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.”

I’m a 22-year-old who is coming out of a pretty rough emotional patch. I got into a bad habit of leaning on a male friend, being a complete needy, co-dependent mess with a guy who is a pretty heavy drinker and, you guessed it, a needy, co-dependent mess. Well. Now I’ve sobered up and tried to develop some space between us, and he’s not taking it well. He drunk-dials me at least once a week, and leaves these crazy, rambling, needy voicemails. (I moved away a while back, and he keeps pushing me to make plans to meet up.) I basically want to cut him out of my life altogether, because I really think he’s bad for me. But he was there for me—albeit in a f*cked up way—when I was a mess. Does dropping him make me a bitch?

There are two sides to every sin; for example, murder is evil while manslaughter is just really unfortunate. The same is true for good deeds, and fidelity, while less deadly (hopefully), works much the same way.

There’s a bad kind of fidelity based on feelings and a good one based on what you think is right. The bad one is a gut-level sense of obligation you feel towards anyone you’ve shared a bed or bread or booze with, who cries out to you in need and expects you to respond.

It’s some kind of basic nervous system bonding that disregards whether you’ve already done your share, whether the other guy can actually make use of your help (or will just need more and more), or whether you have a right to weigh his needs against other priorities, like finding a relationship with a guy who can occasionally walk in a straight line.

Now, if you were judging the conduct of a friend, you’d probably say that you’ve done all you can, but until he stops drinking, you can’t offer much more. He may see you as dumping him, but what you’re dumping is not him, but his alcoholism. You might like him better if he got a grip and got sober, but you won’t know unless he does.

However, since you’re not using the rational side of your mind, leaving him makes you feel like a bitch and you need someone to tell you you’re not. Instead, you’re getting someone who will tell you to think for yourself.

Don’t ask anyone else for that kind of reassurance, not even (or especially) over the internet. Learn to give it to yourself, because your values are fine. You could confidently advise a friend, so stand by what you know and give yourself the same advice you would give anyone else.

Yes, you’ll still feel like a bitch because feelings are feelings. If your goal is not to feel guilty, have a drink (which will eventually make you feel even more guilty, so you see our point).

On the other hand, if your goal is to be your own woman and give yourself the right to weigh moral priorities without having to please or appease, then suck it up and do what you think is right. Until he stops drinking, he’s dead weight to you, so drop away. If he picks himself up, then you can, too.

STATEMENT:
“I hate to feel like I’m causing pain to someone who has been good to me, but I’m tired of being manipulated by guilt and other people’s needs and I have a right to say “enough” when I’ve done my share and want to move on. I’ve learned how to stop drinking and I’m ready for the next level of sobriety, which is to tolerate the guilt of feeling responsible without giving into it.”

My mood is never great, but I’ve survived divorce (my wife decided she liked someone else) and been a responsible dad and I was looking forward to being a grandfather when my middle son, who’s never been too happy, told me our relationship sucked and he didn’t have much hope for it unless I went into therapy. He had some names of spiritual therapists and told me, if I was really serious about making our relationship better and becoming a good grandfather, I should see them. Of course, I’d do anything for our relationship, but this whole thing makes me feel depressed and paralyzed. What should I do if my goal is to hang on to my son?

Kids come first, but that doesn’t justify turning off your own judgment. Which is what you did the minute you heard the words “spiritual therapists” and didn’t giggle out loud.

You don’t have to read my advice (though it helps) to know that you’re not supposed to accept criticism uncritically; otherwise you’re handing out keys to your self-esteem to every overbearing and unhappy jackass you meet, whether or not they’re your spawn. You’re supposed to consider accusations carefully and decide for yourself whether there’s really something you could have and should have done better before deciding whether to apologize and take responsibility for doing better.

What may have hurt your son is something you don’t control, and that includes the personality that the good lord gave you. He may have grown up happier with another dad, but you may have been happier with another son, and we all might be happier with a prehensile tail. Too bad, life is hard, and the only question to ask yourself is whether you managed your faults as well as you could and took care of your son’s basic needs, including safety.

Let’s assume that, after considering his criticism, there’s something you want to improve. Then choose someone who you think can help you do the job; don’t accept your son’s recommendation because you want to please him or prove something, but because you think it’s a good idea.

Regardless of what you decide, there’s a lesson you can teach your son. It’s not just that you’re flexible or that, no matter what he thinks, you really love him; it’s that you have confidence in your love for him, regardless of what he thinks, and that you can have a positive relationship in spite of obvious and painful flaws that you would gladly remove if you could, but can’t. He can call it spiritual if he wants, but you’re calling it like it is.

STATEMENT:
“Nothing makes me feel more like a loser than having my kid tell me I was a bad dad, but I know I wasn’t that bad (I got better reviews from the other kids) and I’m not bad now. I’ll accept responsibility for mistakes I control; for the rest of it, I love him and think our lives will be better if we have a relationship, even if it requires us to bear some pain. The choice is his.”

I’ve always been close to my younger brother but I kept quiet about my objections to the woman he married, although she sure came with baggage—a mean ex-husband and 2 unhappy kids. Recently, however, it turned out that the mean ex-husband wasn’t entirely wrong, and she is indeed self-centered, bossy, and nasty and shows very little respect to my brother or, in one memorable episode, our parents. When she cussed out my mother, I’d had enough, and let him know I thought she’d gone too far. Since then, as you might guess, my brother has not been eager to talk to me and certainly doesn’t want to talk about his marriage, even though my main feelings for him are positive and protective. I would do anything to get him to seek help, since he won’t talk to anyone in the family, but I don’t know how to get through to him. So how can I get him to talk to someone?

There’s a common notion that shrinks are good at getting through to loved ones who won’t listen to anyone else; that a psychiatrist can double as a spiritual Sherpa, able to guide the stubborn up Mount Issues to the Summit of Personal Insight.

What people forget is that shrinks aren’t Sherpas, we’re strangers—we lack facts and a vivid, first-hand impression about whatever the rotten thing is that they should be advised against—and there’s no reason to believe a stranger can succeed where a sibling can’t.

All we know about our patients is what they tell us (supplemented, maybe, by second-hand accounts from their relatives, whom we know even less about), and if they don’t see a problem, even if you do, they wouldn’t tell us about it in the first place.

The other problem with counting on a professional third party to talk sense into someone is that confrontation often drives defensive patients away. Unlike you, however, we won’t be seeing one another at family events for the rest of our lives.

