I am a divorced 26-year-old (I have been divorced for almost 5 years). My marriage was a toxic abusive relationship. Regardless of that, I feel “happy,” I have realistic career goals, a loving family and boyfriend. Everything adds up, but I feel as though my happiness is a mirage. I’m happy with everything and everyone but myself. I just never add up to what I feel I should be or can be, especially when it comes to the number on my bathroom scale. I feel as though I will never be thin enough. I know it is unnatural to feel this way, being that I’m thin for my height, but I worry I am spinning on the edge most days looking at nutrition labels and focusing on the number of the day. How can I over come this mind game? Why did it bloom so late after my divorce? Is it even from my divorce or was this monster seeded a long time ago?

Most people aren’t happy with the way they look or how much they weigh, and all people spend at least a little time each day being unhappy, but many still manage to live normal, albeit slight chubby/grumpy lives.

As to the source of your insecurities, your guess is as good as mine and the many other scientists, clinicians, and desperate-for-a-topic writers who explain this phenomenon. It could be your ex, or it could reading too much Cosmo.

These experts assume, for the most part, that you wouldn’t be so self-critical if you didn’t listen to magazines, celebrities, or your critical-yet-well-meaning grandmother, and just believed in your self. They tell you that self-esteem will conquer all. Of course, they’re wrong.

There’s lots of evidence that self-hating body thoughts can happen to people with perfectly good self-esteem, nice families, and normal bodies. Instead of obsessing about why you feel this way the same way you obsess over calorie counts, stop and ask yourself, first, whether these thoughts are doing you much harm.

I know they’re causing you pain, but ask yourself whether they’re affecting your health or relationships. Right or wrong, you can think you need to lose a few without hiding major parts of your personalities and or being a bad friend or parent.

If you think your body-hate isn’t doing too much harm, try ignoring it. Certain kinds of psychotherapy may help, but watch out if you find yourself becoming more self-obsessed and blaming yourself for not getting better. The mark of good psychotherapy, like good coaching, is that it gives you ideas and motivation for managing a problem without increasing your expectations of control.

If body-hate is hurting your health or relationships—if you purge, have become anemic, or acquired any number of the dire symptoms that come with an eating disorder—assemble a treatment team, including a primary care physician, a psychiatrist and dietitian, and don’t hesitate to put yourself into an around-the-clock “eat-your-food” camp if it’s necessary. It can save your life.

In any case, don’t pin your hopes and self-esteem on self-control, or self-hating thoughts will just get worse. If you make it your job to keep trying and regard the illness as you would the weather, it can’t touch your sense of who you are.

You need never see yourself as a food nut or anorectic; you’re simply a person with eating issues, which puts you in the same camp as 90% of the population. You might feel like shit, but you are truly not alone.

STATEMENT:
“There’s nothing wrong with my values or approach to life, and I’ve managed to build a good life, except for one problem. I have an obsession about food and weight that sometimes drives me crazy. I don’t know that I can stop it, but I will always do whatever is necessary to keep it from ruining my health and relationships.”

I feel horrible about this, but ever since my husband gained weight, I find myself feeling much less attracted to him. Neither one of us has ever been super-models, but after 10 years of marriage, I’ve managed to keep my weight from getting out of control and he hasn’t. I tell him he should eat less because of his health, and he makes a half-assed effort, but the truth is, I also just hate his body like this. I’d never tell him that though because he’d be heartbroken and I’d feel like such a jerk. I’d never leave him over this (we have a family), but not having sex is putting a strain on our relationship, which makes being together so much harder. How can I want to be with him if he keeps letting himself go?

The fact that we spend billions of dollars improving and preserving our sexual attractiveness should be a clear indicator that we have absolutely no control over it.

Specifically, we don’t control what aging does to our bodies or how we respond to those changes, in ourselves and others. That’s probably one of the best reasons for not making a big deal out of it; the more we try to control it, the more it tortures us when we can’t.

Many think over-eating should be more controllable than aging, but to those people I say, try keeping your weight down while making a living, raising a family, and living in the golden age of Oreo Cakesters.

Even if you achieve your ideal body weight, you know how easily stress, sorrow and even inattention can open the door on your bad old habits. As Bush II discovered, there’s nothing more demoralising than declaring victory when you’ve temporarily got the upper hand on a problem that is never going to go away.

Even if weight control is easy for you, you know that it’s not easy for most people, like your husband, regardless of how much they worry about it. Worrying makes us hungry, as does reading about one more diet that does no better than old diets if you measure progress after a year or two. So, as much as you miss the old sexual attraction and worry about your husband’s health, don’t get obsessed with the “would-have, should have” of weight control. Blaming him isn’t fair, and will make the problem much more personal.

