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 done some research, and I think my girlfriend is bipolar. She gets into these very good moods for no particular reason, and when she’s in this mood she can’t stop talking and seems high and silly (and that’s when she sometimes drinks too much). When she’s like that, she’s more obnoxious-funny than really funny, but she thinks she’s a riot. I’m not crazy about her up times, but what I really dread is the crash that follows; it’s hell for her and everyone around her. I know she sees a shrink, so I told her what I was worried about, but she acted like I was insulting her and then she said she was sorry, maybe I was right, but she likes feeling happy and doesn’t see anything wrong with it and why should it bother me. My goal isn’t to take away her joy, but I wonder if it’s bad for her to be bipolar and, if so, what she should do about it.

You’re right to worry about your girlfriend’s highs, but getting through to her may not be easy. Manic people aren’t exactly perceptive, unless by perceptive, you mean frighteningly giddy and overwhelming obnoxious.

Meanwhile, she sees her mania as the time when she’s fun and funniest, so she may resent you for criticizing her behavior when, from her point of view, she’s at her best, wittiest, and happiest.

Being manic also comes with the certainty that you can do no wrong. Between that and the ecstatic feelings, judgment is lost in a heavy, happy mist.

That’s why, if you have bipolar disorder, you should ask trusted friends to tell you if you seem over the top—it’s an “advance directive,” like the one you would use to tell them whether to authorize CPR if you pass out—because mania makes it hard for you to judge for yourself, especially when you’re too busy dancing on cars in a bikini to notice.

Of course, your girlfriend has a milder form of the problem, but it makes her focus on how she feels, rather than on what’s happening now or on consequences. That’s why she’s heard what you have to say and doesn’t appear to give a shit.

So, instead of expressing worry and doom, encourage her to consider the risks while expressing confidence in her abilities, and respect for her right to make her own choices. If she can’t or won’t understand your warning, accept that fact and do your best with it.

You want her to heed your warning and save herself and your relationship, but if she can’t, it’s better for you to know now than to spend months and years in a negative struggle, trapped in an unhappy mist that will drive you crazy yourself.

STATEMENT:
Compose a statement that makes your best case in a non-coercive way. “You’re usually very responsible and good with people, but I worry about your high moods because you seem to get carried away more than you realize, lose touch with how other people react, and drink too much, and afterwards you’re always depressed and very unhappy. Don’t trust my view if you think I’m prejudiced; ask others who know you and ask a professional whether the mood swings might get worse. Then, whatever you decide, I know you’ll be thinking about what’s good for you, rather than what feels good.

I like my brother’s girlfriend—she seems like an all-around good person—but I really worry about the two of them together. They fight constantly, and from what I can tell, the things they fight about are things that are never going to change. Like, she hates that he works so late, but she knew he was a chef when they met and that the hours are long, and he loves his work and isn’t leaving it for anyone. Then he hates how stingy she is about money when it means going without things they don’t need, even when they can actually afford it. I hate to see them fight, but they seem absolutely determined to stay together even though neither one of them wants to, or is able to, change his or her lifestyle. I see that they love one another, and my brother wants to marry her, but I worry that they’re locking themselves into a lifetime of unhappiness.

You’re right not to criticize a relationship that is obviously important and meaningful to your brother, for obvious reasons. What feels like worry to you will feel like criticism to him, with no good results to your relationship or his.

You can help him think rationally, however, (or at least satisfy yourself that you’ve done your best on that score), if you first show obvious respect for him, his girlfriend, and their effort to make things work. Keep your fear to yourself, because it always implies disrespect for his choices. Think like a hostage negotiator, with your brother’s future in bondage.

When he brings up an issue in their marriage, don’t talk about solutions; you’ve already decided there aren’t any, and trying to find one will just make you impatient. Instead, ask him about what will happen to him and her if they are who they are and life does what it does.

The key component you describe as possibly missing is acceptance—she can’t accept the hours dictated by his profession, and he can’t accept her money management–so it’s reasonable for you to wonder what’s likely to happen as their jobs become more complicated, they have kids, one of them gets sick, i.e., if life happens.

If you believe, as you do, that the things they can’t accept aren’t likely to change, then ask him whether, given the worst case scenario for his schedule and her spending, he thinks he can accept her as is and vice versa. You can share the notion that you think acceptance is a more important predictor than love of whether a relationship is likely to work.

Remember, you’re not asking him whether he thinks they’ll be happy together, because marriage is often painful and unhappy for everyone. Non-acceptance, not unhappiness, however, is what blows marriages apart.

You’re asking him whether they’re likely to be able to continue to do business together and, if not, what impact that will have on their lives. If he hears you out and still goes forward with marriage, then at least you can accept that you did your best.

STATEMENT:
Here’s a statement of your mission. “You’ve got three good things going for you: you love one another, you really want to make things work, and you’re actively trying to find out whether you can live together. You can’t necessarily control your own work and money habits, let alone someone else’s, so you never know whether you can make things work, no matter how much you love one another; but doing what you’re doing is the way to find out and, as long as you have the courage to accept what you find, you can’t go wrong.”

