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MAR 12, 2010

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Man in crisis
By Dr. Douglas Berger, M.D., Ph D.|ASK THE EXPERTQUESTION
I am a foreign dad in his early 50s, a science teacher by profession, twice divorced and am in the
middle of an emotional, financial, and psychological crisis. I have enormous debts to pay, no job
security, and most importantly, I am suffering from loneliness and low esteem.
I frequently feel lonely even in a crowd and I feel empty and lost with not knowing what direction
to take in my life. To assuage this loneliness, I resort to compulsive shopping, have a girlfriend forphysical intimacy and loneliness, and also look online to find a life partner. I feel obsessed withfinding an ideal partner, I idealize women, and feel frustrated when they fall short of mystandards.
I admit to a long-standing nature of being a domineering man and want neither to be bossed
around nor treated coldly by a woman. I have zero tolerance when it comes to being the subject ofblame and I suspect that my defensive nature has caused relationships to fail and has alienatedpeople. What’s wrong with me? MarcYour story needs to be simplified into what are the underlying causes and what are the secondary
results. The “Crises” are clearly the secondary results of the underlying problems and only
focusing on them will not solve these problems (i.e., getting a job will only help so much unlessthe problems in your self-esteem and alienating others are also fixed).
Sorting out the underlying problems is a little complex with only the information you have provided
so far. Let’s list them up as: 1. uncomfortable feeling states (symptoms) like loneliness,emptiness, and low self-esteem; 2. behaviors aimed at calming the feeling states like desperation
for physical intimacy, obsession with the perfect women, and compulsive shopping, and 3. longstanding personality traits to protect yourself from control or belittlement that backfire on you.
While more information about your history, symptoms, and the chronology of these issues isneeded, it could be construed that you have either: 1. a disorder in personality style (the controland belittlement issues) that leads to social and occupational trouble that then leads to severe
unhappiness and maybe an illness of depression (the uncomfortable feeling states) that thenmake both the personality style and social consequences worse; or 2. an underlying illness ofdepression causing you to feel lonelier, emptier, and have lower self esteem than is normal tohave, and that inflames your feelings of being belittled or controlled (similar to a cold causing

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someone to be irritable easily), causing the secondary crises and thus a vicious cycle making thedepression worse, etc.
You would need a professional psychiatric evaluation that looks at other associated symptoms(sleep, appetite, risk for suicide, etc.), history of mood problems, drinking and substance use,family history, medical history, your interpersonal style, and then to make a treatment plan on how
to attack these complex issues that cause your social problems and subjective distress.
Dr. Douglas Berger, M.D., Ph.D.
Dr. Berger and his staff at the Meguro Counseling Center in the Shibuya-Ebisu area of Tokyo
provide mental health care for individuals, couples, and families, in both English and Japanese.
www.megurocounseling.com
The discussions herein are meant as general information and advice only. Each person needs tomake their own personal life decisions and to contact a mental health professional for consultation
if deemed appropriate.
Send your comments to: editor@tokyofamilies.com
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2010/03/12