We’ve had lots of laughs at the expense of those idiot Victorians who advised women who didn’t like sex to “lie back and do it for England.” Sadly, it seems like there was great wisdom in that advice, particularly when you care about your partner and you’ve run out of other options.

First, though, don’t let guilt over your own negative sexual response—or anger at his “letting himself go”—prevent you from exploring those other options. Your husband probably wants to lose weight, if for no other reason than to improve his health. With his agreement, explore all the ways you can create “structure”—incentives and habits— in your daily home routine that will encourage exercise and caloric restraint.

Without letting yourself become a calorie Nazi, (which, for most of us, would be a worse sex-killer than growing a lady-beard), see if you can shape your menu, pantry contents, and exercise schedule.

If nothing works, fall back on your marriage vows. The reason you make vows is not because you’re fickle and likely to change your mind about your partner, but because life is hard and will eventually take the things that are fun now and make them difficult. You can try to help him lose weight (and help yourself), but if that doesn’t work, you need to help your marriage.

The test of a good marriage is not whether it’s fun, but whether two people continue to like and respect one another when it’s not. Through sickness and health, slim and flabby.

STATEMENT:
“It hurts to have a sexually repulsive husband, particularly after I’ve tried to help him slim down, but the purpose of our partnership was always to create a family and look out for one another, and was never about being young and sexually attractive forever, so I respect myself for putting up with this loss for the sake of a marriage that I value.”

I’ve been getting increasingly nervous about my aging parents, particularly because my mother, who’s a very vigorous near-90, likes to ignore the real risks of continuing to vacation in their old, 2 story, roughing-it country home. She loves to garden, take vigorous walks, build fires, and keep to the same routine she had when she was 40. I know I’m a nervous person—I’m a nurse, and I’ve had to deal with an injured leg since childhood—but I’m haunted about what could happen to her if she fell down and it’s no place for my dad, who’s very frail after a stroke. When I said something to her yesterday about how she should hold onto my father’s arm when he walks, she told me to mind my own business. I’m the only one of the kids who lives nearby, so their safety is my business. How do I get her to understand she needs to be more careful?

It’s understandable that you worry about your parents, but even if they were both freakishly healthy and lived in a hermetically sealed bubble, the sad fact is, they’re both going to die.

[Moment to process.]

Yes, your aging parents are lucky to have a caring child nearby, particularly someone who’s medically educated, as you are. You also know, however, as someone who’s lived with a crippled leg, how necessary it is to take risks if you want to live a full life and how important it is to make those risk-management decisions yourself.

Your goal isn’t to breathe easy, knowing that your parents are safe as can be, or make yourself responsible for their safety. As much as you’d like them to be safe, they can’t be, so those goals would drive you and them crazy (and provide me with a steady income).

Now that you know you can’t make them safe or ease your own fears, you’re ready to think creatively about realistic risk management, knowing that bad things (like death, but lesser things, too) will happen.

Your goal isn’t to prevent those bad things from happening, but to help your parents do whatever they’re willing to do to prevent them, then forget about them, and live their lives (and let you live yours).

Instead of nagging them to be more careful, offer to get them professional advice on how to manage risks from slips, falls, fainting spells, medication mistakes, and assorted worst-case scenarios.

If that doesn’t work, leave their doctor a message encouraging him/her to do the same and if that doesn’t work, take a course yourself and do what you can. Then, you’re finished and enjoy the veggies from the garden.

STATEMENT:
Here’s a statement for keeping your responsibilities in check. “As much as it would hurt to see my parents injured and as much as it scares me to think about it, I respect their determination to live independently as long as possible, despite the risks. I can do more for them by offering good advice than by inducing guilt. I will take pride in doing this job well, regardless of whether they accept my advice. Indeed, the less I can do and the more helpless I feel, the more pride I’ll take in not letting my management interfere with their choices.”

Two years ago, my wife was diagnosed with Type 2 diabetes. We’re both overweight, but she also used to be a smoker, so her health’s always been more of an issue than mine. We were both warned that if we didn’t get better eating and exercise habits, we’d be in trouble, and now she knows her diabetes puts her at much higher risk of heart disease, hypertension, infections, and kidney disease. Well, two years later, and I’ve started taking the dogs on long walks, stopped eating from the vending machine at work, and lost some weight. My wife, on the other hand, hasn’t really changed her habits at all. She says she’s eating less crap at work, but at night she’s making the same unhealthy (delicious) stuff we’ve always eaten, and she always says she’s too tired to walk with me. I don’t know what I can do aside from nagging her, and that’s not working, so I’m really worried that she’s going to go downhill fast and that I’ll lose her. My goal is to get save my wife from herself.

