Dr. Aimee Ruscio

About Dr. Aimee Ruscio

Posts by Dr. Aimee Ruscio:

April 8 2025

Trying to Earn Your Worth? Emotion-Focused Therapy for Overwork

Dr. Aimee Ruscio Blog

Never enough. Never enough. Never enough.

Success doesn’t really matter if the internal “never enough” drum beat never changes.

Why do people chase success?

Because they want to feel secure and worthy of love. They believe that someday out there in the future, when they finally make it, they will feel secure enough to relax. Of course people want to feel secure and valued. We all need to feel secure and valued.

Success doesn’t get you to where you really want to go.

I guess success just doesn’t get to the core of the issue. You want to feel financially secure, yet somehow, no matter how much I make, save, or my net worth increases, I still feel like I’m skating on the edge of a cliff and one wrong move and I’m back where I started, struggling to make ends meet. I need to FEEL secure and with money, the goal post just keeps moving.

Same thing with promotion or recognition. They fade so quickly. If you are in the habit of pushing pushing pushing yourself constantly. Striving for more, maybe a promotion or some happy bit of luck gives you a few moments reprieve, but soon enough, that old pressure seeps back in and back to the grindstone you go. Proving your worth again and again and again. Always on the precipice of failure.

Of course, success gets you some of what you need. Better to have money in the bank, a solid career, and a good reputation, than not. Success can meet some of your needs, but not all of them.

One problem is that the feeling of insecurity and unworthiness is inside of you. You climb further up the success ladder, check in with yourself and that feeling is still there, so you climb higher. But no matter how high you climb, that insecurity remains.

Chasing success at the cost of the rest of your life

When I was in graduate school, I spent a few months doing intakes at the DC Veterans Affairs Hospital. Often, vets would come in and their whole life had fallen apart, but they were still holding it together at work. No relationship, no friends, no hobbies. They were miserable but they were good at their job. I knew that I was looking both into a mirror and into a window into the future. I could easily be one of those vets in 10 or 20 years. This is a terrible way to live for two reasons: 1. You feel awful…exhausted, resentful, and unhappy and 2. You give someone else so much control and power. You look outside for value and worth, which gives other people’s opinions of you way too much sway.

So what do we do? And don’t tell me not to strive for excellence…

I get it. I want a meaningful life and occupational excellence is a part of that. I’m not suggesting quitting, down-shifting, etc. That’s the right move for some people, but I wouldn’t know whether or not it is right for you.

Change your relationship to the voice inside that tears you down

You know the one.

“You should be doing more.”

“You got lucky this time…you won’t get so lucky the next time.”

“If you just solve this one problem, then you can relax.” (except there is always one more problem)

“If you mess up, you could get fired.”

“If you make a mistake, they’ll lose all respect for you. They won’t want to work with you.”

You get the idea.

People feel weighed down or trapped by this kind of inner conflict. Sometimes there is one part pushing them and another part that wants to give up or rebel because no matter how hard they work, it isn’t ever enough.

You have to resolve this inner conflict at an emotional level. Thinking about it differently won’t get you there.

Go back to the source

Why do you feel deep down like you are worthless, but if you just work hard enough, then you can prove that you have value? I imagine that you missed something important that you needed in childhood. Maybe you had a parent who loved you and wanted the best for you so they pushed you to do well in school. Maybe they didn’t have a lot of financial security and they wanted something different for you. So they were doing the best that they could, but unintentionally, the message they sent was that when you did well, then you were noticed and loved. But when you did poorly, the message was that you weren’t good enough and needed to try harder.

Or maybe your home growing up was chaotic and your parents were unreliable. So you learned early on that you needed to look out for yourself and that you couldn’t count on other people to meet your emotional or physical needs. You put yourself through school and worked intensely as an adult, because if anything ever happened, there was no one there to provide a safety net.

