful. But when you look at me and say, well, I don't know why you're sad today. You have so much going for you. You have so much, you know, you've got a book. come on you know it's like i can't i'm not with toxic positivity if there if there are things you should be grateful for then that locks you out of talking about being sad or tired or depressed or angry or frustrated or bored or getting support for anything yes yes because you know

in fact a woman i had on who happens to be a black physician said um who was dealing with her own depression. She's great. Pay me a Buchanan yet I'll have her on. And she said, you know, in the black church, it's, I'm too, I'm too blessed to be stressed. You know, well, if. I love that though. I love that. Yeah, it's blessed to be stressed. And so, you know, you go and you may not have any food in the refrigerator, but, you know, you're, you're too blessed to be stressed. So, yeah, it's, it's a, you know, it's, it is, it is rampant, especially in more conservative kinds of religions. All right.

Are people using positivity to avoid dealing with real emotions? I think that's where you are going with it. Yes. Yes, they are. So they're jerking themselves around. They're saying there is no debt. There is no debt. There is no debt.

There is no problems. There is no problems. And they're not with their head in their sand, not dealing with it. Is that what you're referring to? I don't really. this is the one part that I'm stuck. I don't understand it. What do you mean you don't understand it?

I mean, I'm limited. First of all, I don't know what positive talks. Toxic positivity. Yeah, toxic positivity. I've never heard that statement before. Well, it's a fairly new term. I'm trying to remember the name of the woman wrote a book. She wrote a book called Emotional Agility.

The story she told was that her father was actually dying when she was a child. He had a terminal illness. And every day, she would go and tell him goodbye and then go to school. And her mother and her family expected her to just handle that. She knew her father was dying. She didn't know if he'd be alive when she came back or not. But there was no talking about it in the family. Absolutely none. Finally, a teacher handed her, I handed the whole class a journal. said, write what you really feel. And she said it just exploded inside of her. And she would write, right, right, right.

Her family was expecting her to be toxicly positive, where the positivity was hurting her. I'm all for being optimistic, being hopeful, being, you know, all this kind of thing. But when you have no, when you're not even given or give yourself another option, that's where I draw the line. Okay.

That woman is a saint. All right. The first time I heard the story, it was hard too. It is. Oh, the lost children. As a dad, you know, with a daughter, that feels so harmful to the child. You know, I love my grandfather more than anything in the world. Really?

More than anything. Save my life. Okay? Because of my parents, who they were. He was the polar opposite. Never said no to play. Loved me more than anything in the world. Oh, well, how wonderful.

I mean, he'd be sleeping on the couch, exhausted. I would jump on him. He wasn't mad. Come on, let's go play. Get up and we'd go play. I mean, he was, everything to me. And he was in the hospital.

Now, I'm 18. Yeah. Not a baby. And he's in the hospital. And my parents are telling me it's fine. He's going to be fine. Yeah. Yeah.

That's a huge mistake to make. Huge. And I go see this guy every three days. Not every day. Not all day every day. Every three days for a half hour, 40 minutes, love them up, you know, fill them up and walk out. I'm still livid. Yeah.

Yeah. So it hit me twice. Sure, of course it did. Yeah. I'd look at how nurturing you are. Look at me. I was a wreck. And now I'm like all.

better because I felt supported and known and heard. And that's the important thing, right, for everybody to understand. Sure. If you have a negative outlook or opinion on therapy, you just don't know better. There should not be a stigma at this. in 2026. If there is the problems you. Okay? Because this is the way elegant people deal with their stressors. It just is.

Okay. So you talk about emotional transparency. Why is it so important for mental health and recovery? I stay away from the term vulnerability. And I've learned that the last few years after I wrote the first book because I call it vulnerability in the first book. I hate that, by the way. It makes me sound like a pussy.

In my head, it just does. And for a lot of guys, it does. We don't want to be vulnerable. Yeah. So I choose now to use the term transparency, which I think is a better term anyway. And how does that help your mental health? I'm not saying, you know, every emotion you realize you feel, you should you know, express or or let it show. I mean, certainly there's certain things we feel and it's

appropriate to feel them privately. But that is the way that you connect with people on an intimate level, not everybody, but the people you choose to have some level of emotion or try to create some level of emotionally and intimacy with them, then you are transparent in how you feel, no matter how hard that is, uncomfortable that is. And what I try to say to these folks who are struggling so with perfectionism is you don't have to start where you think that might, like, all you have to do is really sit down and say to somebody, you know, I don't know how to talk about myself. And you look like someone, I've watched you and I feel like I can trust you. would you be willing, as I try to learn how to talk about myself, would you be willing to sit there and listen?

They'll say, yeah, and they'll go, well, go ahead. No, that's, I mean, if that's the step you can take, is that the first step? Then take that step. Just, you don't have to reveal a damn thing, except that you find it hard to reveal. You know, and that's how you begin getting more and more comfortable with emotional transparency. That's beautiful. That was an excellent intervention.

for therapeutic alliance. That was beautiful. Does PhD create functioning addicts? They're going to be caught in the, in the hiding part of it, especially, you know, to go to an AA meeting or to go to an NA meeting or something.

That's not anything they're going to do. So, yes, I think that it will tend to create, if they could go down that path, then that's going to create a huge problem. To your point, let me accentuate that.

