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Happy Monday and welcome to your
mental Health mini. 

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This week's guest is Doctor 
Margaret Rutherford, and we are 

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talking perfectly hidden 
depression. 

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One of the problems with 
perfectionism is that most 

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people view their perfectionism 
as a strength, and it is in many

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ways. 
And there's constructive 

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perfectionism for sure, but 
there's destructive 

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perfectionism or what I've begun
calling perfectly hidden 

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depression, which can be very 
dangerous because what can 

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happen to someone, you know, the
trauma that causes this 

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camouflage to be warn mostly 
happened very early in life when

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you grew up in a family where 
there was abuse or neglect. 

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And obviously you weren't 
allowed to talk about it or 

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express it. 
If you grew up in a family that 

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just wouldn't allow you sad 
feelings, don't. 

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If you're sad, if you're angry, 
get go to your room. 

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Maybe you grew up in a family 
where your parents were 

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alcoholic and you had to take 
care of your younger siblings. 

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So you, you became a pseudo 
adult. 

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Maybe you grew up in a very high
achieving family and you learned

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that you're not supposed to 
struggle or show struggle. 

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You're just supposed to exceed 
expectations. 

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The point is that when you Don 
this camouflage at first, even 

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when you're 3456, you kind of 
know what you're doing. 

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I mean, even little kids, I'm, 
I'm not supposed to cry. 

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And yet what happens is it seeps
underground. 

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It seeps into your unconscious 
mind where you actually are not 

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even aware you're doing it. 
It didn't occur to me that maybe

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my gut had been trying to say 
something to me, but it's like, 

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yes, I'm hiding perfect. 
And I'm I'm very committed to 

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hiding perfectly. 
And and I've spent years making 

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sure that no one knew my 
struggles, that I didn't make 

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mistakes, that I didn't let my 
vulnerabilities show because 

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it's fueled by fear and shame. 
There's this inner voice of 

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shame. 
You know, you don't really 

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belong where you are. 
You're doing the wrong thing if 

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you admit that you're tired or 
you're sad or you're angry or 

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you're scared you're doing 
something wrong. 

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You know, you're showing 
something and you'll lose 

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everything. 
And so it has gone from a 

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conscious process into an 
unconscious process. 

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I think this inner voice of 
shame that, you know, you try to

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perhaps discard or not listen 
to, but it is highly critical 

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and highly shaming. 
If you're somebody who always 

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takes the responsibility, if you
need a lot of control, you're 

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sort of a hidden warrior, a 
secret warrior. 

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If you believe that you are 
being selfish, if you talk about

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your own needs and that you are,
you know, always counting your 

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blessings. 
I, I have so much. 

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I shouldn't, you know, I 
shouldn't do this. 

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If you live your life by 
absolutes, I must, I ought to. 

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If no one knows you, you know, 
these people make great friends,

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but nobody really knows them. 
Those are the kinds of things 

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you want to kind of assess on 
the spectrum of perfectly hidden

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depression. 
So the model I have for a 

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healing strategy is that first 
it's consciousness. 

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You've got to understand that 
it's a problem and recognize and

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become more mindful of how it's 
governing you. 

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You also have to look at the 
difficulty in actually 

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committing to the change. 
That kind of commitment to allow

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yourself to be vulnerable is 
really part of the work. 

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The third thing is pretty 
classic CBT is to look at the 

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absolutes. 
Generally, you're following the 

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rules that you were taught as a 
child or that you learned the 

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hard way. 
As they say that I must do this,

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I cannot be this, I cannot look 
like this. 

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So you begin to look at those, 
but going deeper than that, you 

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don't just look at the rules, 
you look at the beliefs 

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underneath them. 
For example, I grew up in a 

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family that would say, don't 
tell anybody you had panic 

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disorder. 
They would say, you know, if 

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that's your problem, you, you 
must keep it private. 

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And so by breaking that rule, I 
also had to address the belief 

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of that rule is that if you have
a mental illness or if you are 

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struggling mentally or 
emotionally, you'll be rejected.

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People will think less of you. 
That's the belief. 

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The fourth stage is called 
connection, and the system I use

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is what's called the trauma 
timeline. 

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And you literally go back with 
compassion and you begin to 

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acknowledge the things in your 
life that were good and the 

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things that were troubling and 
abusive or neglectful or 

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whatever they were. 
And you do this timeline from 

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the time you were a young child 
to whatever time you want to. 

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And what you can begin to see is
the pattern. 

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You know, I probably wouldn't 
have done what I did at 14 or 17

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or 27 if I hadn't had this 
happen to me when I was four. 

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And if your trauma is severe, 
you should not do this work by 

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yourself. 
You need a therapist. 

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But the last one is change. 
I've been a therapist for 30 

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years, and I've watched a lot of
AHA moments that are very 

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powerful. 
And you can see a change in 

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there body, you can see a change
in their mind and in their heart

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and in their very soul. 
What gives you hope is behavior 

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change. 
When you see your life, your 

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choices, your behavior changing,
your thought patterns changing 

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that, then you can say, wow, I'm
really very hopeful about this. 

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This is going to be a much 
better life and I think if there

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is a concept or if there is a 
way of being that is the 

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antidote for this trauma based 
perfectionism or perfectly 

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hidden depression, it is self 
acceptance. 

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You recognize that your 
strengths do not define you any 

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more than your vulnerabilities 
do.