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Goals, not wishes-- I'm a doctor, not a genie.

Saturday, November 1, 2014

Tricking Your Battles

Posted by fxckfeelings on October 30, 2014

War might be hell, but the decision whether or not to take on a fight can make you feel, at the very least, like you’re Satan’s upstairs neighbor. Sometimes you want to avoid taking necessary action in order to avoid (marital) bloodshed, and other times, even if you’re not in American government, you’re eager to take on a fight without realizing there’s no hope for real victory. In any case, never let anger or fear get in the way of your own analysis of the facts behind the conflict. Keeping the peace may mean that you have to stand up for an opposing point of view or just feel angry, but a little personal purgatory still beats the alternative.
-Dr. Lastname

My wife and I never argued about money until recently, when she retired and started spending large amounts on her new hobbies. We have more than enough to live on, thanks to the money I got when I sold my company, but I can’t help resenting the way she spends large sums without talking it over or checking to see how much we have left. If I share my resentment, she’ll feel I’m trying to control her, but I just want her to control her credit card. My goal is to get a handle on our finances without starting a fight that will just cause us both to feel bad and then probably prompt more spending.

Talking to your spouse about her spending is as difficult as talking about her drinking or eating, or even her skipping and gum-chewing. This is because, at the heart of it, trying to talk to someone about their actions sounds a lot like you’re trying to tell them what to do. And nobody outside of the military or the bowels of Craigslist’s sex ads wants to be told what to do, especially by the person who’s supposed to be on their side.

Because they feel like scoldings, discussions like this immediately create a quasi-parent/child dynamic, which is why things quickly devolve into eye-rolling, finger-pointing, name-calling. Ultimately, if you’re lucky, your shared tantrum will result in temporary cutbacks, resentment, and the beginning of a running, perhaps-infinite “I told you so” contest that no one will ever win.

So never communicate money worries until first reviewing your anticipated income, expenses, assets, and areas of control. Consult an accountant or a simple book or website on budgeting. Pretend you’re a corporate manager who must find out how much your department—not just this one employee—can spend next year without depleting your assets, and how much will be left after covering necessities.

Then compose a memo describing your conclusions, decisions about the spending you control, and recommendations about the spending you don’t. Edit out criticism, fear, or defensiveness; your job is to provide good information and solid decisions that reflect your values and your family’s shared need for a financial plan, not to make your wife happy.

Before sharing your report, prepare for unfair personal criticism by composing positive, fact-filled answers. If you’re accused of being a control freak, invite her to offer better solutions that don’t break the budget. Regret the fact that you can’t always agree on priorities, but don’t budge from the facts, and avoid getting emotional.

It’s too bad that you and your wife’s spending instincts are not as naturally compatible as they have been, but it’s not unusual to have disagreements when life enters a new phase. You may not be able to make her happy or end those disagreements, but you can come up with a budget you believe in, refuse to let the disagreement become personal, and stay positive about the future security you’re creating by endorsing spending limits, even when she doesn’t agree.

If you sit down to talk about the nuts and bolts of your finances, not to take apart her spending habits, you can have a real discussion that could result in a budget instead of a brawl.

“I hate for my wife to feel deprived or over-ruled, but I will not express fears or argue about spending until I’ve put together a budget and tried to engage her positively in defining what’s necessary and making tough decisions. We may not wind up agreeing, but I will keep our differences to a minimum and not express fear or personal criticism.”

When my son decided to leave for college, we all thought he’d have a great time because he’s gregarious, likeable, and well motivated. Unfortunately, he somehow got depressed almost immediately upon starting school, and the whole year was a struggle with grades that were OK, but a disappointment. Then, after coming home and immediately feeling like his old self, he decided he had the problem licked and would have no trouble going back. After returning to school and another two months of depression, however, he’s ready to call it quits and transfer to another college. I don’t like the idea of his quitting and wasting time, but I can’t talk him out of it. I’m angry, which just means he doesn’t listen to me. My goal is to give him advice he will listen to and save him from making a mistake.