Sometimes it really helps to go back to the child who needed love and support. Rework some of those memories so that you feel more worthy, stronger, and more capable in the present. Instead of a vague fear that all of your success could disappear one day, you start to feel like even if times get tough, you’ll figure it out. You’ll get through it.

Then you don’t have to work so hard to be perfect and to not make any mistakes. And when you don’t have to work so hard, you have more time for friends, hobbies, naps, vacations, and yes, meaningful work. You may be amazed at what you can achieve when you aren’t at war with yourself. You become happier and that happiness creates positive momentum. You cultivate a full life.

Summary

Emotion-Focused Therapy can’t change the past, but I do help people to build rich, meaningful lives that they feel good living. You can find good enough at work and free up time and energy for other pursuits.

If you resonate with any of these, Emotion-Focused Therapy can provide a lot of benefits:

Constantly working and feeling like there aren’t enough hours in the day
Irritated when one more thing lands on your plate
Worried that one wrong move could be the end of everything you’ve worked for
Constantly running through a to do list that never ends
Jealous of other people who look like they are having more fun

If you want to take the next step, please set up a consultation call where we can talk about your experience and goals.

March 31 2025

Unfinished business with a parent or loved one? Emotion-Focused Therapy can help with bad feelings that linger…

Dr. Aimee Ruscio Blog

Maybe you have lingering sadness or anger at your parents for things that they did or didn’t do in childhood.

For instance, maybe you felt invalidated as a child frequently. Your feelings weren’t valid. If you got upset, your parents told you things like “control yourself” or “don’t over-react”. Now, you are at work and raising a concern about a project and your boss cuts you off in a meeting with “that’s not important right now”. Suddenly, you are furious and maybe aware that this reaction seems out of proportion to what just happened. But what you are feeling isn’t just a reaction to your boss, it also brings up the years of feeling invalidated and unimportant from childhood.

This is common, not because parents don’t love their children or do their best, but because they are fallible human beings with their own pain and struggles who weren’t able to meet their children’s needs, and this can leave those children, when they grow up to be adults with lingering pain that sometimes rears its head in the present.

You know this pain isn’t rational, so you ignore it or push it away. What’s the point in feeling it? I’ve been feeling it for years and nothing ever changes…

Old painful emotions stick. Sometimes you end up both feeling and not feeling something for years. It’s always there, in the background, and you don’t go there. You keep it at bay. You never fully feel it. And you are never not feeling it.

We all have ways of protecting ourselves from emotional pain: avoiding or numbing through scrolling, food, alcohol, drugs, staying busy, working, gaming, porn, or maybe just compartmentalizing. Some people just push feelings down, because that seems easier than going through them. And of course, if they feel overwhelming or unrelenting, it makes sense to seek relief.

You have to feel it to heal it

My mentor, Les Greenberg, frequently says “You have to arrive at a place before you can leave it.” and “You have to feel it in order to heal it.” So we have to feel our feelings in order to assuage them. But feeling them isn’t enough.

Sometimes old painful emotions need to be transformed: How you feel them matters

In a recent paper, Nardone, Baher, and Pascual-Leone (2025) showed that for people who presented with lingering angry feelings, exploring and expressing anger then exploring and expressing sadness provided the greatest relief while the opposite was true for people who presented with lingering sadness. They benefitted the most from exploring and expressing sadness then moving to anger. So feeling the same old anger or the same old sadness wasn’t enough for relief. The study participants also needed to add a new emotional experience to the old one.

Sadness softens anger

The study authors stated that exploring sadness after anger has been expressed likely helps to soften persistent anger. It helps people to contact a different aspect of the experience: not only that they were unjustly treated but also putting words to what they missed and what they needed from the other person.

Anger clarifies global distress

Sometimes persistent sadness is what we call ‘global distress’. It’s a bad, maybe helpless, maybe hopeless, collapsing sense that is just there. It doesn’t seem connected to anything. And it can be all pervasive. You check in with yourself and there it is…still sad, no particular reason why.

