My boyfriend went through hell from chemotherapy, but I don’t know what to do with his depression and irritability. We’d been dating about a year and planning to get married when he found out he had a nasty kind of cancer and, since then, he’s been brave about chemo and going on with his life, which has meant working when he’s feeling OK, and our moving in together and being partners. Usually, we get along well, but lately he’s been depressed and telling me he knows he’s a burden, he can’t get much done, and he just wants to be alone. I want him to get help for his depression and stop the negative thinking but I don’t want to attack him or make him feel I don’t respect the fact that he has cancer.

One of the things you always hear from people in pain is that you, the lucky one, “just don’t understand.” It’s the rallying cry of the suffering, whether they’re coping with cancer, or just being between the ages of 10 and 18.

What sick people often fail to realize, at least at first, is that people who aren’t in their position understand things that they can’t; after all, you might have the good luck not know what it’s like to have cancer, but you know what your boyfriend’s like when he’s not depressed, and you know this isn’t it.

If you want to get through to him, put aside your guilt about his bad luck and your fear about hurting him when he’s down. You believe his negative thinking is doing more damage right now than his cancer, and that he needs a better perspective. You’re right, so guilt-be-gone.

Then, remind him about the way he and you usually think of your life together. He’s had the worst kind of bad luck, but you admire the way he’s managed it and continued with his life and you’re happy to share his fight.

After all, you’re not with him because you pity him for having cancer, but because you love his courage and find it gives you strength, and because you hope for the best and are happy to share as much time as possible.

Maybe his cancer, chemo or pain tells him he’s a useless burden, but you don’t accept that and you know he wouldn’t if he were in his right mind, because those things are mean and disrespectful. What he should be saying is that he’s fighting a good fight, respects what he’s doing, and is proud of the way the two of you have created love and closeness in the midst of chaos.

Maybe he needs therapy or medication to put a lid on the negative thinking, but in any case, reminding him about what he values and challenging him to protect his self-respect is good therapy in itself, and you can do it. You don’t need to fully understand his experience with illness in order to help him through.

STATEMENT:
“I can’t rescue my boyfriend from attacks of hopelessness about his cancer, but we’re together because we share the belief that life is worth the pain he’s gone through and, so far, nothing has changed my mind. Sickness has made him forget his beliefs and accomplishments, so it’s my job to stand up for them until he’s ready to reclaim them.”

I don’t know how to tell my wife that we can’t afford for her to continue her present business because she’s losing too much money. She used to be good at it, but cancer and chemo had a bad effect on her brain 2 years ago, and now she gets too distracted and drops the ball. I admire her courage, and I owe her for supporting the family all these years while I raised the kids and taught painting. Now I’m making more money and have taken over the finances, but it’s not enough. I’ve tried to help her keep her business organized, but it just doesn’t work. I feel angry and guilty. I can’t get her to see that she needs to find a new job that doesn’t require her old attention span and can make us some money.

It’s hard to confront your wife about about a new, cancer-related, permanent disability without feeling you’re destroying her hope and confidence and adding to her pain. On the other hand, if she doesn’t accept her disability, you’re all sunk and she’ll never have a chance to make the best of what she has.

Remember, you’re not inflicting her pain—the real cause is life and cancer—and the only reason you think she needs to face her disability is that the alternative is worse. That’s your decision as her partner and someone who’s stepped up to assume a greater share of responsibility for the family’s welfare and survival.

After all, you’ve risen to the occasion. You’re not preparing to confront her because you’re angry about the way cancer has robbed you of her strength and old personality (although you may certainly have such a feeling). If you confront her, it’s because you’ve done your homework, weighed the alternatives, and decided it’s necessary.

Begin by accepting her disability yourself; don’t see it as a treatment failure, or as a problem the two of you have failed to solve, just as a wound imposed by the sucky side of life. Respect the way she’s tried hard to return to a normal life, and respect the way you’ve picked up the load, because you both did the right thing. You needed to know the limits of her abilities, and now you do, but you just got a bad result.

Once you accept her disability without shame, you’re prepared to put it in a positive context. Tell her, without guilt, how much you respect her efforts, and that, though most of her mental equipment is functioning beautifully, there’s something wrong with her attention span that won’t let her make money at her old job.

Don’t sound as if your mind isn’t made up or as if you’re waiting for her to agree; her ability to perceive a business plan realistically may be included in the brain damage, or she may not be emotionally ready to accept it. In either case, sound like someone who has made up his mind.

In your opinion, she shouldn’t continue her old job and, if it’s up to you, you won’t support her doing it. You will, on the other hand, support her in finding something new to fit her current limitations.

STATEMENT:
“I miss my wife’s old strengths, and so does she, (or she would if she was in her right mind), but our idea of partnership was that one of us would take over if the other was injured, and that’s what I’m doing. I will raise painful topics if I think it’s necessary and respect myself for doing so.”

My wife is a good woman, and she loves our son, but she has a trauma history and when she gets anxious, she gets very negative and loses hope in us, herself, and our future. Antidepressants helped some, but less than we hoped. Two years ago, before our son was born, her psychiatrist showed her that negative thinking was half the problem and urged her to get DBT, a kind of cognitive behavioral therapy that would help her develop positive thinking habits. She didn’t follow through but seemed to be doing well until the other day, when I discovered she’s been drinking secretly since she delivered. She says alcohol is the only drug that helps relieve her anxiety, which has been overwhelming. My goal is to find something else that will help her.

Everyone is entitled to anxiety-relief, a fair life, and a healthy body. Along with that entitlement comes the guarantee that everybody (except for a few lucky jerks) has to pay the price.

At this point, her motto is, to paraphrase the New Hampshire license plate, “live free (from anxiety) or drink.” If it were up to you, she wouldn’t feel this way, but it’s not, and you’ve got to tell her that neither freedom nor booze is an option.

Theoretically, there should be a good medication for anxiety, but in actuality all current medications are a compromise. The reliable, effective drugs—benzodiazepines—are also addictive, and the safe, non-addictive drugs—antidepressants and others—are less reliable and slower to take effect.

So, while most people get some anxiety relief from medication, there will always be a few people who don’t. Unfortunately, they’re the ones who are most vulnerable to alcohol addiction and have the most reason to wonder how they can be expected to tolerate anxiety without its benefit.

The sad fact is that she’s fucked, and as long as she’s unwilling to accept that fact—and her question implies that she is—she’ll make herself worse. Helping her means helping her face facts, then seeing what she can do.

