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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I recently started going to a doctor for my depression. She thinks I should take pills, I’ve seen lots of articles about how antidepressants don’t work and the main reason they’re prescribed is because of the huge investment that big pharmaceutical companies have made in producing and marketing them. It makes sense to me that there are better natural, holistic solutions that get played down by the medical establishment because they can’t make money for anyone and threaten the profits made by those companies. My goal is to find treatments that work best, not the treatments that server the corporate interests.

The problem with most criticism of current drug treatments is its hopefulness; it implies that there are good, effective, cheap and low-side-effect treatments for depression (that are being suppressed). If only principal clause of that statement were true.

Sure, a magic bullet, holistic or otherwise, would be great (there are lots of other unsolved and incurable problems I can work on, so I’m not worried by the hit my business will take).

The truth is, however, that current treatments are time-consuming, weak, often costly, sometimes risky, and not guaranteed to work

Please resist the temptation to change the subject to tell me why current treatments are costly and often ineffective. You’re entitled to be angry about that sad fact, as about any other of the tragic, unfair and irritating facts of life, like tailgaters, the fact they cancelled “Firefly,” and almost anything having to do with hospitals and health insurance.

As much as I agree with you, I don’t want to hear it; you’ve got a job to do, and anger is a distracting escape from facing what you need to deal with if you’re going to manage treatment decisions for depressive illness. Instead of getting mad at your hand, play the cards you’re dealt.

Your treatment choices for depression aren’t that complicated…once you accept the fact that there’s no way to tell in advance which treatments are going to work or what side effects you’ll encounter. If you’re not in a hurry (i.e., if your depression isn’t about to push you out a window or immediately end your relationship with wife and family), you begin with non-medical treatments, like cognitive behavioral therapy, exercise, and diet and life-style changes.

If the symptoms are severe or longstanding or coming back after previous bouts, then you also experiment with antidepressant medications. This isn’t because Pfizer decrees it so, but because non-medical treatments are unlikely to perform miracles and an antidepressant medication improves your chance of recovery, even though it also has possible side effects.

If you want to try holistic remedies first, by all means, go ahead, but approach those treatments with the same care you would conventional ones; do your research to see what the data show in terms of results and what the side effects might be. Most data are inconclusive, but if you believe the treatment is working, then take that placebo to the bank.

Either way, you know the major principle of risk management: the more desperate your condition, the greater risk (pain, side-effects, cost, etc.) you should be prepared to bear in your effort to manage it. Draw on your own experience of your symptoms, their severity, and their impact on your life, as well as what the experts tell you about them, to decide how desperate you are.

It’s not a big pharma conspiracy against your health; your options just aren’t that great, and you have to figure out which one will work out, if not perfectly, then best.

STATEMENT:
Include your doubts about medication in a statement that focuses on management, not resentment or silly hopes for hidden cures stashed away in a cave with Sasquatch. “If I ever decide to use medication, it will be because I’m desperate and other methods haven’t worked. At that point, I’ll try to figure out their benefits and risks by looking at scientific, controlled studies, not emotional statements based on single cases or uncontrolled, badly selected patient populations. I will consult specialists and authorities to explain why they place faith in particular data or don’t like someone else’s data; but I will then make up my own mind, shutting out my emotional response to charisma or sincerity or a desire to include everyone’s opinion. When it comes to decisions about my health, I deserve a good, objective risk manager—me.”

I know the tranquilizer I take is addictive and interferes with my memory, but it’s the only thing that works when I get really anxious, and the other drugs I’ve been given for anxiety made me sick and didn’t work. I’m anxious because I’m stressed by some unusual recent events, which I’m sure I’ll get over in time, and then I won’t need to take medication. So my goal is to get the medication that works for me and avoid the stuff I know is going to make me sick.

It’s wonderful to get relief from severe anxiety, which is a terribly painful and frightening sensation. So I hate to make you more anxious by telling you that, unfortunately, there’s no good, safe medication that provides rapid relief.

The medications that provide rapid relief pose high risks of addiction and impair memory and balance, and the medications that are safer don’t provide rapid relief. That’s not very reassuring, but if you don’t cowboy up and face that fact, you’re in for trouble.

Remember, anxiety isn’t the worst thing that can happen. Much worse is what anxiety can make you do, like avoiding whatever stirs it up, medicating with alcohol, and making it your goal to feel less anxious. Given these dangers, your real goal is to do what you can to reduce anxiety while not letting it change what matters to you.

Don’t stop trying alternatives to addictive drugs because previous trials failed—that’s anxiety whispering its lies. It tries to tell you that everything that caused you pain in the past should be avoided now and in the future.

