My 15-year-old son needs treatment for his irritability. He gets unbelievably angry over small things, to the point that he ups and goes to his room. He agrees that things are basically OK and he’s sorry afterwards, but it happens at least once a week. We have a happy home and he has friends in school and gets good grades. I think it’s his mood that’s the problem and it causes him and our family a lot of pain. My goal is to figure out how to get him some help with psychotherapy and/or medication.

Just because someone’s in pain doesn’t mean he needs help. Pain is just part of the complete life package, along with joy, hunger, death, etc.

Of course, you’ve got less to lose and more to gain from treatment if his irritability has caused bruised knuckles, broken sheetrock, and a growing familiarity with your local police. Pain is a normal part of life, but serving life in prison isn’t.

What you’re saying, however, is that, aside from his verbal explosions, he remains in physical control, does self-motivated time-outs, retains good relationships, and has no trouble focusing on work and getting it done. No pill could improve upon that.

So, if he’s handling his pain well, getting things done, and engaging in life, then making him get treatment for his irritability may make a bigger deal of his problem without necessarily providing relief. It’s a sad fact, but neither talk therapy nor psychiatric medication reliably improves irritability—just sometimes and more often than placebo.

It’s always possible that his irritability foreshadows a mood disorder that will eventually get worse and might be prevented or disarmed by beginning medication early. The trouble is, we have no way of telling whether he’s at high risk, and the medication has risks of its own, as well as being costly. The risks from antidepressants aren’t great, as far as we know, but there’s always the risk of what we don’t know because our tools for examining the long-term effects of medication on the brain are limited. If you try an antidepressant, ask yourself whether it’s helpful enough to be worth that risk.

As for most mood stabilizers, like Lithium, Depakote, and Abilify, the risk is much higher than for antidepressants (although you wouldn’t think so if you didn’t listen carefully to the end of Abilify commercials). Sometimes, pain treatment is worse than pain, and shouldn’t be considered without a careful assessment of the risk and rewards. From what you’ve said, the risks of most mood stabilizers dwarf the rewards by a mile.

Psychotherapy can be harmful if his shrink doesn’t accept the fact that treatment has limits. Find someone who can accept the possibility that your son’s irritable outbursts are unavoidable and coach him on managing them if they can’t be cured—though, clearly, your son is already a good manager himself.

In the end, the decision is yours, and various treatments might be helpful. If you accept the possibility, however, that treatment for painful conditions is not always better than no treatment, then you will weigh risk against benefit, regardless of how you feel, and make a good decision. After all, it’s risky to overestimate the power of medication and treatment, but it’s riskier to underestimate your son.

STATEMENT:
“It breaks my heart to watch my son have a meltdown and I’m terrified of what can happen to a teenage boy with an anger problem. I know he’s a good kid, however, and he’s showed an amazing ability to keep it together socially and academically. If a treatment seems to help him and be worth the risk, I’ll support it. If it doesn’t, I’ll support the many good ways he’s dealing with his temper and help him develop even stronger anger-management skills.”

My son is a nice kid, but his ADD makes him completely irresponsible. He seems motivated about getting his college degree, but, even when he takes his medication, he always comes late to lectures, leaves assignments to the last minute, and doesn’t get problem sets finished. He was asked to take a semester off because his grades slipped and he seemed out of control. Now that he’s back at home, he pays no attention to his bank balance and has bounced a lot of checks. When I confront him, he’s sincerely apologetic, but then he does the same thing the next day. I just wish I could get him to stop lying and care about what he’s doing.

If you can’t help someone with love and medication (see above), it’s normal to assume that he doesn’t really want to get better and your goal is to find the key to motivate him. The trouble is, some people who are motivated (and medicated) are nevertheless unable to perform.

They feel ashamed, apologize, avoid, feel more ashamed, and so on. They seem sleazy and unmotivated. The problem is that, if you treat them as if they’re sleazy and unmotivated, you make them worse.

The sad fact here is that medication can usually sharpen attention and make learning easier, but it can’t correct the executive function problems that make it hard for many people with ADD (and others) to get things done and deal with unpleasant priorities. Yes, you need character and willpower, but you also need some help from your brain, and some brains are too “in the moment” to be pushed into planned, prioritized activities, even when the will is willing and the attention razor sharp.

In that case, your goal isn’t to get your son to stop lying—he’s not purposefully dishonest, just permanently flakey—but to disarm his shame while helping him face the full extent of his disability. Forget about his lying, insincerity and apologies. Make it clear you’re not interested in the merry-go-round of avoidance and remorse and instead want to examine the power of whatever makes him fuck up in spite of the fact that he doesn’t really want to. That said, your goal is to help him find ways to manage himself.

Don’t let him present himself as a bad guy who could do better if he’d just try harder, because the evidence says otherwise. In reality, he’s a good guy with a permanent impairment, and it will take him a lot of work to get a handle on it.

Ask him if he’d like a wake-up call in the morning, or whether he should compose a daily log of his lateness to see when it’s better or worse and whether it’s responding to interventions, including medication changes. The more you talk about his lack of control as a fact, the more you challenge the shame that reinforces avoidance. Too bad he’s fucked, but there’s lots to be done. Most of us have weaknesses we have to work hard to manage, but most involve food and don’t involve bank fees.

Once you limit his responsibility and yours for what he doesn’t control, you’re free to bear down on the one part that he does have some power over. You don’t expect him to change his disability or understand why he has it—it is what it is—but you’re confident he can work on managing it, and that, with hard work and discipline, he can gain the control he needs and lose the shame that’s holding him back.

STATEMENT:
“It’s hard to watch my son’s overly sincere apology for behavior that cost us half a year’s tuition, knowing that, if he hadn’t lied about what was happening, we could have helped him, and that he’ll do the same thing again. Nevertheless, he wants good things for himself and has a legitimate problem that is worse than a poor attention span. I will talk to him about the good things he can do with a bad problem, and urge him to seek coaching rather than moral reform or absolution.”

I have always had a problem with keeping friendships because of moving too much, anxiety, and some other reasons. Almost every friend that has come into my life seems to be very needy and I tend to become anti-social when this happens. My current best friend has showed many signs of being very clingy and a bit controlling; she buys me things when she knows I am busy just so she can hang out with me, she calls me frequently even though she knows I dislike talking on the phone, she is demanding and apologetic at the same time. I am confused on what to do because she is always there for me and I can’t always be there for her. Lately, I have been having so much negative feelings about her that I don’t want to work on the relationship and this is exactly my problem—I lose people because I let my feelings get in the way. Maybe I am not finding the right people to hang out with? I mean we have so much in common, but that might be the problem because we both have severe anxiety and what we hate about life seems to be all we talk about, so it’s just negative energy most of the time. I will admit I am selfish and should be more thankful that I have someone that understands me and is there for me, but I guess I am too unhappy in my life and unhappy with myself to be appreciative of the goodness in others. It’s something I would like to work on, but I don’t even know where to begin.