There’s no immediate relief, and sobriety, which is what she needs, will begin by making her feel worse. That said, if she can stay sober, she can learn new ways to get stronger. The psychiatrist was right—DBT will help, and so will AA.

Let her know you’ll stick with her if she tries, and protect yourself and your child if she doesn’t. You’re not warning her because you’re angry or want to control her, just because you’re stating the sad facts of life.

Hopefully, once she realizes what’s at stake, and accepts the lack of feel-good alternatives, she’ll be ready to make sacrifices to preserve what’s truly valuable in her life.

STATEMENT:
“My wife’s pain is real and it’s hard to see it without feeling she deserves better, which she does. If she can’t find the strength and motivation to get sober, however, she’ll become a dangerous parent and weak partner. I love her and believe in her potential strength, but I must do what’s necessary to survive if she can’t get herself under control.”

My wife has been horribly depressed for the past 6 months and none of the medications that used to help her are doing much good now. ECT, the treatment they use when medications don’t work, caused her too much memory loss and she can’t do it again. Her psychiatrist says the only medications that might work are ones that sometimes cause weight gain, so she refuses to try them. (Another psychiatrist, whom she saw for a second opinion, agreed.) Now she’s suicidal and insists that there should be a medication that won’t cause weight gain and that she needs to find a psychiatrist who can help her. My goal is to help her, but she’s making it impossible.

Weight gain is bad for her health, as well as her looks, self-esteem, and pants budget, so it’s understandably the side effect your wife hates the most.

The one positive sign in all of this is that your wife is eager to find treatment, even if she’s got the wrong priorities (which is better than reacting like the wife above and looking in the wrong places). The key is getting her to look harder, expect less, and be willing to put her mind above panic about her body.

After all, she should remember that side effects are usually mentioned in the same phrase as the word “risk,” which usually means less than 100%, and that weight gain never appears overnight, so she will always have time to recognize it and respond before acquiring 10 new pounds and a need for bigger pants.

Of course, depressed people often don’t think rationally–weight gain, panic, misery—but that’s where you have to come in and remind her that, unfortunately, a risk of weight gain is a possible side effect of almost all psychiatric medications that are used after the first round or two of treatments fail.

So, if you can’t persuade your wife to take it one step at a time before she rules out meds that might cause weight gain, tell her that she has no other choice. She’s done a good job trying medication, hasn’t been lucky, so now comes the same tough choice that cancer patients face about chemo: brace for possibly serious side effects, or make the most of living with your illness.

If she clings to false hope, expect trouble. You’ll be living with a hypochondriac who puts the search for treatment ahead of other family priorities and blames you and others for not being helpful. The longer she looks for a non-existent solution, the longer she postpones hard choices and distances herself from what’s good in her life.

Show respect for the courage it takes to make tough risk management decisions when there’s no good option. Remind her that there are often good ways to manage bad side effects. Assure her you’re there for her no matter what size pants she wears.

STATEMENT:
“I don’t understand why my wife isn’t able to recover from depression the way she did before, but I know it’s not her fault or the medications’ and that her options are now limited. I’ll encourage her to make tough decisions and respect her, no matter what decision she makes. I’ll make adjustments to help her manage her condition. If she avoids reality, however, I will not accept responsibility for relieving her pain or re-ordering my priorities to help her find a non-existent cure.”

I was a wild girl as a teenager and took drugs and cheated on my boyfriends, but one of them stuck by me and now I’ve got a good marriage and 2 nice kids. Life has been pretty good to me, but lately, I don’t know whether it’s getting older or having some acquaintances die, but I feel preoccupied with death and a feeling of not being a very good person. I mean, focusing on those things makes me feel ungrateful, because I’ve been so lucky, but then I feel guilty that I’ve had so much while people I came up with didn’t get the same things I did. I wish I wasn’t so worried about death and thinking about what a jerk I was and how I didn’t get what I deserved.

What we all deserve is a good childhood and a decent set of genes. What most of us actually get doesn’t come close.

Instead, most people end up with a random mishmash that easily includes an extra dose of wildness and parents who are too wild themselves to help us manage our own impulses (the apple, and the genes, don’t fall far from the tree). In a world that’s this unfair, nobody can claim to deserve anything.

If you’re disturbed by the unfairness of life, especially the way it doesn’t punish you the way you deserve, you’re not alone (although it might not comfort you to know you’re in the same company as Woody Allen). Think of it as an instinct, a need for justice, that’s both good and bad.

The good side is that a passion for justice helps you be fair with your kids, and keep your mean side under control. The bad side is that it gets you mad and upset when things aren’t fair, which causes you to try to straighten things out, which, in this messy world, usually winds up with causing more unfairness (see: Vietnam). Instead, you need to get used to living with the feeling and keeping your hands folded in front of you.

The awareness of death is another one of those painful feelings that can be good or bad. The bad part is that it’s painful to lose people or die before your time or die almost any time (unless you’ve been previously softened up by a long, punishing course of illness, suffering and disability, and that’s another story).

The good part is that death-awareness helps you get your priorities straight. Yes, you’re gonna die, but that should make you think hard about what matters today. Hint: it’s not about feeling better, being happy, or owning more. It’s about doing whatever you think is important.

So what counts is what you do with this mess. If your boyfriend loved you enough to stick by you, you were smart enough to appreciate and take advantage of what he was doing, which means you both deserve credit. You’re not into drugging and excitement, but building a family together.

You’ve done the right thing, but don’t expect it to make your pain go away. Life isn’t just unfair, but painful and difficult. Don’t feel guilty that you’ve avoided so much of that pain, but proud that you’ve achieved so much in spite of your flaws. Doing good things, in spite of losing friends and facing death, is what makes us great.

STATEMENT:
“Life has been better to me than it was when I started out, and that’s partly because I’ve done the right thing and I’m on a good course. Sometimes I feel like I don’t deserve it or that I should be more happy than I am. Wrong. Unhappy feelings are part of the territory, part of what I work with. Fuck’em. I’m proud of my ability to ignore them.”

I don’t know why, but my grandmother always relies on me whenever she has a problem with her health, her roof, her taxes, whatever. She doesn’t rely on my mother, because she’s a flake, and she doesn’t rely on my brother, because she sees him as an important lawyer who doesn’t have the time to spare on her little problems. I’ve always pitched in because I’m a good guy who likes to care for people, (I’m a social worker), but I realized, recently, that my grandmother has willed the largest part of her estate to my brother because she assumes I can take care of myself and besides, I’m gay and don’t have any children. My goal is to deal with how angry I am and get my grandmother to see that she’s being unfair.

