I decided recently to listen to my friends and family and see a psychiatrist about my depression, but I don’t know whether I’ve made the wrong decision, or whether I’ve just chosen the wrong doctor. Basically, I decided to get help because I feel helpless, but my doctor wants me to do a lot of the work myself and doesn’t really help that much. It’s not just he wants me to ask myself a lot of questions (and answer them—if I had the answers, would I really be paying him?—but also deal with my insurance company and read up on the medication he suggests (he tells me about them, sure, but he says I owe it to myself to read up on them on my own, and that doesn’t make sense to me since he’s a doctor, knows everything about the pills, and he could just tell me himself). My goal is to figure out whether therapy is worth it, or whether I’m just getting help from the wrong source.

I hate to sound like your psychiatrist, but ask yourself what you have a right to expect from treatment, given what you know about its limits and your resources for paying for it.

If you want, you can spin things positively by saying that you’ve heard about good new treatments that can really help and that you’ve got great insurance that you pay a ton of money for. Of course, you’d probably be full of shit.

You don’t need to do months of research to know that no treatment has yet been acclaimed as a cure for mental illness or any other life- or personality-related problem.

Plus nothing you’ve read (or probably haven’t bothered to read) about the effectiveness of any current treatment implies that it works 100 percent of the time or that the treatment, if medical, is safe from possible side effects.

In addition, every method of “screening” for depression that you’ve heard about involves a questionnaire, right, rather than a blood test or scanning machine, which means that the burden for enduring, measuring and tracking the results of a trial of treatment falls, inevitably, on you the patient. And those are unfortunate facts of life whether you’re rich or poor, smart or stupid, board certified or not.

That’s the next problem: you’re not rich. And while you bristle at having to deal with insurance limits, you can’t afford insurance that would give you unlimited mental health treatment because it doesn’t exist. All insurance puts a limit of some kind on the amount of treatment you get and, unless you know what that limit is, you’ll use up your resources too quickly and have no idea about what, if anything, entitles you to more.

In addition, insurance limits your doctor’s fees and the amount of time s/he can afford to spend on a visit, so don’t fall for the professional who is ultra-amiable until your money runs out. Instead, look for someone who gives you what you most need in as little time as possible. In other words, beware smiles and frills because they may drain your limited resources.

Depressed people like yourself also tend to get negative and helpless ideas, which make them act negatively and passively, which makes them yet more depressed. That’s why mental health clinicians will push you to challenge your negative assumptions, learn more positive ways of thinking about your problems, and put the breaks on the depressive cycle.

It’s a cognitive kind of psychotherapy and is very helpful, although it’s often unpleasant in the beginning because you need to clamp down on your natural instincts. It’s a mental workout to make your non-depressive muscles stronger. No pain, no gain.

So yes, therapy of all kinds can be worth it, but you’ll be the one doing much of the work, not because someone else is slacking, but because mental illness sucks and both treatment and the resources to pay for it require careful management—by you.

Now you just have to decide what’s harder—doing the work or doing nothing. It might not be what you want to hear, but there’s no psychiatrist out there with a better offer.

STATEMENT:
Here’s a statement to keep you positive about a negative treatment process. “It’s hard having an incurable illness and knowing that the treatments are iffy, take a long time, and can easily use up my insurance before helping me, but I owe it to myself to give every reasonable treatment a try and become and good resource manager because that’s what I have to do.”

I’ve been in therapy for five years, and while I like my therapist a lot, I’m moving soon (my girlfriend got into grad school on the west coast), so I’m ending my treatment with her. She asked me recently though whether I was going to continue my treatment in my new town or whether I thought I’d taken it far enough, and I realized I honestly don’t know. She had some suggestions in terms of determining when and why to end therapy, but to be honest, they didn’t really help. I’ve been in therapy long enough that I don’t really remember how I coped beforehand, and while I feel much less tormented than I did when I began therapy, I’m not sure if my state of mind will crumble once I’m no longer getting help. How do you think one can determine when therapy has run its course, or whether there’s more to be done?

There’s a simple way to figure out how much talking psychotherapy you need: imagine paying full fee for it.

Before you crunch the numbers, ask yourself why you started therapy in the first place. Forget self-improvement, introspection, or generally pondering your bellybutton. Figure out what’s so bad about the way you feel and/or handle your life that you need to continue to spend lots of time and money on changing it.

Having failed to solve your problems over the past 5 years, you should wonder whether you can realistically expect a cure in the next year (no way) or whether you need maintenance treatment to keep you from slipping backwards (which is what you’ve been wondering all along).

At the same time, go back to the original question and ask yourself how much you can afford to spend on treatment each year and whether you should hold a few sessions in reserve for use in emergencies.

Unless you’re rich, don’t waste time worrying about how stopping treatment will make you feel. Instead, try stopping and see what happens. Even if you miss your therapist’s support, lose confidence, and re-experience your nervous stammer, suck it up, give it time, and the earth will continue to turn.