Assuming you’re right about your son’s depression, and that he can’t help it, you have more reason to be proud of his efforts to make school work than you have to be ashamed of his desire to quit and come back home. After all, you don’t see him as fundamentally immature or dependent, just prone to an away-from-home depression that he can’t shake. That doesn’t mean that college has to be torturous for him, even if it can’t be an average experience.

Homesick-triggered depression doesn’t seem to have been studied objectively, but it happens to some very solid kids and is just one of those problems that usually gets better as we get older. It shouldn’t be surprising that some people have reflexes in their brains that keep them at home, at least when they’re younger, and some are born to go roving; genes are probably important and, in a Darwinian process, circumstances sometimes favor the survival of the stay-at-homes and sometimes the wanderers.

In any case, the fact that your son finds himself burdened and partially impaired by homesickness doesn’t mean he has failed or that he has to leave home, unless leaving home is really necessary, which it does not appear to be.

Instead of assuming that he needs to complete his studies at Homesickness U., ask him to consider the pros and cons of transferring to a local college by leading him through the risk/benefit analysis. Ask him to find out what transfers are possible and whether transferring will cost him any course credits or special opportunities.

Ignore his expression of disappointment and regret over how much better he could have done if he hadn’t gotten depressed; tell him that depression isn’t something you control and that it often happens in this situation. He’s been enrolled in Depression 101, a mandatory part of the Core Curriculum, and from your point of view, he’s done well with it.

Meanwhile, if it hasn’t happened already, ask you son whether therapy with a good, positive coach could help him fight the negative thoughts that depression puts in his head and whether, if it’s impairing his ability to learn, he should see a psychiatrist and try medication.

You’re sorry he had to go through this painful experience, but remind him and yourself that he went to college to learn, not necessarily to be happy, and you’re impressed that he’s learning a lot.

“I hate to see my son feel like a loser, but he’s done nothing to make himself depressed and he’s learning how to manage it. I’ll keep on coaching him through this experience.”

Re: Liable Source

Posted by fxckfeelings on October 27, 2014

Along with avoiding conflict, favoring calm, and having taste that’s too sophisticated to tolerate Michael Bay, human beings are also notoriously bad at correctly placing blame or finding the true source of an issue. We punish ourselves for problems that we have no control over and indict others for creating trouble that it’s our job to prevent. Instead of rushing to judgment, we should ignore our thoughts, dreams, and tempers and consult our values first. Then we can decide whether we’ve really done wrong and need to do better, or whether someone else has erred. Either way, we’ll know where the blame truly lies and be able to buck our nature to calmly find a solution.
-Dr. Lastname

I have done a pretty good job of keeping things together through a very tough few years. I have mostly come to terms with the break up of a long and unhappy marriage and become a stronger person as a result. In my waking life I have learned to choose my thoughts and control my feelings and behavior to good effect. The trouble is my dreams, which are frequent and often disturbing. In dream-life I am still very emotional and out of control and tied to past experiences. I will dream I am dancing with my ex or that we have reconciled happily and wake up feeling sad. Or I dream that my new partner is cheating or being an asshole when he has given me no cause to doubt him. Sometimes I wake up in a state of distress after reliving painful events without the benefit of rational thinking and wish I could sleep without being invaded by the bizarre and the uninvited. Are dreams just random or a result of what lurks in the subconscious mind? My goal is to have faith that I have coped quite well with very difficult circumstances and to understand the message behind my restless nights.

It’s a good thing we can’t be held legally responsible for our thoughts or dreams, or we’d all be in jail, riddled with STDs, or kicked out of school due to failing exams we didn’t know we had or excessive public nudity. If the law can’t punish you for your dreams, there’s no reason to punish yourself.