As much as you’d like to keep your wife around as long as possible, you know that your influence over her health habits is limited, and trying to control her health will cause you more conflict and probably drive both of you to an earlier grave…which contradicts your purpose.

Unlike the concerned daughter above, you don’t have the luxury of ignoring the inevitable; she can’t make her parents immortal, but theoretically, you can help your wife to change her habits. If you’ve ever tried to change any of your own habits, however, you know it’s never really that easy.

Weight control, for example, should be easy because putting food in your mouth and swallowing are supposedly voluntary actions. In reality, people don’t have that much control over their habits or their health. Ask anyone who’s eaten at Cinnabon.

It takes great effort, not everyone can do it, and other legitimate priorities, like raising kids and making a living, get in the way. Biology is powerful, and our bodies are designed to survive famine, not taste-bud seduction.

Accept that she has a chronic, incurable illness and you’ll start to be more helpful. Instead of nagging, offer advice on impulse management and eating better (but don’t force that advice, because then you’re back to square one).

If that doesn’t work, ask her doctor to do the same, and if that doesn’t work, learn CPR, read up on living with a diabetic, and enjoy your time together. After all, you don’t want to ruin the quality of your relationship for the sake of a little more quantity.

STATEMENT:
Here’s a nagging-restraint statement. “It’s hard to watch my wife’s unhealthy habits, but I’ll do more for her by keeping my feelings to myself, offering advice if she wants it, and enjoying her while I’ve got her. A good marriage always requires tolerating the pain of traits you can’t change, and this is more of the same.”

When I broke up with my girlfriend, I felt like I didn’t have a choice; she was smothering me, she made me feel guilty and like a bad person all the time, and I just couldn’t take care of her anymore. We’d been together for a relatively long time and I had reached the end of my rope (she’d even started hitting me and breaking things in our apartment). The problem is now that I feel even worse because, in the months since I ended it and she moved out, she’s started getting high a lot and has threatened to kill herself more than once. If she goes through with it, I don’t know what I’ll do with myself. My goal is to feel less awful about breaking up with her (which I did to feel less awful).

As a not-sociopath, you can’t feel less than awful about your ex-girlfriend’s drugging, depression, and self-destruction.

It’s the feeling responsible, as well as awful, that will not only do nothing to help her recovery, but will also turn your sorrow into well-entrenched, call-the-doctor depression. So…Dr. Lastname here, how can I help you?

You might think it’s good to take responsibility for the feelings of those you love; it’s a necessity if there’s something you really need to do for someone who’s helpless, like a kid or an invalid, or if you’ve done something wrong to cause those feelings.

On the other hand, life is hard for everyone, and most of the pain you’ll cause others is not something you or they control. Assuming responsibility for that pain is a way of pretending you could control it and make it right, which is a false hope that will prevent you and her from moving on.

Also, if you take responsibility for pain you can’t help, you’ll wind up blaming others and getting nasty, which will cause pain that you actually are responsible for, and then things get truly impossible.

The bad things she’s done and is doing (for love of you) are not your fault, but they’re not her fault, either. What they are are her problem, and, sad fact, your love seems to make it worse.

So don’t let guilty feelings affect your beliefs and don’t express them when you communicate with her, assuming that you do communicate, even if it’s with a look or through friends. You can’t stop feeling guilt, but you can stop guilt from controlling your actions. Stop feeling responsible, so you can stop calling on people like me.

STATEMENT:
Here’s a statement that pushes both of you to make the best of a sad situation while killing any hope that guilt will ever bring you back together. “We’ve both tried everything to make our love work and it can’t and now it’s time for us to move on. We’re both sad and it’s too easy to think about what either of us could have or should have done but that’s a dangerous, negative direction to go in. We both need support and nurturing, from ourselves and our friends, while we pick up the pieces, learn valuable lessons, and start a new life.”

My daughter is just starting high school. She’s had emotional problems since she was a toddler, and her current diagnosis is OCD (eating disorder, cutting, wild mood swings…it’s a mess). My wife is very easy-going with her, but also doesn’t really set any rules or limits, and I end up being the bad cop all the time. Having a teenage daughter is supposed to be hard for anyone, but as the only enforcer trying to take care of a girl with a bunch of problems I can’t understand, I’m in hell. At this point, as much as I hate to admit it, I hate my daughter—she’s impossible, angry, and just mean—and I’m jealous of how easily my wife gets along with her, and angry that she makes it my job to do all the discipline, and my feelings are an ugly mess. My goal is to love my daughter, like any normal dad.