If you find yourself listening to that shit, you desperately need some cognitive therapy to help you straighten out your thinking. You can get it from books or a therapist or hanging out with anxious people who have learned how to manage their fears. There isn’t an actual Anxiety Anonymous, but there are groups like it.

If you stay with your current plan, you’ll not only lead a restrictive life, but you’ll tend to choose immediate relief over long-term advantages, whether it’s in treatment, jobs, or relationships. At that point, your anxiety is managing you, and that’s a real cause for worry.

STATEMENT:
Here’s a statement to keep you strong. “I need to develop new methods for dealing with anxiety because, as much as I wish it weren’t true, anxiety will always come back, eventually, and the tranquilizers that give me great relief in the short run will cause problems if I take them for too long. There are lots of non-medical techniques I should learn; and, if they aren’t sufficient, there are lots of non-addictive medications I should try that have a very low risk of causing serious harm. I need the courage to do what makes most sense to me, not what my anxiety would prefer.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My wife and I liked to party when we first met (nothing too crazy, we just went out a lot), but we just had our first kid, so we now spend a lot more time at home. My wife used to be a fun, bubbly person, and she still sort of is, but ever since the baby was born she’s been really stressed out, worrying that something bad will happen and the baby will die. Not stuff she could possibly prevent, just a random act that would kill our child, and the stress is so bad she is haunted by visions of our son in a casket. I think she’s dealing with this stress by drinking a bunch of wine with dinner and getting a little more than tipsy. I’ve told her to relax about stuff she can’t prevent, but she says she can’t help it, and I don’t like that she’s drinking too much, and where that’s going to go. I want to see my wife get some treatment that will relieve her stress so she can stop drinking too much.

You might wonder how wanting to help someone could be bad, and it’s because, as goals go, it’s often one you can’t reach. If you don’t accept that fact before making your plans, you’ll make things worse.

Here, for instance, there’s a good chance she’s too busy drinking and/or avoiding her problem to heed your good advice and, at least at first, she may not be able to stop herself (and if she could stop herself, you probably wouldn’t be writing me in the first place).

If you sound frustrated, frightened or critical when you talk to her, it will make her worse. Your goal is to see if you can help her, not force her into help. You can bring a wife away from wine, but you can’t force her not to (fret and) drink.

Once people get into the habit of using alcohol to treat anxiety, they often can’t stop, particularly if they’re waiting to feel better before stopping. All the while, alcohol makes anxiety worse (as well as depression, mania…the only things it doesn’t worsen are weddings and sporting events).

So, your goal for her drinking isn’t to reduce her anxiety so she won’t feel like drinking, but to provide her with reasons for stopping drinking, now, regardless of whether it makes her anxiety worse, (which it will), while she also searches for tools to feel better. You can’t make any of that fear go away, but you can give her good reasons to find ways to ignore it and focus more calmly on your baby’s bottle than her own.

Sure, remind her about the availability of treatments; but don’t be surprised if she just wants you to leave her alone because treatment makes her think about her fears, and she’d rather not/would rather open another bottle of red.

Don’t tell her that going to treatment will be enough to make you happy, because treatment is not always effective and it’s useful only if she undertakes it for her own reasons, rather than to get you off her back. Don’t tell her treatment will definitely make her happy, either, because if it doesn’t, you’re a liar and the fault is still yours.

Encourage her to consider her options, including cognitive therapies with ideas and mental exercises to counteract negative thoughts, behavioral therapies with physical exercises to reduce anxiety, and medical treatments that might ease both anxiety and the intensity of her visions.

Her biggest danger is not the pain of anxiety, but that her fear will drive her to give up doing what matters and stop her from being a good mother and wife. The fear scares her, but it’s her fear of that fear that drives her to drink, and that’s where you need to start.

STATEMENT:
Prepare a statement that gives her positives alternative and encourages choice, not compliance. “You’re a strong woman and great mother, and I’m sorry that you’re tortured by fearful thoughts, but I’m more worried about the way your efforts to avoid those thoughts are interfering with your life. Instead of figuring out whether there’s a treatment worth trying, you’re panicking and using alcohol for relief. I know for a fact that alcohol makes anxiety symptoms worse, while it also undermines your ability to make tough decisions about treatment. You’re good at decisions. Don’t let fear make them for you.”