Next, think of therapy as a course that’s supposed to give you a specific marketable skill in exchange for your hard-earned debt. Don’t think like a college kid; you’re not there to party, please your parents, or become cool. If the first few sessions don’t deliver what you need, drop the class.

If you do have ample insurance coverage for therapy, don’t let it make you forget basic resource management skills. For one thing, many insurance policies are stiffening the limits on outpatient psychotherapies and are about to force you to do the above.

For another, being an active manager protects you from unnecessary dependence and time-wasting. Give your therapy specific goals, then examine how close to those goals you’ve come.

If therapy is more about discussion, then save the insurance hassle and start a search for a fun hairdresser. You can get your hour of talk and never have a bad hair day.

STATEMENT:
Here’s a statement that keeps you focused on making the best of limited resources instead of going for all-you-can-eat and then feeling deprived and abandoned. “I like psychotherapy and feel it’s been good for me, but it’s time, before it eats up more time and/or money, to think hard about how badly I need it, how well it’s working, how much is necessary, and how much I can afford to pay for it. The more I answer these questions for myself, the less likely I am to depend on experts to tell me what I need.”

I’ve been depressed for some time and could use some treatment, but my insurance has a big deductible, so I’ll be paying everything out of my pocket, which isn’t deep. My goal is to get treated for the least amount of money.

I’ll assume from your tone that depression isn’t making you suicidal or putting you at immediate danger of losing your job and/or family because, if it is, you need to forget about the cost of treatment and value the cost of your survival.

If depression is putting your life/work/family in danger, get a psychiatric evaluation, in an emergency room if necessary. Do not pass go, do not collect $200 (no matter how much you need it).

If that isn’t the case, there’s lots you can do to reduce the amount of money you spend on treatment…if you’re willing to spend some time, do some research, and use your common sense.

While the above question is quite short, the answer is anything but; looking for a treatment on any budget is a serious, involved process, so we have an involved, serious answer. Behold, our five step process that will help you with your depression without hurting your wallet.

Step one is telling your primary care physician (during a brief visit or even email) that A, you’re feeling low, B, you don’t have any physical symptoms (no fever, no weight loss), and C, you’d like to get some tests to rule out a physical cause of depression, like thyroid disease.

Tests will reveal if you’re feeling low because your glands, not your brain, are problematic.

Assuming your glands are good and your brain isn’t, step two is considering the options other than antidepressant medication, which, because it’s medication, always has a higher risk than non-medical therapies.

I’m guessing that medication is probably the last thing on your mind. It’s important to think about it upfront, however, because sometimes depression doesn’t wait for psychotherapy to work before causing severe pain and/or damage to your life, and medication always increases the odds for a better and faster (and sometimes cheaper) recovery.

Step two then, (postponing the issue of possible pills), is considering psychotherapies, including the how-do-you-really-feel-about-that kind. Many people assume this is the only kind since it gets lots of airtime on TV, where it uncovers exciting and unexpected changes of heart and inspires tears and plot reversals.

Despite what TV tells you, however, not everyone with depression needs psychotherapy. Psychotherapies are better at helping you manage depression than cure it, so it’s not surprising that many people with depression have had a number of psychotherapies.

Before considering a feelings-focused therapy, ask yourself and the people who know you whether there’s an issue you need to talk about. Remember, sharing your feelings with a professional is most effective if you haven’t done it before or your confidantes are unsupportive bozos and bartenders.

So, while the bad news is that psychotherapy is not a cure, the good news is that you don’t have to pay for it unless you think there’s a kind that’s worth trying. Either way, you save!

Your job is to figure out whether you (still) need one or more of them. If you want to save money, do your homework. It’s that, or pay a professional to do it for you.

If you decide that a feelings-focused psychotherapy is necessary, you may get a bargain at a state-subsidized community mental health center or a psychotherapy teaching institution. Don’t assume you should see a therapist every week, because you may get just as much bang for your buck by making the meetings less frequent.

You haven’t completed step two, however, until you consider other psychotherapies, particularly cognitive behavioral therapy or “CBT”, which is a good option if your negative thinking (caused by depression or being human) is making you more depressed.

Read books on the negative thinking caused by depression and anxiety (like The Feeling Good Handbook by David Burns) and decide whether you need to do thought exercises to stop your negative feelings from becoming negative beliefs or actions. If you find it useful, look for a therapist who “does CBT” or “DBT”, a form of CBT that focuses on thoughts of self-worthlessness and the desire to injure oneself.

Please note: we’re not recommending all kinds of self-help. In fact, if you see a self-help book about “healing the inner hurt,” run the other way as if it were on fire. If Dr. Phil recommends a book, we forbid it.

Step three is taking a break from the books and tuning up your diet and lifestyle. Exercise is a powerful antidepressant (the way you feel afterwards, not during, anyway). Vitamins and omega three fatty acids help, and, despite what most people think, drinking and drugs don’t, so learn to abstain.