Whatever draws people into relationships– neediness, sex, an encyclopedic knowledge of “Law & Order”—it isn’t necessarily good for you. When you’re operating on instinct, you stop thinking.

It sounds like you’ve got a good idea of what’s good for you, and it’s a friendship that discourages whining and encourages breathing room and independence. Nevertheless, you give in to the pull of your instinctive need for needy, whiny friends.

Once you give in, you’re stuck. You like the close attention and some of the intimacy, but you also don’t like the high demands and expectations, so you want to pull away. That leaves you guilty, lonely, and more in need of a needy friend. The shitty friendship cycle remains unbroken.

Instead, get a grip and start to choose friends who are more independent and less fun to complain with. Don’t expect the getting-acquainted process to feel as natural and easy as it usually does, because if it feels too comfortable, you’re probably making the same mistake.

At the same time, discourage your current needy friends from expecting long windy complaint-fests. Keep the conversation positive, don’t share negative feelings, and stick to a schedule. You may be pleasantly surprised to find that needy friends get less sticky when you give them firm boundaries.

Don’t let guilt make you passive or discouraged. It may be impossible to change your relationship preferences, but you can have better relationships if you’re clear about what you want, force yourself to make better choices, and get the kind of friend you really need, not a needy friend.

STATEMENT:
“I feel like I’m a selfish friend who never gives as much as I get and resents the needs of others, but I believe I can do better if I find friends who are less needy. It’s time for me to find such friends, discourage needy behavior in others, and avoid indulging in it myself.”

My closest friend and I usually tell each other everything, and she always seeks my advice before doing something rash and probably dumb (she’s really ADD), and give it to her straight (within reason, and/or as tactfully as possible). The problem is that, when she wants to go forward with a decision she knows is risky (at best, really dumb at worst), I become the bad guy who won’t admit that I really don’t want her to be happy, even though, in reality, I just want what’s best for her. When she got together with her now-husband, I told her the situation was tricky (long-distance, financially rough, etc.), and when she stuck with it and complained to me about the whole thing, it was hard to be totally supportive. After a while, she took my worries about the nature of the relationship as me lying, actually hating her husband, plotting against her happiness, etc. So she didn’t tell me she was eloping hundreds of miles away until the last minute, and when I couldn’t make the arrangements with 10 minutes notice, she thought it was another lie, not a logistical nightmare. When I found out that I was the only person not told she was pregnant, that was the last straw; she said she wanted to talk about it, but her lying to me was so hurtful, unfair, and hypocritical that I didn’t see the point in trying to change her mind anymore, and it’s been months since we’ve talked. My goal is to do the right thing, and while I don’t want to hurt my friend and I miss her, my gut tells me it’s best to just let her live her life and protect myself from being hurt again, since she treats me like an enemy, anyway.

Whenever you find yourself giving a close friend constant coaching about her life, watch out. Intimate advice-giving makes a relationship feel very close and, at times, it may do some good; but you’re playing with fire or, more accurately, all the feelings your friend has towards her parents and everyone else who has given her advice and criticism over the years.

Given that she’s often impulsive (or so you’re implying), she’s probably received more than her share of disapproving advice and is touchy and defensive as hell. She doesn’t think you’re a liar—she thinks you’re her mom.

True, we shrinks give coaching and advice all day every day, but it works best when we keep it brief and business-like and don’t need friendship from the person we’re advising. When we start to care too much, we sound like parents and stir up the same damn hornets’ nest of negative feelings in those we advise.

Imagine, for a moment, removing the “tell each other everything” part of your relationship with your friend and then ask yourself whether the friendship might still be worthwhile. Yes, it would be less satisfying for both of you, but, if she really likes complaining about her life, she should get a dog (that’s my answer for almost everything). If you really like giving advice, become a shrink. Or a manicurist.

When the stinging goes down a bit, firm up your boundaries and see if your relationship becomes more positive. Say whatever honestly positive things you can possibly say about her husband, marriage, and pregnancy. Discount your months of withdrawal in a way that blames no one and signals no danger of confrontations—just wish her well.

Perhaps your performance will salvage the love and good times you’ve shared over the years. If not, you’ll hurt, but you’ll know you did the right thing, and that’s the truth.

STATEMENT:
“I feel unbelievably hurt by my friend’s shutting me out after we’ve been closer than sisters for many years, but I think she did it because we were too close, and not because she wished to hurt me, and there may be a way to build a better relationship. I’ll try to ignore the hurt, build on what was good, and see if a better kind of intimacy can develop.”

Like a lot of artists, I don’t think I’m good at anything else. I’ve been “the arty one” since I can remember, I went to art school on a scholarship, and I’ve gotten illustration work pretty steadily since then. Ever since my last job, however, I’ve started to wonder if I’ve lost it somehow. I got a steady gig in a graphic design department, and at first, I totally got along with my co-workers and we seemed to share a sensibility. Then, for some reason—maybe it’s my age (I was the youngest one), the new department head, an off-the-mark project I completed, I don’t know—the group consensus turned on me and I was treated like an untalented hack for the first time in my life. I’ve never dealt with this before, and I still don’t get it, because the higher-ups were still pleased with my work even if my peers decided it sucked, and I was always nice to everyone. The only thing that did happen was that I started to doubt my ideas more, because every time I’d come up with something I’d immediately think of all the reasons my co-workers would hate it. After a few months of this, I couldn’t take it anymore, so when a college friend told me there was an opening at his work, I jumped on it. The problem is that I still can’t get that negativity and doubt out of my head—maybe I am a hack, after all—and I’m terrified of starting this new job and either not coming up with anything good or not coming up with anything period until eventually I can’t get a job at all. I’m not good at anything else, but what if I’m not good at design anymore, either? My goal is to get my mojo back (or at least get these assholes out of my brain).

One of the curses of being talented, in arts or sports, is that talent becomes the heart of your self-esteem. Talent and ego have a flawed-yet-symbiotic relationship.

It’s particularly true if, like many talented people, you’re actually not so hot at doing other things. It’s as if your talent takes up extra brain-space, crowding out room for the basics and leaving you both gifted and klutzy, brilliant and ADD, hyper-capable and totally incompetent.

Other people might tell you that you’re good at other things, but those other people are wrong; they don’t have or understand an artistic mind. They had to decide on a career, whereas you probably felt like you didn’t have a choice. They also probably have health insurance.

What you’re “good at” is what you and others respect until you come to believe that nothing but hard work stands between you, success, and being a somebody. That’s when ego starts to assume you’ve got control over your artistic career when, in truth, no one controls art.

Even with all the hard work in the world, art is outside of your control. Sooner or later, you’ll perform poorly, perform well but meet an unresponsive audience, and/or get ill, injured, or misunderstood. And that’s when, if you rate yourself by performance, you’ll start to fear failure, and then fear the fear of failure, which is the fear of losing your mojo.