So shrinks don’t mind acting as messengers—everyone has to make a living, and we aren’t being asked to lift heavy furniture or sing—but it doesn’t work, and it isn’t free.

On the other hand, you might do better at getting your own message across if you could keep your negative feelings under control and adopt a professional stance. After all, professionalism isn’t about not having feelings for your clients/patients, it’s about keeping those feelings out of the conversation while helping someone think through their best interests.

As much as you want and feel entitled to share your negative feelings of disgust and outrage with your brother, put them aside for the greater goal. Instead, talk to him about your wish that his marriage work out well for him and ask him whether the partnership has developed the good, positive things he hoped for, more than enough to outweigh the “baggage” of his wife’s other obligations.

If he bristles at the mere mention of baggage, take a step back and focus on his needs again. If he sticks with you, proceed with caution and watch your word choice carefully. After all, semantics are everything during a tense negotiation, so, when talking professionally about his asshole wife’s bad behavior, do NOT call it bad behavior. Talk about it as “conflict” or “difficult feelings” or “control problems.”

Again, take your lead from him, alluding to her problem if and only if he sees her as having a problem, and describing her as a good person who has less control than one would wish. Make it clear you only want good things for both of them, even if what you really want to do is tear both of them brand new assholes.

If he worships her absolutely, then the conversation will be short. Chances are, however, that your brother holds his wife partly accountable and wishes to talk about her problems, but can’t until he’s assured you won’t condemn her.

Stay focused then on the state of his union and whether or not he can help her to change. Assuming he hopes that she can and you know better, urge him to consider what he’ll do if she can’t. He has to Sherpa is own damn self, but your job is gently getting him to realize that there’s a hike in the first place.

STATEMENT:
“I hate to see the way my brother and our family are disrespected by his wife, but I have the experience and skills to stay positive while I urge him to think about what he can do, if anything, to make the situation better for everyone (including his wife) and whether or not this partnership is likely to go where he wants it.”

I like to do things for people, but sometimes I spread myself too thin, and my friends sometimes accuse me of not delivering on my promises, and sometimes they’re right, which just makes me feel superficial and disloyal. When I try harder, however, I then find myself promising even more and delivering less, so I just can’t seem to prove myself. I wonder what’s wrong with me that I keep doing this to myself.

Focusing too much on your promises, particularly when you like to give, will usually draw you into a cycle of over-commitment, broken trust, guilt, and, of course, a renewed need to make more promises. The need for redemption (like message-delivery, see above) is a major source of my business.

People who like to do good often assume that the opposite is doing bad, or not doing good enough, or failing to keep your promises, when, in reality, it’s not that big a deal, particularly when you consider the many things you don’t control that don’t reflect on your character whatsoever.

You might think you gain control of your goodness by making promises—keep them, and you’re a good person, entitled to self-esteem—but the opposite is true, because of that little problem, mentioned above, of your having imperfect control and being obliged to do lots of other things, and not enough time to do them. The more control you want, the less you get.

What counts most is keeping commitments with people who depend on you the most—who make the most commitment to you—and doing what you can with what you control while taking into account other commitments to your own survival and betterment. In other words, while it’s not an easy thing to do, it’s important keep your priorities straight.

So, instead of letting guilt or a need for redemption push you to over-commit, learn to improve your self-management. Take commitments under advisement, consider your resources and other promises before opening your mouth, and respect your good intentions without submitting to them automatically.

When it comes to performance ratings, use the same system you would use for anyone else: whether you’ve been doing a good enough job at being a self-supporting person and friend and relative, given what you’ve had to put up with and the resources at your disposal.

If you rate yourself after careful thought, rather than relying on the flushed aftermath of having done a good deed, you’ll give yourself better management and steer clear of many troubles. You won’t be driven crazy by the need to be good if you learn to be satisfied with doing your best.

STATEMENT:
“I always feel better about myself when I can do good for others and I hate not keeping my promises, but I know it’s not the worst thing in the world to over-commit and I’ve developed my own standards for deciding whether I’m working hard enough at being a good friend and making the world a better place.”

I have a friend who has a history of being diagnosed with depression, self-mutilation and, recently, suicidal thoughts. She was forced to seek treatment with a counselor in HS (now 24-years-old) whom she said was no help, and now she says she won’t ever seek treatment again because it won’t help her. She acknowledges she has issues that need addressing, but she doesn’t believe in mental illness diagnoses, states she just needs to “deal” with it. However, all we talk about is how much she hates her life, hates feeling this way but isn’t willing to do anything about it. I’ve told her she’s an adult, and makes her own decisions and no one can force her to do anything, but I’ve been very honest with my concerns about her, and that she needs help. I don’t want to treat her with kid gloves or enable her but I also don’t know how much I can push her, since I know its her mental illness that’s clouding her view of the world/reality. How can I continue to be a good friend without beating my head into a wall and enabling her?

For many people, “help” and “cure” have become interchangeable words, as if good motivation and proper treatment will always make things better (tell that to the common cold).

Sadly, the help your friend needs, just like a cure for what ails her, may or may not exist, depending on her luck, the severity of her issues and whether she sees them as hers or just a reaction to other people.

Regardless of treatment, the normal course for severe problems like depression, eating disorder, and urges to hurt yourself are the same; off and on, for many years. There is certainly no cure, and very rarely can anyone provide the help to stop recurrence completely.

Don’t then assume that treatment would make your friend feel better if she were “willing to do something about it,” because, unfortunately, this might not be true. After all, she was willing to try something, and it simply failed to take.

Instead, find out what she knows about the various kinds of treatment available to her and what she thinks about their possible benefits and risks. If she lumps them all together as useless because the one didn’t work, you have good reason to warn her against the power of negative thinking when people are in pain and/or depressed.

If you can persuade her that depression-pumped negative thinking has clouded her judgment into fearing and avoiding options that are worth exploring, you’ve also provided her with some excellent cognitive therapy and shown her that she needs it—a beneficial trifecta. If not, you’ve shown yourself that she’s too negative to be logical, you’ve been as helpful as you can be, and you just can’t get penetrate her depressive pseudo-logic.

Never buy the idea, however, that you have to get better to get better. If she has, in actuality, exhausted all likely treatments and nevertheless keeps trying to work and be a good friend, respect what she’s doing, because that’s what beating an illness is all about.