The study authors suggested that maybe anger helps to clarify global distress. Instead of feeling generally helpless or hopeless, assertive anger requires people to put words to what specifically they are angry about. I’ll often prompt clients with “I’m angry at you for …” when we are exploring old anger at a parent. As Antonio Pascual-Leone said in a recent talk, “You need to know what you are fighting for.” What specifically was the injustice? How do you want to be treated differently next time or by others? Anger sets boundaries and increases a sense of deserving good treatment. It can help people to feel an inner strength or scaffolding, which is an antidote to the collapsing into global distress.

Our bodies know how to heal

In this study, participants explored their emotions using writing prompts. They were randomly assigned to either explore sadness first then anger or vice-versa (anger first then sadness). This is a useful research paradigm, but it doesn’t capture the complexity and moment-by-moment responsiveness of a trained therapist.

In Emotion-Focused Therapy, we start with exploring what you feel currently and then, often, new emotions emerge organically. So while the intervention used in the paper walked people through exploring two emotions in a defined order, our bodies move from one feeling to the next automatically, given the right support.

For more on emotion sequences, please check out Nardone, Baher, and Pascual-Leone (2025).

March 10 2025

How Emotion-Focused Therapy Can Help in Uncertain Times

Dr. Aimee Ruscio Blog

“How can Emotion-Focused Therapy help when the world is on fire?”

This is a fair question. And an easy one to answer. I’ve talked to a lot of people in the last few weeks who are having understandable reactions to current events: frustration, anxiety, disbelief, resignation, etc. Maybe you are reading the news more, checking out more, having difficulty sleeping soundly at night, or worrying about the future more. I understand. There’s a lot of that going around. I can relate both from conversations I’ve had with clients, from conversations with friends and colleagues, and from my own experience.

We can’t control the world

That’s the difficult truth. We are impacted by events that are beyond our control. The COVID pandemic was a great example of that and one that many (but not all) of us made it through to the other side of. Therapy isn’t going to help you to control or change the world.

We can change how you feel

Well then what’s the use in talking about it? Won’t I just be wasting my time?

Not at all. In Emotion-Focused Therapy (EFT), we can change how you feel without having to change the situation itself. And that’s the challenge when the situation is so big and beyond anyone’s control. The last few weeks have felt like that. Similarly, the pandemic felt like that. Big events are happening and we are all along for the ride.

At its most basic, an emotion is a feeling in your body, often your chest or stomach. While we can’t change the event, we can change the feeling. This feeling is a physical sensation. It is something that happens inside of you: tension, heavy, sharp, buzzy, etc. And maybe there is a word that captures the sensation: exhausted, weighed down, or on guard. Maybe there’s a situation that this feeling is in reaction to (incredible uncertainty at work) and maybe if you stay with it for a moment, it brings back memories of other times you have felt this way (when your dad lost his job when you were 10 and you had to move to a different neighborhood).

Meet Ben, a fictional government employee

Ben works at the National Institutes of Health and is currently worried about losing his job. He is understandable anxious, watching people being let go left and right. And there is a non-zero chance that he could also be let go. His anxiety is justified. But what he is feeling is more than that.

Ben also has an emotional scar from childhood, when his dad lost his job, the family had to move, and Ben lost his circle of friends. It took his dad a long time to find a new job and when he did, it wasn’t at the same income level as before.

Ben, understandably, is sensitive to feeling insecure. He has a fear that he won’t just lose his job, he’ll lose his social circle, and maybe won’t ever be able to recover. Facing potential job instability today brings up complicated feelings from the past: feeling insecure and afraid, feeling unprotected, vulnerable, and powerless. And that all makes sense, because as a child, he was afraid, vulnerable, and powerless. And while his parents loved him deeply, they were too distracted with their own struggles to fully attend to how he was feeling at the time.