Do you know how bad, Do you know how bad we are? We're so bad that we don't want to go to Alcoholics Anonymous meetings because initially, what if somebody sees us? Oh, yeah. And you add being in a rural community, who? Yeah, but do you hear the insanity of that? Who's going to see you?

Other alcoholics. Yeah. It's like that's who you, that's, they're not telling anybody. Yeah. It's crazy. It's insane. What are some coping mechanisms you recommend for people battling these emotions? Okay.

Compassion is going to be the first step. Well, I take that back. The first step is really understanding that your perfectionism, this kind of perfectionism is a problem. You know, it's probably been your best friend. You know, it's the persona you get out. I can handle this. I can do this. I'll take responsibility for that.

I got this. You know, you have counted all that aspect of your personality and of your training and your skill set. So for somebody like me to come up and say, well, you know, your perfectionism is a problem. You know, it's like I have to work with somebody as they begin to unravel their life for me to describe it to me, is to say, so how does your perfectionism affect you there? Oh, well, I can never say I'm mad. Oh, really? So what's that like? So you begin to help them understand that the way they, that they, that they're, as we said many minutes ago at this point, that there's some really wonderful things about their ability to focus and have that drive and have that success.

But there are also some parts of it that are damaging. And as they begin to recognize and become more aware of how that lack of self-compassion, lack of options that they're in a tunnel that they have to live their life in this tunnel, this box. And so as they become more aware of that, then you move into actually challenging their belief systems, understanding there's a thing called a trauma timeline that you do, that you have them go back and look at their lives and say, this is some great having me when I was four, but man, five was, I had some really hurts at age five. And they go and they,

they look back all their lives and begin to realize there is a, there are patterns. So you develop self-compassion, which is a, it's a kindness towards yourself. It is a, but I will tell you, my experience has been that the hardest thing to do, the step that most people have the most problem with is actually beginning to change, actually telling someone, I'm not who you really think I am. I'm not totally who you think I am or who I've led you to believe I am. And so, I've said, Richard, it's like a jinga game. You know, you have to find the piece that it's going to come out and you're going to put it on top that won't topple the whole damn thing. over what that's big in arkansas

got a lot of shit to do there and so you all go around and play jenga now come on come on we've got the hogs we've got caliperi we've got all you know we got baseball football's a little ify you had a good football coach you just fell off a motorcycle yeah well yeah that was unfortunate i'd go on to say that i have a working definition of self-acceptance that i've come up with all by myself And I think that is true self-acceptance is when you begin to recognize that your strengths don't define you anymore than your vulnerabilities or your weaknesses. And vice versa.

I used to, I still tell me. Can you give me an example of that? I'm about to give you an example of my own life. I've been married three times. Okay. I kept those first two marriages secret for a long, well, not secret to the people who were with me when I was living. living them but when we moved to Arkansas, I just wasn't going to tell anybody, right? Wait, wait, wait, wait, wait. You weren't going to tell anyone that you were married to your first

two husbands? I just was going to leave them out of the story, you know? Why? Because of my shame. Why? Because I, you know, I wasn't perfect. I, I mean, hold on. I need to understand this. I'm losing it. I'm losing it. I know I'm not getting it. I'm missing. something. Why, if you're married to a man, do you not want to tell anybody you're married to that man? Oh, no, no, no. I told him we were married. I just didn't tell them about the previous marriages. And I wouldn't lie. Oh, you didn't. Okay. It's a southern thing. You didn't tell anybody that you were a failure in your first marriage. That's right. Actually, the first two marriages. Right. Oh, so this is, you're married to the third guy and you're not telling anybody about

the first two failures. Not openly. Okay. Not like. like, hey, fun fact about me, you know, is this. Okay. So I also have three letters after my name, Ph.D., as you have counted on. I'm pretty proud of those damn letters. I mean, I worked hard, you know, but what I've come to realize is that those divorces, and I've been married now for 30, almost six years, don't define me any more than my degree does. I'm happy about one. I'm not so happy about the others. It was painful. I hurt people. I got hurt. Not a pleasant time. My family went through with me. And so, but it doesn't define me. And when you can begin believing that, then shame loses its grasp. We're going to leave it there. That was beautiful. Tell us where

people can find your workbook and find you. Okay. I'm easy to find. my website has the creative name of Dr. Margaret Rutherford.com. I have a podcast called the Self-Work podcast, S-E-L-F-W-O-R-K. Been doing it for nine years. I love doing that. And my book is anywhere. You might have to order it. If you want to go to your local bookstore, you might have to order it.

But the workbook came out last week, and we're still kind of waiting. We had a couple really good reviews. And then my TEDx is called How to Recognize Perfectly Hidden Depression. Yeah. Didn't that get like 2 million views? Over. There it is. There it is.

That's the subject. It's the subject. Thank you so much for joining us today. I really appreciate it. This was a blessing for me personally. And I know my audience is going to love it. Well, I have loved being here. Congratulations on the workbook.

That's great. Thank you very much. That's how people learn. You put it. The topic is something. I will tell you, Richard, as I said before, I'm in my early 70s. The last decade of my life, probably not the last one, but the previous one, has been so full of meaning because of writing about this and talking with people about this. I mean, it's an unexpected gift.

So I'm glad to be the bearer of the message. See you next Tuesday. We're out of time. Please subscribe on YouTube, click the thumbs up, and leave a comment. Please subscribe on Apple Podcast and Spotify, and leave a rating and a review. And share the We're Out of Time podcast with others you know who will get value out of it. See you next Tuesday.