It’s easy when treatment works, but the true heroes are the ones who keep on going when it doesn’t. If you’re there for her during that struggle, that’s the best kind of help there is.

STATEMENT:
“I hate to see my friend suffer and I’m worried that she could do herself serious harm, but I know that mental illness and negative thinking can brainwash good people and that help, from me or a professional, is not necessarily the answer. I will always insist that there is a hopeful way forward, but accept the fact that she may not agree and that argument is not helpful.”

I can’t stand the way I’ve become a disorganized idiot when I used to be incredibly good at juggling multiple responsibilities. I’m only 35-years-old and, while becoming a father has been stressful, it shouldn’t have destroyed my basic organizational abilities. Admittedly, I ‘ve been through a major depression or two, but I’m in a good mood now, I love my work, I’ve got a great wife, and my life isn’t a lot more complicated than it used to be. Nevertheless, I ruminate over tasks that go nowhere, get distracted before I get important things finished, forget my priorities and miss important meetings. I’m a mess, I’m an incompetent ditz, and I hate it. Medications haven’t helped so far, and neurological tests show nothing. There must be something that will give me back my competence.

If there was some way to restore your mojo, you probably would have found it by now, because you’ve had yourself evaluated and tested, and you’ve tried treatments and nothing has worked. In other words, here lies your mojo, may it rest in peace.

It’s sad, but I’ve seen this kind of acquired ditziness happen to people who’ve had a bad depression or two, as well as to people who’ve been concussed. Things may get better in the long run.

Meanwhile, a part of your brain has shut down, even though you feel normal in every other way and nothing shows up on an MRI. Only a voodoo doctor will notice the missing mojo, and your insurance won’t cover all the chicken blood that likely requires.

On the plus side, there’s lots you can do to help yourself if you stop trying to turn the clock back and substitute your old brain for the one you’ve now got. Yes, it’s humiliating, but so is a colonoscopy. Accept it, and you can keep yourself in the clear.

You can ask your wife and friends for help, take a course on organizational techniques, buy a to-do calendar book to write down priorities and create a schedule. You can also put alarms into your smartphone, and set up habits for checking your book, your messages, and your checkbook. Accept the need to learn simple, dumb-looking methods for doing things you used to accomplish intuitively, and you may be able to compensate 100% for your dysfunction.

Ambitious perfectionists fight this notion, because they want to control their lives in their heads. They get mad at themselves for losing control, then depressed, then more dysfunctional, and then more depressed. They also keep me from becoming unemployed.

Fighting your ambitious nature will not be easy, but remember, your goal isn’t to be who you were; it’s to be organized enough to make a living, run a family, and keep your life together, that’s all. The next step is to accept that what used to feel like “that’s all?” is now “that’s a lot.”

STATEMENT:
“I feel like a brain-damaged ex-whiz kid, but my real goals haven’t changed. If I can force myself to endure rehabilitation, and become competent enough to keep my major commitments, it will be the biggest achievement of my life so far.”

My best friend drives me crazy and doesn’t give me room to breathe. She calls every night and wants to talk for at least half an hour, even when there’s nothing to talk about, but we’re adults, not high school kids. I work full-time and get home late, so she doesn’t expect us to get together during the week, but if I don’t want to see her on Saturday or Sunday she wants to know what I’m doing and acts hurt if I could have been doing it with her. We’re both over 40 and don’t get asked out much, but I’d like to develop a wider group of friends. Instead, I feel like I’m always on the defensive. The more irritated I get, the more careful I have to be about what I say, which just makes me sound more defensive. I’m trapped. My goal is to be myself with her.

Even though your friend sounds like the emotional Ike Turner, I’m sure she isn’t all bad; she might be good at offering support, or fun to hang out with, or talented with a guitar.

On the other hand, your friend is clingy by nature, over 21 and, if she hasn’t responded to comments about her clinginess so far, incapable of getting it. Remember, no matter how much she sounds like a jealous spouse, you and your friend aren’t married. It’s OK to ask yourself how much time you want to spend together, not just what’s best for Ike.

The point isn’t trying to be yourself, because that will just lead to a venting of poisonous feelings that will kill your friendship entirely. Instead, figure out what you want to do with her and how she fits in your life.

Don’t hold yourself responsible for feelings or expectations on her end that you haven’t encouraged or for debts you don’t owe, so regardless of what she feels or says, be OK with your own conscience when you put limits on your time together. Instead of defending your right to set limits or getting her to understand and approve, just set limits, and do it as if you have a right.

If she pushes, tell her you’re tired and get off the phone. Let her know you’re busy on Saturday and you don’t always like to talk about what you’re doing. If she pushes again, tell her it’s not a secret, you just don’t like to talk about it.

Don’t be blackmailed by guilt or fear; you can’t be guilty if you’re treating her as you would want to be treated, and you can’t be afraid of losing the relationship, because if she breaks it off, then you’re better off with loneliness than bondage, and you’re strong enough to suck it up.

What’s most likely is that, after huffing and puffing and looking for a reaction and seeing that it’s getting her nowhere, she’ll accept your terms and have a good time. If not, then you’ll have to accept the friendship divorce, but if Tina’s any indication, you’ll do better solo, anyway.

STATEMENT:
“I’m careful not to abuse my friendships so there’s no reason I should feel guilty about my best friend’s neediness or let it force me to be closer to her than I want to be. I’ll be firm and friendly about the way I want to do things and, if that doesn’t work for her, too bad. There are worse things than being lonely.”

My wife doesn’t interact all that much with me since her last stay in the loony bin. She doesn’t hear voices anymore and she can answer questions appropriately, but all she wants to do is read and watch television, and not interact with anyone. She tried a volunteer job but stopped going. She’s not interested in working and I can’t imagine that she would stick with it. She wants me around but also wants to stay in the other room and doesn’t enjoy interacting. Thank goodness we don’t have kids. I’m out every day working to support us. I married her for sickness and health and I take my vows seriously, but we’re in our early thirties and I see my whole life consumed by keeping her company while she watches TV. My goal is to figure out how to shake this feeling of being trapped.

If we lived in a world where total devotion to the people you love always did a lot of good, then it would always be a good thing. That would also be a world where no one got sick.

Unfortunately, illnesses happen that don’t get better in response to love and devotion—some people with psychiatric illness get worse—and that’s when love and devotion can do lots of harm, both to the would-be protector and his or her other dependents and relations.