The feelings are awful and there’s no avoiding them. You can sense the rejection and feel your creative juices drying up, like you’ve lost your gift and can’t get it back. Meanwhile, you feel like there’s nothing good you’re good at. Without talent, ego feels like a total failure.

So here’s the hard part for people who want to do well at what they’re good at (and everyone else): develop a deeper set of values. You’ve already got the hard-work ethic for managing the controllable part of your gift—no need for improvement there. Now, learn to respect yourself for dealing with shit, which is just a technical term for that part of life that you don’t control.

Counter those fucked-up feelings with your beliefs; that you’ve done your best, and if you can’t do what you’re good at, you’ll do your best with other things. You’ll try to make a living and be a good friend. You’ll do what matters with what you’ve got.

Remember, what you admire most in others is not their ability to do great things, but to eat shit and still be a good person (unless, of course, you’re one of those shallow people who admire nothing but good performance, and then you don’t really have any friends and you’re probably an entertainment executive). Suck up the pain and remember who you are.

That’s the antidote to losing your mojo: redefining what you value. When you decide that mojo doesn’t matter, it comes back. When you care more about trying and less about results, results improve.

No one can stop the agony of unfulfilled talents, but the real challenge is to bear that pain, remember what you’re here for, and do what you can with what you’ve got until your ego’s healthy enough for talent to return.

That’s not easy to do—it’s a lot harder than being lucky and performing well—but it’s an art in itself, and a much higher achievement.

STATEMENT:
“I’m stuck with excruciating feelings of failure and self-doubt, but I have no doubts about my hard work or my ability to do whatever is necessary when I think it’s worth doing. I have no doubts about my ability to be a good friend. I will not let my feelings touch my self-respect.”

I can’t deny that I’ve had success as a musician—I’m well known in the area—but fashions have changed over the last few years and now gigs are far from plentiful. Financially, though I have a day job, I’m just getting by. I do my best to schmooze and talk up producers, but I’m basically a shy person who’s happiest to be alone, practicing. I know the economy is bad and every performing artist is having a hard time, but I can name at least 3 other musicians of my generation who are doing much better than I am because they’re more energetic and sociable and maybe more talented. I feel like a failure who’s wasted his life and watched his professional reputation ebb away and now I’m facing a sad end in a lonely rooming house. My goal is to turn this situation around.

As noted above, it doesn’t matter whether you’ve proven yourself as an artist; sooner or later, the pursuit of an artistic career exposes you to an unusual amount of shit you don’t control and, when that happens, it feels personal.

Fortunately, you’re too old and well-established to worry about the negative impact of your feelings on your music, and thus on your career, and thus on your music, etc. It’s good not to worry about the losing-your-mojo whirlpool.

It’s not much better, however, to fear that no one cares about your mojo, you’re facing a sad and lonely decline, and you’re sure it’s your own fault, as proven by the fact that your peers are doing better.

That kind of proof, however, is one of the nastier tricks the human mind plays on itself in the name of so-called reason. You know you’ve managed a good career for many years, in spite of a shy temperament, and you’ve never neglected the business side of music-making. You also know that other people’s gifts, both musical and non-, are different than yours. So real logic tells you that the only thing that deserves criticism is your luck.

If you believe in making music, you also know it’s a meaningful thing to do with your life, whether or not it pays. Remind yourself that no artist in his or her right mind expects to get rich and that living with poverty is part of your job description (though one you hope to escape).

Be proud of your choices and the good music that resulted. Keep with your successful formula, playing when you can and paying your bills when you’re able. Don’t doubt that you chose a tough life…and did well with it.

STATEMENT:
“When I’m poor, old, and gig-less, it’s hard not to feel miserable; but music is important, I worked hard at it, and I will not regret past or future sacrifices. Life is hard, but good music is forever.”

I was diagnosed with major depressive disorder and anorexia nervosa purging type a few years ago. Both of these issues had pretty much consumed my life during the years leading up to that diagnosis and have continued to be impairing ever since. I started cutting myself two years ago (it has become more frequent this past year), and I’ve had several panic attacks in the past several months. Fortunately, my overwhelming desire to commit suicide has subsided, although I still think of suicide and my death in general fairly often. In addition to my own issues, I have watched my mom slip into a state of psychosis during the past two years, triggered by the death of her father. She has become so depressed, delusional, and violent that my parents separated and sometimes I don’t even feel safe staying in the house with her—a few weeks ago my dad and I had to stop her from going through with a suicide attempt. The police were called, and I had to hold her arms down while she was clearly in a psychotic rage. At one point, she tried to stab my hand to make me let go. She was taken to a mental health facility where she stayed for a week, and now she’s furious at us for making her go there and hasn’t been much better since then. I feel like I never get anywhere with therapists because they just prescribe medicines that make me feel numb to any emotions or focus on my eating disorder so much that I never get to work through these other issues. I feel like my life is unraveling and it’s gotten so bad that, honestly, I don’t feel like I even want to fix it. My goal in telling you this is to figure out a way to help my mom and how to get through school while I’m dealing with this.

It may seem strange to hear this, for someone who suffers as much as you do from depression, anorexia, and the burdens of taking care of a very sick mother, but I think you’re doing an amazing job.

Yes, you’re chin-deep in shit, but you haven’t drowned, and that’s a remarkable accomplishment.

Your depression hasn’t made you hate people or blame them, and your anorexia hasn’t caused you to pretend you’re not sick, so you must have a solid hold on reality. There you are, with all your pain, finding the love to help your mother and the energy to go on with your studies. You’ve got good values and a big soul.

So you feel hopeless because treatment hasn’t done you much good, or, I should say, hasn’t done your symptoms much good. It sucks, but that’s the way it usually is when symptoms are as severe as yours. That doesn’t mean they won’t get better by themselves, or that a better treatment won’t come along. It does mean that, at least for the time being, you’re stuck with heavy-duty pain.

That’s not important, however, or at least not nearly as important as what you’re doing with that pain, which is, as I said, amazing, and there’s treatment that can help you distinguish between you and your symptoms. Any good cognitive treatment will help, whether it comes from a cognitive therapist, a good coach, or a friend with a positive attitude. One treatment that is aimed specifically at helping people with this much pain keep a positive attitude is Dialectic Behavioral Therapy, or DBT.

The inventor of this treatment, Marsha Linehan [link: https://www.nytimes.com/2011/06/23/health/23lives.html], suffered similar symptoms and, like you, managed to stay focused on the value of helping people and improving her own skills. She wound up inventing a kind of treatment that helps others do what she did for herself, and, like you, she found that helping others was a great way to keep her own demons in check.

It’s normal for you to feel that your life is unraveling, but trust me, it isn’t; your pain is a mess, but you’re doing a good job of bearing it and doing good things with it.