My daughter likes to bring her young son to our house on weekends (she’s a single mom) so he can see his grandparents and she can relax. Of course, my wife and I love to see him, but he’s getting to the age where he can walk and likes to grab everything he can get his hands on, and she doesn’t seem to notice. He’s knocked books off of shelves, broken some plates, and I recently wrenched my bottle of Lipitor out of his hands just as he was getting the lid off. I’ve told my daughter that she needs to watch him more closely, and she assures me she has a mother’s intuition and always stops him before he does anything wrong. She’s wrong, and my wife and I are too old to keep up with him. My goal is to get through to her, and protect our grandson, without getting her pissed off.

Forgive me for saying so, but I’m guessing your daughter’s obliviousness isn’t new. That and a lack of condoms is probably one of the main reasons she’s become a single mother.

If you’ve been wrestling with her obliviousness for years, now is the time to stop. She’s been your daughter a long time, and if you (and having a kid!) haven’t gotten through to her by now, it’s time to raise the white flag.

It’s sad and scary to admit that her obliviousness is not going to go away and will always force you to bear an extra burden of parental worry, but if you don’t accept this fact, you’ll clash, drive her away, and reduce your chance to make things safer and hang out with your grandchildren, even after they can control their limbs.

Your goal then isn’t to get through to her, but to do what you can to improve your grandson’s safety. Do what you can afford, be it toddler-proofing your house or hiring a teen babysitter/child-chaser who can walk around for hours bent over at 90 degrees.

For your sake, hide your worry and resentment. If your negative feelings show, she’ll feel you don’t trust her (which you don’t) and then avoid you. With luck, however (and given her track record), she’ll be too oblivious to notice how you feel.

Expect problems and look for dangers, while at the same time conveying pleasure and confidence. Behind closed doors, you can share your fear and resentment with your wife, but in front of your daughter, keep a poker face.

In the long run, maybe you can teach your grandson to watch out for himself, but resist the urge to follow him with nanny cams. The hardest thing you need to do, after you’ve done what’s reasonable, is let it be. Enjoy being grandparents and lock up your Lipitor.

STATEMENT:
Here’s a statement to keep your fears in check. “We did a reasonable job teaching our daughter about safety and responsibility (as did others), but she just doesn’t get it. Now we watch out for her and our grandson, when we get a chance. Our biggest achievement, however, is not solving the problem, because we can’t. It’s bearing our worries, keeping quiet about them, and not letting them spoil our relationship with her or our ability to get on with life.”

My parents have decided to retire, sell the big house I grew up in and move into a smaller condo closer to my sister and me. The move makes sense—my sister and I are adults with our own families—but it’s brought up a sort of taboo issue for my parents, which is my mother’s attachment to stuff. She’s not a hoarder, but if my dad wasn’t around to put his foot down, I sometimes worry it could be, because my mother has trouble throwing anything away. She says that moving all the time as a child has given her a different appreciation of objects, and that it’s better to regret having too much stuff than to miss something you threw away and can’t get back. Problem is, there’s no room for this stuff in the new condo, they won’t have the budget for storage, and my sister and I aren’t able to put all of her old work files, souvenir spoons, and elementary school textbooks (seriously) in our basements. What I’m afraid will happen is that my father, who has always taken responsibility for managing their money, will try to get my mother to agree that they can’t afford to move and store her stuff when they move, she’ll keep complaining, and he’ll get nasty. How can we get my mother to learn to let go?

I know you and your father want to make your mother happy and have harmony, but it looks like she’s not eager to adapt a sparse, Zen lifestyle.

The problem is, trying to make someone happy when it’s just not possible usually causes more unhappiness. False hope is dangerous, no good deed goes unpunished, and stuff happens (sometimes in great quantities).

There’s no way you can spare your mother the pang of parting from her horde. Trying to do so, while well intentioned, makes your father assume responsibility for her pain and its relief. In reality, life imposes the problem, not your father or any other member of your family, and it’s your mother’s job to deal with it, because no one else can.

Ask yourself (and your father) why he takes responsibility for a problem that isn’t really his. By managing the budget, carrying out spending decisions, and insisting on making your mother happy, he assumes total responsibility, infantilizes her, and garners himself a shitload of blame.

Tell him to accept that, while he might have failed as family manager/mom’s #1 cheerleader, he can succeed in not being responsible for any unhappiness caused by the stuff-alanche.

Seriously, you can tell him he’s done a wonderful job managing the household and your mother’s angst, but there are limits to what he can do, and that he’ll do better if he presents the situation to your mother and invites her to come up with a better solution.

In other words, instead of your father telling your mother it all has to go and your mother saying she can’t bear to part with any of it until the whole dispute becomes a clusterfuck, your father should instead do some math.

After he prices storage, figures out their fixed income budget, and sees that the two don’t mix, he can present that evidence to mom, explain how he can’t make it work, and give her the chance to find a solution.