The thoughtful wedding vow should bind you to stand by your spouse if it will substantially help his or her well-being or the success of what you’re trying to build together, which is usually a family. If, however, something happens that limits the amount of good you can do or that endangers your other obligations, then you have to make a decision.

That’s another way of saying it’s not right to stick with an out-of-control spouse if it endangers you or the kids, whether the problem is violent behavior, compulsive spending or hyper-sexuality. Your goal isn’t to be the very model of devotion, but to manage competing obligations, including one to yourself.

Ask yourself how much good you’re doing for your wife, given the damage her illness has done to her ability to have a relationship with you. If the main thing she gets from you is a benign presence in the next room, she may get as much from someone else, including a health aide.

You’re the one who must judge how much your partnership is costing you in terms of your other goals and relationships, then decide how much good it’s doing. If your roles were reversed and you were the one whose ability to relate were damaged by incurable illness, ask yourself what you would expect your wife to do.

Don’t do what looks right or feels good; do some moral heavy lifting by examining the competing obligations and prepare to feel bad no matter what you do. If you consider all your obligations and weigh your devotion to your wife in terms of necessity, i.e., how much good it does and how much it costs you, then whatever you decide will feel more like a choice and less like a trap.

Unlike the pair above, you did take vows, but the circumstances of those vows have changed. Now you have to decide whether being there for her in her sickness is actually healthy for either one of you.

STATEMENT:
“I will always honor my commitment to my wife, but I acknowledge that life can prevent that commitment from having a positive effect, and that it’s my job, if that happens, to give priority to what does the most good or prevents the most harm.”

Please Note: In responding to suicidal goals, as in the case below, we do not presume to offer emotional support. If you’re at risk of hurting yourself, you should, of course, go to an emergency room, discuss your state of mind with a professional, and decide how much support you need in order to remain safe. In most of the cases we encounter, however, our correspondents are not simply suicidal; they are familiar with treatment and have come to believe that it won’t help. Often, we must agree that their feelings are unlikely to change in the near future. What we try to demonstrate, however, is that negative feelings create falsely negative and hopeless beliefs and that there are ways to recover your strength and perspective, even when the pain won’t let up.

I’m considering suicide. My life is a joke. I am in my late 30s and female and I have never had a relationship with a man. Several men have used me for sex and at least 2 of them begged me not to tell any of their friends they’d had sex with me. I’ve never been loved, been held, been listened to, been cherished. I’ve just been used like a toilet. On the outside I’m pretty. I can hold a conversation and I have a reasonable number of friends. But I hate myself and I don’t feel good enough. I was abandoned by both parents and I was raped for the first time when I was about 2-years-old. It’s like men I meet can smell the self-hate on me and they treat me accordingly. I do not have even one person in my life who cares about me or who I could trust. My friends are there to go for drinks or dinner with me if they can find nothing better to do but they are not there to be supportive ever, in any way. What is the point of me continuing to live?

It’s horrible to feel that you don’t belong to the human race, except for your ability to satisfy the needs and cravings of jerks.

Remember, however, that those feelings almost always beget more falsely negative beliefs, particularly about relationships. Whether or not you’ve done anything wrong, you feel infinitely rejectable, comfortable in the company of jerks, and anxious around people you respect, since you know they will reject you for your anxiety and fundamental worthlessness.

You distrust other people, but it’s your feelings and instincts that are far more suspect. In turn, you can’t trust your feelings to guide you in relationships (even more so than the rest of us).

If you do, you will seek out jerks and excoriate yourself after real or imagined rejection, and of course, life will appear meaningless and full of relationships that always end badly. Being needy strips away the friendship filters that would otherwise keep jerks away and it makes non-jerks look like jerks or, even worse, like people whose rejection would be devastating.

For instance, after starting to trust a potential friend, you might be so hurt after noticing that she was slow to answer your calls, even if that dearth of calls was due to a busy work week or broken phone, that you would feel you could never trust her again and would feel like hurting yourself. It’s hard to make real friends when your own sensitivity is such an enemy.

Don’t give up, because there are other ways to build a more rational, positive set of beliefs that can protect you from dark feelings, even if they can’t ease the pain. They don’t require you to risk a relationship; all you need do is assess your own response to the hardships of your life, using reasonable criteria for judging your effort and the difficulty of your accomplishment.

If, while bearing the scars of neglect and abuse, you’ve picked up skills, earned a living, and treated people decently, you’ve accomplished something you have good reason to admire. Forget whether anyone else knows, understands, or respects what you’ve done. Then forget the fact that you continue to hurt like hell, (when you’re not feeling numb). You know what you know, and it’s your opinion that matters most.

If only therapy could help you make better choices and avoid negative distortions, or at least give you a sense of being respected and valued; but it often doesn’t work that way. Instead, relationships with therapists often fall victim to the same false beliefs that ruin potential friendships.

Because of your age, I’m assuming you’ve tried therapy and it hasn’t worked. You aren’t alone in having that experience, but it is possible to see beyond it. Don’t be surprised if a relationship- or emotion-focused therapy or support group hasn’t helped. Don’t give up hope, because there are other approaches that can help you grow stronger.

DBT (dialectic behavioral therapy) is a kind of cognitive-behavior therapy that can help you maintain your perspective and fight negative thoughts and actions. It’s taught as a course, and discourages participants from sharing strong feelings or engaging in intense relationships. As such, it doesn’t offer relief from loneliness, but it does provide ideas and mental exercises to root your self-worth in your own values and actions and thus protect your beliefs from distortions caused by fear, sensitivity, and loneliness.

When emptiness consumes you, it’s almost impossible not to feel like a disposable loser. If, however, you can make an honest assessment of your accomplishments, and acknowledge that there has also been triumph and survival despite tragedy, you will get stronger and find reasons to live and respect yourself.

If you review the things that you’ve done without the approval or involvement of others, jerks and not, you’ll see that you’re not just a member of the human race, but an exceptional one.

STATEMENT:
“I’ve never found a friend and often feel that life has no meaning; but abuse left me determined to be independent, treat people with respect, and be a good person, and I value what I’ve accomplished, regardless of self-hate or loneliness. I will build self-respect on my own actions, and hope that someday I will have the strength and luck to find a friend.”