You are not your pain; you’re dealing with a lot of shit, but you are anything but. You’re the person who’s managing it while leading a good and meaningful life, and that’s not someone you should give up on.

STATEMENT:
“I may feel like a hopeless, deteriorating mess, but I love my mother and care about my education and I’m doing good things about both. I may not be able to stop my symptoms or save my mother, but life sucks and that’s not a personal failure. I haven’t let my symptoms stop me, however, and that’s why I’m doing well, even if my pain and my mother are doing badly.”

I have a great life and there’s nothing I care about more than my family, so I became really worried when, out of nowhere, I started to have horrible thoughts about murdering my children. I’m too ashamed to tell my husband. I’m not an angry person, and I love my kids and get along well with them, and I’ve never needed a shrink, but the thoughts keep me up at night. If there’s the slightest chance I could hurt my kids, I’ve got to do something about it, but I don’t know what to do. Please help.

Before you get crazy about having crazy, murderous thoughts, check out the risk factors for crazy murders. It’s not hard to do. What you’ll find out is that crazy murderers don’t just have intrusive murderous thoughts; they’re crazy as well.

By that, I mean they’re very detached, or they have strange ideas about their kids that they actually believe in, or they’re hearing voices, or going through extreme mood swings.

Ask yourself whether you fit the picture of people who really run amok. While I don’t know you, of course, my guess is that you don’t fit the picture at all, which means you run the same finite-but-small risk as your average Joe.

Trouble is, everyone who has intrusive, horrible thoughts without other symptoms of craziness is nevertheless terrified of losing control, so reassuring yourself is hard to do. What you want, of course, is total reassurance that the horrible thoughts will go away and that you’ll never, ever lose control; as you say, if there’s the slightest chance that you might hurt your family, you feel obliged to take definitive action. Unfortunately, you can’t. No one controls such thoughts, and trying to control them will just add to your helplessness.

Your goal then isn’t total reassurance or freedom from fear, but reasonable self-control and an ability to go ahead with your life in spite of fear. Assess the real risk you pose to your family and take steps to protect them if you think it’s necessary. Having done that (and realizing that your family is better off with you just the way you are, crazy thoughts and all), learn to bear your fear and go about your business, which isn’t easy to do.

If you want to tell your family about your symptoms, that’s the story you’d tell. You’ve got these crazy thoughts, but you’ve checked on the internet, and probably seen a shrink, and discovered you’re at no particular risk of doing harm, you’re just at risk of suffering from creepy thoughts. Reassure them that you have no intention of letting the crazy thoughts interfere with your normal activities and that, if you thought you were dangerous, you’d do whatever’s necessary to protect them.

As with the woman above, you are not your symptoms; a good mom can have crazy thoughts, and a great mom can carry on despite them.

STATEMENT:
“I feel like I’ve got crazy thoughts and might lose my mind but the truth is that I’ve checked out my symptoms and the part of my mind I’m losing is pretty small and insubstantial (although the process is scary and painful). Whether or not I can make my symptoms go away, I’m competent to manage them, keep everyone safe, and go on with my life, and that’s all I need to do.”

I have suffered from anxiety and depression much of my life. My most recent (and most devastating) bout was a couple of years ago, when I worked with a therapist and managed to heave myself out of it without the use of antidepressants (which I had been on in the past and want to learn to live without.) Now I find myself slipping back in. My biggest issue seems to be that I put too much stock in what others think of me or might think of me (I’m really good at fabricating things people might be saying about me.) I also had a baby last year, which has prevented me from pursuing my career fully, so when I hear of the successes of others (or see them on Facebook) I get very anxious and feel that the universe is unjust. I want to be a good mom, and I want to be good at my job, but I feel I am failing at both and resenting others who are great at either. I was made fun of a lot when I was a kid and I think I still carry some of this baggage around, like whatever decision I make is the wrong one because I’m basically a loser. How can I focus on myself and my own life without worrying about what everyone else is up to or what they may think about me?

While you already have a good idea of what to do about your negative thinking, you still need to protect yourself from two bad ideas that you express here. Unfortunately, those two ideas are also your “goals.”

First, disavow yourself of the notions that you should be able to stop depression without using medication and that you should find a way to be less, for lack of a better word, insecure. In doing so, you won’t be giving up—you’ll be giving yourself some relief.

The good idea, and better goal, is to train yourself to fight negative thinking, and there are lots of ways to do that. A therapist can help, but so can the right kind of friends, readings, church, and/or spouse. Though you can’t make the negative thoughts go away, you can assemble a strategy (and maybe team) to help you handle them.

Develop a routine for reminding yourself that you’re the one who’s managing your life and working with your unique gifts and disabilities, and that you’re the only one who can judge whether you’re doing your best. Then, when you start to compare yourself to the better gifted, give yourself a dose of positive reality. Nobody else can judge you, not even Facebook.

The sad truth is that depression could sweep you away, regardless of what treatment you use and how motivated you are in pursuing it. It’s scary, but it’s also liberating; you’re responsible for doing your best with depression, not making it go away. Cancer patients don’t set performance goals, and neither should you.

Instead, set your goals in terms of the process of managing, rather than the outcome, of recovery, using non-medical and other minimal risk treatments whenever possible. Then go ahead and choose riskier treatments if and only if you think they’re necessary. Don’t let fear or guilt prevent you from choosing what’s best for you.

Don’t always listen to your doctor, because your doctor doesn’t know how much pain your depression is causing or how much it has disrupted your work and relationships, so it’s your tough decision. All the doctor can do is tell you the relative risk of the treatment, compared to your symptoms, and what he or she would do in your place.

Embrace the fact that every parent with a career has to contend with bad feelings about difficult compromises. The challenge for you is to accept those bad feelings and the fact that there’s always someone out there who can do things better than you, then learn how to manage yourself positively and tell Facebook to go fuck itself.

STATEMENT:
“I don’t often feel good about my performance at home or at work, but that’s my nature. I’m proud I’ve taken on parenthood and that I’m doing OK, whatever my insecurities tell me. I know I try hard and that I’ve made good decisions and I will use those facts to lift myself up when depression tries to tear me down.”

I shouldn’t be writing you about my depression because I have no reason to be depressed. I’m a lucky person with a good job and great boyfriend. I eat a healthy diet, exercise every day, and work hard to stay healthy, mentally as much as physically. I had a severe depression as a teenager but I worked hard in therapy (and still do all I can to keep those negative thoughts at bay), took my medications as directed, and have been much better since. So now, 10 years later, there’s no reason I should be unhappy, tearful, and unmotivated to do anything but go back to bed, but no matter how much I exercise or try to stay positive, I can’t get ahead of this thing. I must have missed something. My goal is to figure out what.

The one big thing you’ve failed to understand is that depression, like most illnesses, can’t be controlled. You can be careful, do everything right, avoid giving into negative thoughts and actions, but still feel like shit. It’s not fair, but it’s the nature of the beast.