My husband worries a lot about my drinking and depression but, to my mind, I don’t think my drinking is a problem and I don’t think I’d be depressed if I wasn’t worried that he’d leave me. For the sake of our marriage, I’ve agreed to stop drinking for a while and go to AA, but I really feel that my drinking wasn’t causing me any problems and that I’m doing this to make him happy, which makes me feel weak and angry. I want to get him to accept me the way I am before I can’t take it anymore.

You’re in a tough spot, because partnership really can’t work without acceptance, and acceptance is not something you can control. The more you force acceptance, the harder it is to achieve. Accept that, buddy.

If you try too hard to get his acceptance, you’ll hide whatever you think he won’t accept, which means putting your drinking in the closet and going to the mall instead of AA meetings.

On his end, if he tries too hard to make the relationship work, he’ll pretend you’re not really drinking or that you’re going to change, which also means no real acceptance.

The sad fact of life is that you are never going to change who you really are, which, at the very least, is a girl who enjoys drinking, and he’s going to have to take it or leave it. On the other hand, if you present the issue positively and he considers it realistically, maybe acceptance will occur, now that you’re not forcing it.

That’s why your goal shouldn’t be to win acceptance from your love; it’s to find out if your love can be accepting. He doesn’t need to like your drinking, but you need to know whether he can accept that it’s part of your package and accept the whole deal.

Instead of getting him to accept you the way you are, begin by accepting yourself. Forget how much you like to drink and ask yourself, on the basis of your own experience and what you’ve read, whether drinking gets in the way of anything you hold dear, like your health or making a living or being a good woman and a good friend. If in doubt, stop drinking for a while and see if there’s any difference.

Once you know your own mind, lay things on the line with your husband in a positive way. Of course, if you’ve come to agree that you’re a lush, let him know that you want to stop drinking because you believe you need to, and not to please him.

Otherwise, state your differences positively while letting him know how much you’d like him to accept you, if he can. If he can’t, then that’s a sad reality you both have to accept on your own.

STATEMENT:
Prepare a statement of your own views that is not overly reactive to his. “I respect your concern for my drinking and regret that it worries you. I’ve looked hard at how much it affects my health, work, and friendships. In the end, I don’t see it as causing me problems and, as much as I love you, it won’t help our relationship to appease unfounded fears. I hope you’ll accept my decision. Meanwhile, I think we should drop the topic of my drinking and, hopefully, move on to other things.”

My daughter is severely bipolar and lives with us so my wife and I can try to make sure she takes her meds and doesn’t hurt herself. We aren’t always successful—she’s practically an adult now and hates when we parent her—so she stopped taking her meds because she thought she didn’t need them anymore. Now she’s extremely manic, maybe using hard drugs, and extremely irritable. We’re absolutely helpless and there’s nothing we can do because she won’t talk to us. Our goal is to get her to listen to us, stop drugging, and get back on her meds.

Mental illness makes all families helpless; after all, it’s hard to have a dialogue with someone whose brain is diseased, irritable, inattentive and unresponsive. You’d have better luck reasoning with a rabid wolverine.

If you believe that your only power derives from your ability to have a heart-to-heart talk with her, then you are, indeed, helpless. The good news is, you’re wrong. After all, you can help wild horses improve their self-control without first teaching them English. Thus, you, too, can become a bipolar whisperer.

As parents and landlords, you control a number of powerful incentives, like access to money, car, refrigerator, shelter, and, oh yeah, money. That doesn’t mean you can control her or her illness, but it does mean you can create some pretty strong reasons for her to do the good things she needs to do.

Set rehabilitation goals for your daughter that you believe are truly essential, which will probably include sobriety, doing enough household chores in order to live independently, controlling violent behavior, and stopping sudden impulses from affecting her safety or treatment. Add or subtract from these core goals, based on your own experience and other parents’ war stories.

Once you know your priorities, announce them and back them up with rules and incentives for following them. I said announce, not converse. If you’re too worried about her anger or hurt or lack of understanding, you’ll be ineffective.

Don’t pick a fight, but don’t hold back on saying what you think with friendliness, conviction, and optimism. Tone of voice is as important as content. Don’t end sentences with a rising, Valley Girl inflection that asks for approval. Use the same calm, assertive energy praised by Cesar Millan.

Yes, there’s a risk that she’ll do something dangerous or force you to ask her to leave, but a bipolar-veteran parent knows how to manage crises without appearing to panic. It’s a risk you need to take, and be prepared for, because the alternative is way worse than facing an angry four-legged beast.

STATEMENT:
You need a statement that says, “This is what we believe, here are the rules that are required for self-control and independence and this, very simply, is what will happen if you don’t follow them. There are no punishments and we do not believe you are being stubborn or childish; but we will withhold privileges and, if necessary, ask you to live elsewhere for a while if we think it’s necessary, either because your behavior makes it impossible for us to live with you, endangers your safety, or blocks you from making progress.”

My psychiatrist thinks I should increase my medication, but it already makes me sleepy and has caused me to gain 10 lbs. If anything, I’d really feel better getting off it entirely, because I hate being dependent on it. For the time being, I know I need it, because I’ve barely recovered from my last depression, but even thinking about increasing the dose makes me feel depressed. I’ve seen this doctor throughout my entire illness and she’s been very good with me up to this point, but now that I don’t agree with her I don’t know what to do. I don’t want to have to take more medication.