My mother only has one sibling, but I’ve never met my uncle because he’s had severe agoraphobia for the past 30 years. My mother says that it started right before he graduated high school (he stopped talking to his friends, stayed in his room more, washed his hands compulsively, etc.), and it’s been going on since then. The only person he regularly communicates with is my grandmother, who also supports him, and while he sometimes talks to my mother, he doesn’t let her see him, and, like I said, I’ve never met him because if I’m in the house he won’t talk to anyone or leave his room (this is how he treats anyone who isn’t my mother or grandmother). My mother says that my uncle’s too macho to admit he has a problem, and “too Italian” to ever leave his mother’s house. I guess my problem is that my grandmother isn’t in the best health, and I know that nobody else in the family has the resources to take care of my uncle when she’s gone. Plus, I mean, he’s sick, so my goal is to get my uncle some help.

If almost every chronic illness is a test of character, agoraphobia is one of the most challenging. The fear goes far beyond anything you’ve experienced; think of it as a migraine headache where, instead of pain, you’re flooded with fear and the only relief is to hide out.

Yes, there are treatments that can dull the fear and help people recover their lives, but they take effort, they’re not a cure, and, somewhere along the line, they require people to leave their caves and endure some additional anxiety. It’s no wonder many people with severe agoraphobia will accept tranquilizers or use alcohol, but will not stick with any other kind of treatment, particularly if they have to leave home to get it.

So don’t blame your grandma or your uncle or put responsibility on anyone, including yourself, to get help. That bird has flown, leaving much pain and helplessness behind. Respect your grandma for carrying an extra load and your mother for bearing the sorrow of losing her brother.

Now that you’ve given up on helping your uncle directly, however, consider an alternative. Ask yourself whether he would accept behavioral treatment if he had no place to stay. Consult with experts and find out what would be available to him if he were flushed out of his hideout.

Obviously, eviction would make him more anxious in the short run, and might make your grandmother and mother guilty and anxious as well. If you believe there’s a positive alternative, however, encourage them to consider offering it to him. Urge them to trust their idea of what would benefit him in the long run and to ignore their gut response to seeing him in pain.

If they’re ready to push him out, good for him. If not, your mother will encounter this option further down the line, after your grandmother dies and the family can no longer afford to keep her house/his prison.

You’re right to fear for your uncle’s health and your family’s future, but as long as fear imprisons your uncle, you are all, to some degree, stuck.

STATEMENT:
“I’m sorry my uncle has a painful mental illness and I don’t want to add to his pain, but his current dependence on the family can’t last forever and he might do more for himself if he had less support and more encouragement to man up and get treatment. There are 2 generations ahead of me with responsibility for his care; but if, after learning more, I think they’re overprotecting him, I’ll let them know I respect them for caring for him, I’m concerned about what will become of him when grandma is dead, and I have a plan that might allow him to get stronger, regardless of his fears or urges to disappear.”

I made the executive decision today to not participate in our airport’s body scan or pat down procedure, and now my whole family is f*cked. I had my “no more than 3oz bottles” in their “official” airline approved baggies, so obviously I arrived at the airport planning to suck it up and be a team player. When we got to the security checkpoint however, I discovered there was not enough scope (or vodka) in my 3oz bottles to get me through the required security procedure. I started having flashbacks dating back to a sexual assault 20+yrs ago, and called off the idea of being a team player. I’m pissed at myself for ruining our plans, and equally pissed that my husband (who knows about my past experience) thinks it’s “silly” that I couldn’t just suck it up and go through it like everyone else. My kid’s are totally confused now as to why we are at home and not at Grandmas. I know from news stories I’m not the only one having a problem with our new security procedures. I know I don’t “owe” anyone an explanation, but it seems avoiding their questions is only making matters worse. How do I explain, without really explaining, why I’m refusing to put myself back in the position that clearly was not in my best interest at the time?

If you’re reactive to your feelings in public, for any reason, life becomes more dramatic, unpredictable and sometimes humiliating. You want your junk, physical and emotional, untouched.

Unfortunately, most times you do end up saying something emotionally, it doesn’t come out cool, leaving you and everyone else feeling a bit violated.

There are, however, some advantages to being emotionally reactive, particularly in the anxious way you describe, even if those advantages don’t involve airports.

For one thing, emotional reactivity is probably the strongest attractive force between people, stronger than sex or a shared political party affiliation. No, seriously, you probably have a gift for connecting with others, which is why you have a family to embarrass in the first place.

For another thing, you panicked rather than blowing up. Chazz Palmentari (and Macchiavelli) say it’s better to be feared than loved, but that’s within Mafia families, not ones that get along.

Among your flesh and blood, it’s better not to have people walking on eggshells for fear that you’re going to explode and then sneaking off to see their shrinks. Chazz may get his way more easily, but people stop sharing things with him, and, after a while, even the Don gets lonely.

You didn’t tell airport security they were creeps, or your family that they didn’t care, or the TSA to say hello to your little friend. You simply said that you can’t take it and requested to go home.

Another positive thing about your reactivity is that you remain realistic. You’re not saying that you hate yourself for being sensitive and can’t stand it anymore; you’re saying that you know feelings of being overwhelmed sometimes come back to haunt you and probably always will, and that you need a way to deal when those moments arise.

So, even though you’re reactive, you’re also accepting your lack of control over your lack of control, which is a huge plus. As positively as you’re dealing with things, there are other steps you can take to make things even better, and the first step is attacking the shame.

Shame is a powerful force in making your anxiety worse; you get afraid you’ll embarrass yourself, which makes you more anxious, which makes you come closer to losing control. Fight it by telling your family that some people get overwhelmingly anxious sometimes, and you’re one of them. You’re good at controlling it, but sometimes it gets the better of you. That don’t make you a bad person, it’s just part of who you are.

Then, if you haven’t done it already, check out the treatments that might improve your control. Begin with cognitive and behavioral treatments, like “CBT,” positive imaging, relaxation training, etc. They don’t have side effects, and if you have insurance, you have nothing to lose but your time. Alternatives, when it comes to a traumatic situation you can anticipate, include taking a tranquilizer an hour before.

For now, congratulate yourself for your realistic outlook, write your representatives about changing TSA regulations, and learn to accept all the emotional junk that comes with who you are.

STATEMENT:
“Knowing why I get anxious doesn’t change the fact that my fear can get triggered at the worst possible times. I accept this fact and take pride in how well I tolerate and recover from anxiety without letting it ruin my life or make me act badly. I’m open to learning new methods for managing anxiety. I don’t apologize for what I can’t control.”