Just in case this sad fact depresses you, think about how, just like the person above, you’re depressing yourself even more by holding yourself responsible for staying healthy. Maybe you want to assume that awesome responsibility because you wish you had the power to stay healthy, but you don’t, because nobody does. Even those people who follow all the rules and work their butts off.

Luckily, staying healthy is not part of your job description; coping with illness is, so stop telling yourself you shouldn’t be depressed. What you should be doing is reviewing what you need to do to cope with depression, and realizing that you’re probably doing most of those things.

You sound like the kind of person who tries hard to keep working, relating, and parenting regardless of how you feel. If that’s true, you’re doing most of what you need to do already. You’ve probably talked things over and tried to figure out whether something’s getting you down that you don’t know about, which takes care of another basic self-management task.

Decide whether to try any new medications (see above case), using the same procedure you would use for weighing the risks and management of any treatment. Don’t be a sissy about your dislike for treatment—no one likes treatment—so just add up the risks and benefits, and don’t let fear make your decision for you.

Finally, keep working on how to think positively, beginning with the most positive statement of all: you aren’t responsible for your illness, and despite bad results, you’re doing your best. You’ll quickly discover you’re doing a much better job of coping with depression than you realize, and while the situation may still seem unfair, your efforts are all that matter.

STATEMENT:
“I never expected to get depressed again, but I realize now that I didn’t fail to prevent depression, I failed to give myself reasonable expectations and responsibilities. Now that I know what to do, I have little to fault myself for and I can be legitimately hopeful about finding new tools for managing depression.”

Please Note: Monday is also a fxckfeelings.com holiday. Happy New Year (and again, if/when it’s unhappy, you know the drill).

I’m a current student and I’ve sort of self-diagnosed myself as having an unusual kind of OCD. It started out four years ago when I was studying for an upcoming major exam. I had always been one of the few top students, but at one point in time in the midst of hours of straight studying, I couldn’t absorb any more info, and in a fit of frustration, a ball of emotions welled up and I actually said harshly in my mind to myself, “you shall FAIL!”, even though I’ve always tried to avoid such negative thinking. What came next was an unshakable, unexplainable, and annoying-yet-scary series of feelings, thoughts and emotions for the next few days and weeks. After that episode, I developed an irrational apprehension about me having “ruined” myself and my academic ability. To get myself back to my normal, anxiety-free mind when studying or doing anything related to studies, I imagined “transferring” the whole chunk of this mental mess on other stuff, whether it is the faces of people who did badly in academics in my field, to those I don’t like, etc. Still, my mind would automatically be inclined to have these random obsessions appear in my mind while studying, and it’s really prevented me from fully unleashing my full academic ability in subsequent grades. I really felt restrained and trapped by this, and my goal is to eliminate this strong-rooted (it’s been 4 years) mental condition that happens whenever I study and then makes it almost impossible.

Some OCD thoughts are crippling but come out of nowhere, like fear of contamination or making a mistake. While they often lead to compulsive rituals, like repeated hand-washing and fact-checking, you manage to keep studying. So, while you’re suffering, you’re still lucky.

The fact that your obsessive fears are tied to school may make them easier to deal with, because, unlike germs, school (usually) doesn’t go on forever.

School is built on mental constructs that attract obsessions like lint to a dryer vent; it’s got grades, grade-points, and exams that hinge on a word or the instructor’s interpretation of same. It invites obsession and obsessive argument, which can be torture, but at least it has an end date.

After school is over, you can find branches of almost every major profession that thrive on obsessional thinking, but you can also avoid them if you want; you’ll have choices beyond what courses you can take and how much to put on your meal card.

Also, the mental activity that sticks words in your mind as if they’re big, significant boulders is probably good for certain kinds of learning, and it’s not uncommon. Respected psychiatrist John Nemiah liked to point out that Martin Luther had a similar problem, and went on to start Protestantism (although his Catholic colleagues might not see this as a success).

The bad news, I guess, is that you’ll probably never “eliminate” your fear of certain intrusive thoughts. What you can do, however, apart from putting school behind you, is develop techniques for breaking into the vicious circle that enhances the power of whatever you’re afraid of.

In other words, if you’re afraid to think about something, you’ll think about it, and your fear will probably have a small negative effect on your performance, which will prove you’re right to fear the intrusive thoughts, which scares you even more. What a good cognitive therapist can offer you is a bunch of mental and physical exercises that either distract you from the vicious circle or remind you of your ability to deal with fearful events as they occur.

Get used to the idea that, like many people for whom ideas and words have a life of their own, you can be troubled by obsessive thoughts. You can’t get rid of them, or always prevent them from distracting you, but you can always stop them from changing your goals or failing to try your best and reach the finish line of graduation.

STATEMENT:
“I’m afraid that intrusive thoughts will prevent me from ever living up to my potential, but, if I have to live with them, I can do it. I will regard them as just one more weakness that I can learn to deal with as I go about pursuing my interests and trying to graduate and make a living.”

I do pretty well as project director at work, but I’ve always been troubled by thoughts that get in my head and just won’t quit. During the last year, I’d get haunted over and over again by the thought that I’d said the wrong thing to one of my colleagues and offended them. What I’d want to do was ask them if I had in fact offended them, but if they said no, I’d probably worry that my asking them had offended them, and I’d want reassurance about that, thus making it worse. Instead, I ask my wife, who listens carefully and reassures me…but then I think of something I left out of the story and ask her again, and make it worse at home instead of at the job. She’s a kind woman and understands I can’t help it, but, after a while, her patience wears thin, and then I worry about my marriage. My goal is to figure a way out of this trap.

A couple good things about your obsessive thoughts are that you’re used to them and they haven’t stopped you from succeeding at a tough, challenging job. The bad thing is that your technique for diminishing painful self-doubts has gained a hold on you and, if unchecked, could trap you in a dangerous vicious circle. Instead of washing your hands, you’re using the Purell of reassurance to wash your mind of guilt.

If you read up on obsessive compulsive disorder, you’ll learn that the behaviors for reducing painful thoughts (like your reassurance technique) are called “rituals” and they can get out of hand. The treatments for controlling them are a lot like the one invented by Mel Brooks’ comic alter ego, Dr. Haldanish, who cured a young boy of a paper-tearing habit by yelling at him not to tear paper. Which is to say, an absurd-seeming disorder has a similar therapeutic approach.

The goal of these treatments is, simply, to help you stop the ritual, even if this causes more short-term pain and doubt. The therapist may give you reassuring thoughts to repeat or exercises you can use to distract or calm yourself. In extreme cases, the therapist may actually accompany you and directly encourage you to refrain from the ritual (alas, Mr. Brooks doesn’t do house calls).

If you think there’s an element of truth in your concerns and that your speech with colleagues is too negative when you’re stressed or find yourself worried, angry, or unhappy, coaching would also be helpful. You may discover new ways to keep your statements positive, while being direct about tasks and responsibilities.