Finally, read up on antidepressants while ignoring the eye-witness accounts of horrors and miracles. Consider the risks (fairly low, despite what Scientology says) and possible benefits (positive, but delayed and very iffy). Then, if you decide that the risks of staying depressed are worse than the medication risks you’ve read about, ask your primary care physician for an “antidepressant medication trial.”

Remember, you’re conducting a trial, not taking a cure. Note, quantify and record your symptoms and possible side effects over the next few weeks. (There are programs on Google that can help you do this). You’re the one who decides whether the new medication is doing more good than harm.

If a couple medication trials haven’t worked, the very last possible step, number five, is to get a referral to a psychiatrist and give him/her a list of the medications you’ve tried, the doses, how long you took them, and the good and bad things you noticed. You can find a psychiatrist on the cheap at the same clinics we sent the feelings-focused types to.

Follow these steps, and you’re on the road to dealing with/managing your depression. It’s not a cure or an easy answer, but it’s a start, and hopefully this is all the information you need to start on a good path to treatment without paying a pretty penny.

STATEMENT:
Here’s a statement of purpose that will counteract depressive helplessness and pessimism. “I don’t know why I’ve been feeling depressed and I may never know, but I know how to find any causes that are worth finding and to try the cheapest treatments first. I expect to run into a lot of dumb ideas about depression because many people want to believe they have the answer and an easy way to control it. Whether or not I can control it, I know that, by doing the research myself and using professional help whenever I think it’s necessary, I can do a good job of taking care of myself.”

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’m an older woman with two advanced degrees in creative writing (one from Iowa, la di da). My career, on the other hand, hasn’t risen beyond doing commercial writing, be it technical or ad copy. I get published in small journals here and there, but after my first novel got a handful of rejections, my agent dropped me, and I haven’t been able to finish another novel in order to get a new agent and sell the first. My limited number of published pieces has also made it hard to get a teaching job, even though I got degree number 2 specifically to enter academia. So now I’m stuck working in advertising, and while it’s a good steady job that pays well, it still kills me a bit inside. Nevermind that I’ve absolutely struggled with depression my whole life, and while I take a handful of medications to control it, it’s just an added level of difficulty. Nonetheless, with my illness under control but my dream still very much out of control, my goal is to make this job work so I can settle and maybe even be happy.

You could say writing is a stupid career choice, given the unlikelihood of making money, and that academia isn’t much better, given the current job market. It’s as stupid as counting on a career in the NBA because you’re good at basketball.

The truth is, a large part of being a writer isn’t a matter of choice; it’s who you are, and trying to find a life that fits. It’s not so much a bad choice as a bum calling, with inspiration necessary but never promising to come when called.

The good news is that you’ve got a day job that involves writing, you’re making a living, you’re gathering experience that may inspire your next novel, and you can always find some teaching opportunities that will spiff up your credentials. For your parents, it’s very good news.

I know, my congratulations do nothing but cause your inner-writer chagrin. That voice says you’ve failed to fulfill your creative purpose, find your voice and message, connect with an audience, or put together something that moves people.

The good news, again, is that there’s nothing I or anyone can say to quiet that voice, because it will never let you be entirely happy. Short of getting a lobotomy, that voice will be your most constant companion, and if you succeed in writing a book that sells, his demands become more relentless.

So invent a good, kind speech for your inner narrator to tell yourself. You don’t control the result, so your job is to respect the effort. Consider the many writers and immortal characters, from Chekhov to Buffy the Vampire Slayer, who remind us that we don’t fight against hardship to win, we fight to fight, regardless of the result.

If you’ve learned to carry on despite depression, you can keep on going even if your job isn’t ideal. Your story isn’t dramatic, but that’s precisely what makes it heroic.

STATEMENT:
Let your narrative voice frame the meaning of your efforts. “I wish I could do more writing and teaching, and someday I may, but in the meantime I have good reason to be proud of the compromise I struck between the need to make a living and the wish to do what I love, because it’s hard, it’s the best I can do, and it’s for a good cause.”

I was a promising graduate student in English, doing well, respected, enjoying talks about books and ideas, when something happened and I just faded out of the real world. Nothing traumatic happened to me. I didn’t get dumped or mugged. I just stopped getting my work done and the extensions grew longer and longer on my projects and papers until finally I had to leave without getting my PhD. Whenever I try to go back and finish off my old projects, I just stare at the computer. I’m sort of depressed and medications have helped me feel a little better, but I’m still not good at getting things done. Now I’m teaching high school English and the kids like me and I like teaching, when I’m prepared, which isn’t always. I never know when I’ll get paralyzed and not prepare a lesson plan or fail to grade papers. My goal is not to be the total fuck-up I’ve become.

Some people regard procrastination as a kind of laziness resulting from a secret loathing for work, or a rebellion against bosses, or a rage against life in general.

Those same people, however, are the ones who see mental illness as an emotional failure. They’re not all Scientologists, but they are all wrong.