When I was a child, I was sexually abused by a neighbor. It really haunted me for years—totally screwed up my time in high school—but when I got to college, I finally spoke out about it, got into a support group, and met my closest friend there, who experienced something very similar. I’m in my 30s now, and after years of therapy and various support groups, I feel at peace with my past. I have my own family now, I have a job I really enjoy, and while I still get flashbacks and sometimes get overwhelmed by anxiety, I feel like I’m doing OK. My friend, however, along with others in the abuse survivor community, thinks that I’m regressing into denial; she thinks that unless I confront my pain everyday, it’s going to build up and destroy my life again. I care about her a lot, and she’s helped me a great deal, but I have to disagree. If my goal is to feel okay about what happened, should I continue on my own path, or continue with therapy and support?

There are those who believe in pursuing complete “healing” and “recovery” after trauma; no surprise, I’m not among them, but I’m also not insisting you take my opinion as %100 correct. A first, I know.

Instead of accepting my point of view, or your friend’s, ask yourself how you define “complete recovery,” how often you see anyone with severe symptoms of anxiety who is able to control them completely, and whether you can find evidence of a treatment with objectively documented sure-fire results.

While seeking support from fellow victims can be very positive, not every person who experiences trauma recovers in the same way. You can gain from their comfort and advice, but only you can decide what your recovery means.

If you devote yourself to complete recovery and it doesn’t exist, you’re not only wasting time and money, you’re magnifying and prolonging the ability of trauma to define your life. No, Virginia, life doesn’t always offer you closure, but it always offers you the opportunity to make bad things worse.

I think you’ve done the best you can with childhood trauma and deserve credit for bearing the pain without letting it define your life. Yes, you still experience pain, but that’s not a sign of your failure to deal with issues. It’s life and you’re brave.

It’s also positive that you don’t dwell on the evil of the neighbor who traumatized you, or your need to see him punished or exposed. Yes, of course it was evil, and we all know how satisfying it is to see evil punished. Usually, however, evil people are evil because they don’t see the evilness in what they’re doing wrong and never will. The meaning of punishment to them isn’t regret for what they’ve done, but just that they were caught by people who over-react and ignore greater evil, etc.

You’re accepting a world in which evil is a part of life, and you’re not letting it stop you from doing good. It’s our job, not to eradicate evil and find complete peace, but to learn to protect ourselves in a world that will always include creeps and psychopaths.

Respect your goals and perspective, and resist the temptation to defend yourself to your friend. On this issue, insist on your right to stand by your own point of view and not discuss it. True friends will always respect your decision.

STATEMENT:
“I know how much pain can ensue from being abused as a child. I regard the fact that I still experience that pain as an unavoidable fact of life and am proud that I’ve done much to fight shame and prevent trauma from interfering with my life. I manage it well. I use my knowledge to protect my children. I am less interested in punishing people who cause that pain than in preventing them from hurting others. I’ve had time to develop my own views on this subject and those are the ones that matter.”

My old college roommate is one of my closest friends, and he’s always been one of the most generous people I’ve known. When I got laid off and totally broke, he got me a job at his company, and when I first started working there, everything was great. Now he’s my boss and things are very weird. Outside of work, he’s the same old guy—we carpool to work and crack jokes like always. Once we get into the office though, he’s a different guy, not just serious, because that would make sense (he’s my boss, after all), but really nasty with me. He snaps whenever I ask him questions about work stuff, like I’m an idiot who didn’t follow directions and is wasting his time. I really don’t think I’m asking him to do anything above and beyond, just regular employee/boss stuff, but he’s a total jerk about it. I want to stay here because I need the money and like the company as a whole, but I’m afraid that if I do stay, our friendship will fall apart. Then again, if I leave, he might also take that personally. My goal is to keep my job and my friendship intact.

Fortunately, you don’t have to worry about your friend firing you anytime soon. Instead, you have an opportunity to choose whether to lose your friendship or your job.

As Jack Benny once famously said, when a robber barked “Your money or your life,” “I’m thinking, I’m thinking.” And, of course, you could wind up losing both.

There’s no way you could avoid being your boss’s close friend, nor could you predict that working for him would become an exercise in torture, but now the question remains, how to set up boundaries to protect you from this mess.

Before making your choice, remember that there’s always a good way and a bad way to communicate with someone about personal conflict (and thus avoid the choice, if possible).

The bad way, of course, is to rely on the ease and intimacy of your friendship to share your feelings about what a dickhead he’s been. It’s hard to imagine a response that won’t include the word “ingrate” and leave you with a shitload of blame with sugar on top, along with the steaming remains of your relationship.

The good way is to be professional and business-like as you tell him that you want to improve your work relationship so it can be as positive as your friendship, and that you’re wondering about how to do your job better and/or report to him differently. Put aside your hurt and anger to consider the possibility that your learning style may rub him the wrong way (although it may delight him when you’re not on the clock) and that having you report to someone else may ease some of the tension.

However personal his criticism feels, or however personally it’s meant, it’s not really personal as long as you’re doing your best. He’s being mean either because he’s always a bear at work (with other people as well as you) or he has a rage allergy to your work-style. That knowledge won’t ease your pain, but it will help you respond as if you’re trying to work things out with an important client, instead of slamming a raging asshole.

If, in the end there’s no way to ease the personal sting of your work-place humiliation, decide whether it’s more important to avoid hunger and homelessness. In other words, work often requires people to eat shit for a living when times are tough, even if that shit is served up by one of your oldest friends.

If your bank account tells you it’s necessary, remember to smile, take pride in your survival skills, and remember that your friend is still being generous…just with abuse.

STATEMENT:
“I may not be able to avoid the pain of personal humiliation at work, but I’m proud of the way I try to manage it while doing my best to look for my next job. It also hurts to lose my trust and respect for a friend, but there’s nothing I can do about that except not make it worse, which requires a heroic effort, and that’s my challenge.”

I work for a small business run by a husband and wife out of their house. I’m one of a handful of employees, and we’re all pretty close (we have to be, the offices are tiny). I like the wife—we’ve gone shopping together once or twice, and she gives me dating advice—but, weirdly, I’m actually closer to the husband since we’re both from the same town, like the same music and movies, etc. I’m not attracted to him, I swear, but I do like talking to him about our shared interests, and I can tell it’s pissing the wife off. I love this job, and I really like my bosses and co-workers—we’re like a family—but I’m not sure how to keep my job and keep my friendships while keeping the wife happy.