It’s much easier to have an agreeable disagreement if you’re not pushing someone with your emotions; after all, lawyers use evidence, not tantrums, to win a case.

Still, it’s hard not to push with your emotions when the issue is personal and scary. Unfortunately, you don’t have a choice.

If you don’t put your emotions, you’ll sound (even to yourself) like a kid who hates needles. Your doctor will then feel like you need protection against your fears and impulses, and so will become even more insistent and condescending (and afraid of a liability lawsuit when your fear turns to anger).

That attitude will make you feel more like a helpless kid who isn’t being heard, and long story short, it’s a vicious circle we’re all familiar with, and it requires you to shift approaches, not give in.

Besides, if you’re pushing someone with your emotions, you’ve got to wonder whether you’ve conned yourself into doing what you want, rather than what’s best for you.

Switch your language (and maybe your way of thinking), list risks and benefits, and prepare a list of the questions you need answered to make a good decision. Put your feelings aside, put facts first.

No one likes medication, but it’s your job to know enough about the possible course of your long-term, incurable mental illness to judge whether the beneficial promise of a given medication outweighs its costs and sluggish, chubby side effects.

Becoming educated about your illness and its treatment is the only way to avoid being a medical victim who feels helplessly reliant on a doctor’s judgment.

If you want to have a discussion with your doctor that doesn’t sound like you’re trying to escape the ouch of your camp shots, learn what your odds are for relapsing and whether resuming meds at the beginning of a relapse can be counted on to stop your symptoms before they damage your life and/or your brain. Also, find out what the chances are that a higher dose will make a positive difference in the short or long run.

Don’t forget to ask what evidence the doctor is drawing on for his answers. Then you’re prepared to announce your verdict as a responsible adult.

STATEMENT:
Here’s a formula for a worst case, high risk disagreement. It alludes to your fears but sticks with a managerial point of view. “I know that rejecting your recommendation carries a 10 percent higher chance of relapse, that there’s no guarantee that we can stop a relapse once it’s started, and that relapse can cause a little brain damage. But I’ve weighed these odds against the risk and side-effects of the medication and my own conviction that I’m less vulnerable to relapse now and I’ve chosen to keep the dose where it is and wean off in the not-too-distant future.”

Admittedly, I’m a neurotic, depressive guy—I’m a New Yorker, I’m normal here—but when I had a shitstorm a year ago when my girlfriend left me and my job changed/became horrible, I started going to a therapist. It was helpful to rant and get some perspective, but now I really think I’ve come through the other side of the situation and don’t need therapy anymore. My therapist, on the other hand, thinks I still have a lot of work to do, because we never really talked about my relationship with my father (not great) or why I had trouble with my ex-girlfriend. Thing is, I don’t really think my dad has anything to do with anything, and I know what my problem is with my ex-: I chose badly. How do I convince my therapist I’m ready to leave and that there’s nowhere deeper to dig?

There are always therapists out there who, when it comes to accepting the fact that people are the way they are and treatment is a limited tool, need more therapy than their patients do.

What your therapist may have trouble facing—more so than you—is that your treatment has produced all the change and relief that it’s going to, despite the fact that you still have pain and other problems.

Many therapists can’t accept imperfect results. They feel they’ve failed if they can’t help you and, so as long as you’re suffering, they’ll look for a deeper level of change.

If they could bring themselves to accept you the way you are and let go, they could also become more creative about teaching you methods for minimizing the harm your behavior can cause. Obviously, this is not the case here.

So prepare for your decision by gathering data about whether or not it’s really time to stop. See your therapist less often, or take a designated break, and see what happens.

If you slip back into that shitstorm feeling, your goal is to figure out what the treatment was doing to help you, whether you can get that help for free from any other source and, if not, how often you need to see your therapist to sustain the benefit.

If, after running that test, you decide to stop treatment but don’t want to get drawn into a fight with your therapist in which you sound like you’re trying to avoid your homework and your therapist sounds like a concerned adult, there are 2 options.

You can lie, and tell your therapist you’re feeling better and last night you had a dream about a happy bird flying high above the clouds and missing its nest down below but confidently soaring towards the mountains in the distance where your dad and ex-girlfriends were waiting to give you a hug.

Or.

You can be straightforward and truthful, telling your therapist exactly what you told me, backed by the results of your experiments with withdrawal, and stick to it.

After all, you’re an adult who can make your own decisions, and your therapist will have to accept your decision. And if s/he can’t seem to cope, s/he’s the one who needs time on the couch.

STATEMENT:
“I know I’ve still got problems but I think I’ve got what I’m going to get from this treatment and I’m managing things well enough. I wish I were less grouchy but I don’t think that’s going to happen and, meanwhile, it’s not doing me any harm. I’ll always look for new ideas about how to manage my problems but, for now, I don’t think I need more psychotherapy.”

I’m a 58-year-old gay man and it’s a long time since life has been any fun. I’ve been single for some time (with no real prospects of a relationship), my friends don’t seem to have time for me, and at the end of a hard day’s work running my own business, I’ve barely broken even and have nothing to look forward to but spending the evening alone. That’s when the depression closes in and I can’t stand living. I write all this because I know that I’m a miserable failure, and that facts, not depression or any other mental illness, are behind my reasoning. I mean, when I tell my few close friends how I feel, they tell me I’m being too hard on myself, but if you’re almost 60, alone, and a financial mess, doesn’t that mean you’re a loser? My goal is to be real about myself.