The evidence is growing that procrastination arises from disordered neurology, the equivalent of “chemical imbalance” except sadder and scarier, because what’s happening is brain damage. You’re probably not firing on all cylinders, literally, since brain images shows cells missing from critical locations.

It happens to lots of people who’ve had depression, even when the depressed feeling gets better. It’s true, theoretically, you could grow new brain cells, but in practice, the damage often doesn’t improve.

I blame your neurons, not to let you off the hook, but to show you that, while you’ve got more ambition than most, you’re running on less horsepower. Which means your diagnosis is, you’re fucked. The good news, as always, is that there’s no point in blaming yourself, and there’s much you can do once you accept that you’re fucked and stop feeling ashamed.

No blame, but there’s no escaping the hook, and it hurts more because you have high ambitions, which causes more depression, and so on. You might not be able to meet deadlines, but you can still cook up brilliant thoughts, and there are worse ways to have a busted brain.

I know, it’s hard to feel proud when the teacher is farther behind on his homework than the kids, but that’s the way your equipment works, so do your best with it.

STATEMENT:
“I still care about English literature and teaching, but I have trouble doing what’s necessary for reasons I can’t help. So my goal is to try to provide good teaching by using a number of tricks, including asking my friends to help me stay on task and stick to a work schedule. I don’t know if I can teach a good course, but I’ll try, and I respect myself more for trying to get half-decent work out of a busted brain than great work from one that’s super-gifted.”

I need to stay married because, while I work a pretty demanding job, my wife stays at home and watches our two kids, whom she adores. The problems are, however, (and there are many): she doesn’t work because of a migraine disorder that’s so debilitating that she’s on disability, and she takes too many non-prescription pain pills for those headaches, and, while they don’t make her a bad parent (I know the kids are safe), they often make her, in your words, a really needy, grumpy asshole and an impossible woman to be married to. I never know when she’s going to kick me out of the bedroom, scream at me in front of friends, or nod off after dinner. Needless to say, she won’t try marriage counseling or cutting back on the pills and thinks I’m bullying her if I suggest we have a problem. I can’t leave her, because it’d break the kids’ hearts, plus, like I said, she provides childcare, which is not something I could afford on my salary, and if I lost custody of the kids, I’d be in a worse hell than I am now. I know I can’t leave, but I don’t think I can live like this much longer. My goal is to find a better way to survive.

You’ve got good marital reasons for staying vs. leaving (the kids, the kids, the kids, and money, but also, the kids). There’s no escaping the fact, however, that her headache is infectious, and you’ve got it, too.

You’ve obviously built up a good, solid tolerance for living with your wife’s problems without fighting all the time, and your values and perspective are great. Which is why you probably already know that your goal is impossible.

Although the pain of living like this is pretty bad, it’s unavoidable, and the alternative, which you’re realistic about, is worse. The question then becomes, is there anything you can do to make things better.

If by “things” you mean hanging on to your initial hopes of a peaceful goodnight kiss, talk-things-out, happy-Mother’s-Day kind of marriage, then the best way to make your relationship better is to give up on your dream, take out your hankie, weep, blow your nose, and get on with it.

As you probably know already, trying to manufacture that kind of relationship using the reality of headache, drug abuse, and unrestrained nastiness will get you ripped up and make things worse for the kids. You probably already know this because you live it everyday.

On the other hand, if, by making things better, you mean minimizing pain and maximizing stability (instead of making your dreamiest dreams of a tranquil union come true), then discard the old conventions and remember the calming power of a wall, whether it’s made of bricks, silence, politeness, or emotional restraint. Hopefully, all of above.

Don’t be ashamed to show that you and your wife are not on the same page; fuck convention, because trying so hard to get on the same page is impossible and killing you both. Don’t be mean, but don’t hesitate to separate whenever you think the alternative won’t work.

Friends and kids may urge you to make nice, kiss, communicate, and listen to the minister/couples therapist. Don’t. Be ready to stand by your own idea of what works best.

Your wife copes with her worries by maintaining a steady diet of denial and pills, but that’s working for her and no one else. You can make everyone happy by being less of a good husband, more of a good roommate, and always a good dad.

STATEMENT:
“My relationship with my wife is very important. We’ve tried hard to stay close, despite a number of unresolvable problems, and too much closeness seems to make things worse. We still believe it’s best to stay and work together. What helps most are arrangements that allow us to live, work, and sleep separately when the tension or disagreements are too emotionally intense. I refuse to talk with her—with or without a helper in the room—about our anger and the issues behind it, because it opens the door on bad feelings and impossible expectations that invariably cause more pain. If, however, the talk is about ways of accepting and managing our differences and disengaging when we must, then I’m open to new suggestions.