Comparing record collections is fun, but getting calls from collections isn’t. Which will happen when you have no way to pay your bills.

In other words, work is work, and it’s more important than the friendships you’ve described, so stop relying on work for your friendships or you’ll wind up with neither. That’s what happens when you ignore boundaries and follow your feelings.

In the beginning, being friends with the bosses seems like a compound win. You don’t have to worry about losing your job, or being criticized, or not knowing where you stand. They like you, they really like you, and they like your work. No reason to be anxious, and it’s a promotion for the self-esteem.

Nothing that feels so good is good for you, however. Your all-day intimacy can pull the husband away from his wife; after all, they’ve been married awhile and share management responsibilities and a bank account, so there’s got to be some bickering and bruising that will make your sweet, respectful relationship with him seem preferable to his marriage.

His wife should worry, and so should you, because trouble in the home-office is not good for business or your job security, just an increase in production of drama.

So chill and be friendly in a professional way. Stop sharing personal information, keep the chatting short and superficial, and if you need distraction in the workplace, listen to music on your computer via headphones.

STATEMENT:
“It feels nice to be closely involved with a happy, friendly ‘work family,’ and particularly with its leaders, but my overall priority is to hold my job and not interfere with the power structure, even if it requires me to stifle a natural, heart-felt need to be close and valued. I will put my own sense of doing a good job, and my belief in the value of minding my own business while doing business, ahead of my need to be valued by those I respect.”

Last fall, I started hooking up with a girl who’s been a friend of mine since freshman year. It wasn’t anything serious, just your average friends with benefits deal, and neither one of us ever talked about her being my girlfriend or anything “real.” What I never knew before though is that this girl gets really depressed, and when she got really sick this winter, I was there for her because that’s what I’d do for any friend, whether we’re hooking up or not. She’s better now, but I’m kind of confused as to what’s happening between us. Sometimes I think I want to be her boyfriend, but I’m not sure I’m really that into her, and I don’t think she wants that from me, and at this point everything’s just really awkward and weird. I just want to know where we stand, or what I should do.

People often choose to be “friends with benefits” (FWB) because it seems easier than committing to a relationship, but don’t be so sure.

Having a FWB is like playing a fretless guitar that seems to offer musical freedom, but is actually more likely to produce noise unless you really know what you’re doing. In other words, don’t attempt a FWB situation unless you’ve learned what the rules are and can stick with them. It’s not for those who haven’t mastered their instrument.

You need that toughness and discipline so you don’t cross the line between friend and more-than-friend, which means being direct about your intentions (honorably limited) and vigilant about the many ways your actions can unwittingly contradict your words (by calling or sharing or sighing or talking too much).

Regardless of the actual ups and downs of how you feel, your words and actions should convey an unambiguous, consistent message. Otherwise, love or neediness may escape and create a situation you and/or your partner are not ready for.

Toughness is also necessary to determine whether your prospective sex-buddy has what it takes to stay within agreed-upon boundaries. Some agreeable friends really want something more and will be disappointed when it doesn’t happen.

This may sound like some pretty rigid guidelines for what should be a care-free relationship—I ordered the sex, hold the commitment!—but at least when you’re a boyfriend or girlfriend, you know where you stand thanks to some fairly universal relationship guidelines. Being a FWB is living a gray zone unless you draw your own line in the sand.

In your situation, charity made you cross that line and become your FWB’s depression counselor. Good for you as a friend, bad for you as a recipient of benefits, because now, no one knows what to expect.

If you did it because you really, really liked her, then you would want to upgrade, but that doesn’t seem to be the case. Don’t over think your feelings about her, because when most people are interested in someone romantically, they know pretty fast.

If one of you not being single is what kept you apart when you first met, getting together now makes sense, but if the spark just wasn’t there, then that’s why you aren’t together. As such, the reason you hooked up has more to do with loneliness than a unique connection, and might be worth leaving at that.

If you decide that you truly do want to go for a love upgrade, be sure your erstwhile non-exactly-lover is a solid person who would make a good partner, and that the benefit of a successful upgrade outweighs the loss of what you’ve already got. After all, once you jump from friends to boy/girlfriends, downgrading back to friends can be tricky, if not impossible.

Check out whether he/she is steady in other relationships and not too needy, sensitive, or vulnerable to runaway feelings. Remember, Glenn Close’s character in “Fatal Attraction” promised an attachment-free fuck and was probably sincere (in her own nutty way).

It’s your responsibility to make sure things are what they seem. Then figure out whether you want to make beautiful music together, or whether you’re just not ready to jam.

STATEMENT:
Here’s a Mission Statement to share with your friend. “I think we’re good at being friends, with or without benefits, but I know I’m not ready to go further because I don’t think the chemistry is quite right. I hope our friendship helped you during the winter when you were depressed. It left me feeling good about our friendship and with the same overall impression that that’s what our relationship is meant to be.”

Like a lot of single women in their 30s, I’ve gotten into internet dating, but I’m not very good at it, because I really don’t want to be mean to anyone, and I don’t think it’s fair to make up your mind about someone when you don’t really know them. I mean, sure, I have a physical type, but what I’m talking about is that I don’t want to brush off some poor guy after one cup of coffee just because he’s not my dream guy right off the bat, know what I mean? And I don’t think you can really learn that much about somebody based on a few emails, so basically I end up going on a bunch of dates that often aren’t that much fun or, if they are, I don’t get a call-back and wind up ruminating for a week about what went wrong. My goal is to figure out how to make online dating work.

Online dating doesn’t work unless you’re tough and disciplined (see case above). That’s because getting attached to someone who can’t return your feelings will wear you out and make you feel like an unattractive loser. It’s the way we’re wired (pardon the pun).

If your priority is to make everyone feel valued, send them some of Oprah’s favorite things. If you want to take advantage of the wide reach of online dating, which will expose you to large amounts of raw suiterage and toxic jerks, learn how to become an efficient and effective screener.

First, decide for yourself whether it’s moral to reject people, especially if it seems to cause them pain. In my opinion, it’s immoral not to reject people (assuming you do it politely and respectfully). Better to be tactfully honest than grudgingly lie.

If you don’t just rip off the Band-Aid, you’re leading them on and assuming responsibility for their feelings, making yourself vulnerable to manipulation and guilt, and/or promising what you can’t really deliver.