There’s no way you’re going to make things fair in your family (see above) or change your grandmother, so ask yourself instead what you can do with the situation as it is. I know that doesn’t take care of your anger, but that’s the idea, because almost anything that makes your anger better makes things worse. Anger is only useful to actors, professional fighters, and hack comedians. For everyone else, it’s a detrimental, dangerous pain in the ass.

It’s nice that your grandmother has money; that means she can pay for services without your having to worry about what will happen to her if you don’t help. Which allows to me to review the Three Laws of Giving.

1) Don’t give unless it will actually do some good (not a problem here, because your grandmother doesn’t misuse help). 2) Don’t give beyond what you can afford (meaning you’ve got other responsibilities). 3) Don’t give when it would be better for someone else to do it, and that’s the one that applies here.

If you charge market rate for your services, then your grandmother gets what she needs from someone she loves, and you get paid for your time and a little bit of the lost inheritance. Everyone wins, no one blows a gasket.

You can always try to overcome your grandmother’s prejudice by noting how much you enjoy helping people and how much more you could do if you weren’t as tight for cash. That’s the same pitch you would make with any potential funding donor. Beyond appealing to her rationality and generosity, however, you don’t want to go.

Most prejudiced people tend to feel it’s the other guy’s fault, so confronting them usually causes nothing but conflict. You might feel proud of yourself if you stand up to her, but when you add in the pain it causes her and everyone else involved, and her inability to understand where you’re coming from, it’s probably not worth it. You’re not an ultimate fighter, you’re a put-upon grandchild; don’t get angry, get paid, and then, get over it.

STATEMENT:
“I’m proud that I like to help people and I’m getting smarter about doing it while keeping other things in mind, like my obligation to take care of myself and consider other values and priorities. I can’t help but feel angry at my grandmother; but I will keep that feeling under wraps, if necessary, while I stick with my original goals.”

I’ve been very helpful and patient with my husband since he suffered brain damage after being hit by a car, but I’ve just about had it. Everyone in our families focuses on finding a new treatment for him, and we’re all happy that he’s recovered some functions and can now talk and stand up. The trouble is, I’m exhausted, I’ve got no time to go out and make a living, and he’s gotten into the habit of telling me what I’m supposed to do without a please, thank you or may I. My goal is to set him straight and let him know I can’t keep it up at this pace and that he needs to improve his tone.

Setting someone straight when he wants too much from you usually leads to a guilt fest; you make him feel guilty, he guilts you right back, and it’s a regular guiltapalooza.

You wouldn’t be knocking yourself out in the first place if you didn’t feel responsible and, yes, guilty for not doing more. Of course, you may be knocking yourself out doing things that are really, really necessary, but that’s unlikely. Guilt rarely works that way.

Almost always, the #1 reason for exhaustion is that you’re already doing everything you’re asked to do and everything you can think of that could possibly be helpful, regardless of whether they’re likely to help or have been done before, so of course you get tired and cranky and afraid of the limitlessness of the task you’ve accepted for yourself.

If you complain, prepare to feel guiltier, particularly if you seem angry at a hapless victim of brain damage who needs your love and support, which obliges you to do even more and so gooses the RPMs on your vicious-cycle-mobile.

If you’re lucky, your husband will understand your feelings and change his tone, but his brain damage may not let him. And your families may channel their own guilt into expectations about what you’re supposed to do, and so react negatively to your protest like Monday morning homecare quarterbacks.

Instead, consult your own standards about how much a good person should do. Without compromising on your determination to help your husband, question the need for each treatment based on how likely it is to help, how much of an improvement it is over doing something easier, and how well it seems to be working. Ask the doctors how long you need to try a treatment before deciding whether it’s helping, what you should look for, and what you should do if that treatment doesn’t work.

You’re not young, you’ve been married a long time, and you’ve become an expert on his illness; you’re entitled to draw your own conclusions about treatment because you’re in the best position to observe how well your husband responds. You’re the one responsible for the tough decisions, and, while that might seem to be a source of guilt, it also gives you the right to do what you think is best.

So don’t focus too much on his tone of voice or the advice you’re getting from the family. Educate yourself, observe, and make your own decisions. Then you’ll be able to say “no” to your husband when necessary without become negative, either to him and to yourself, and give the guilt fest a rest.

STATEMENT:
“I wish I could do more to help, but we’re stuck with a limited amount of time and, at some point, a level of damage that won’t go away and that we’ll have to learn to live with. It’s bound to get frustrating and you may well want me to do things I can’t do, even though I’d like to if I had more time and energy or good reason to think they could help. Regardless of your frustration, or even criticism, I’ll always do what’s important and we’ll get through this together.”

My wife and I have been depressed lately since we looked at our finances to see when we could retire. A lot of our friends are preparing to retire and spend time with the grandkids. We realized that my wife’s divorce 20 years ago destroyed her savings and my job doesn’t have any retirement or pension plan, so we’re really screwed. It’s clear we don’t have any good prospects for retiring, other than living in a trailer down by the river, and that we’ll be left behind when our friends up and fly south. I should be happy that we’re healthy and like our work, but I’m not. We both made mistakes, and now we’re paying for them.

Modern expectations are a killer when it comes to almost everything associated with happiness: health, sex, money, relationships, and aging. Retirement seems to cover all those bases and more.

TV ads make it seem that you should always get a good result if you work hard, exercise, and buy the right products. Experience, on the other hand, says that life is hard and lots of good, hard-working people don’t control their happiness or ability to reach their “golden years:’ and, if they do, it gets taken away from them without notice.

The answer isn’t to find a guy in the gutter so you can feel thankful for what you’ve got; that’s a dumb idea that will always come back to bite you. If you’re supposed to thank God for your good luck, then you’ve got good reason to complain and feel angry and/or to blame for your load of shit. Never thank God, because he has a wicked sense of humor.

The idea of luck is that you don’t receive it for any reason—it just is—so don’t make believe there’s a good luck fairy you can thank or piss off, or you’ll feel much worse when it’s your turn to suffer. Accept what you don’t control, even if it means trailer living.