At that point, the future of mom’s stuff collection is nobody’s fault. Hopefully, she’ll find an option that works for her, but in the meantime, you, your father, and your sister have avoided a stuff-load of aggravation.

STATEMENT:
Here’s a positive statement your dad could make to protect the family from blame while requiring his wife to share responsibility for a painful but necessary decision. “I’m glad we’ve been able to retain our family memorabilia until now, but I’ve looked at the cost of moving and storage, given that our new condo has no basement, and it doesn’t fit our budget. Please review the numbers and see if you can come up with a better answer and we’ll talk about it. One way or the other, it looks like we’re facing a painful compromise.”

I don’t know why my 10-year-old kid is so selfish and materialistic, because her mother and I aren’t. I can’t take her past a toy store without her having a tantrum if I don’t get her what she wants, and by tantrum, I mean she just keeps yelling and crying, even after I’ve dragged her out of the store and put her in the car. It’s not like we deprive her, either, because we do buy her toys occasionally for no reason, but she’s furious when she can’t get them on demand, which is all the time. She sees a shrink because she throws tantrums in school whenever the teacher wants her to stop doing what she’s doing and start something else. I’m afraid she’s spoiled and I don’t know how to undo the harm.

If the main cause of tantrums and other bad behavior in children was poor moral values like selfishness and materialism, then we’d know how to correct it by teaching better values, as forcefully and loudly as necessary.

All we’d need to rectify bad behavior is a Sunday school nun with a metal ruler.

You’ve got evidence, however, that whatever triggers your daughter’s tantrums is not simply a matter of her being spoiled, because she also has tantrums in school over the non-materialistic issue of being asked to stop what she’s doing and transition from one activity to another, sans toys of any kind.

What you’ve got here isn’t a bad set of values, but a problem in her nervous system that you don’t know how to correct. It’s understandable that you’d focus on the toys instead; you’d rather blame her and yourselves rather than face something you can’t control.

Once you face the sad fact that you’re helpless (but good) parents, you’re free to consider ways to help an unavoidably irritable kid improve her self-control.

At first, of course, try behavioral tricks you learn from teachers and therapists, because they’re less risky than medications. You learn to give her more “structure,” which means keeping her busy, providing her with clear rules, and imposing immediate time-outs when she starts to tantrum. It also means avoiding toy stores.

Therapy seldom helps if it focuses on your faults, but can be very helpful if it teaches you new child management techniques, and protects you from feeling responsible for your child’s (bad) behavior.

If non-medical treatment isn’t enough, and you think her behavior is seriously interfering with her schoolwork, friendship, and self-esteem, find out whether medications are safe enough to be worth a try.

As I’ve said many times, meds are never a cure, they sometimes don’t work, and they can often come with less-than-desirable side-effects. They’re worth a try, however, if you think the risk of her behavior is worse than the risk of the medication.

You and your daughter are in this together, and you have a lot of options for ways to manage and cope. One day, she might have a peaceful relationship with the toy store, but in the meantime, do your research, stay calm, and avoid women in habits.

STATEMENT:
Prepare a way to announce your new policy that conveys acceptance and hope. “I know that seeing new toys gives you very strong feelings that make it hard to walk away without them. We’ll help you by staying away from toy stores until you’re old enough and strong enough to manage those feelings. If you get those feelings anyway, we’ll try to find you a quiet place where you can be alone until you no longer want to scream or hit people. You’re not the only kid who’s had this problem, and we’ll get through it until you grow out of it.”

My husband quit drinking four years ago. I supported his decision to get sober, but I’m disappointed with the result. He used to be a fun goofball, but now he’s a dull grump, and I don’t like his company (and he doesn’t seem to like mine, either). We’ve started to go our separate ways but he’s not interested in talking about it. My goal is to restore the chemistry of our marriage and the good parts of his character without driving him back to drink.

Having fun with your husband is not your top measure of a partner. If you want fun, go out and have a drink.

Acceptance, rather than fun or passion, is the most essential requirement for a long-term relationship, and now you know it. Oh, first marriages have so much to teach you.

To find out whether you can accept a prospective partner, don’t go on a bar crawl; spend time together sober, tired, stressed, hungry, and short of money.

You’ll find out whether you can work together and trust the guy to do his share, shut up about the things he doesn’t like, and not irritate you too much by what he says when he’s dumb. That’s a better measure of true love than the tingle you get from laughing at one another’s sloshed jokes.

You have two choices at this point in your marriage. One possibility is to accept your husband the way he is and try to put aside the understandable anger and sadness about what you’ve lost. You can’t have the happy guy back unless you also want his alcoholism, and you don’t.