Sure, you may feel guilty if someone looks pained by your decision not to continue contact, but that’s just a passing feeling. Know the difference between guilty feelings and real guilt and learn how to ignore the former.

Of course, if you’re too sensitive to pain, either theirs or yours, you’re not ready to go hunting in love’s wild e-yonder, because hunting usually requires a willingness to tolerate pain. Your goal isn’t to avoid pain (or cause pain), but to minimize it, learn from it, and not let it interfere with an effective search.

If you’ve decided it’s OK not to run a ministry for the horny and needy and that guilty feelings can be ignored, then you’re ready to learn the principles of wide-reach screening and discover that you probably know them already.

Begin by listing the 5 or 6 criteria for excluding candidates, regardless of attractiveness. They include drug-use, poor money management, unreliability, a history of backing away from reasonable relationships, an inability to say no to horrible relatives, and a lack of interest in the kind of future that you want.

Then, while you’re chatting and searching for interpersonal chemistry, keep your list in mind and say good-bye whenever a red flag pops up. Time is short, screening is tiring, and the hunt is on.

STATEMENT:
Use your criteria to prepare a statement. “I’m interested in a reliable, hard-working, loyal grownup who can manage his/her money responsibly and is looking for a committed partner to share (name your future). I’m not in need of friendship or sex and I don’t have much time to chat, but I’ll get back to you if you’re interested and seem to be a possible match. ”

For years, I’ve talked to a friend of mine about my problems who’s also a counselor, and during that time, he’s urged me to seek professional help. I used to brush off that advice, mostly because this friend lives in another city and only ever really talks to me on the phone when I have problems, but in the last few months, I’ve begun to consider taking his advice. I don’t know what to say when I call to make the appointment, however, because I haven’t the faintest how to explain the unknown in my head (which is the main issue that frustrates me). I want to scream, but don’t know why or what. Do you have any advice as far as how to ask for help when I’m not sure what I’m really asking help for?

Remember, funny feelings in your head cause fear, which causes funny feelings, which cause fear, which create a spiral that will flush you down the toilet of needless worry. The first thing to do then is shut up and think about whether you need help.

If you’ve had funny feelings in your head for years, they’re not about to kill you; they’re not telling you to kill yourself or anyone else, and they’re not annoying you to death. Plus, they’re obviously not getting in the way of at least one long-term friendship.

So, taking all that into account, you have time to use your usual problem-solving methods to determine whether or not your weird head sensations are a big deal. You can try exercising and going on vacation, to see if you get better.

The big question isn’t what you say when you ask the shrink for help, but what you say after forming your own decision about why help is necessary. After all, you can’t shut up your worrying friends until you know your own mind.

There are several criteria for deciding when to seek help that apply to most situations, like if your problem gets in the way of making a living or being a good guy, or if your problem causes too much pain.

Assume, of course, that you haven’t been able to solve the problem without help, and throw in one special-knowledge exception: get help if the problem might be a sign of an illness that you might cure and/or prevent if you had expert advice. Then come to your own conclusion about whether you need help and then stand by it.

If you don’t need help, don’t bother to tell your friend to shut up. Let him/her know, if you need to talk about the problem, that you’re satisfied with your own way of managing it, and he’ll probably shut up on his/her own.

On the other hand, if you decide you do need help, shut up about your helplessness. Tell your doctor what the matter is and why you think it’s necessary to talk about it. Then the advice you get will be more focused and less patronizing, so you’ll actualy want to shut and listen to it.

STATEMENT:
“My symptoms are subjective and I don’t know anyone else who has them, but they hurt and distract me a great deal, so I want expert advice on what I can do about them that I haven’t already tried. I don’t care if the experts explain them away or tell me they’re in my head. That just means no one has an answer, and I have the answer I need (though the answer I want would include a cure). Then I know it’s not cancer, I’ve done my best, and it’s time to accept pain and move on with my life.”

After graduating from college last spring, my son moved to a new city for graduate school. The problem is that his psychiatrist, the one he credits with saving him from severe depression and turning his life around, did not make the move with him, and my son doesn’t want to talk to anyone else. The fix so far has been phone sessions, but this doctor is not covered by my son’s meager student insurance, so his father and I have been footing the bill, and that bill is staggeringly enormous. We love our son and want him to be well, but between our own expenses and the money we’re putting towards his graduate education, our goal is to get him to look for a new, local doctor without making him relapse.

Severe depression is scary and hard to control, so it’s not unusual that recovering survivors cling tightly to whatever may have made the bad symptoms go away, including anything from the lucky underwear they had on when the cloud lifted to, of course, their shrink, particularly if he or she is nice to talk to.

On the other hand, it’s also hard for parents to stress a kid who’s gone through depression, because it’s not just the kid that fears a relapse. That’s why you don’t want to tell your son and the therapist that it’s time for them to shut up.

Your goal, however, isn’t to protect him from stress or make him feel good, but to teach him how to deal with depression effectively, and superstitiously clinging to good luck charms isn’t the way to do it.

Instead, encourage him to make the most of his resources by bravely figuring out what he really needs, and what he can do without. Treat him as the agent of his recovery, the expert of his own experience, and the client who seeks useful ideas from many sources, including new therapists, all while debunking the therapeutic impact of nurturing/”special” relationships.

Yes, suggesting change will raise his fears and your own, but it’s your job to do that while offering him reasons for beating the fear and methods for managing it. Also, of course, don’t act frightened; sure, you can admit to fear and talk about fear, but not show fear, or else everyone will be so afraid as to soil their lucky underwear.

You’re there to convince him that facing fear will pay off; it’s for his own benefit in the long wrong, not just so you can make it easier to pay off your bills.

STATEMENT:
“Of course you need a doctor to help you manage depression, but our resources are needed for your education, so we can’t waste a cent. Find a doctor who is covered by your insurance. Don’t use that person for comfort and understanding unless it’s necessary; remember, we’re your friends and you have a dog and we’re all free. Ask yourself what you learned from your old doctor that helped you manage your negative thoughts and/or symptoms more effectively and look for someone who has similar ideas. Also, if you want to learn more about coping with depression, join a group of strong depression survivors. If you want to learn how to correct negative thinking, read a book and take a course. Use your doctor to get what you can’t get elsewhere. Whether we’re managing depression or diabetes, that’s how we can keep the costs of treatment under control.”