Sounds like your goal isn’t to be real about yourself, it’s to be mean to yourself because you’re in a bad mood. If you were to reread the above paragraph when your mood wasn’t so shitty, you’d see your treating “facts” with the same care as Bill O’Reilly.

So, to quote Bill, Shut up, I don’t want to hear it. You wouldn’t talk like that to a friend, or even probably your worst enemy, so don’t do it to yourself.

Sure, the pain in your life is real, but there’s a monster in most of us that speaks up when we’re hungry or poor or lonely and says, “Look what a mess you got yourself into, you worthless piece of shit.”

If you’re smart and have high standards and a well-developed sense of style, the monster will comment on the bad clothes, dull conversation, and depressing colors; it’s very specific and discerning, because it’s the meanest side of yourself. It will give meaning to your pain, alright, by telling you that it means a lot and it’s your fault.

It’s your job to keep that monster from influencing your values. I assume you’re working hard on your own business, because you care about being independent and self-supporting.

I also assume you have old friends, because you care about friendship and maintaining relationships, regardless of whether someone is wealthy, clever, or stylish. You haven’t mentioned doing anything wrong; you’ve just described the kind of bad luck that often happens to everyone at one time or another, with or without depression, or a partner, or a great job.

If you have good values, be prepared to use them. If you want to talk “facts,” remind yourself how hard you work at your job and your friendships. Your goal isn’t to get me or anyone else to confirm that you deserve to feel bad; it’s to keep your perspective and not let the negative thinking of loneliness and bad luck undermine your sense of pride.

STATEMENT:
“My life sucks right now, but I respect what I’m doing. I work hard and stand by my friends when all my efforts are relatively unrewarding and, on top of that, I’m fuckin’ depressed. I can’t wait for my luck to turn but, until it does, I wouldn’t want to do anything differently, and that’s what counts.”

I have struggled with bipolar disorder for almost ten years now, but sometimes I can’t see the point. The last time I was admitted to a hospital, I was actually raped by another patient, and the whole experience left me with fears and nightmares I just can’t get over. I’ll never let my family or a psychiatrist put me in a hospital again. My goal is to find a psychiatrist who will give me the support I need so that I will never, ever have to go into a hospital.

If you had diabetes and got the best possible supportive care from the best physician in the world—you could even marry her—you might still need hospital treatment if you got an infection, overdosed on peeps, or just fell into a manhole.

So, while you have every right to feel traumatized by your assault, don’t paint yourself into a corner because of it. When it comes to this anti-hospital stance, (or pro I-need-to-be-nurtured-very-carefully-or-else), you have to shut yourself up.

Thinking about the risks logically, it becomes clear that you probably wouldn’t get raped a second time, and there would be steps you could take to make it more unlikely. So, in reality, you aren’t facing a choice of rape vs. death, but rather terror vs. death.

Terror or death is a decision most of us face every morning before we get on the subway; that’s life. There would be no other choice.

Unfortunately, you can’t change the way rape gave you nightmares, and you can’t avoid the possibility that you’ll find yourself in the same neighborhood. What you can do, however, is bear the terror—the fear of fear—so that you can promise yourself the best possible care and manage yourself as carefully and respectfully as possible.

Your goal shouldn’t depend on finding the kindest or most available psychiatrist, or extracting promises about what he or she would never allow to happen. Your goal should depend instead on your own ability to ignore fear while benefiting from your bad experiences to make good treatment decisions.

Yes, bad things might still happen, but you can be sure you will have done everything to protect yourself while taking the risks necessary to manage a bad illness. If you go to the hospital, something bad might happen, but if you need care and you don’t go, something bad is guaranteed.

STATEMENT:
I may never be able to shake the rape nightmares or promise myself that a mood swing won’t become catastrophic and push me into a loony bin. I can swear, however, that I’ll take reasonable care of myself and that, when I’m well, I’ll try to focus on living life, caring about friends, and ignoring pain, regardless of whether I can get it to go away.

I know that my depression is one of the main obstacles keeping me from getting a new job; I got laid off three months ago, and even though my meds had stopped working way before that, I had enough discipline to push through. Now I don’t have a workplace to go to, I have trouble getting motivated enough to do anything, so between my inability to get out of bed and the fact I look like a mess, interviews aren’t happening. My wife is pissed because I’m not motivated to get new work and I won’t go back to see the psychiatrist, but I don’t see the point in trying this new prescription, because it’s my fourth medication so far, and I don’t understand why the first medication I took, which worked the best, stopped working, and why none of the others since has done the job. I don’t see why I should waste my time getting treatment if it isn’t going to work, but my wife thinks I’m being complacent and lazy. My goal is to find some way to get better or at least get her off my back.

You’re reinforcing something I’ve been telling my children their whole lives; life is unfair.

It was unfair for them when I wouldn’t by them a Happy Meal or the latest Nintendo game, even when they deserved it, and it’s unfair for you now that you’ve lost your job and can’t find the right meds. Unfair is unfair, as they say (or at least as I say).

The trouble is, it isn’t a fair world for anyone, young or old, and you won’t survive if you can’t take your lumps and keep on going.