By the way, if your goal is to communicate with him before you’ve decided whether you can accept him, you’ll probably give him an earful of your sorrow, disappointment, and anger, and that will drive him away, but not before giving you an earful in return. Your best bet is to shut up until you’ve made up your mind.

The other choice, if you can’t accept your husband the way he is, is to stop being married. It’s not pretty, but the fact is, you can’t talk him into being the guy you want. Talk instead to yourself about whether you can accept the sober guy he now is.

Having finished your most important conversation—with yourself—you’re now ready to let him know which direction you want to go in. Either you can make it work with your dry husband, or take your newly acquired wisdom to marriage #2.

STATEMENTS:
Here are two alternate statements that avoid negative statements about who he isn’t and say positive things about what you want to do.

If you think you can accept him: “I want us to spend more time together. I’ve been hung over from the indirect effect of alcohol on our relationship; but I respect what you’ve done and I want to try new, sober ways for us to have fun, find common interests, and work together.”

If you know you can’t accept him: “I admire your sobriety, but alcohol interfered with my ability to get to know you, and, now that I know you better, I respect what you’ve done but think that we’re not meant for one another.”

I’ve been working for the same company for almost twenty years. I started at the very bottom and have worked my way up to a respectable position in middle management. I’ve never gotten a poor review, never had a dispute with a superior, never let my responsibilities slide. That’s why I’m totally bewildered by my new boss’ persistent criticism of my performance. I haven’t changed a thing, but he’s constantly telling me he thinks I’m slow on my projects, even though he can’t pin down anything I’m doing wrong. My goal is to get him to see that it’s his judgment, not my ability, that’s flawed.

The trouble with telling your boss he’s wrong is that it pushes him to find more fault with you. The chance of changing his mind, if he’s really down on you, is zip.

If anything, he’s more likely to prove he’s right by making it his project to get you fired. If you can’t convince him he’s wrong with your stellar performance, a talking-to won’t help. Sadly, you’re now employee of the month at Fucked Industries.

If you pay too much attention to his response, you’ll get angry at his lack of respect or appreciation for your good work, which will cause you to scowl, lose your motivation, and do less work, which will prove him right and make your actions and self-respect reactive to his stupidity. Don’t talk to him, and don’t react to him more than absolutely necessary.

Instead, assess your own work and be sure it meets your own standards; if you have two decades of positive reviews, that’s tons of evidence that it does. Then move forward, knowing that your work is OK, you’re probably not going to change your boss’s mind, and you need to make a living.

If it’s safe, see if you’ve got enough support from other higher-ups to counteract your boss’ influence. Warm up your résumé, and start looking at other options (e.g., if there’s an opening at It’s A Living And Co.)

Now you’re ready to talk to him. Give him a prepared, positive response that edits out all anger, attack, or defense, and pose for your “employee of the month” picture with a shit-eating grin.

STATEMENT:
“I greatly regret that you have not been satisfied with my work. I paid close attention to your comments, reviewed my work habits, and considered ways of either improving my work, if I thought it was deficient, and/or presenting it to better advantage if I thought communication was the problem. I’ve reviewed supervisory input from the past 20 years—all of it positive, I’m happy to say—requested additional input from current colleagues, and compared current with past performance. My conclusion is that I’ve been doing good work and that your dissatisfaction results from a difference in our styles. I will continue to listen carefully to your input and hope to win your satisfaction.”

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

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

[Moment to process.]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My ex and I had a drama-filled relationship and a rough break-up. Drama because I was drinking, which meant I was sometimes out of my mind, and rough because I got my shit together and tried to make it right with her but she dumped me anyway. The problem is that we work for the same boss, and now that we’re not together anymore, but I’m sober and sane, I’m wondering how to act towards her. Be friendly and normal? Are hugs in bounds? I can’t just ignore her, and I don’t want to, but things are strange. I want to show her that I’m cool, not nuts, and want things between us to be normal (whatever that means).

Be you an alcoholic or a Mormon, you have zero chance of instantly re-establishing friendship with someone you’ve just broken up with. Like cold fusion or a 2010 World Cup game without vuvuzelas, it’s never going to happen.

Since you are an ex-drinker, however, you should know that self-control is something you can never count on, particularly when your feelings for an ex-love are intense and her actions unpredictable.

Yes, you’d love to have a normal friendship; but ask yourself what your actual feelings are, and what they’ll push you to do, and what she’s likely to do in response, and, before you know it, you’ve got an answer that does not include the words “friendship” or “sobriety,” and may well include flying chairs.