While it may make you feel like shit, it’s not a sin to hate your daughter; it’s hard to feel warm and fuzzy all the time for an adolescent who’s probably rather verbal (and maybe physical) about how much she hates you—but it is a sin to be mean to her, and your feelings sure make it painful to be her dad.

Parenting under these circumstances is about as hard as it gets—it’s extreme parenting. You don’t need to bungee off any cliffs to encounter a day full of high suspense and drama, not knowing whether you’ll keep your behavior under control (hers, of course, you won’t).

This bad chemistry problem happens a lot to adoptive parents who have less familial experience with the kind of temperaments their kids present to them (no good deed goes unpunished). You’re one of the lucky biological parents to get stuck in this situation.

The pain of having no warm feelings and being angry much of the time is horrible, but feeling responsible for those feelings is much worse, so don’t.

You don’t hate her because you like to hate, but because of many factors over which you have zero control, including your daughter’s temperament, your wife’s personality, and your own reflexes. This isn’t your kind of kid, so you’re responsible only for making the best of it, and keeping her alive and safe.

Put your guilt aside, and you can applaud yourself for the hard job you’re doing and be more inventive about it. Nope, your goal isn’t to have positive feelings for your daughter (although you can still hope it will happen someday, and, honestly, I’ve seen it work out that way). It’s to do a good job of parenting someone you don’t like—that’s what defines a true professional—and respect yourself for doing a hard job under beyond-Mountain-Dew-level “extreme” circumstances.

STATEMENT:
Here’s a statement to draw the line on guilt-provoking accusations, whether emanating from you, a therapist or, after intensive psychotherapy, your daughter. “There’s nothing I value more than being a good, warm parent, but we have to play the cards we’re dealt, our personalities are not a great match, and it causes both of us lots of pain. I don’t apologize and neither should you, because I think we both do a good job of keeping that pain under control. I do lots of good parenting, in spite of those negative feelings, and they haven’t stopped you from having a good relationship with your mom and doing many good things, so I think we’re doing well, all things considered.”

I just started at college, and I like my roommate, but she’s bulimic and hard to be around. Not just because she’s sick (and everybody on the floor knows about her problem, it’s hard not to), but because when she binges, it’s on my food because that’s what’s closest, and she always feels really bad about it and cries that she wishes she could stop, but then she doesn’t offer to pay for it and it’s costing me a lot of money. Part of me just feels bad for her, because she’s clearly really messed up, but another part of me is pissed because I’ve lost a lot of money this year on food that she’s eaten and thrown up, and that just makes me feel guilty like I’m a bad person for putting my lost money above her health. I want to move after the break, but I don’t want her to feel abandoned. My goal is to help her and myself.

Welcome to that other part of college, Hard Knocks University, where the class Helplessness 101—what to do when you can’t help both someone and yourself, and sometimes you can’t help at all—is a frosh requirement.

The tough part is not the decision, but accepting the shitty nature of your options. Bulimia, like any chronic condition (depression, addiction, etc.) is not completely curable, not by you or certainly the patient herself.

If you buy into the psychobabble about body image and low self-esteem, you might think you could help her by praising her strengths, noticing her attractive qualities, or getting her to think about the superficiality and limitations of attractiveness. Ha!

Whether it’s coming from you or the Mormon Tabernacle Choir of Therapists, your therapeutic support is not going to change those mysterious urges to binge and puke. Buying into that notion will waste you even more time and money than all the cash you’ve already flushed away at the supermarket.

Bulimia, like all addictions, can turn people into assholes. Don’t get me wrong, they don’t choose to be assholes, but when you’re more interested in binging and purging than in anything else, including other people’s feelings and squaring your debts, you’re an asshole. Or really, you’re a normal, possibly good person suffering from a bad case of asshole-itis.

It’s a humiliating thing to say about ourselves, but what helps most in controlling dangerous behavior, when all else fails, is to be treated like a soldier or dog-in-training in a program where our every movement is controlled. That’s the kind of treatment that saves lives when bulimia gets dangerous.

Obviously, it doesn’t cure it, but it stops us from going over the cliff until we can get enough control back to keep it down to a barf or two a day.

So the most you can do is let her and others know if you think her life’s in danger. Otherwise, you’ve got little influence over her for good or ill, and you’re living with an asshole you can’t cure who’s costing you a bundle.