If you were really offensive, however, you’d be getting more criticism at work and at home, and you aren’t. On a professional level, that’s really your standard and it’s one you want to think about and reinforce as much as possible.

Your goal isn’t to make your doubts go away, though that would be nice; it’s to have respectful conversations at work, even when you’re stressed, and feel confident about your ability to have those conversations. And to keep all paper intact.

STATEMENT:
“It’s hard not to ask for reassurance when I’m haunted by doubts, but I have my own good standards for professional behavior and, so far, I know I’m meeting them. My job is to make them stronger while I tolerate the doubt that seems to be part of my brain chemistry.”

Helping my daughter pay the rent on a bigger apartment seems to have lifted her out of her depression and she’s much more active at her job, but she’s still not making enough money and I’m running out of cash. If I tell her that she has to take a roommate, I’m afraid she’ll just crawl under the covers again and we’ll be back where we started. It shouldn’t be that hard for her to make enough money, but it is. I’m mad and I’m stuck. My goal is to get her to make more money and/or understand that I can’t keep supporting her like this.

While you may think you’re giving your daughter money out of love, you’re actually doing it out of fear. That’s trouble, because when you give money out of fear, you’re usually being mugged.

Fear makes you forget long-term risks, like what you’ll do after you run out of money and the consequences for you, her, and other people who depend on you. Your love is infinite, but your finances aren’t.

You’ll also forget that your daughter may be able to do more for herself now than she could before. She may be able to tolerate more stress and access other resources if yours are less available.

Finally, your fear amplifies her fear and vice versa, until you both doubt that she’ll be able to survive without your current level of support, without there being any evidence of that, other than fear itself.

If you want to manage her disability, rather than be managed by it, you must continually test out what she’s capable of. If she’s stressed by looking for a roommate, coach her on how to do it or how to find a coach. If the roommate is hard to live with, advise her on ways to protect herself. If you protect her more than absolutely necessary, you’re just stifling her growth in the long run.

After all, you’re not responsible for relieving her stress, but for teaching her how to live with it. You’re trying to ensure her basic safety and security, and while you wish she could be happy, that’s not something you or she control.

If she’s afraid of slipping back into depression, point out the constructive things she’s doing to prevent it. Stress may make her feel overwhelmed, but that doesn’t necessarily cause depression or mean that she’s slipping back. It just that means life is hard.

Don’t let her panic incite yours. Instead, think up an emergency, affordable bail-out plan in case she has a bad relapse. Don’t share it with her, just remind yourself that you know what to do for her safety and that the pain she may experience as you cut her funding is an unavoidable part of her recovery and your solvency.

By giving no more than you think is necessary, you become a strong fear-manager and learn self-defense against an emotional hostage situation. Ultimately, that’s the skill you want to give her.

STATEMENT:
“I’m terrified of the stress my daughter will experience if I cut back on the money I’m giving her, but I’ve thought carefully about what she needs and I’m sure she’ll be stronger if she can cope with the stress and do more with less.”

My 22-year-old daughter is mildly retarded, but she’s pretty well taken care of. She’s not unhappy—she worries about things much less than I do—but I’m unhappy, because I’ve never felt comfortable with her. Most people think she’s sweet and docile, but my daughter very much has a will of her own; she doesn’t like to shower, she doesn’t care about other people’s feelings, and she has no idea of how people are reacting to her, or anyone else. I’ve tried hard to find a point of positive connection, and failed. Other people think I’m a great father, but I can’t get over the feeling that I never met this challenge and that there’s unfinished business between my daughter and me.

Regardless of whether your daughter is retarded, super-powered or “normal,” you can never be sure that you’ll like her. It’s so much easier to be her father if you do, but that’s never a guarantee.

It may be that no one would like her if they really knew her, but that doesn’t matter. It sounds like you’ve tried hard to like her, but you don’t, and it’s not in your control.

Given the lack of good chemistry, however, you should appreciate your achievement all the more. You haven’t punished your daughter or told her she’s a failure; on the contrary, you’ve taken good care of her. You’ve done your job under much tougher conditions than most parents have to deal with, and I don’t mean because she’s retarded, but because of your negative feelings for her.

The test of a good teacher isn’t how well she teaches the kids she likes, but how well she does with the kids she doesn’t like and how well she hides that fact.

If this were the movies, your business wouldn’t be finished until the two of you have a good hug. Since this is real life, it’s never finished, so every day, do your best to treat her with respect and friendliness. If you slip and get nasty, apologize. It’s one day at a time.

It’s certainly sad that you couldn’t like her more, but it’s not a failure. It’s a success that, in spite of that, you treat her right, and one that only a great father could achieve.

STATEMENT:
“I will never feel comfortable with my daughter and I will always suspect that, if I were a better person, I would; but I am who I am and she is who she is and I’ve done the best job possible given that simple fact of life.”

I have been struggling with performance anxiety for years. It was particularly difficult during university, where I saw three psychologists, including a campus counselor, who, while supportive, weren’t helpful. It got much better though when I was able to take control of a treatment group I was facilitating, where I could design the program and run it the way I wanted to. I enjoyed being the therapist who helps others, and the experience gave me confidence. Still, the anxiety has not been extinguished in all situations—when teaching and presenting at conferences, the anxiety in these two areas is just as high as it was previously. I have been managing this for a long time and I do not feel motivated to continue to place myself in situations where my anxiety is raised again so high that I experience nausea, stomach pains, dry mouth, etc., not to mention the exhaustion I feel after the anxious-provoking event has finished. I do have some mild/moderate social anxiety—I don’t like socializing in big groups unless I know the people, and this prevents me from making new social contacts and networking for my profession. I am well versed in exposure therapies and ACT and have used these to get me to the point I am at now, and I continue to use them. However, I don’t think my anxiety will ever improve beyond where it is now and I am too exhausted to continue to try. I guess I’m stuck and don’t know if I should try to find a specialist to help me to continue to force myself to network, push myself to present at conferences, and become an academic psychologist or move into working as a clinical psychologist in a private practice, where I would work more on my own and I would be happier and more relaxed but also know that I am avoiding the events that are anxiety-provoking.

Maybe being in the mental health business makes you feel more responsible for controlling symptoms of anxiety and becoming a role model for good mental health. It’s ironic, given that most people in our field are the worst role models for mental health. If we were totally sane, we’d just go into dermatology and rake it in.

If you are driven to perfection, it’s causing you to forget that certain symptoms, like anxiety, tend to be incurable, and that, if you’ve reached the point where you can’t make them better, it’s because you’ve done an amazing job of managing them and pushing yourself to the limit of what you can bear.

That you’ve pushed yourself so hard during a long educational process may have caused you to become academically institutionalized, i.e., to rate your progress by where you stand in the institution (not the other, less fun kind).