I thought I could help my 13-year-old step-daughter after I married her father and taught him how to set some limits with her, but what’s happened is that he continues to be a can’t-say-no, don’t-damage-her-self-esteem wuss, she continues to raise hell to show him how much she hates her evil stepmother, and I’m starting to worry about her bad influence on my own 7-year-old girl. My stepdaughter is not just a brat; she’s already gotten suspended twice for drinking at school. Yes, twice. Our therapist can’t seem to get my husband to take a stand and has started to get down on me about how angry I am and she’s right, I’m starting to hate both my husband and his daughter. I don’t want to lose this marriage or act like an evil stepmother but I also want to protect my own girl.

Not every mixed family can end up like the Brady Bunch. Especially when Jan’s got a flask, Marsha’s pouring, and Cindy’s thirsty.

Once again, if what you want is a conventional, all-healed-up family, you can’t have it. It would be nice, but you gave it a good try and, as often happens in real life, you can never count on getting what you don’t control.

So if that’s what you want, and you keep trying to get your husband to take a stand, or stop your stepdaughter from misbehaving, or make sure bad influences can’t reach your own child, you’ll make things worse. As above, the first thing you can do to make things better is: give up on the idea of one happy family.

Decide for yourself whether what you’ve got is worth keeping; ask whether your husband–the-wuss is a good-enough partner when his daughter isn’t acting up and whether there’s a good chance that your stepdaughter’s troubles won’t gobble up your savings or infect your younger daughter.

If it’s worth staying, then cast aside convention, resign as a strong stepmother, and become a wise consort.

Yes, people (including your husband) may criticize you for not being more nurturing and involved in the life of your troubled stepdaughter. Assuming you aren’t, however, you’re free to avoid disciplining her or having much to do with her unless she asks for your help and is reasonably well behaved.

You can keep your door locked. You’re not punishing her; you’re just avoiding issues that can only end badly. In the meantime, you can remind your daughter how you expect her to behave, no matter what her step-sisters do, and remind yourself that it’s better to be an ex-step-mother than an evil one.

STATEMENT:
Prepare a statement that makes clear your distance is not intended to punish or demean. “I love my husband but it’s become clear to me, after trying hard, that I can’t make a positive contribution to raising his child. There’s no one to blame. Her age and our chemistry are simply wrong. The best way for us to manage our relationship is to keep it friendly but formal and avoid my assuming any parental authority. By this I do not mean to criticize her or withhold love; merely to make the best of a family relationship.

I have a 30-year-old patient whom I’ve been seeing in weekly psychotherapy for 6 months and he had a terrible history of sexual and physical abuse and years in state care. Amazingly, despite all his trauma and several prior failed treatments, he settled into a trusting relationship with me. He tells me I’m the first person he’s bonded with, and he’s been able to stop using cocaine, and, for the first time, sees some hope for himself. The problem is that he just got a new job, and I’m not covered by his new insurance plan. He wrote me a letter telling me how much he feels his recovery depends on continuing the treatment we’ve started and I feel professionally obliged to put his welfare ahead of my financial needs, but I’d like to get paid. My goal is to do right by my patient, and not trigger the feelings of abandonment that underlie much of his negative behavior, but I’m not sure how long I can afford to see him for nothing.

There are many therapists who believe the best thing you can do for a troubled patient like this is to “be there,” providing the steady acceptance and secure relationship that they need for healing. I’m not one of them.

The sad fact is that the healing power of currently available treatments is vastly over-rated and a good example of false hope and the harm it can cause.

What’s wrong is that our treatments, in terms of demonstrated effectiveness, are all rather weak, and it shouldn’t be surprising; we do our best, but life, such as it is, is a bitchmonster from hell. You can’t undo the past, change personality, stop drug cravings, or even guarantee that you’ll be available next week.

Look where you’re going with this treatment and “mind the gap,” as they say on the London Underground, because, as ideal a healer as you seem right now, there are many ways this dynamic could get tripped up.

For example, unexpectedly, you and/or your treatment rub the patient the wrong way. It may be that you fail to live up to an impossibly high ideal or that you have a bad day and say the wrong thing. When that happens, trust disappears and with it, your patient’s rationale for healing.

You try to stay calm, remain empathetic, and ride out the storm while resenting having your personality dissected for an unpaid hour. If your anger shows, it gives your patient more reason to feel victimized and find a therapist who can help him recover from his latest trauma/treatment.

Another common outcome is the “Bill Murray Morass,” whereby he continues to feel strongly that treatment is beneficial and can’t imagine living without it, and you, and this continues for many years, while you continue to feel responsible and indispensable. “What About Bob?”, indeed.

You and “Bob” could argue that treatment has benefited his control over negative impulses, but it has also fostered a sense of dependency and fragility that will surface if, God forbid, you should die first, or, more likely, he just changes his mind.

So don’t buy into his idea of your precious relationship. If he liked you, it proves he has the capacity to like another therapist. There are many fish in the sea, many therapists in his insurance directory. If he depends on that positive feeling to stay sober or maintain a positive idea of the future, he’s in trouble, and so are you.