Maybe Ben isn’t even aware that this is what’s happening. He knows he’s got a knot in his stomach, not sleeping as well as he usually does, putting a lot of pressure on himself to do as much as he can at work, and monitoring the news constantly so that he won’t be blindsided if the worst happens.

Ben needs to find a way to feel more secure in himself in the current situation he is in.

The opportunity with EFT: Transform past pain to feel differently in the present

We can always change how we feel. In this case, I would work with Ben to both understand and to transform his emotional scars from the past. And this is incredibly helpful, because it will decrease the intensity of his anxiety in the present and will allow Ben to respond to the present more flexibly.

Maybe we work to transform some of that old pain so that he feels less fear and more assertive anger and confidence. Maybe he develops more confidence that he’ll be able to get through it to the other side, even if the worst happens and he does get laid off, rather than the old fear that he’ll be doomed to repeat his parents’ story of a job loss leading to slow and one-way decline. Maybe shifting his internal pressure (“I need to do more, do more, do more so someday I can feel safe”) to a more supportive stance (“This is difficult, and I’ll get through it. I’m not alone. I’ll find the people and resources that I need.”)

Summary

Emotion-Focused Therapy can’t change the world, but I do help people to feel differently in the world. That possibility is always available to you. And when you feel differently, you respond differently.

If you resonate with any of these, Emotion-Focused Therapy can provide a lot of benefits:

Worried about losing your job
Doomscrolling for hours
Feeling irritable, powerless or anxious
Not sleeping well
Using food or alcohol to numb or checkout

If you want to take the next step, please set up a consultation call where we can talk about your experience and goals.

January 20 2025

The two fears that keep people out of couples therapy and how EFT for Couples helps with both

Dr. Aimee Ruscio Blog, EFT for Couples

I’m both an individual and a couples’ therapist. In the regular course of my work, I often recommend couples therapy to individual clients and vice versa.

I’ve seen two fears that over and over again either stop couples from going into couples therapy or delay them for months or years…often until there is some kind of blow up that prompts action.

So what are the two fears?

Fear #1: What if I’m the problem?

Often fights between couples take the form of both partners trying to argue why the other person is in the wrong. We’re triggered, angry, maybe feeling wronged and we go into this attack/defend “let me tell you why I’m right and you’re wrong”. Both people attack and defend “No. Here’s why I’m right and you’re wrong.” But maybe underneath there’s a fear that if I go to couples therapy, will I find out that my partner is right and I really am “the problem”? And shame is painful and many of us deep down feel like we’re not good enough. The thought of having a therapist assess the situation and agree with our partner’s worst accusations is too painful and too risky. So we protect ourselves by not taking the risk. And this is a very human thing to do. We all avoid pain. But at the same time maybe the status quo in the relationship isn’t great or slowly (or quickly) gets worse. Maybe we lose time in which we could feel better in our relationship. In a worst case, maybe too much time passing leads to a partner losing faith that something could be different in the relationship and that is actually when relationships start unraveling.

So is it possible that you’ll go to couples therapy and hear that you are THE problem? – No!

Problems in relationships are interactional (between two people)

No. With a few exceptions (abuse, maybe unaddressed trauma, maybe substance use), problems in relationships are interactional. They exist between two people and both people contribute in unique ways.

In EFT for Couples, you will identify your negative cycle

One of the first steps in emotion-focused therapy for couples is to identify the couples’ negative cycle. This is the old argument that couples get caught in and they develop over time in any long term relationship. The question is whether the couple know how to navigate their cycle so that they can resolve it quickly vs. increasing the intensity of it.

An example of a negative cycle

A classic example is a pursue/withdraw cycle. One member of the couple tends to withdraw from conflict to try to manage their own emotional intensity alone and then come back when they are feeling less overwhelmed. The other person wants to resolve conflict right away so that they can feel close to their partner. Both are trying to meet their emotional needs, but the more the withdrawer withdraws, the more the pursuer pursues and vice versa. In EFT for couples, I work with couples to understand their cycle so that they can navigate it differently. Maybe the withdrawing partner needs to step towards their partner and the pursuing partner needs to hold steady and trust that their partner will be back soon.