You’ve become the very model of an up and coming academic psychologist, but now that the institutional phase of your life is no longer a requirement, you have a wider array of options and no easy reference points. You don’t have to present papers or schmooze colleagues if you don’t want to; that’s not avoidance, unless presenting papers and schmoozing colleagues are part of the life you want to lead going forward.

You know what they call the PhD who came in last in his class? Doctor. Sure, it’s a nasty MD joke, but the fact remains that your degree sets you free, offering you many different career options and you’re now familiar with most of them. Ask yourself how much money you need and then rate your options according to how well they pay, and how much you might enjoy them. Then, when you consider the amount of anxiety each will require you to bear, you’ll know whether it’s worth it.

Remember, like its first cousin, depression, anxiety causes your brain to focus on helplessness and failure rather than achievement and courage. It will tell you that treatment has failed and that you’re a failure if you don’t act normal, but wisdom tells you that you’ve already accomplished your biggest academic goals, in spite of great obstacles, and reached the point where you can finally put your own spin on life.

Be proud of what you’ve done, and don’t mistake anxiety and fatigue for discouragement; they’re challenging you to recognize what you don’t enjoy doing, and there’s no shame in choosing the career path of least (torturous) resistance.

It’s up to you, however, to decide what’s meaningful enough to be worth the pain. If you can maintain a practice despite your own struggles, you’ll be a role model, with or without symptoms (or an MD).

STATEMENT:
“I feel like I’ve failed to conquer my anxiety, but in reality I’ve done everything I set out to do, other than get rid of my symptoms. Now I’m in good position to decide what I want to do next and confident that I can bear whatever unavoidable anxiety goes with that choice.”

Whenever I screw up at work, it causes a chain reaction of even more fuck-ups until fate mercifully intervenes. The most recent incident started when I miscalculated the logistics of a project and ended up forcing another department to work overtime to make up for it. The department head was understanding, but I was so pissed off at myself that I actually couldn’t sleep at night, and that made me late enough for work to miss at least one really important meeting, so now I’m of course thinking that this time I won’t get lucky and will actually lose my job. There’s got to be a way to fix this myself.

It’s certainly unpleasant to make mistakes (that make mistakes that make mistakes), but don’t lynch yourself before you conduct a proper trial. It’s possible that your pain is torturing you to confess to crimes you didn’t commit, just because confession makes you feel better and provides a cheap sort of redemption.

You don’t need a judge and jury to conduct a proper trial on your own conduct, just rules that you believe in (i.e., that you’d apply to a friend) and an ability to review your behavior.

You’d expect a friend to take reasonable precautions to avoid making the same mistake twice; your standards, after all, are for his conduct to be good enough, not perfect. So you wouldn’t assume his miscalculation, the overtime, or his missed meeting were easily avoidable unless he hadn’t followed procedures that he should have known about. At least, those are the rules I think you’d use, but you be the judge. It’s your trial.

Then ask yourself what you should do if the verdict from your trial is “not so bad” but your heart still proclaims you a loser who should embroider a scarlet L in your shirts. That’s when you have to give yourself some good coaching and dismiss your heart’s request for an appeal.

Remind yourself that challenging projects always expose you to the unforeseen and congratulate yourself for taking responsibility and working hard, and give credit to your boss and co-workers. Apologize, but only once.

Be aware that frustration and humiliation, like anxiety (see above), make you think of the should-haves and could-haves without regard to actual, reasonable responsibility. They trigger a lynch mob in your head, but you’re not just the law, but order, and justice will overcome.

STATEMENT:
“I feel frantic when things go wrong and I’m sure I could have or should have prevented it, but I’m also capable of deciding what my real responsibilities should be and standing by that decision.”

So I’m a 20-something girl who has been faced with a couple big problems in a short period of time, the first being that I am in my last semester of nursing school and I failed. This has been a very long hard stressful experience, and being faced with failure is devastating. I have to wait till September to try to get back into the program and that’s my last chance, so I’m having a hard time accepting that my very laid-out plan for my life is now in jeopardy. Also I am being faced with health issues, with myself and with my family, and finally, I have been in a mind-fuck of a relationship for three years with a person that shows me five different faces. I know all the ways he’s done me wrong but I cannot walk away because I have yet to conquer him, even tough I’m trying to accept the fact I cannot change him and need to stop being a doormat. In summary, I have obvious control issues, over-analyze everything, have anger that is uncontrollable if I don’t get what I want, and really need help to fix it.

Priorities are like dominos, and if you put the wrong one first, you lose your goals one by one. So, while this may look like a chaotic clusterfuck of issues, you probably already know that it’s actually a chain reaction caused by putting school behind this five-faced jerk.

After all, the main source of your strength is your desire to get stronger, pick up skills, and make a living, while the main source of weakness is, as usual for most people, your need for something/someone you can’t have.

Fortunately, you’re smart enough to recognize your effort to change your boyfriend is a compulsion that you just can’t stop, and you have the willpower and determination in your character to take on and pursue difficult goals.

Unfortunately, you’ve focused this strength on changing your boyfriend, thus throwing said smarts and willpower down the shitter.

In addition, you expect to control your school performance and your relationship without bowing to the fact that you don’t have the time or energy for everything, but your school performance won’t improve unless you have more time for it, and your boyfriend, well, we covered that.

Besides, you can’t “conquer” someone; even actual conquerors like Napoleon don’t die happy (or even with their genitals intact).

When you give yourself a reasonable assignment, your control demon helps you do a great job. If you don’t put a limit on your self-assignment, your demon will eat you alive. It’s a tough reality to accept, but if you can—not just admit that you can’t change your boyfriend, but find the strength to stop trying—you can give yourself an assignment you can do, and do well.

You’ll probably do better in school if you stop blaming and scaring yourself, because that can’t do wonders for your ability to focus. Instead, don’t be ashamed to look for help, either from a nice, positive tutor or a study group, and prepare a new study plan that helps you with your weaknesses.

No problem, you’ll have the time, because there’s no reason to continue wasting it with your boyfriend. This is probably not the answer that you want, but it’s the only acceptable one since succeeding in school means more to you (and is more tenable) than putting up with quintface.

Inside, it may feel like a defeat to let him go, but once you do, all the other, better goals in your life will have room to grow. You just need to stay vigilant about your priorities, because it’s amazing how easily a compulsive person can make them all fall down again.

STATEMENT:
“I feel like a total, helpless loser, but my priority is to put my energy into getting ahead, and not into relationships that don’t work. I can’t conquer my boyfriend, but my compulsion can’t conquer me. I’ve learned a valuable, painful lesson that can help me move forward if I stop criticizing myself and start doing what I need to do.”

I had a terrific boyfriend, whom my parents loved, but I just couldn’t see us staying together all our lives, and my feelings for him weren’t as positive as what I see my parents’ having for one another (they have a wonderful marriage). So I left him and broke his heart, and now I’m dating someone I feel closer to, because I think he understands me better. We’re going very slowly, however, because I’m afraid of making the same mistake, and I want to see if I still feel the same way about him in another year. He’s getting impatient, and I wonder if you think I’m right to go slow.