You may wish you could help her, ease her pain, and not make yourself feel guilty by locking the refrigerator if you don’t get a check. Well, I hate to say this, but fuck you. That’s a goal of feeling good, which is much like her goal.

If, however, your goal is to make the best of this situation, it’s not to feel good but to do what’s right by helping her if you can and otherwise preserving your resources for worthwhile causes.

That means bearing the pain of watching her in pain, feeling helpless, and ignoring the guilt of receiving a look that accuses you of adding to her misery. It also means letting her know you’re there if she wants to get real help, establishing your refrigerator perimeter, and getting to eat your own damned ice cream.

STATEMENT:
Prepare a mission statement that protects yourself from false guilt. “I can’t help my roommate feel better or control her eating behavior, but I can watch out for her if her life is in danger and I can encourage her to be a stronger obsession manager by requiring her to pay for what she eats. In doing so, I may temporarily make us both feel unhappy; but that’s an unavoidable part of her recovery and my self-protection. It’s the work we both must do to pass this course in making the best of a bad situation.”

Since there’s no easy way to say it, I’ll just put it out there that I have a problem with my anal sphincter (a botched surgery when I was a kid that left me with very little control). Like everyone since then, my co-workers notice that I sometimes smell bad and like to joke about it, usually but not always behind my back. I do my best to control it, and I’ve seen specialists about it, but what it comes down to is that everyone is happier when I keep my distance and I just wish I could find a job I could do from home. I even avoid attending family events and leave early when I go because I don’t want to embarrass my parents (and I obviously avoid women and people in general). I just transfered to another branch, and now I’m terrified about the reaction of my new co-workers. I know this sounds like a joke, but it isn’t. My goal is to find a treatment that can control this problem or a lifestyle that is less full of humiliation.

By now you should know that you can’t have what you want, either a sweet-smelling body or a solitary, well-stocked bat cave to retreat to. Forgive the pun, but tough shit.

You’re fucked, and if you keep trying to eliminate the problem you’ll never live your life and your parents will die and you’ll regret the things you didn’t do with them or the other things you want to do with yourself like make more money.

Now that that’s cleared up, ask yourself what your goal is when the goals you’ve been chasing are unattainable and there’s no way to avoid a shit-load of pain (last sly double-entendre, I swear).

The obvious answer is to try to reduce your sensitivity to humiliation so that you can live life as fully as possible. It would be nice if you were a natural-born comedian who could deflect nasty jokes, or an insensitive clod who never understood them in the first place; but you’re not. Now that you’re an adult, however, and no longer a school-kid, there are lots of other things you can do.

First, confront the Madison Avenue notion that your self-esteem depends on attractiveness. Your goal isn’t to be attractive, but to make people feel as comfortable as possible with your ugly side while you pursue your other goals.

So pretend you’ve got a colostomy and that’s the way it is and learn how to be shameless. Wear a diaper if it will help, just learn how to not take shit personally and put together a list of what you want to do with yourself and do it. That’s your goal.

Make people more comfortable by telling them, frankly, that you have a GI problem that sometimes causes bad smells and you can’t stop it but that you’re pretty good at managing it. That’s why you, for instance, use incense and deodorizers, and sometimes have to leave meetings unexpectedly. If your smell is a problem and you don’t notice it, you don’t mind having it pointed out to you.

Keep a candle burning on your desk. Be the first to let them know when you’re having a bad day. Read a book of bathroom jokes beginning with “What died in here?”

Your goal isn’t to control your colleagues; that’s impossible with heaps of cash or hypnosis, so accept that they’ll be nice or nasty, as they are. Instead, create a wall between you and your problem and invite them to see your problem as something apart from you. Lots won’t, but a few will.

After all, you’re not a bad smell, just a guy who’s trying to do a good job despite a tough, humiliating handicap. That’s something to be proud of, a much bigger accomplishment than being sweet-smelling and attractive. Fuck advertising.

Give your parents similar directions, letting them know that you’re happy to attend family events, but you’ll let them know if you’re having a bad day and you won’t take it personally if they’re planning a big event in a poorly ventilated space and don’t want you to come.

You can’t control your problem or how people react to it, but you can’t let those factors take over your life completely. After all, even for those of us with cooperative anuses, life often stinks. You just arm yourself with Fabreze and carry onward.

STATEMENT:
Prepare a manifesto that keeps you focused on your own priorities rather than the reactions of idiots. “My job is to lead my life and try to make a living and find friends, and I’m not responsible for my bad smell. I manage it well by protecting others and making it easy for them to protect themselves. My bad smell may humiliate me; but it can never outweigh my pride in not letting it stop me.”