Your goal is for him to build up ideas for staying sober and fighting off despair that are not dependent on a single relationship or good feeling, and that can stand up to rejection and depression. In other words, you want to “be there” for your patient, but you don’t want to be the only thing between him and oblivion. Don’t beget a Bob.

STATEMENT:
Our relationship has been positive, but it’s important for you to manage negative beliefs, despair, and anger when you’re not feeling closely supported, and our stopping treatment gives you just such an opportunity. You have the capacity to form a positive relationship, so I’m confident you’ll do well in shopping around for a new therapist. Meanwhile, it’s good for you to focus more on the ideas than on the individual, because it’s your own ideas and the way you use them that will give you strength to manage yourself. I’m confident that this will work out well.”

I have a new patient who’s a young woman, college freshman, who was sent to therapy by her parents after her roommate turned her in for cutting her arms and drinking too much. After a fair amount of discussion, I started her on a medication trial and explained to her that these pills take a while to work (if they work at all), but it didn’t sink in, because after a week she’d had enough with feeling tired and hungry, especially because she still felt depressed and anxious. Not long after that, she declared that therapy in general was a waste of her time and she could stop drinking and self-mutilating on her own. Part of me thinks that it’s not my job, or anyone’s job, to sell her on treatment if she’s not ready, but I admit, there’s a softy side of me that doesn’t want to let her off the hook just so that she can really hurt herself or get kicked out of school. My goal is to get this kid to give treatment one more chance.

It’s tempting to tell a young woman with obvious problems that she should stay in treatment, but don’t. This is not the time to listen to your softer side. Of course you wish she would feel better and stay positive, but first, you and she must accept your lack of control.

If psychiatric treatment—medication or psychotherapy—were more reliable and effective, maybe it would be worthwhile to give such advice. More often than not, however, the first trial of treatment doesn’t work or causes side effects and patients who are already angry and disappointed about their life expectations are then quick to feel that their negative beliefs have been redeemed.

Your goal isn’t to get her to stay in treatment; it’s to give her tools to make rational and positive decisions about treatment. You don’t want her treatment decisions to depend on her positive relationship with you (see: above Bob) or an initial positive result. You want them to depend on her own ability to weigh risks and benefits and do what’s right.

It’s easier to help her think realistically about treatment if you crush false hope up front. You are obviously well aware that treatments of any kind rarely bring about a “cure.” I’m often reminded, when patients cite a pharmaceutical add touting a particular medication as “effective,” that the scientific meaning of the word is the opposite of its meaning in plain English.

In the language of science, effective means “better than nothing,” not “helpful most of the time.” Life is tough and so are most psychiatric problems. Unfortunately, so is your patient’s attitude.

Ultimately, you want her to know that, while you don’t care which decision she makes, you do care a great deal that you make she makes that decision rationally. Being soft won’t work, so be hard, or really, be honest, not emotional or sentimental.

STATEMENT:
Here’s a speech for encouraging her to take good care of herself and use treatment appropriately. “I wish I could tell you that treatment will ease your pain, but it often doesn’t. Given the fact that depressive feelings often come from genes and that we don’t have a cure, it’s not surprising that they tend to come and go and then return, even when a medication or other treatment has been very helpful. So the main goal of treatment isn’t to make you feel better, but to make you stronger and better able to tolerate your condition, much as if it were diabetes. You can get stronger by choosing the right psychotherapist or therapy or 12 step group and also appropriate friends and readings, because the right choice can make you stronger, and the wrong choice won’t. Medication is worth trying if your symptoms are hurting or threatening to get you canned. There’s a risk that each medication will cause side effects or won’t work, but you don’t want to make a choice about meds because you love or hate them. You want to weigh the risks of not taking them and the possible benefit of their working. If I were in your position, I’d definitely be trying them, but it’s your call.”

When my husband and I first got married (and married young, over 20 years ago), his job was physically intensive, but he enjoyed it and it paid well. Not too long ago he got injured, and it was bad enough that he can’t go back to that line of work, so he’s collected disability and taken over the childcare, which he does well. I found a good job, so we’re making enough money, but I don’t like working and miss spending time with the kids, so I push him to find a desk-job, but he obviously hates that kind of work and can’t seem to find anything that suits him. The whole thing is so unfair, I can’t help but dig into him sometimes, in a way that I know, even as I’m talking to him, is just nasty and inappropriate. It’s really putting our marriage through the ringer, but as hard as I try, I can’t control my temper. My goal is to get through this problem without getting divorced.

You clearly value your partnership with your husband…even if you hate your new role as breadwinner so much that it awakens the asshole within.

It leaves you with a big lump of anger and disappointment that you can’t get over and won’t go away. The expression might be “like it or lump it,” but sometimes, you have to do both.

You’ve found it isn’t easy to shut up about your anger because your inner asshole wants to whine and complain and punish your husband for the unfair suffering he’s put you through. Yes, it’s unfair, but it is what it is, and your inner asshole could ruin things for you and your family.