We also know that depression floods us with irrational, negative thoughts, causing us to blame ourselves for everything that has gone wrong and assume that everything will go wrong in the future. So making a big deal about dreams seems like a sure way to magnify the impact of negative thoughts and self-doubts that we neither deserve nor control. WAIT! There is more to read… read on »

Moral Exam

Posted by fxckfeelings on October 23, 2014

We’ve said many times that the worst relationships teach the best lessons, from what to look for in your next partner to what you need in a good lawyer. Knowing how much you’ve actually learned from the lessons, however, can sometimes be tricky; sometimes you get so connected with someone that breaking up makes you underestimate how much you’ve learned, and sometimes your connection is so superficial and one-sided that you wind up feeling you’ve learned more than you really have. In any case, don’t judge what you’ve learned from a relationship by your emotional reaction. If you’re honest with yourself and give or take credit where it’s due, you should’ve learned enough to ace the next test.
-Dr. Lastname

I always knew deep down that my relationship with my college boyfriend was never going to work out—he was restless, attractive, and hated the idea of settling down, and I wanted to get married—but I loved him and couldn’t let go. We stuck together for eight years until he finally had an affair, I broke up with him, and now, five years later, I’m happily married. I would have told you I had no complaints until I was recently invited to a big party by an old friend, who told me my old flame would be there, which bothers me more than I thought. I don’t know who he’ll be with or what has happened to him, and I’m afraid to find out, mostly because I’m so eager to find out. I hate the idea of still having feelings for him, particularly since I’m married. My goal is to figure out what’s wrong with me and why I can’t move on and forget about him.

If you’re looking for someone to tell you whether/how/why your feelings for your ex are important or dangerous, you’re obviously looking in the wrong place. You shouldn’t expect to control having feelings, just to control what you do with them, like not obsessing over them in the first place.

You finally did what was necessary after recognizing that your old college boyfriend would never make a good life partner, but only after he had an affair. Still, that affair was a teachable moment, not just about your future together (or lack thereof), but about your tendency to let uncertainty bind you to things for longer than necessary. WAIT! There is more to read… read on »

Focus Pocus

Posted by fxckfeelings on October 20, 2014

In this day and age, it’s almost impossible not to know what Attention Deficit Disorder is (or to not have a direct connection to someone who has it, or to not have an opinion on it, just because). On the other hand, very few people are aware of Attention Surfeit Disorder, which is when people habitually get so perfectly focused on the problems that grab them that they can’t see why anything else matters, even if it’s a looming disaster. Whether you can’t focus on any one thing or focus far too much on one thing exactly, be aware that our brains have different ways of focusing, and that each has its own strength and weakness. Then, whether you have a fun diagnosis or not, you’ll be better at managing your priorities instead of following whatever captures your attention.
-Dr. Lastname

I’m curious to your thoughts on subclinical anorexia. I was (voluntarily) hospitalized with anorexia nervosa last year. Since then I’ve managed to keep my weight out of the danger zone, but not up to where my physicians would like it. Honestly, I don’t see the point. Even at my lowest weight I completed an MPH at Hopkins (my third post-graduate degree), I’m in the “healthy” BMI range, technically, and I hold a full time job in addition to teaching science at a local University two nights a week. Who the hell cares if I don’t hit my target weight? My goal is to continue to achieve excellence without worrying too much about what doctors tell me about my weight.

When you focus too much on perfection in one particular aspect of your life, be it in terms of appearance or professional achievement, it’s like searching for a house based on the quality of the faucets; you become so fixated on the gleaming chrome that you don’t notice the lack of square footage, light, or even plumbing.