Rather than holding yourself responsible for something you don’t control (always a no-no, unless you’re the President or a weatherman), your goal is to do what you can to promote mutual self-control and minimize pain. If that doesn’t meet your definition of “normal friendship,” I repeat, there is no such thing as normal friendship with someone you just ended a relationship with.

Maybe after some time passes and you both forget the hurt and bad behavior, you can get coffee together without excruciating awkwardness. For now, it’s more important that you salvage a working relationship and your job.

It doesn’t matter that you’d like to show her you don’t or do care, or that you’re happy without her, or dying because of her or that wish to re-unite/be friends/have some of that old crazy monkey sex, whatever. You’re entitled to have all those feelings and more, but keep them to yourself if you want to work and avoid a rapid re-enactment of your recent pain.

The standard operating procedure for limiting pain in these situations is labeled “polite detachment,” and blocks you from sharing or responding to feelings that fan the embers. She should get the same treatment as any other co-worker; polite hellos at the water cooler, appropriate eye contact, no flying furniture, and no hugs.

STATEMENT:
Stifle your romantic yearnings with the following directive. “My heart may want to share, but my job is to keep my job and protect my heart from receiving or delivering more hurt. So, if I seem stiff or cold, it’s not to wound, but to create a boundary that will help us both return to making a living.”

I had a tough childhood and spent lots of time in therapy learning how to take my feelings seriously and not let people step on me, so I think I did a pretty good job the other night, during a meeting of our coop board, when my neighbor, whom I like, was sarcastic about a project I proposed. I expect more respect, particularly from a friend and neighbor, so I really felt hurt and betrayed. But I was able to stand up and let him know I thought he’d been disrespectful. I was hoping he’d apologize, but afterward he walked out without looking at me. My goal is to get him to understand I want to be friends, but I won’t tolerate verbal abuse.

Sure, sometimes people are mean and shouldn’t be, and the hurt is real and devastating. It’s your responsibility, however, to figure out whether the mean people can ever recognize their meanness.

(If you’ve followed this blog, you know that most mean, hurtful people never recognize their own meanness, seeing it as retaliation for the wrongs of others, because that’s the way they are. If they recognized it they would have apologized and you wouldn’t be writing me).

When you try to hold a mean-blind meanie responsible for being nasty, he’ll tell you what you did to deserve it, and more. You’ll wind up more hurt, and he won’t.

Your background may have added to your being a very sensitive person. That’s not a horrible thing; your sensitivity probably makes you a better friend, more creative, and more tuned-in.

The downside is that being very/overly-sensitive may make you over-react, over-speak, and look bad, and then, if your right to feel offended depends on how you interpreted someone’s tone of voice (“tired” vs. “sarcastic and demeaning”), you’ll wind up arguing about the unprovable.

Your job then is to stop looking to change the meanie or bring about justice. Make the best of your relationship with him. If he’s worth the hurt, shut up, don’t fight, and keep the conversation cool, at least until you recover. If he’s not, shut up, bite the inside of your lip to keep from crying, and stay away.

In either case, keeping your feelings to yourself means less pain and more options. As a sensitive person, you always need to stop and think before you react. That’s not letting yourself get stepped on; it’s keeping your emotions from trampling all over your life.

STATEMENT:
Here’s a motivating statement: I have better missions in life than to stand up to jerks, regardless of how easily I’m hurt by them. If a worthwhile friend is a sometime jerk and can’t take a hint, I accept the pain, do my best to protect myself, and focus on what works. It’s too bad; but that’s life, and I don’t let hurt feelings determine how I deal with it.”

Most people thing my mom is really fun, if a little flaky and emo, but they don’t see how crazy and mean she gets when there’s no one around but my brother and me (my parents are divorced). When she’s in a bad mood, she tells us we’ve been mean to her, and reminds us of things we’ve said that hurt her, and tells us how bad we are until we’ve apologized, and then she forgets it ever happened. There’s one cousin who’s seen what she gets like and I rely on him to remind me that it’s OK, she’s crazy, but the other day he seemed charmed by her and then, when I complained, he told me I had to get over her and not be so angry, and now I feel totally unsupported. My goal is to get someone to understand what’s going on.

Nothing gets people more stirred up than dramatically pitched false accusations and punishments by a powerful, inescapable, totally two-faced authority, like your mama.

The good news is that, while you’ve got the makings of a perfect soap opera, it sounds like you’re not getting swept away by it.

The trouble with soap operas, of course, is that they trap the good guys into endless rounds of angry, hurt reactions to crazy bad guys. In the process, they take up huge amounts of time and energy for tears and talk, talk, talk before, finally, there’s a glimmer of comfort and validation…before the cycle starts all over again.