Focus on what you do with the shit that comes your way. Baby, you’re not a rich man, but it sounds like you and your wife married well, after a hard start, and that you’ve done well by one another. You haven’t spent money on bad things, and worrying about life hasn’t driven you apart. That’s a major achievement and one to be proud of; prouder than being rich and retired.

If there’s a big difference in income between you and your friends, well, who cares. Soon enough, it will tell you who your real friends are. I’m not saying it doesn’t suck to be working hard when your back hurts and your bladder has declared its independence from central control, but you should never, ever let your hurt affect your pride. Even if you keep working, you can happily retire from petty bullshit.

STATEMENT:
“I don’t want to be working and there’s no reason I should be slaving away when my friends can afford to take it easy; but life was never fair and there’s nothing wrong with the way my wife and I have handled our money. We believe in paying our bills, being independent, and helping others, and that’s what we do. Not being able to retire sucks, but that’s not our department.”

I am writing about my wife, who’s in her 50s. She is a very successful surgeon (one in a handful women head of dept. in her country), but she’s been very unhappy at work and I am writing you a), for advice on how I can help her and b), to ask if there is something I overlooked. She is unhappy since she has now twice been sidelined and been made to leave jobs where she worked very hard and believed she made a positive difference. In the first case, her department (one she build from scratch to become the largest in the region) was merged with another to meet international norms, but she was passed over to head the new, merged unit and was asked to accept half her salary (she refused and won a settlement in a lawsuit). In the second case she ran a department for a few years, then management decided to hire a new head as her senior and restrict her duties to exclude her specialties and personal preferences. She decided to stay, but even though she’s working hard, and numbers and patient reports say she is doing a good job, she not only does not receive recognition she craves, but sees her career and job threatened again. She cannot do her job halfheartedly, but she doesn’t have a sunny temperament and is hard on herself. Our children have moved away, and she and I work so hard we really only see each other on weekends, so there’s so much to put her happiness in peril. How can I help her? Why did she get demoted? Would fixing her work fix things or make them better?

Of course you’d like to spare your surgeon wife the unhappiness that goes with perfectionism and power politics. You love her, you want to see her happy, and you wish you could remove the pain the way she’d slice off a tumor.

Before I get to all the questions you’ve posed, however, you need to ask yourself one important thing—why or how you think sparing her such pain is possible.

Lots of good surgeons are perfectionistic, to both their advantage and detriment; working hard while not playing well with others is, no pun intended, how most surgeons operate. Also, many executives, both medical and civilian, know what it’s like to be humiliated by a lying boss or a change in who’s in charge.

Unfortunately, it’s not in your power to change her work unless she’s been doing something wrong that you and she can both correct. So far, you haven’t found it. You can’t change her luck, as bad as it’s sometimes been, nor can you change the part of her character that pushes her to work harder to get the recognition she deserves.

What you can do, however, is look for the telltale signs that she holds herself responsible for what she doesn’t control. Ask yourself whether she seems obsessed with proving herself, gaining recognition or being treated fairly. If she does, then you have something good to offer—your respect and perspective.

Tell her that, while you’re aware she’s been treated unfairly, passed over for prestige jobs, demoted, and given work to do that she doesn’t really like, you don’t really care. You’re more concerned with what she’s done with this humiliation and bad luck, and that what she’s done is truly impressive; she has worked hard, helped people, made a living, raised kids, loved her partner, and never let humiliation stop her. She’s your idea of success.

Having made this distinction, ask her whether she’d prefer to work elsewhere, work less, work at something else, or whatever, because, as someone who has nothing to prove, she’s entitled to do what she wants. No matter what her answer, you can offer the strongest weapons in your arsenal, support and perspective.

Assure her that her pain is an unavoidable result of life’s unfairness, respect her for bearing it well, and encourage her to treat herself with that respect. You might not be a slicing surgeon who can remove her pain, but you are her husband, which is one better.

STATEMENT:
“I wish my wife had better luck at work and was less frustrated and unhappy; but that’s not her fault. I respect what she’s done with her luck and wish she could share my feeling of pride in who she is and what she’s accomplished.”

I am in a major career crisis. I am 42-years-old and have devoted much of my life to being a musician and performer. I moved to France a few years ago to make a go of it there, and almost succeeded … only to walk away due to problems with my management. I came home and had a baby with my wonderful man (on this front I have no complaints). More than four years have passed now since I have been back, and I have no desire to pick up with music again, although I am being prodded by people to go back into it now. I know I should be recording but I don’t, even though I can do so at home. I barely practice, I barely write—it is as though my inspiration has gone … I already feel very hopeless about what I might be able to accomplish on a career front musically, and am avoiding it. I see peers with as much talent (or less!) doing well and I wonder what my problem has always been. A fear of success perhaps, or a deep lack of belief? Either way, I am becoming very stressed out about not having time to focus on a career (as the caregiver to my dear baby) and that I am running out of time … but also that I am not 100% sure I want to go back into music—yet plagued by the thought of regret years down the road and also of disappointing people who think I need to go back into it. What if they are right and I am simply in denial? I know I am really talented and good at what I do. My goal is to find clarity around this situation and make some decisions I can work with.

When a highly motivated and accomplished person has trouble getting it together, I always wonder whether the problem is a lack of motivation or a neurologic change in the get-up-and-go center in the brain.

That second possibility is real, particularly for people who’ve had depression. Long after the depression is gone, they still can’t accomplish nearly as much as they used to. They often think it’s a lack of confidence or a change in priorities, “a fear of success” or “a lack of belief,” when the equally probable answer is neurologic dysfunction (or, as I call it, PDSD, post-depressive stress disorder).

Ask yourself whether you’re having trouble with other tasks that are complicated or require you to structure your own time, such as doing your taxes, keeping your place clean and organized, or practicing your instrument without a parent looking over your shoulder.

Whatever the cause of your professional stagnation, you also need to think objectively about the value of re-starting your musical career. Put aside your self-criticism and and prepare a standard business plan; first, add up the negatives such as the cost in time, travel and separation from family, and then compare them to the positives in terms of your pleasure in performing, projected income, and the value of doing something important and worthwhile.

If, after doing this evaluation, you think reviving your career is worth doing, regardless of your oomphlessness, don’t wait until your motivation returns. Instead, try to give yourself more structure by scheduling your practice times and inviting friends who know you’re having trouble with your discipline to come over, listen, and offer encouragement (or maybe your mother can stand over your shoulder).

