Dr. Aimee Ruscio

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.

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.

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.