Obsessional, single-minded focus is always unhealthy when it gets you to disregard whatever else is truly important in your life, like your health and friendships. You tell yourself it’s good to work harder to make yourself better…while losing track of the fact that what you’re sacrificing is worth more than the excellence you’re driven to achieve. WAIT! There is more to read… read on »

Label Ready

Posted by fxckfeelings on October 16, 2014

You know that the how/when/why of diagnosis is a loaded topic, not just because you’re either longing to find or determined to reject one, but because those of you who read this site with some regularity know how many letters we get on the subject. A diagnosis is a powerful thing, but, like your authors’ posts, it’s rarely the last word. As always, ask yourself what a diagnosis really means before giving it too much meaning, or too little. We won’t be shocked or disappointed, however, if you want to ask us about what it means, also.
-Dr. Lastname

I have severe mood swings which don’t help at all, because some days/weeks I will be normal anxious me, but then I can have periods where nothing scares me anymore, pretty much like I’m ‘on top’, and I’ll have so much confidence. But then I have periods which are the exact opposite, meaning that I’ll be constantly upset and feeling self hatred for the way I am. As a result of this, I researched Bipolar Disorder and I have nearly all of the symptoms, I also took some of the online tests, which I know are not completely accurate but I thought they would give me a brief outline. Each one said that I possibly have moderate to severe Bipolar Disorder. After thinking for a while, I spoke to my mum, but she shunned the idea. I later convinced her to do some research on it and let me know her opinions, which I think she had no intention to let me know her thoughts as I only got a reply one month later as a result of my frequent questioning. She said I am definitely not bipolar. I have now been put on the contraceptive pill to control my irregular periods and mood swings, however they have not altered my moods, nor has the Teen Multivitamins that my mum has been buying me to prove that it’s entirely just my hormones. My goal is to control my moods and lessen my anxiety.

Just as there are eight major levels for classifying biological organisms—from general “life” down to the precise “species”—there are several unofficial levels of diagnoses. The most general level might be by location (e.g., the brain) and the more specific would be by identifying the cause of the disease. Unlike with plants and animals or even more common diseases, however, scientists can’t classify your individual diagnosis beyond basic symptoms. In sum, not surprisingly, it’s hard to classify crazy.

If the characteristics of the bipolar “species” vary greatly, depending on the person experiencing bipolar illness, then the usefulness of the diagnosis is limited, and your own observations and evaluation become much more important. What matters most then is not whether you do or don’t have a certified bipolar diagnosis, but whether your mood swings interfere with your life. WAIT! There is more to read… read on »

No Pro

Posted by fxckfeelings on October 13, 2014

In a culture that proudly sells medications created by grade school teachers, financial advice by religious figures, and recipes by celebrity wives, being an expert, or just seeking advice from one, is, in many people’s “expert” opinion, stupid. While we are sometimes more knowledgeable than supposed experts, we sometimes really, really aren’t, but you can’t know whom to trust if you get too influenced by feelings of self-doubt or omniscience. Instead, ask yourself whether you have the information you need in order to make good decisions, and whether, when it comes to that information, someone else knows more than you. If you can be objective about your decision-making ability, you’re much more likely to accept your strengths and weaknesses and take them into account; become an expert on your own problem and you can confidently find the help you need, no matter what the source.
-Dr. Lastname

My wife has been disabled since her second nervous breakdown; I thought she was a free spirit when I met her, but early in our marriage, we both realized that something was wrong, and she was diagnosed bipolar. Now that I’m writing my will, I realize I should probably take account of her condition; she’s been doing well for the past year, but another breakdown is always a possibility. If I knew better what to expect for her, I’d know whether I need to protect her from misusing the money, or just make sure the money is put towards making sure she has what she needs when I’m not around, like a roof and even a nurse. My goal is to find an expert who can tell me what to expect from her illness and how I cam make sure that she’s taken care of.

There are plenty of instances where people choose to follow their instincts over professional advice, and, whether it involves not vaccinating kids, not hiring a licensed electrician, or not getting that oral surgery, the results are not often pretty (but plenty painful and dangerous).

When it comes to knowing what to expect from your wife’s relapsing mental illness, however, you and your wife are the top experts in this unique field.