So no. You aren’t the problem. Fundamentally, the cycle is the problem and both partners contribute uniquely to the cycle. Which is good news. It means that both partners have opportunities to get the couple out of the cycle when it starts or maybe even before it starts.

Fear #2: Will starting couples therapy be the beginning of the end?

Most people value their relationships. They want to preserve them and couples therapy can feel risky…maybe things will get better, but what if they get worse instead? Of course you have this fear. Therapy involves sharing more of yourself with your partner, deepening intimacy, and that is taking an emotional risk.

So what does it take to move forward together?

Two people who are invested in the relationship and willing to work on it and on other challenges together.

Couples therapy is about wanting to feel differently and that is always possible

Couples therapy is about wanting to feel differently in our most important relationship. And feeling differently is always possible. In a relationship, it does take effort and a willingness to be vulnerable from both people.

Emotional vulnerability creates closeness

Let’s talk about emotional vulnerability for a moment. Here’s the truth: it can be really difficult, especially for people who didn’t experience healthy relationships growing up. But, it often brings people closer together. We fear that if you really knew me, you wouldn’t like me. But the truth is often exactly the opposite. The more we know about someone’s experience, who they really are, the better we understand them AND the closer we feel to them.

Emotional vulnerability feels risky, because it is AND it tends to bring couples closer together.

Working as a team improves relationships

We won’t solve all of your life problems in EFT for couples, but you should develop the sense over time that you and your partner are a team working on those problems together.

Summary

People often delay starting couples therapy due to fear that they are the problem in the relationship or that they might lose their relationship if they look at it more closely. Both fears are normal and they can stand in the way of developing the intimacy and trust that make relationships stronger.

EFT therapy for couples helps couples by identifying the problem in the relationship in the interaction between two partners, meaning both people contribute and both people have chances to positively change the relationship.

EFT therapy for couples provides opportunities to develop more closeness, teamwork, and trust in the relationship, which makes the relationship stronger.

If you’re reading this, have been thinking about couples therapy and want to take the next step, please set up a consultation call where we can talk about your relationship and goals.

April 2 2024

Emily (she/her), Age: 48

Dr. Aimee Ruscio Success Stories

Government Contractor: Internalized Transphobia Experiencing Shame and Self-hatred

Why Emily Entered Therapy:

Emily, a transgender woman, entered therapy extremely distressed. She was filled with self-hatred at how her body appeared. She felt she didn’t look feminine enough.

Emily was angry at herself and society for the years she lost trying to be someone else.

Deep down, she worried that she was unlovable, wouldn’t be accepted by others, and was doomed to go through life alone.

Emily was also afraid that she’d be criticized or laughed at if she came out at work. Moreover, she was worried that she’d lose her job.

Emily was desperate and was close to being suicidal.

The Outcome of Therapy with Emily:

Therapy with Emily required developing a gentle patience with herself. It took time to transform her shame at being born trans into a sense of herself as a fully valid person with as much right to exist and be herself as anyone else.

She also had to grieve the time she lost in her life before she transitioned, and forgive herself for not doing it sooner.

In time, Emily began to feel more softness for who she was and developed more self-love.

She acknowledged her inner resources of strength that got her this far in her life.

Emily took the risk to come out at work. Her worst fears didn’t manifest. People didn’t treat her differently, and she didn’t lose her job.

Emily was surprised and relieved that the people she had rapport with at work accepted her fully and appreciated knowing who she really was.

For the first time in her life, Emily felt like she belonged.

Emily acknowledged that in social situations, she would not always be treated with respect. However, she now viewed any disrespect she experienced as being due to people’s ignorance and limitations rather than evidence of a flaw in herself.

As Emily became more accepting of herself, her optimism about her future grew. She decided to return to design school as she had always wanted to be involved in interior decorating.