I suppose the traditional reason for going slow in a relationship is to see how you really feel about someone as time goes by. Still, that won’t do you much good if you happen to really love him a lot, and he’s a useless jerk.

Yes, it would be nice if you could find someone you love as much as your mom and dad love one another; but many good partnerships are not totally lovey-dovey, and good partners are hard to find. Begin then with the important stuff and consider perfect harmony as the icing on the cake, rather than the filling.

So, instead of hooking yourself up to a love-meter and graphing your progress as time goes by, tthink about the basic qualities you’re looking for. Again, priorities are key, but if a relationship is your main goal, then looking for the right things in a relationship is what you need to be mindful of.

The important stuff that makes a prospective partner eligible for consideration, as you know, begins with a solid character, reliability, common values, and mutual acceptance. He’s got to be able to do his share and share your mission, without your having to change or persuade him. Otherwise, it’s a no-go.

Yes, positive chemistry is necessary, but it can also be dangerous; the guy who connects with you most is not necessarily a solid character, and often the exact opposite. So take your eyes off the love meter long enough to do your due diligence.

If your guy checks out as a good prospect, but the emotional fit is not quite as perfect as your parents’, think carefully about how many good guys you’ve run across and how much mileage you have left on your dating tires before deciding whether he’s worth the compromise.

Don’t wait for the love-meter to make your decision for you while you pick mental daisy petals to see whether you love him or love him not. Add up the reasons you trust him to be good company in hard times, and prepare for a possible compromise.

Yes, you may cry a tear for the loss of romantic dreams; but you’ll have far fewer tears in the future, when the stakes are much higher. As we always say, if you want unconditional love, get a pet. If you want a partner, get your priorities straight.

STATEMENT:
“I don’t want to break another guy’s heart because I don’t love him enough, but t won’t let my worries stop me from checking out his basic strengths and deciding whether we have the makings of a good partnership. When it’s time to decide, I’ll use my wisdom and experience rather than measuring my love against my parents’ romance.”

My brother is really an upbeat, cheerful, friendly guy, but he turns into a viper whenever someone tells him what to do, even when it’s sure to get him into lots of trouble, and afterwards he’s convinced he’s been calm and diplomatic. When he and his wife got divorced, he was so argumentative with the judge that he lost custody of his kid. When his boss asked him to do something stupid, my brother fired off emails to Human Resources declaring he was being unfairly attacked. The funny thing is, he doesn’t mind when I tell him he’s being stupid, and the next time something happens he’s sure he’s done better; but he hasn’t. He’s not nearly as difficult as he seems to be, so my goal is to keep him out of trouble.

God bless the antagonists, for they know not what bile they speak.

Whenever someone is particularly quick to resist being pushed, we assume there’s an emotional reason for his actions, and that understanding why will help him to control himself, or help us shut him up and make him more tolerable.

Truth is, we often can’t explain or control oppositional behavior, which suggests there’s a basic force of nature driving some people to be reflexively, unthinkingly oppositional.

It’s actually on the spectrum of Asshole ™ behavior, but, since it lacks the malice required to actually fulfill the Asshole criteria, it remains a general pain in the ass, especially for those people, like you, who are close to him.

Maybe the Oppositional Instinct springs from a genetic trait that spurs creativity or guarantees that not everyone will follow the leader of the human herd, thus guaranteeing that some will survive if the herd leader is fatally wrong. The Bible’s Abraham certainly wasn’t a get-along kind of guy, Steve Jobs wasn’t a people person, and no shrink with a blog fxckfeelings.com is eager to go with the professional flow. Most of the time, however, instant opposition doesn’t win friends among authority, co-workers, family, and/or most mammals.

Since their actions are often infuriating, we think oppositional people must be furious, but in reality, they’re often just doing their thing, taking courage from the fact that everyone else is getting mad and is therefore the irrational party. You can’t try to change your brother then, or teach him how to protect himself.

Short of averting your eyes, you can help other people who care about him—the victims of his accidental provocation—most of whom will hate and love him in equal measure. Friends will feel he wasted their help and ignored their advice, family will blame him for endangering their security, and they’ll all speculate about the impact of the things they could have or should have said or actually did say.

If you brought them together in a support group (or did individual sessions), they’d discover that everything had been said, more than once, and it did no good. It’s sad, but, on the other hand, no one failed.

While you and those who related can help each other deal with the pain (in your ass), sadly, you can’t stop him from being an ass in the future.

STATEMENT:
“I can’t help feeling that I could save my brother from his worst problems if only I could get him to shut up, but I know better. The best I can do is appreciate his better qualities and accept the fact that it’s probably more painful to watch him than be him, since he’s always doing what he knows is the right thing to do.”

My father is the kind of guy who would always complain about my mother (his ex-wife) to my face, even when I was little, but, if I objected, he would get mad at me for being ungrateful and unsympathetic. He still does it now that I’m an adult, and there’s got to be a better way to deal with him then just avoiding him so I don’t have to hear it. My goal is to set limits on him that will stick.

While you may be in a unique position to know that your father has good reason to be hurting, you also know, from experience, that airing grievances repeatedly is a good definition of whining. It may provide your father with temporary relief, but it also binds him to his role of victim/husband in a relationship that’s long over.

The fact that he attacks you for not being sympathetic is the icing on the cake, as far as proving the unhealthy nature of his kind of venting; he widens his victimhood by sucking his near and dear into the role of villain. OK, I know he can’t help it but still, it’s not good for you to have this kind of conversation.

You’re right to want to stop it, and telling him how unhealthy his father-son venting is is a start, but you need stronger weapons than reasoning with him about his violating a parental boundary. In order to prepare, ask yourself what you’d do if he ignored your wishes and crossed that line, and be ready for when it happens.

List the reasons that you believe it isn’t good to listen, even though he believes, in his heart, that this makes you a hard-hearted kid. You know your listening does no good, brings out nothing good in him, and has you walking on eggshells. You also know that you won’t get him to understand this point of view.

Ironically, once you believe in your own values, over and above whatever your father tells you, you’re an adult, not a kid. It’s as an adult that you tell him it’s not a good subject to get into and you don’t’ want to talk about it. Knowing that he’ll object, and refusing to explain, is what an adult does.

So what’s important is not what you tell him, but what you tell yourself. If you believe that what you’re doing is best for everyone, then your silence speaks louder than words, and distance won’t be necessary.

STATEMENT:
“I’ve always felt trapped by my father’s complaints and confessions, particularly because he jumps on me if I don’t listen, and I can’t help but feel guilty. I’ve thought through the consequences of his actions, however, and my sense of what’s right is stronger than the guilt reflex he can always make me feel. As long as I stick with what I know is right, I’ll never be trapped.”