Otherwise, there’s nothing else you need to do and there’s no need for self-recrimination. If you really want to play music, but no amount of help can get you going, then it’s sad, but that’s life, especially for artists, good ones included. You wouldn’t blame yourself if arthritis prevented you from practicing, and an inability to get going is no different.

As long as you’ve tried your best, you need never see yourself as a failure just because you can no longer perform. Just because your get-up-and-go might have got-up-and-left, you still have reasons to be proud, even if they won’t be expressed in song.

STATEMENT:
“It’s weird to have lost my desire to play music and it hurts to hear people wonder whatever’s happened to me and where is she now. But I’m determined to figure out whether a musical career is still worthwhile and, if I think it is, to do all I can to make it work. If I can’t, I have a loss to mourn, but nothing to be ashamed of.”

I have arrived at a destination in my life after a long period of study, with a two year gap to overcome the burn out, and a return to the mammoth uphill battle to complete the certification requirements, where I thought, never again will I feel apathy, scared, bored, hatred of employment. I was a passionate dedicated student and I loved being a student up until the last couple of years, which were made worse by a university in turmoil and academics who lost interest in my specialist field when it was cut from the university. I was dedicated and driven to succeed, but after a immense effort to find any work in my new chosen field or related field with not much luck, it then struck me, that at the ripe old age of fifty-two, I don’t care much for work, of any kind. I am now living on welfare, because I could find work initially but now I don’t want it. I have to do something with my life, I can’t just up and retire and I don’t have the money anyway. My friends seem to be getting on with their lives, buying houses, but do I want to slave away and struggle on my own to pay off a mortgage only to be probably too old to enjoy it when I get there? I have developed some medical issues over the years, but I do not see myself as disabled. My goal is to become unstuck, find meaning in life/work balance again, get my mojo and drive back.

One of the good things about being 52 and unemployed is that you’re old enough to see your priorities more clearly than when you were younger. You now have the experience to know what you can and can’t do with none of the messy hopes and dreams.

One of the bad things, however, is that you don’t have that much time left on this earth and your material needs are obvious and more and more pressing.

You need to do what you have to do, regardless of whether work is interesting or fulfilling, because when you’re in your fifties, living like a grad student isn’t just depressing, it’s potentially unhealthy.

I’m assuming from what you say that you could work if you wanted to, but that you’re discouraged by your inability to find anything meaningful or related to your training. Please confirm this assumption with yourself by doing a thorough review, because it’s sometimes not true, even when you believe it is.

One way to evaluate your capacity to work is to set yourself a series of simple tasks, like reading or composing a letter, and see how you do. If you find these tasks difficult, keep in mind that some discouraged people become impaired by depression, often in subtle ways, and are actually less able to work than they appear, or believe themselves, to be.

If this is true for you, you will need to adjust your expectations accordingly; settle for a less demanding job (or the dole), or decide whether it’s worth getting treatment so your job options can improve.

If there’s nothing wrong with your ability to work, ask yourself how much you need to work. Don’t get distracted by whether the available work is interesting or meaningful, just consider your long-term needs, including worst-case scenarios, and the ability of your current resources, including welfare, to meet those needs.

Keep it simple and unemotional. Ditch the therapist and use a financial advisor, because financial necessity is often a stronger and less complicated motivator than ambition, mojo, or drive.

If you can’t work, or can afford not to work, you can become a man or lady of leisure (and modest means), even if that means never being a property owner, just the proud renter of a studio apartment and a sturdy futon.

If you can work and your basic needs demand more resources, it’s time to start looking for work. It probably won’t be the job of your dreams, but you’re old enough to know that it’s worth taking a shit job to avoid living a post-grad nightmare.

STATEMENT:
“I feel disappointed and burnt out at 52 after investing heavily in a career that false-started; but I’m experienced enough to know that hard work often fails to guarantee success because the world is unfair. I’m proud of what I’ve done. Now my job is to figure out whether I’m fully functional and do what I need to do to survive, regardless of how dirty the job.”

I love my work, but I haven’t been able to find a partner, and I wonder sometimes if I’m missing out on something important. I’m a top performer in my industry and jump at new challenges, even if they require me to move around the globe. I always find time to enjoy myself and I have wonderful friends, including a few who are in similar fields, or just share my vagabond ways. While I do wonder what it would be like to find someone and start a family, I just can’t imagine getting off the fast track and rooting in suburbia because my partner couldn’t give up her job, or because my kids didn’t want to change schools. My goal is to be less selfish, or find a way to have a family without changing my life.

Being as engaged as you are by work that requires high performance, special talent, and a love of globe-trotting is both a great gift and a burden. Obviously, it’s hard to imagine settling down with someone when you can’t settle on a continent.

Meanwhile, it’s clear that you don’t consider yourself lonely and that you don’t really see yourself as selfish. Your life doesn’t contradict your values, it just doesn’t allow you to fit yourself into conventional expectations.

The expectation of being partnered is a dangerous one, in any case. After all, you know how hard it is to find a good partner under the best of circumstances. Anyone who expects to find one as part of their definition of a successful life is more likely to make a dangerous compromise and/or feel like a failure if a good partner doesn’t show up, and that’s true regardless of the time zone you happen to be in that day.

Instead, take on the hefty task of asking yourself whether you’re doing your best to support yourself, offer a good day’s work, and be good to your friends and family. Other people (or your internal voices) may say that you’re missing out because you don’t have a special someone, but it’s white noise.

Add partnerhip to the list of the many things that might make your life happier but that you don’t control and so shouldn’t think about. Value what you’ve done with what you’ve got, and where you’re going next.

Your life style isn’t normal; but, as in the case above, you’re old enough to know that normal is relative and that the hopes and dreams that aren’t bullshit don’t come without a price. If you’re doing what you love and doing right by yourself, then don’t settle for anything less.

STATEMENT:
“I’m unusually good at what I do and get unusual pleasure from it, but my life makes other things unusually difficult. I like what I’ve done with my life, even if it wasn’t what I or my family expected. I would like a partnership, and I’m open to one, but I’m determined to live my life fully in the present, which is what I’m doing, and not hold my breath waiting for something that might or might not come along.

I’ve got 4 kids, all under 7, and a wife with a chronic, hard-to-diagnose condition that has her walking with a cane. So sometimes I feel overwhelmed. That fact is, I’ve got a good job and my wife and I get along well, and I know people who have more problems than I do. I feel I should be grateful and counting my blessings, and that’s my goal– to be at peace and not feel so overwhelmed.