April 2 2024

Steve (he/him), Age: 42

Dr. Aimee Ruscio Success Stories

Lawyer: Experiencing Extreme Stress and Panic Attacks

Why Steve Came to Therapy:

Steve, referred by his doctor, came to therapy stressed and exhausted. His doctor recommended counseling due to the frequent panic attacks he was having.

Steve was reluctant to attend therapy as he didn’t see how it would help. However, he was at his breaking point. His anxiety was intense, and he was desperate for relief.

Steve sometimes worked 60 hours or more per week. Steve also hated his job. He dreaded going to work in the mornings.

He made good money but felt trapped because of it.

Steve had a massive mortgage on his DC row house and a six-figure student loan debt from law school.

He couldn’t imagine how he could leave his job. He needed the income and didn’t know what else he would do.

Steve was also lonely. During his entire life, he’d had unsuccessful relationship after unsuccessful relationship.

He was tired of the stress and conflict in his relationships and the pain he experienced when they ended.

The Outcome of Therapy with Steve:

Using Emotion Focused Therapy, I helped Steve begin to trust his emotions and what they were telling him.

Steve came to see trying to meet everyone else’s expectations by working longer hours and fitting himself into relationships that didn’t work amplified his stress and feelings of panic.

As we worked with Steve’s anxiety, he became aware of the deep insecurity underlying his panic. Fearing that he was incapable or weak led to constant striving and trying to prove himself to others.

By acknowledging and attending to his underlying vulnerability, Steve began to feel more relaxed and was able to think more clearly.

He realized he had to discuss cutting back his hours with the head of the law firm. Fortunately, when Steve did speak to him, his boss agreed to hire another lawyer to take some of the load.

Steve began to slow down and take better care of himself. He decided to take time out from seeking a relationship and concentrate on looking after himself, get his debt under control, and engage in activities that gave him pleasure.

When therapy ended, Steve felt more optimistic about his job and his life. He started dating with caution – something he had never done in the past.

Steve wanted to get to know a woman before jumping into a relationship and risking another painful ending.

April 2 2024

Angela (she/her), Age 31

Dr. Aimee Ruscio Success Stories

University Professor: Stressed and Feeling Unloved by Her Parents

Why Angela Came to Therapy:

Angela, a lesbian, came to therapy because she felt stressed and hurt due to her family’s reaction to her sexual orientation.

On the one hand, they told her that they loved her. Yet, they also maintained religious and political views that threatened her rights as a lesbian.

And, it wasn’t only her parent’s attitudes about homosexuality that were painful for Angela.

In some ways, she had always felt unloved by her parents. Although they cared for her physical needs, they were emotionally unavailable. They rarely praised her or showed physical affection.

Angela’s parents pressured her to perform in school and in her occupation. Consequently, Angela suffered from feelings of low self-worth.

Angela never felt “good enough” for her parents or anyone despite being a well-recognized leader in her field.

The Outcome of Therapy with Angela:

It became clear in our first therapy session that Angela had struggled with depression for much of her life due to her low self-worth.

With my support and using the powerful Emotion-Focused Therapy method, Angela connected how she treated herself to feelings of low self-esteem and deep pain that she didn’t realize she had.

Once Angela became aware of these feelings, and how she generated them, we worked to transform her self-criticism. As a result, she developed an internal sense of acceptance and self-support and started to enjoy her life more.

Angela also began to accept her parent’s limitations. She acknowledged the pain from her childhood and her need for closeness and support that her parents couldn’t give her.

She came to see that her parents loved her as much as they were capable of doing.

Further, Angela came to terms with the fact that she could not change her parent’s religious views. She needed to love herself unconditionally and value those in her life who also loved her for who she was.

As therapy progressed, Angela’s depression lifted, and she began to feel lighter and more at ease in her life. She experienced a wider range of positive emotions more frequently.

When Angela left therapy, she was well on her way to living a more fulfilling life.