The less you do, the more you scare and burden your wife, who gives you an earful, which makes you more depressed (as does doing nothing), and so on down the pit that leads to self-pity and divorce, all of which you can blame on your wife, who will be happy not to hear it.

Let’s get your expectations about depression straight. If anyone told you that antidepressants were effective, they were using the medical meaning of the word, not the English meaning.

The English meaning is, “usually works,” but the medical meaning is, “better than nothing.” You might get helped by antidepressants, but never count on it. Meanwhile, you’ve got to take care of yourself, so ask yourself how you’re going to manage, not why you can’t get a cure or stop your wife from being critical.

Consider the job description for a depressed survivor in an unfair world. If treatments don’t work, your job is to suck up the pain and ask others to give you the prompts, reminders, and coaching you need to keep going. If a treatment might help, pursue it.

Remember, when you had a job to get up for in the morning, you found the strength to keep moving and work all day, regardless of how bad you felt. Now that you don’t have a job, create a schedule of activities and meetings with people who are expecting to see you.

It isn’t easy when you’re unmotivated and unemployed, but you still have a job, assigned by you, and that’s to prevent your disease, unfair as it is, from taking over.

If you’re angry, disappointed, discouraged, or resentful, it’s also your job to shut up and not let your negative feelings become nasty words. Don’t expect your wife to be positive; after all, you’re not, and it’s an infectious venereal disease, bouncing back and forth.

You want your wife to help you recover, so put your negative feelings aside, reassure her that you continue to care about her and finding a job, and enlist her help in fighting an illness that can’t be helped.

After all, life provides us all with hard times, whether or not we deserve them, all the time. Don’t add to the unfairness quotient with your own behavior; if life pushes you down and hands you an unHappy Meal, there’s always something you can do, even as a depressed person, to push back.

STATEMENT:
Hit yourself upside the head. “Depression is sapping my natural motivation and ability at a critical time, but my goals haven’t changed. I believe in work and independence. I won’t let false pride, resentment, or negative thinking stop me from doing my best and asking others to help me.”

My husband and I are at the stage where we should start thinking seriously about starting a family. The problem is that his father and that entire side of the family have a history of severe mental illness, so he’s not just afraid of having kids, but of even adopting, because he’s afraid he might get sick down the line and ruin our future child’s life. When we got married, it didn’t seem to be a problem, but as his own father has gotten more and more nutty, he’s become convinced that having kids is a bad idea. I want to stay with my husband, but when we got married, he knew that I wanted a family, as well. And I’m OK with adoption, but it’s a long, expensive process, so if we want to go that way, we have to start now. Basically, my goal is to get him to come to his senses, or at least be willing to take a risk.

Life is tough, and having a child—creating a life—is risky. In fact, it is never not risky, even at the best of times, regardless of all that crap on TV about the power of eating right and giving birth in a bathtub, so don’t reassure him that things will turn out OK, because then he’ll have truth on his side.

After all, while modern medicine greatly reduced the rate at which pregnancy killed mothers, it hasn’t changed the way genes sort out randomly and often badly. So, whether you’ve got mental illness in the family or not, there are always tons of bad genes floating around and having a kid is a dangerous lottery.

The question isn’t whether having kids is dangerous (it is, always and forever), but whether your husband has the balls to take on the usual, scary, risky human lottery that is, for the time being, the only way to begin a family.

Once you accept that the risks are real and the results sometimes devastating, you can take pride in the good qualities that you bring to parenting.

You’ve got a good team; you seem open-minded, and he has lots of experience handling mental illness, which he’ll need for those many problems over which good parents have no control.

Remind him that many of those dangerous genes are also beneficial and it will be your job, as parent, to help your kids to manage traits that may be both a gift and liability, be it depressive sensitivity or athletic hyperactivity.

If your husband can see that there is no such thing as risk-free child-rearing, then you can calmly assess which parenting option—standard conception, adoption, foster care, whatever—would work best for you both.

Then, in the most educated way possible, take the risk of your life and take pride in your work, regardless of the (inevitable) helpless times. Just don’t let fear make you throw out the baby plans with the (birthing) bathwater.

STATEMENT:
Your message is: “Absolutely right, having kids is scarier than hell, but that’s the way it is. Don’t panic. We’ve got some good stuff going for us and, regardless of what happens, we’ll do a good job.”

Living with my mentally ill 30-year-old daughter is wearing me out. My wife and I can never leave her alone, but we also can’t take her with us because she gets uncomfortable when she’s around people she doesn’t know and says inappropriate things in a loud voice and has to get up and leave. The problem isn’t her, though, it’s my wife, who is so worried about what will happen if we put her in a half-way house with other sick people that she can’t think clearly about it. We’ve got some money, but if we paid for my daughter to have her own condo and a nurse to keep an eye on her, the money wouldn’t last long. Then again, if she continues to live with us, we won’t last long. My goal is to get my wife to see that we have to get her into a state-supported program, for her sake and ours.

You hope to get your wife to see that your mentally ill daughter needs to live independently, but if you were making any progress in that direction, you wouldn’t be writing.

Let’s assume then, at least for the moment, that your hopes are false and your wife can’t let go, and if she can’t let go, she’ll always be thinking of new ways to make your daughter feel more comfortable and better understood. Which makes your goal a more and more distant dream.