The unhealthy part about feeling grateful for life’s blessings is that they’re often transitory and sometimes non-existent (unless you consider a cane a blessing).

After all, if you’re grateful today, it’s hard to feel grateful tomorrow when you don’t have those blessings, or meet someone with many more of them who is far less thankful or deserving than you (unless you’re grateful for getting to punch them in the face).

Then there’s always the chance you’ll actually meet that special person who is even worse off than you. If you feel lucky you’re not him or her, you’ll wonder why you deserved better and then need a lobotomy to protect yourself from guilt.

That’s the problem with the words “grateful” and “blessings;” they imply a relationship between you and the Celestial Bestower of Good Luck, and that will always drag you into questions of why, why-me, and what-did-I-do-wrong if/when things get worse.

The opposite of feeling grateful to God for good things isn’t atheism; it’s simply a refusal to hold him/her or ourselves responsible for the stuff we don’t control, so that we can avoid the time and expense of all-in-your-head ruminations about blame and find better-grounded ways to be positive when times are tough.

Assuming that neither God nor Buddha nor Pat Robertson’s prayers are steering the hurricane of bad luck in your direction (or narrowly to one side), the most positive way to fight overwhelmed feelings is to think long and hard about what you’ve done with your disasters.

You’ve got good reason to feel scared, but you haven’t run away or turned the fear into a fight with your wife. You’re soldiering on, and you’ve got your priorities straight. This isn’t good fortune, it’s heroism.

Heroism doesn’t mean feeling at peace about your prospects when danger threatens; fear, from what we know of evolutionary biology, probably helps you fight harder, spot trouble sooner, and run faster. Animals that don’t get worried and feel their adrenalin pumping are the ones most likely to get eaten, which is why most of us have jumpy ancestors and are not so calm, particularly when danger threatens.

So don’t expect not to feel overwhelmed, don’t count your blessings, and don’t feel grateful. Accept your fear, bad luck and bad feelings and then count the good things you’re doing with them, or trying to, anyway.

That’s where your pride should come from, and nothing can touch it as a source of strength, including more hard times, an angel, or a punch in the face.

STATEMENT:
“I can see disasters ahead and no way to prevent them, but that’s not my job. If I can avoid them, I will. Otherwise, I’ll keep on working hard and try to be a good husband and father and scrape by on what we’ve got. The tougher it gets, the bigger our achievement. Nothing else matters.”

My teen-age daughter has always been a handful, but she did much better last term when she played soccer because it kept her busy and used up her extra energy. Once the new term began, however, she was back on the phone every night, non-stop, and texting and browsing Facebook and not doing her homework. When I try to stop her, she gets nasty, and I can’t seem to get through to her that she needs to control herself and that grades are important. I have a strong belief in self-discipline and the value of hard work and it seemed to be getting across when she was playing sports, but now it’s gone. How can I get through to her?

Thoughtful discussion is not the only way to get through to a kid, although it’s not a bad place to begin. That’s because some kids, like the rest of us, have trouble with controlling their impulses and can’t do what they’re supposed to do, even when they know it would be much better for them in the long run.

So, not unlike adults, they become adept at avoidance, misdirection, secrecy, and obstruction. At that point, reasonable words are not your strongest weapons, nor are weapons your strongest weapons, no matter how tempting adolescents make that option.

Your strongest weapon, probably, is an acceptance of the fact that you never have complete control of your kid, now or going forward. The best parents have partial control, and it’s often good enough, but there will always be certain times with certain kids when nothing works, and it turns out that no one else has the answer, either, including teachers and mental health clinicians.

It’s another one of those sad facts of life, but it leaves you free to focus on doing your best to manage your child, rather than wondering what you’ve done wrong, or what they’re doing wrong, or what’s wrong with the universe that soccer can’t be played all year round.

The next weapon is a belief in your own values, so that you don’t feel obliged to explain and aren’t concerned if your requirements cause some unhappiness. Of course, you’d prefer your child to be happy and agree with what you’re doing and, indeed, give it her blessing. If you believe in your values, however, your need for peace, happiness and understanding are subordinate to getting the job done.

Now that you’re as well-armed as possible and ready to go, tell her she loses the phone until her homework gets done. If and when she resists, prepare yourself to be friendly and calm. Don’t explain or argue, just tell her what will happen next and then do it. If one thing doesn’t work, keep trying other things, and if nothing works, at least you’ll save money not having to pay college tuition.

There’s a good chance though that, between your efforts and the repercussions of slacking, your kid will figure something out. Or maybe she’ll just learn to ski.

STATEMENT:
“I know my daughter controls her impulses better and gets more work done when school and sports keep her busy, but that doesn’t mean I (or she) can control her impulses all the time. I believe in the value of hard work and self-discipline, even if her temperament makes her very resistant, so I’ll stop at nothing to give her incentives. If she’s not happy with my rules, there’s no need to feel guilty or argue or blame. If they don’t work, I’ll take pride in doing my job and avoid blaming her or myself.”

I’m a competitive, hard-working woman who’s always been a star among my peers at work. My social life has been pretty good, too, though I haven’t been lucky in finding a partner. My problem is that I’m bored and discouraged by my current job—it doesn’t allow me to get the outstanding results I’m used to achieving—and it’s starting to put a dent in my confidence, my dating, and even my ability to look for a new job. I want to get my mood back to normal, I don’t care whether it’s through medication or psychotherapy, so I can again lead the work-pack and have more energy for my social life.

It’s nice to be a work superstar, especially when that confidence extends outside the office to every other facet of life. Too much hubris, however, and you’re starring in your own corporate episode of “Behind The Music.”

When you depend too much on being outstanding, as good as it feels, you’ll get into the special trouble that always happens to gifted people who need that special feeling of achievement (you, Leif Garrett, same difference).

For one thing, if you’re ambitious and good at what you do, you’ll always be recruited, and sooner or later, you’ll be recruited into a position that can’t work out. Your skills are still perfect, but your luck isn’t.

It will look good and pay well, but there will be no way to get the results you’re expected to achieve—like being hired to coach the Yankees when all of your star players have lost their hands in farming accidents (we can dream). At some point, every gifted person rises to a position of having great responsibility over something s/he doesn’t control.