The good news is that you’re not a complete (or “perfect”) asshole, which, as you know from our scientific papers on personality, is a person whose nasty problems are always everyone else’s fault, and who can be reliably counted on to never, ever change, regardless of the number of treatment programs he or she is sent to by spouses, bosses, judges and bishops.

The bad news is that, having an inner asshole that isn’t the total driving force behind your personality means that you will frequently experience the remorse of a were-asshole, who is always trying to put herself in a locked cell before the moon turns full.

So don’t assume your anger will go away by talking about it with your therapist, friends or husband an understanding where it comes from. Women usually think that talking about things makes them better, but, in this situation (and in most situations), it often makes them worse.

See, while you’re talking away, waiting for your internal rage to ease off and your inner-Oprah to soothe your soul, your internal asshole is venting its stuff and ruining your marriage. So your goal isn’t to get relief; it’s to push your inner-asshole voice down so deep that it might emerge out of its namesake.

You might speculate whether your inner asshole is more like your id, or a reaction to loss or an aspect of your inner child. If so, you might want to shut up. You’ve avoiding the fact that you won’t control it by becoming an inner proctologist. Your goal is to close it.

You’ll discover that, if you’ve got an inner asshole, it doesn’t go away. Close it today, it’s just as strong tomorrow. If you’re ashamed of it, it gets stronger.

So dealing with it requires, as do most such problems, a shameless acceptance of the fact that your inner asshole is going to share your personality for life, and that you need to work hard, every day, to keep it in check, one day at a time.

If you don’t, then there’s more than your marriage at risk; like your actual anus, if you don’t control your inner-asshole, it will shit all over your life.

STATEMENT:
Prepare a statement to help you bear your burden and tighten your sphincter. “I have a right to be disappointed by the change in my family life but the real problem is that life sucks, my husband doesn’t, and my marriage will if I can’t keep my disappointment to myself. I’ve put together the best compromise for keeping us afloat. Supporting a big family is never easy. The rules are subject to change without notice. The more I hurt, the more I’m proud of what I’ve been able to do. My job is to share that pride and keep the hurt to myself.”

I know it’s a cliché to hate your mother-in-law, but I actually don’t have a problem with mine; it’s my wife who’s decided that my mother is the devil. To be honest, I know that my mother isn’t perfect—she gets on my nerves a lot, too, and has never been good at butting out of my life, and does tend to give my wife a hard time about a lot of things—but I never should have admitted that to my wife, because now she can’t contain herself. When the topic of my mother comes up, my wife becomes a totally different person, like, she dislikes my mother so much it’s almost unhealthy. My goal is to get my wife over her hatred so she can be a normal person all the time.

Blessed be the peacemakers, because they’re always getting fucked by the angry, out-of-control people they like to hang out with.

That’s what warring parties means—people who are angry and out of control—so don’t think for a minute that you’re going to make peace. If anything, you’re going to get blasted from both sides.

Your mother and wife may both have nasty, overbearing tendencies—what a coincidence! Perhaps we should start a linked website, menwholovewomenwithinnerasshxles.com.

The good news, I take it, is that you think your wife is basically a good, reasonable partner, as long as she’s not focused on your mother. The bad news is that she doesn’t see her inner asshole as a problem (and neither does your mother, further coincidence), so you can’t expect her to change and her control will never be great.

Now that your expectations are properly shattered, the real healing can begin. Start by giving up on notions about Sunday brunches with the extended family, and accept the fact that your partnership with your wife is priority one, of necessity.

You can see your mother whenever you want, as long as you don’t see or talk about her with your wife. Don’t try to put them in the same room, because two women will enter, and only one will leave..

Suggest to your wife that it will be in her best interest, and the kids’, to participate in occasional family get-togethers but that, if she agrees, she needs to decide when it’s necessary and how she can best get through it. If your wife won’t agree to contact, there’s nothing you can do about it except to develop your own ways of keeping in touch with your mother and trying to negotiate some contact with the kids.

Either way, don’t try to help your wife to get over her hatred; just make sure to put a healthy distance between her and her hatred’s source.

STATEMENT:
I have a good partnership but my wife turns out to have an inner asshole that will always make it agony for her to spend time with my mother and it’s my job to work around that fact. I won’t try to bring them together. I won’t listen to their complaints. I’ll make it clear, to both women, that I love them and see the animosity as an unfortunate fact of life, rather than something either one caused. I’ll urge my wife to view the problem as my partner in family management and hope that, without changing her feelings, she can see reasons for occasional diplomatic engagement; but if she doesn’t, I’ve done the best I can and must be proud of that fact.

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.”