It also means less legitimacy for other priorities, like preparing your daughter for life after you’re gone, or tending to your own needs or the needs of other kids.

When your wife’s approach wears you out (and it will, if you aren’t a saint), you’ll get angry and then she’ll blame you for making your daughter feel unloved and causing conflict that makes her sick.

As such, your wife’s not letting go will make things worse, as will your own refusal to let go of pushing your wife to let go. So, let’s stamp out your presumably false hope and ask how to make the best of things if your wife won’t change course.

First, figure out what you think is the right way to proceed, given the limitations of your resources and the nature of your daughter’s illness. Whatever you do, don’t expect what you have to do to feel good, because whatever it is, it won’t produce a cure or happiness, and won’t provide the guilt-blocking pleasure of unrestricted giving.

Then get advice from experts about her illness and what public benefits exist. Talk to other parents who have dealt with this issue, and count your savings. After that, put together a plan that represents the best compromise for dealing with two absolutely unavoidable and insoluble problems: the riskiness of independence when you’re mentally ill, and the costliness of long-term care when you’re not super rich.

Finally, ask yourself what you can do to implement this plan without your partner’s help, while encouraging her to join you if she chooses. You need to be able to stand by your plan so that her fears or criticism won’t paralyze you or draw you into argument.

You can’t reassure your wife that things will turn out well, but you can show her that you believe your way is best. If you appear calm about your plan and confident that you’re doing the right thing, she may eventually feel less responsible for all the bad things that could happen to your daughter and better able to do what will work best in the long run.

STATEMENT:
I have a duty to push our daughter towards independence while also attending to other responsibilities. I know this will cause her pain in the short run and deprive her of help I wish I could afford, but can’t. If I put together the best plan I can, however, I can take pride in being a good parent and offer that confidence to my wife and daughter as an alternative to fear.

My wife and I recently retired and we’ve been looking forward to a good life together, but recently I noticed she’s been getting forgetful and I wonder if she’s developing Alzheimer’s, which runs in her family. I hate to admit this, but I don’t think I’m capable of taking care of someone with Alzheimer’s, even if it’s my wife, whom I love very much. I can’t talk to her about it, because I don’t want to frighten her, and most of the time when I think about what to do, I just want to get away. Should I persuade her to get an evaluation so it can be treated? My goal is to do something to prevent this disaster from happening.

Getting into a panic with the goal of preventing Alzheimer’s is as useless as being paralyzed with fear over anything you can’t help, from the Rapture to the weather forecast to the Red Sox prospects in 2010.

Yes, you can urge your wife to get a physical and whisper to the doctor that she seems a little forgetful, and that will get him/her to check out curable causes of memory loss, like vitamin deficiency and depression.

At that point, believe it or not, you’ve done your job. If you press further by urging her to get cognitive testing and trying all available treatments, you may well make your lives worse.

A better goal for almost all the chronic problems of aging is to do what you can to treat them and then forget about them. You don’t want her to become her illness; you want her to live her usual life as much as possible.

For most people with memory loss, there’s no impending disaster. It’s only later, if and when it becomes severe, that people lose their personalities and require constant watching.

In your wife’s case, later may be a long, long time away. Meanwhile, you’ve got a life together that you don’t want to ruin by worrying about something that may not happen. Your goal is to fight fear, do what’s necessary for a possible illness, and live life as usual.

Your goal also isn’t to be extra nice to her; forgetfulness can be irritating to live with, and if you try too hard to be nice, you’ll get extra nasty. Instead, just try not to be mean, and give yourself credit when you can keep yourself in check. That’s always helpful in marriage, whether your spouse is demented or not.

STATEMENT:
Reassure yourself. “If there’s something that will actually help my wife with her memory, I’ll do it. Otherwise, it’s business as usual for as long as possible.”

In the last ten years, I’ve heard voices in my head and most doctors describe my symptoms as psychosis, but nobody can tell me exactly what’s wrong, or find a medication that makes them go away, or really do anything but listen to me give them my laundry list of “how I’m crazy” and try to take the problem apart. In the meantime, I’m struggling to hold onto my job, my wife is struggling to put up with me, and my kids (now grown) just worry and get more distant. My disease stays the same, my life gets worse, my diagnosis goes nowhere. My goal is to figure out what is causing the symptoms, get a real diagnosis, and make real progress.

I wish the word diagnosis meant “we know what’s wrong and what to do,” but it often doesn’t, except in certain special cases. (Like, right now I feel safe diagnosing your reaction as disappointment.)

Very often, all a diagnosis means is that we recognize a group of symptoms that often travel together in the same social circle, and often get a little bit better when they’re treated with a particular group of medications. Tada.

That’s almost always true when the doctor making the diagnosis is a psychiatrist, because we know less about mental illnesses than almost every other kind of illness (and less about the brain then we do about any other part of the body).

We really should use some other word than “diagnosis,” but we don’t, because we love to think we know more than we do, which goes to prove that doctors are just as vulnerable to idiot false hopes as everyone else.

Some people put a premium on hope of any kind, but false hope is dangerous, because we pay for it with unrealistic expectations that lead to feelings of failure. You expect that, once you get the right diagnosis, you’ll get the right treatment, but I diagnose that assumption as bullshit.