You’d think that treatment would improve your mood, help you find another job, and restore your groove. Sometimes it will, sure, but when treatment goes up against bad luck, bad luck often wins, so get used to the idea that sometimes when you’re stuck, you’re stuck, no matter what your gifts are.

The other thing that is hard for high-achieving people is finding a partner. The confidence of high achievement that helps you get dates can later interfere with long-term partnership. Life on the road/outside of the office can be lonely.

It’s not just because you don’t have enough time for your social life but because it’s painful to take your focus off your work, cut corners, and stop before the job is done perfectly.

So restoring that achieving feeling is really not your first priority, particularly if it can’t be done. Instead, remind yourself that good careers often include bad jobs, at least for awhile, because life is unfair and the economy periodically sucks. Do your best in the meantime and respect yourself for doing so even when there’s no way to get special recognition.

After you learn to suck up your current work pain, decide for yourself whether partnering is worth the trouble and frustration of reining in your perfectionism and love of achievement.

Being a superstar is great, but having achievements to comfort you, as opposed to another person, won’t sustain you forever (unless you’re in Metallica, or A-Rod).

STATEMENT:
“I love getting recognized for being really good at what I do, but I know it’s not always possible, and I take special pride in working hard when there’s no recognition. If I want a partnership, I’ll also take pride in my ability to make tough choices, cut corners and do without some of the satisfaction in achievement I used to depend on.”

I loved my job and, working mainly on my own, developed work procedures my company adopted as standard practice, but after the company got sold a couple times, the new owners didn’t realize what I’d accomplished or how much they needed my work, and I’d never pushed for official recognition or a raise, so I got dumped suddenly and without severance. I have a terrific network of people I know because I’m a leader in my church and love helping others; but it’s very hard for me to push my own cause, so I haven’t told people I’m unemployed, and I’m getting more and more depressed. I also wish I could find a partner, but I’ve never felt comfortable asking girls out and my community work fills a social void. My goal is to feel less depressed so I can do better with my job search and maybe even get up the courage to ask for a date.

Being dedicated to your work, even as a selfless team player, can be too much of a good thing.

Obviously, it’s given you much satisfaction and, with the right boss in the right job, you would have received more appreciation, a raise, and satisfaction. So your immediate goal is to feel better and continue your search for a better job.

Living in this world, however, rather than in the fair outcomes universe that exists at the end of every TV drama, you know that good deeds at work will often do nothing but allow the boss to increase profits, pay you less, and make the company’s balance sheet look better for prospective buyers. You’re not a team player, you’re a self-deluding sucker.

As for finding a partner, your selfless instincts will further sabotage you by giving you a warm feeling for helping other people get together while making you feel guilty and anxious for openly pursuing what you want from prospective dates.

Instead of trying to feel better by satisfying that team-spirit, courtly-love instinct, define your legitimate needs, throw a Hail Mary pass, and go for yours.

For your job hunt, list your achievements, describe what you have to offer a prospective employer, and place a legitimate market value on your services. While you’re at it, write up a description of the personal achievements and qualities that make you attractive to a prospective partner. Don’t force yourself to sound confident, just let the facts speak for themselves.

Now for the most selfish part, and this goes for both searches: list the qualities you require in a prospective employer or partner, qualities like a record for decency and an ability to maintain respectful long-term relationships. You’ll be surprised how much the lists overlap.

Look for what you need, in addition to your need to be needed. It might feel awkward, and it might not feel nice, but you’re not being nice to yourself by ignoring your own legitimate needs. It’s time for a new game plan.

STATEMENT:
“I love helping others and sometimes that helps me make a living and win friends; but I also have a responsibility to define and pursue other personal needs, regardless of whether the process makes me feel guilty, selfish, or anxious; and now is an opportunity to do that.”

I’m a 47-year-old woman who has never been married. My goal is to find out if circumstances have simply kept me from meeting a suitable partner, or if there’s something I’m doing or something about me that has kept me from finding/recognizing someone who might have been the right choice. I’m attractive, extremely bright, I have a great sense of humor, and am warm and open. I have wonderful friends of both sexes. The downside is I’ve had some serious health issues, including one chronic illness that has directly and indirectly undercut my most important career and personal goals and, to some extent, my sense of myself as the kind of person I wanted to be (accomplished and desirable). I’m under a kind of chronic stress and I don’t feel I’m living my life fully. To restate my goal, how do I figure out what, if anything, has kept me from having a successful relationship?

Don’t disrespect yourself by assuming that being single means you’ve done something wrong. If your problem finding a partner were anything obvious, like a stupid compulsion to dump good guys or an aversion to bathing, you probably would’ve figured it out at some point in the past 47 years.

Also, don’t disrespect yourself by giving illness and bad luck the power to define your self-worth. Yes, it’s nice to be healthy, rich and thin and it feels like success. Real success, however, is knowing you did your best when things turned out badly and left you hurting; it comes from pride in the effort, not pride in the outcome.

That’s why you respect friends who deal well with bad luck even more than you respect those friends who worked hard and did well. Dealing with bad luck, rather than getting good results from hard work, is the heaviest of heavy lifting and the biggest kind of accomplishment. The lucky hard workers may get results, but the cursed, diminutive college football player Rudy gets an eponymous biopic.

So feeling like accomplishment and desirability are necessary to being who you want to be and living the “full life” you want to live is dangerous, because it links your self-esteem to your fate, rather than to what you do with it. The same goes for your luck in partnering.

It sounds like you have a gift for friendship and have done a great deal with it, but that doesn’t guarantee that you’ll find a good partner, because matching with a good partner is beyond everyone’s control. Perhaps partnering wouldn’t be beyond your control if the world was fair, and guys were as good at marriage as women are, and people of good character were easy to find, and “Arrested Development” was never cancelled.

Unfortunately, that isn’t the world we live in. In our world, not only are good matches hard to find, but bad matches are amazingly easy to find and can wreak terrible damage for years to come (see: the next case).

You’ve got good relationships and you’ve had the strength to tolerate loneliness without straying into bad partnerships. Don’t mistake your sadness, loneliness, and illness as failure. Instead, be proud that you haven’t let them compromise your principles and be aware that, regardless of your feelings, you’re living a full and successful life, given what you’ve got, even if you don’t have what a lot of other women do.

STATEMENT:
“It hurts not to have a partner and kids to love, but I will not let sadness or illness make me doubt myself or devalue who I am and what I’ve accomplished. I may not feel successful, but I am, and as a successful person I will keep looking for a partner without compromising my principles or the network of close relationships that I’ve built.”