The process leaves no time for any other (boring, make-a-living) activities or relationships, positive or negative, and the good guys’ angry responses and efforts to expose the villain usually make them more vulnerable to slander in an endless vicious circle.

So enjoy validation if it comes your way, but don’t seek it out too intensely or your life will become ready for daytime. Besides, even if somebody sees what your mother’s really like, her behavior is not going to change. Sadly, you drew her number in the mother lottery and won a nut job.

Not to be indelicate, but, as you might have guessed, your mama sounds a little crazy. On the positive side, that basically means, while her behavior is erratic and sometimes cruel, it’s not personal, just like your cousin says.

She’s not motivated by anything except a blip in her brain, so keep that in mind when you’re tempted to “fight back,” because you can’t win against crazy, no matter who acknowledges how crazy she is.

Your goal then isn’t to out your mother as a witch from hell, but to keep doing whatever you think is positive, good for you, and likely to spring you free, like getting your schoolwork done, keeping busy with out-of-house activities, and keeping these goals in mind when she does blow up and accuse you of untold (and likely fictitious) evils.

There’s more good news in that it sounds like that’s what you’re doing; you’re not describing angry, “cry-for-help” drug-downing or cop-defying behavior that will accelerate the soap opera cycle at the expense of your health and future independence.

You’re moving ahead, regardless of anger and turmoil, and that’s what you need to do. Forget exposing her two faces, because nobody will be happy if the soap hits the fan.

STATEMENT:
Here’s a standard business plan for growing up with a closeted witch. “I’ve got good reason to believe I don’t do bad things unless she gets me mad, and I can’t stop her from getting me mad, even if the world knows it’s her fault, so I’ve got to believe in myself and pursue my regular goals, like schoolwork and building a life. I can’t expect to be happy when she gets going, but if I can keep my mouth shut and fight the temptation to join her in big, dramatic scenes, I’ll be doing a good job and acquiring an excellent training in how to be a therapist.”

I’m a psychotherapist with a small but thriving practice. I’m also recovering from an addiction to pain meds (please note: I cannot prescribe medication, nor can anybody in my practice, so there’s no ethics violation there, I got my pills like any other druggie would). I’ve been completely sober for three years now, but I’m afraid to be open about my problem with almost anyone, including my family, because I can’t see how people would respect or want to get help from someone who was as messed up as I was (and I know most drug counselors are addicts, but I think this is different). The problem is, I feel more stressed than ever. I’m burning out on my practice because I’m always staying late and trying hard to make sure everyone is settled before I let them out of my office. And I feel terrible about not spending enough time with my family, and I never have time for myself. I feel I’m in danger of slipping, but there’s no escape.

Your drug use might be under control, but right now, your life isn’t.

Your life is being managed by your need to do a perfect job and keep your patients safe and happy. Meanwhile, you’re running out of gas, losing credibility with friends and family, and slipping closer to the pit of pain pills.

You’re not at the wheel, your desires are, and we know where that road leads. Caring too much about how people feel and doing a perfect job are what got you into this mess in the first place.

You can’t make people happy, particularly if you’re a shrink. Patients are unhappy; that’s why they’re patients. So far, there’s no cure to life sucking, so, like a good physical therapist, your job is to use your time efficiently to offer coping tools. After that, it’s quitting time.

Sometimes people are helped; but sometimes they’re disappointed. Your job is to do a good professional job and then move on to other responsibilities.

Then there are patients who want to hold someone responsible for their unhappiness, and their therapist is target number one. They know you haven’t done enough, or you’ve done the wrong thing, or you need to do more. If you react too much to their beliefs, you’ll never leave the office.

Of course, you can’t stop being sensitive, because that’s your nature; I might as well ask you to start writing with your other hand or grow a foot overnight. Instead, accept your sensitivity and learn to manage it.

You need to take pride in how you manage your weaknesses and, to do that, you must first acknowledge them, not disown them. Out yourself and lay claim to the management credit you deserve.

STATEMENT:
Here’s a management directive. “I always feel better if people respect me and are happy with my work; but I will not let that need interfere with my building better self-control, limiting workaholism, and doing what I think is right to balance my life. The greater my weaknesses, the more right I have to be proud of what I’ve done with them and intend to do.”