The two of you know better than anyone what her illness has been like in the past; how frequently it recurs, how much disability it causes, and how much it affects her judgment and her ability to manage money. Unless your doctor is also a psychic, her powers to predict your wife’s future are nowhere as strong as yours. WAIT! There is more to read… read on »

Top Fear

Posted by fxckfeelings on October 9, 2014

Fear, like high school and colonoscopies, is an uncomfortable-yet-necessary part of life. Problems arise, however, when fear either becomes excessive, thus limiting our life experiences, or insufficient, thus opening us up to dangerous experiences that could end our lives entirely. If your fear level is set too high or too low, draw on your experience and values to decide what actions are necessary, then manage your fear accordingly. You may not be able to change your fear level or the amount of dis/comfort it entails, but you can definitely prevent fear from changing your life for the worse.
-Dr. Lastname

I am very afraid of presenting in front of the class. I start to shake and stutter and it really happens automatically and I can’t do anything about it. Even when I don’t have to present, I always feel nervous and shy. I’m actually very afraid to talk to someone at my school even if it’s another student. Do you have any advice I can use? My goal is to be able to talk to people and stand up in from of the class without looking like an idiot.

Talking to people, especially in school, is more dangerous than most people think; one false word, sneeze, or pop culture reference, and before you know it, you’re saddled with a humiliating (possibly sneeze-related) nickname for the rest of your life or an open invitation to get your ass kicked. So, when your brain floods you with nervousness whenever you try to speak up, it’s actually trying to protect you from a dangerous activity.

Unfortunately, that fear may make you shake and stutter, thus attracting humiliation, thus proving your brain is right and making you terrified to open your mouth again, etc., perpetuating the safety/silence cycle.

You haven’t done anything wrong to make yourself nervous; you are just extra sensitive to the risks of embarrassment and rejection in school life, and you may have good reason. Unfortunately, though, it isn’t easy to make severe nervousness go away, and if you avoid class presentations and social contacts until you start to feel better, you may not learn much or talk to anyone for a long time. WAIT! There is more to read… read on »

Social Insecurity

Posted by fxckfeelings on October 6, 2014

Much is made of the inextricable link between trust and love, but the assumption seems to be that you can’t love someone else unless you can trust them (to listen, keep it in their pants, rescue you from a sinking ship, etc.). Just as important, however, is the ability to trust yourself and your own judgment when entering into a relationship; if you have too little confidence, you can sabotage your relationships, and if you have too much, you’ll make commitments that won’t last and will hurt like hell when they break down. Learn to trust yourself by gathering facts, observing carefully, and using common sense to judge your friendships and make smart decisions. Then, regardless of over or under-confidence, you’ll be able to love someone you trust and have trust in whom you love.
-Dr. Lastname

I am in a good relationship and have been now for a while (around 9 months). But none of my relationships seem to last more than a couple of years (I’m now in my 40s), and I worry that some of them I have sabotaged myself. I am at a point in this relationship where we have acknowledged that we love each other and have started making plans months into the future (nothing like moving in together, but definitely trips and such), and suddenly, I have this fear I’m going to lose him. But not just lose him—lose him to someone, and that someone is my friend. I had a friend when I was younger that flirted with my boyfriends, and even though nothing ever happened, it bothered me that she never understood these boundaries, didn’t have a sense of loyalty towards me, and used her looks and sexuality to get attention from those that should be considered off limits. Now I have a newer friend who is younger than me—she’s very pretty, smart, and single, and she has a tendency to try to connect with my boyfriend in ways that I am unable to by finding the gaps and honing in and I don’t like it. I am acting as though they have already run away together, or have a secret relationship. Is my own insecurity causing me to worry about this? My goal is to alleviate these fears of betrayal.

Having fun friends with fickle boundaries may damage your calm, but you do yourself more damage by letting them distract you from the real issues surrounding your boyfriend and your future together. Instead of worrying about whether your gal pals have good intentions, focus on doing the necessary homework to find out whether your boyfriend is a good match.

Assuming you’re not able to stop yourself from being insecure about your friends and boyfriends, use your insecurity to assess your boyfriend’s trustworthiness. Maybe you can also use it to get better at screening friends in the future, but for now, believe it or not, your best weapon against your paranoia is paranoia itself.