My father always went out of his way to spend time with me and my brother after he divorced our mother, but he also had a terrible talent for finding subsequent wives who really didn’t like kids, (he didn’t have any more), so our times together weren’t much fun, to say the least. Now I’m 21 and he wants us to be close (he’s on wife #4), but I can’t stop resenting him for all the lousy times we had and the fact that he would never own up to the problem. My goal is to have a better relationship.

No one screened your father for his skills other than your mother, and she long ago admitted that mistakes were made, so she left. Alas, you weren’t so lucky.

As a kid, you might have felt that he preferred his wives to you because he didn’t seem to mind that they didn’t like you. The greater likelihood, however, is that he was clueless about their feelings for you or the way they made you feel, because that’s the way he is.

He might not be a bad guy, but he is a crappy father, and it’s one of the many things he seems oblivious to. If he is truly clueless, you can never expect him to see or take responsibility for his parenting problems.

Don’t share your disappointment with his parenting; you’ll just make him defensive and he’ll tell you all he’s done for you. If trying to talk about it will cause more problems, your only choice is to let it be.

On the other hand, he’s probably got some redeeming qualities, so add them up, subtract the step-mom factor, and decide how often you should get together.

When you do spend time with him, you may often feel frustrated by his cluelessness and it may awaken old, painful feelings. That’s unavoidable, so don’t take your anger and hurt as evidence of a failed relationship or as a problem that needs solving.

Bear your discomfort proudly as proof of the effort you’re putting into being the good son of a guy who tried hard to be a good father, but found it easier to be a husband (many times over) of non-nurturing women.

STATEMENT:
“There are times when I don’t like my dad or my memories of his parenting, but that’s unavoidable. I see him as often as I think is right, without reacting too much to his expectations. I’m proud of the fact that I do.”

It took me forever to get my engineering degree because I had to work and go to night school, but I stuck with it because I believed it would get me a good, secure job. What’s killing me is that, now that I’m qualified, I can’t find one, because I don’t have a driver’s license, because the idea of driving gives me panic attacks. Meanwhile, my classmates have gotten all the good jobs and are moving ahead. I’m feeling angry, bitter, and depressed, and I know it’s my own fault. My goal is to get over my fears so all my work doesn’t go to waste.

You’re right to be frightened of panic attacks, because, in addition to making you feel terrible, they can come on just when you need to be at your best, look confident, and show you’re reliable. They’re the acne of mental health.

Like bad zits, they tend to come back whenever they want, for no reason you’ll ever understand, and picking at it just makes it worse.

So, when a panic attack hits with its perfect timing, you have to miss that something important or, if you show up, you have to hide in the corner. Of course, the fear of panic attacks makes you more vulnerable to them—Panicophobia!—so it’s no wonder that you’ve been afraid to drive.

If you’d hoped to outgrow the panic attacks or figure out a way to make them go away, forget it; panic attacks cannot be Oxycuted. Instead, it’s time to enroll in Panic Management 101…if you’re willing to meet the course requirements.

For starters, you’re not allowed to ask why you have panic attacks or, indeed, any “why “ questions whatsoever. Such questions are just a sneaky way of delaying the inevitable, which is nerving yourself up to do what you need to do, whether or not it triggers attacks/plain old bad feelings.

Most importantly, the prime requirement of the course is courage. While “why” isn’t allowed, “how” is the sole focus of the course, as in “how can I keep the fear of panic from becoming overwhelming?”

Read up on the many treatments for panic and decide where you want to begin; you’ll get good advice and encouragement if you let others know you have the problem. Try the talk and behavior therapies first, because they have fewer side effects, but don’t be surprised if you also need to check out medication.

Above all, don’t get demoralized because panic attacks have slowed you down. It’s not a race, and the winner isn’t the guy who gets their first, but the guy who keeps moving forward despite the biggest handicap.

Having cystic acne might end one’s career as a model, but your panic attacks don’t need to end anything (except your pity party). You worked a long time to get this far, so it’s not worth throwing in the towel before you try to get behind the wheel.

STATEMENT:
“It’s frustrating to come so far and still find myself paralyzed, but panic attacks have overwhelmed bigger and stronger people than me. I’ll do what I can to manage them and, with luck, I’ll learn how to drive. Whatever happens, fear won’t stop me from doing my best to achieve this goal, and that’s what defines a winner.”

I’m tired of not being able to retire and having to work long hours providing nursing care for people who don’t really respect what I do and, in the end, still being poor. My wife never earned much—she really never worked that hard—and she was often verbally abusive, though she’s been nicer since she got sick. I love her and take good care of her, but it’s never been easy and I never get a break. There are so many good things I would do if I had the time and money. I love painting and have a good portfolio, but not good enough to earn a living from, and I haven’t done it in 5 years. I love gardening but I have no time. I wish I didn’t feel like such a loser.

If it weren’t humiliating to be poor, we wouldn’t try so hard to look rich, and we’d stop buying half the things we do, and the economy would collapse. Never fear, we’ll never stop declaring war on poverty, particularly our own. It’s just the way we’re wired.

What’s wrong with hating your own poverty, however, is that it stops you from giving credit and respect to the best things you do and exposes you to undeserved disrespect for things you don’t control.

Most poor people aren’t lazy, stupid, or undeserving. Their talents are good for non-enrichment, or they have a weakness that gets in the way of getting rich, or they simply lack the luck. The most common reason for being poor is that they do so much giving, to their kids and the people they care about, that they can’t accumulate wealth.

Whatever the reason for your current economic shortfall, on some level you don’t care why you’re not rich. Being rich means having better self-esteem, which is another reason that self-esteem isn’t all that important.

You’ve got many reasons to respect yourself. You loved your wife, regardless of whether she was rich or a big earner or even terribly nice, and stuck by her through sickness and health. You do work that helps people and you persist in spite of fatigue, humiliation and the frustration of not being able to pursue your real interests.

You should be proud, even if you’re living in poverty. Money does not make the man, and while you can’t buy respect, you should give yourself plenty, because you’ve earned it.

STATEMENT:
“I may never get respect, but I’ve done what I believe is important, I’ve lived up to my values, and I’ve made the most of the hard luck I’ve had. That’s real wealth. I will not bow down to the good feelings that more money would bring (though it would be no crime to win the lottery); and I speak respectfully to myself, because that’s what I deserve, regardless of how I feel.”