In the psych business, if a treatment turns out to work, then you’ve got a sort-of diagnosis about what’s wrong. That’s as good as it gets.

The bad news is that the experts have much less to offer than you (or they) would wish, but the good news is that you can help yourself by doing a regular risk-benefit analysis of your symptoms and the various treatments, regardless of whether or not your symptoms fall under a neat umbrella or not.

Ask yourself how desperate you are to improve your symptoms, not just because you feel bad or want to be normal, but because they get in the way of what matters in your life, like work and relationships. Your treatment choices include some high risk options, so you need to decide, right from the beginning, whether getting rid of them is worth exposing yourself to the equivalent of cancer chemotherapy, or just Advil.

From what you say, it isn’t clear whether your symptoms are causing you nearly as much trouble as your shame of having them. If you can ignore them, get your work done, and have a decent conversation with your wife, then maybe they aren’t worth pursuing unless the treatment is fairly safe. On the other hand, if they’re driving you and everyone else crazy (them figuratively, you literally), then go for the big guns (“big” as in “risk of nasty side effects”).

Use what you know about treatments to classify them into low, medium, and high risk. Then review the treatments you’ve tried in the past to see whether there’s anything left, in any category, that is still worth trying.

If you’re really desperate for a diagnosis, here’s your second opinion from a real MD—you’re nuts. I prescribe giving up on naming exactly what’s wrong with you and moving forward on figuring out what treatments are worth what risk.

STATEMENT:
Now you’re ready to make your own decisions. Keep yourself on course with a set of directions: “My job isn’t to get rid of my symptoms, it’s to manage them as effectively as possible while going on with my life. I’ll compare the risk of treatment with the risk of having the symptoms continue. Once I’ve made my decision, I’ve done a good job, regardless of what happens to my symptoms, and, if they don’t go away, my job is to ignore them and avoid doctor visits and treatments unless I think they’re absolutely necessary.”

My 10-year-old son has afternoon tantrums that are really, really hard to watch. He screams, kicks, and cries, and nothing my wife and I (or anyone else) do can stop him or calm him down. We finally took him to a psychiatrist, and he told us our son’s probably bipolar, and that we should try one of those drugs you see on TV, but the side effects sound brutal. I don’t know if I want to put my son through that, but I do know things can’t continue the way they are now. Our goal is to make his tantrums better.

A lot has been made recently about the increase in cases of bipolar disorder among children. Some people are quick to point to household toxins poisoning children, while others think that drug companies are inventing problems to make a buck. The reality is probably something far less sinister—semantics.

Adults who get manic symptoms (that’s what we generally mean by the diagnosis “bipolar”, that and not much more) were holy terrors at a young age, so it’s tempting for well-meaning and helpless-feeling psychiatrists to wonder whether the adult symptoms could have been prevented with early treatment.

The trouble is, the number of kids with bad tantrums who eventually develop manic “bipolar” symptoms is probably pretty low, it’s hard to determine, and none of the experts can do more than make a rough guess.

So don’t get spooked by spooks, screaming, or diagnoses. As you learned above, the predictive power of a psych diagnosis is limited and doesn’t tell you much (we wish that weren’t true), and parents who live with a kid are usually much better able to make a risk assessment than a shrink who sees him for an hour.

For example, these tantrums seem really scary—and loud tantrums are rattling—but you’re not saying there’s a risk of serious injury to life, limb, pet, teacher, or classmates, so maybe the overall risk isn’t all that high (except in terms of eardrum damage, embarrassment, and fear). And if you’re afraid for his future, remember, there are lots of nice guys who were holy terrors at his age.

The other troublesome thing is that the medications that (sometimes) make bipolar symptoms better pose moderate risks themselves, particularly when they’re taken for longer than a few days. These risks (and don’t tune out the way you do when a cheery television voiceover recites a list of catastrophes as if they’re unlikely) include weight gain, diabetes, high cholesterol, and/or kidney or thyroid damage. That doesn’t include the long-term effects we don’t know about, since we’ve done no testing on what taking drugs like this can do to kids over time.

If, after a reasonable risk-assessment, you feel the situation is desperate, then the risk of trying these drugs despite the lack of testing might be worth it.

Review the types of treatment and their risks. There’s behavioral treatment, which is lowest risk and always worth trying, except when a kid is in too much danger and needs a locked room right now. The treatment is for the kid, of course, but you’ll be the main one doing it, so find a local kid-whisperer and get to work.

Sure, you can put “how are you feeling” talk therapy in the low risk treatment group, and sometimes it helps, but don’t keep doing it if it doesn’t, no matter how much you (and the therapist) wish it would help eventually.

There’s a group of low risk medications that might help (or hurt). What makes them low risk is that, if they hurt, it’s easy to stop the medication, and, from what we’ve seen so far, there’s rarely any permanent harm done.

Naturally, you’d love keep your kid healthy, but you can’t. So first think hard about how much danger his health is in, and then how much health he might lose if you try to make the original illness go away. It’s tricky and unfair, but so is life, no matter what your diagnosis.

STATEMENT:
Give yourself some upper-lip-stiffening advice. “I want to stop these terrible tantrums and protect my child from future mental illness, but my control over both those wishes is limited. So I’ll learn behavior management, get earplugs, assess the risks, make the hard decisions, and hope we can turn him over to his wife as soon as possible.”