As rabbi of a medium-sized temple for 10 years, I’ve enjoyed a good relationship with my congregation and I love the work. My problem is that I rely on the temple Board to decide whether I get a raise, and, during the last recession, there wasn’t one because everyone felt too poor to pay more dues. When, recently, I began looking at what rabbis of comparable congregations are making, however, I found that my salary is well below the mean, so I’ve been wondering how to become more active without appearing to be greedy, selfish or unresponsive to the problems of the congregation. One way that occurred to me was to do a “360 degree review” and ask everyone to give me feedback on how I’m doing, including the congregation, the board, and people who work for me. My goal is to get a high approval rating and use that to get a raise.

Unlike the woman earlier this week who was too afraid to rock the boat by asking for a raise (until anger made her want to torpedo the ship), you’re inhibited by guilt, empathy, and that certain Jewish ne sais quoi.

Still, no matter how tempting it is, don’t ask the congregation to clap if they think the rabbi deserves a raise. You’re a scholar and a leader, not Tinkerbell.

I know, it’s easy for a rabbi, or any figurehead of an organization, to rate him/herself by how a congregation responds as an audience; they may not clap, but they sure let you know how they feel, and a “360 review” seems like a good way to quantify your ratings.

You can do a good job as a rabbi, however, without necessarily getting good reactions or being able to control them. Instead of linking the value of your performance to the reaction of your audience, do a self-360, using as your criteria how well you do all the activities that are important to your job, without overemphasizing the obvious crowd-pleasers (although I’m sure your Purim service is hard to beat).

Then, link a raise in your salary to the market value of good-enough rabbinical services, and not to your current popularity, so you won’t be overly influenced by the ups and downs of congregational politics.

Sure, as a leader who is supposed to provide comfort, it’s easy to feel responsible for your congregation’s pain. As a rabbi, however, you should know how to distinguish between selfishness and legitimate self-interest.

You have an obligation to make a living, support your family, and get paid for your services, so it’s up to you to decide what your services are worth, and then allow your congregants to decide whether they’re willing to make the necessary sacrifices. Your instincts may be Rabbinical, but you have to think a little bit like a C.E.O(y vey).

Don’t ask the board whether your needs are legitimate; you’ve done the self-360, determined that you’ve done a good enough job, and made your own allowances for their current financial problems. Now it’s up to you to grow balls/pray and tell them the salary you deserve. If they think differently, it’s their job to explain why.

Be prepared to respond to the emotional questions that make you feel most guilty or insecure about your request. When you’ve answered your own guilt-provoking questions, your posture and voice will tell people that you’re at peace with yourself.

These questions probably include; “Do you feel that we aren’t taking proper care of your needs?” and “Why should you get more when others are making do with less?”, all of which are really asking, “Why is this Rabbi worth as much as all other Rabbis?” Lucky for you, you’ve figured out the answer.

STATEMENT:
“I’m requesting a raise because my current salary has fallen too far below what similar congregations are able to provide for their rabbis, taking into account the current bad economy and assuming that I’m carrying out my duties diligently and responsibly. My family has been feeling the pinch. I am very happy with this congregation and it is easy for all of us to forget about the salary issue, particularly when times are bad. But it’s necessary. Here are my data and here’s my idea of a fair salary.”

I’m a salesman and I love selling, but I’ve always had mood swings and I’ve never been that disciplined. For the last few months, and for seemingly no reason, I’ve been depressed, and it’s starting to destroy my life. I’m pretty good at putting on a smile, but people have started to notice that I’ve lost my bounce, and that just pushes me further down the spiral. I can’t get myself to do anything more than the bare minimum, so my numbers are going to be terrible. I can’t stand what I’m doing to myself. I need to get my control back.

Nothing feels more like failure than a depressive meltdown that makes smiling and/or talking to people a huge chore, and undermines the good work habits you’ve managed to put together. It feels shameful, personal, and avoidable. In reality, it’s none of those things.

When you’re a salesman whose earnings depend on the attractiveness of your personality, it’s hard not to rate success by the response of others to your self-presentation and take responsibility. The same is true for actors, politicians, and, you guessed it, rabbis.

Don’t believe those speakers and supervisors, however, who tell you there’s no limit to the persuasiveness of someone who stays motivated, focused and on message. Believing their words may help you when you’re a novice who needs to overcome shyness and learn how to talk to people, but once depression sets in, belief in your ability to control how others think of you will cause you shame and make you worse.

Your goal isn’t to control the way people respond to you, no matter how good you are at sales. It’s to accept your lack of control over the symptoms of a disabling illness, and respect yourself for dealing with it as well as you can, taking each day as it comes.

Decide for yourself whether you can do a good enough job, and what you need to do to get help. Then you’re ready to confront the worst thoughts you can imagine people having about you, knowing that you’ve done your best.

Before you can get deal effectively with your symptoms, you need to sell yourself on the fact that your depression is out of your hands.

STATEMENT:
I like this job and it requires a large amount of energy, which I can usually count on. Right now, however, I have an illness that prevents me from working at full capacity. While getting treatment, I’ll continue to work if I can, trying to do what’s most important. I hope that I’ll be back to normal as soon as possible. Meanwhile, I appreciate your help and understanding.