I love my work, my kids, and my wife, but I have bipolar mood swings (and I’ve taken medication for years) that lead me to do things that get me into trouble. Recently, in spite of the medication, I felt a surge of energy and started to stay up late, sneak into my studio and paint. I’ve also started to drink again. I don’t want to change meds or let people know what’s happening because I want to keep my options open. I love the highs and the freedom, and I hate being told what to do, but I’ve got a demanding day job that doesn’t involve painting, and a wife who doesn’t like it, to say the least, when I’m not honest. So my goal is to get myself under control before people catch on to what’s really happening.

There are few fathers and husbands who can’t identify with the goal of wanting to feel special, have time to themselves, and avoid humiliating comments about eating, drinking, toileting or sleeping habits from their next of kin.

The fraction of these fathers who are dealing with mental illness and addiction to alcohol don’t want to be asked if they’ve been taking their medication or started drinking.

So, if your goal is to avoid immediate disrespect and hang on to your secret Van Gogh identity a little longer, then keep doing just what you’re doing.

On the other hand, if you want to avoid the long term chaos of going nuts, listening while your doctors try to find a mental hospital that also does alcohol detoxification and having your wife tell you that you’re not welcome home until you straighten out and maybe not then either…then you’ve got to give up on secrecy and come out of the out-of-control closet.

That’s because it takes a powerful part of your personality to make a good guy risk his health and marriage for the joy of a very, very good but relatively brief mood and paintings that will never reach Sotheby’s. It takes a demon.

Lots of people have demons—they pay my bills—and it’s a waste of time to figure him out instead of looking for ways to manage him better, all of which require you to face and ‘fess up to your (or should I say his) possession.

Sorry, but it’s almost impossible to gain control of a demon without acknowledging that he’s A, there, and B, can’t be extirpated or exorcised (except through lobotomy). That’s because he gains strength from being hidden.

So tell your wife and trusted friends about your problem, share your story with similarly possessed people, discard false shame, and do your best to keep the demon under control.

In recovery, they say you’re only as sick as your secrets; admit your secrets, and you can keep your demon at bay.

STATEMENT:
Here’s what you need to say to yourself (and others). “I’m living a good life, but it isn’t easy. My priorities are to make a living and raise a family, but there’s a part of me that wants to drink and paint and stay up late and enjoy the bipolar highs, and sometimes that part takes control, particularly when I think I’ve beaten him for good. Making my problem public is the best way to strengthen my self-control. I respect my willingness to humiliate myself for a good cause.”

My girlfriend and I keep breaking up without ever really getting together. She’s obviously interested in me, or she wouldn’t keep calling, and I can sense her sincerity. We have a good time together when we get a chance to go out. Whenever we’re at the stage of taking things to a new level, however, like we’ve been talking every day for a couple weeks, she’ll suddenly drop out of contact for a few days and then act like nothing’s happened and I shouldn’t expect her to be that available. A couple times when she dropped out, it was because she couldn’t decide whether to get back together with an old boyfriend. That’s no longer the issue, so I thought we were clear to go, but we can’t seem to take off. I’d like to know if I’m doing something wrong or if there’s a way she could get help.

Don’t trust your feelings to tell you whether someone is really interested. Feelings are easily fooled and love is blind; watch her feet and see what they have to say.

This girl’s feet are doing the cha-cha-cha, one step forward, one back, quick shuffle, one more back, one forward, another shuffle, and repeat. She likes to dance with you, but that doesn’t mean she’ll ever move forward or make you her number one partner.

If you trust your feelings, then you must ask yourself what you’re doing wrong, which keeps you stuck with her and introduces you to doubt, depression, and me. It costs you time and money to stay at the mindfuck disco.

Ask yourself what you’re dancing for. It’s not because you need to dance (though you do), but because you’re looking for a partner, which requires you to know what you’re looking for and keep your feelings out of it until you’re sure you’ve got a likely candidate.

One of the requirements—I know, it’s amazing that I can read your mind, but remember, I went to Harvard—is that someone has a good track record with relationships. No one who does the cha-cha-cha need apply, ever.

Don’t tell me that’s easier said than done. First, I’ll tell you it’s harder if you don’t do it, so you don’t have a choice. Second, given today’s theme, I’ll tell you you’re possessed by a demon who loves attention and wants to dance and you have a hard time keeping him in check.

Your goal is to make a solid, independent choice, regardless of your short-term needs. Cowboy up, be a grown-up and give yourself the benefit of solid, caring protection and a nice, sturdy, one-on-one waltz.

STATEMENT:
Here’s a statement, in case your demon (or sometime dance partner) asks why you can’t, at least, enjoy a nice, friendly talk. “I don’t think our chemistry is right for what I’m looking for, though we certainly have a good connection. Spending time with one another right now doesn’t take either one of us in the right direction.”