I’m fine now (I’m 14), but I’m trying to figure out how to deal with a crazy father who physically abused me until a couple of years ago—that’s when my mother finally figured out what was happening and had me come live with her. The trouble is, I guess you could say my father doesn’t see reality the way other people do and he never remembers hitting me. In his mind, when he’d hit me, it was because I was trying to destroy him, so what he tells the judge is that he loves me and that my mother is a raging alcoholic who has brainwashed me to hate him (my mother stopped drinking after the divorce, years ago) and he really believes what he says. My goal is to get him to stay away from me and convince others that his version of reality isn’t real.

Kids aren’t the only ones who have trouble accepting the fact that we often can’t protect ourselves from scary crazy boogeymen, particularly when the craziness isn’t obvious, and the boogeymen are family.

We’ve said it here before: certain crazy people are not obviously crazy and are particularly good at persuading other people to see them as injured victims because they truly, truly believe they are, no matter what really happened. It’s a kind of sickness for which no one has the cure, and nobody feels sicker than the victims in the wake of these sickos, who don’t necessarily feel sick at all.

So cops, judges and social workers often can’t figure out who is telling the truth for a long time. Meanwhile, they often make mistakes and put restrictions on kids and families that hurt everyone and cost more money than the family can afford. It’s a sad fact of life, but they’re trying to do the right thing.

The system usually works to try and protect the weakest party, and when you’re aggressive, even if you’re just aggressively trying to get people to see the truth, you make sickos look that much more weak and innocent. It’s unfair, but pushing hard to express the truth will often push it underground.

So Dr. Lastname’s advice for kids is the same as for adults: don’t think that expressing your emotions sincerely and eloquently will solve the problem. If your father is sincere and has a good lawyer, he’ll persuade the judge that you have, possibly, been brainwashed by your mom, and they’ll treat you like a poor, emotional kid who deserves pity but doesn’t really know his own mind. Then everyone will spend lots of time visiting shrinks. Thanks for the business, but no thanks for the bullshit.

First things first, give up on the goal of convincing others, and try instead to make positive sense of this experience and prepare a statement that you could, if necessary, read to your father.

The less anger and fear you put in your statement, the more it will help others get at the truth. I’m not saying you shouldn’t have negative feelings—of course, they are what they are—but the goal of your statement is to keep out the negative feelings without in any way holding back on the facts of what really happened.

You might not make his sickness go away or get people to see the truth, but being clear, honest, and emotionless is the best protection against the boogeyman.

STATEMENT:
Here’s an example. “I think it’s a bad idea for us to spend time together. I know you care about me and want to see me, but I think you forget about the bad things that happen when you get upset and lose your temper. You forget about (put in details, including bruises and dates). I don’t want to hurt you and I want you to be happy but I don’t think we should spend time together until I’m old enough to protect myself from your temper. Sincerely.

I’d like to get help for my wife’s younger sister because she drives the family crazy. Simply put, she’s a lying drug-addict, and my wife’s parents are always trying to help her in a way that ruins things for the rest of us—they give her money, pressure my wife and me to accept her at family events, and then make us feel guilty if we don’t want to see her. She’s totally poisonous as she is, but I know she can’t help herself, and I’d like to get her real help, not just hand-outs and pretending everything’s OK, so we don’t have to continue like this.

Your goal is just as bad as your wife’s parents’ goal, because you’re both assuming that your sister-in-law can be helped when all the evidence points the other way. They’re throwing their money away at her directly, you’d be throwing your money away at “real help” she isn’t ready for. It’s a lose/lose.

Really, everyone wishes your sister-in-law could be helped, but proceeding on that assumption when it’s not true is a good way to make things worse, and that’s exactly what you’re complaining about.

The sad fact is, treatment is often hopeless. You know that’s true for lots of medical problems, from cancer to Crohn’s disease, so why not accept the fact that it’s equally true for everything else.

Instead, stick with the realistic hope that she’ll change someday, and that you (and others) will have an opportunity to help. It might happen, but it’s not something that you can make happen or are responsible for.

In the meantime, don’t blame her, because there’s a good chance she has as little control over the problem as you do, even though it’s her body and her problem. Blame life, it sucks more reliably than anyone or anything else.

Now that you’ve listened to me and given up on your goal of getting help for your sister-in-law, realistic thinking suggests some positive things for you to do. Since you’re not responsible for saving your sister-in-law or protecting your parents-in-law, you can bow out of family events you don’t really want to go to.

Ignore feelings of guilt or responsibility. You’d help if you could, but you can’t, and there are other important priorities, like going on with your life and enjoying time with those you love.

STATEMENT:
Prepare a statement that responds to the most guilt-provoking accusations you can imagine. “I’m concerned about my sister-in-law and take full responsibility for helping her whenever possible. One thing I’ve learned, though, from watching her parents do a wonderful job of trying to help her is that, for the time being, it’s just not possible. When it’s not possible, we do more good by distancing ourselves from her problems so as to limit their harm and provide her with more incentive to change. Distancing ourselves from her problems does not mean distancing ourselves from her. The better we protect ourselves, the more welcoming we will be if and when she begins recovery.”

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.”