Instead of trying to feel better by talking about your fears and asking for reassurance, use them to review your boyfriend’s history with women and your girlfriend’s history as a femme fatale. Your anxiety will drive you to ask the right questions, and, with any luck, the right answers will allow you to tell that anxiety to shut up. WAIT! There is more to read… read on »

Learning Swerve

Posted by fxckfeelings on October 2, 2014

Breaking up with someone is a lot like breaking a bone; if it doesn’t set properly, the bone won’t really heal, so you’ll end up with a nagging pain unless you break it and set it again. With relationships, the way to set the break is to learn from it, but sometimes the pain of lost love prevents people from learning lessons, or worse, teaches them the wrong ones. So don’t let negative feelings frame the lessons you learn, or fail to learn, from breakups. Instead of looking at how your relationship failed, look at the relationship between the character of your ex-partner and the way things turned out. Then, as long as you’re ready to take your time and live lonely as long as necessary, you won’t have to deal with the same pain again.
-Dr. Lastname

I’m in my mid-thirties and on my third serious relationship living with a man. I’m good at being single, but like anyone, I get lonely sometimes and enjoy the positive things about being in a relationship. The trouble is, I re-energize when I’m alone in a relaxed environment (like at home), and if I don’t get that occasional time to myself it almost acts as a depressant and I start to feel cagey, stressed and grumpy, as if I’m losing myself. The men I get involved with seem to start out very independent with lots of interests, but after a while, once we move in with each other, they become very reliant on the relationship/my company. They don’t really end up having anything else going on, i.e., few friends and outside interests and a non-demanding/or no job. In my current relationship it’s got to the stage where I can’t even get an evening to myself a week. The ideal scenario would be for me to always have my own place and for my partner to have his, but that’s not financially realistic or a fair thing to expect. Am I unusual/weird in this need to be alone? I need to figure out how to not lose myself when the initial exciting, independent phase of a relationship evolves into something more routine and constant.

Loneliness is a good reason to get many things—a gym membership, a dog, a regrettable haircut—but a terrible reason to get a partner. That may not seem logical, but there is no room for logic in courtship, because all the space is taken up by irony.

What you’ve discovered about yourself, after three serious live-in relationships, is that you require someone who is stimulating and independent; otherwise, you wind up feeling smothered by your partner’s passivity and neediness. Unfortunately, when you’re looking for someone to settle down with, the needy often cut to the front of the line. WAIT! There is more to read… read on »

Push and Null

Posted by fxckfeelings on September 29, 2014

Pressuring somebody to care about their self-interest when they’re obsessed with something else is an often foolhardy endeavor, and not just when it comes to trying to rescue people from drugs, bad boyfriends, and Apple products (at least if you’re broke). Whether they’re too absorbed in a dysfunctional marriage or in very functional childrearing, don’t use anger or guilt to break them free. Instead, spell out why it’s necessary, regardless of the discomfort and guilt their self-restraint may cause. They will either find a personal reason for adopting your view or go back to their obsession, no matter how damaging/buggy it is.
-Dr. Lastname

My partner and I have been together more than ten years and were both in unhappy marriages when it began. My husband knew and agreed to divorce, but he only left when I gave an ultimatum. I have now moved in with my partner and his adult children are cool, but civil. It is unfair to blame me for breaking up their family as he had a previous affair and only stayed until the children grew up. I have told him that I will not tolerate being lied to and playing second fiddle to his family any longer and he now puts me first. They are not yet fully divorced but his wife has another partner. My goal is to protect our hard won happiness from the demands of others and trust that he will stay strong.

You know what you need from your fiancé, including fidelity, honesty, and being one another’s top priority, and telling your partner what you require has clearly moved him in the right direction, namely, towards you and a better future.

I assume you write, however, because you wonder if your partner’s future commitment will waver; given the amount of effort it took you to get him on course, you wonder if he’ll actually stay there. WAIT! There is more to read… read on »

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