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RealSupport, Psychotherapist
Category: Mental Health
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Experience:  MHT-MHRS-MS-MA Integral Psychotherapist & Life Coach
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I have been in a relationship with a very intelligent, kind

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I have been in a relationship with a very intelligent, kind and sensitive man for three years. He suffers from low self esteem, chronic pain and severe depression. He mentioned he had a pain issue when we met– which he believes is due to a surgery years prior. While the surgery was successful, he opted for an invasive procedure, and is convinced this is the cause of the pain. He first saw a doctor who diagnosed him with a type of “mind-body syndrome”. As his symptoms worsened, I suggested that he see another physician. We met with numerous doctors at major hospitals. Test after test came back negative. Although one doctors indicated there was a slight chance of “over active” nerves causing pain, still nothing they can do. He sees a psychiatrist 2 x per week and is taking anti-depressants & pain meds; some control the pain for a short time, but his depression continues. Contributing to his depression are his family’s problems, which he is sucked into and while he admits this is a contributing factor, he says that even if that situation came to a conclusion, his other issues would not be resolved. He blames himself for choosing the invasive and cannot forgive himself. I know he is in physical pain, although I just don’t know if it is from the surgery, part of his severe depression (which he admits in had to some extent prior to the surgery) or a combination of both. He sent me an email which in part said - he feels he needs to be alone to deal with his issues. He feels guilty that in his mind he cannot contribute to our relationship, and the negative impact it has on me is unfair and his guilt is eating away at him. His friends are very accomplished, and while he has amassed financial wealth – he feels he never achieved Expert success as joining his family business was an easy way out. He had dinner with two old friends, which I thought would be good for him, yet he returned more depressed. Although not jealous, he feels they achieved success in their professions while he did not. He is retired, so no daily interaction with the outside excpet his psychiatrist and a few phone calls. He sees no one on a regular basis except me, and now wants to be alone. I want nothing more than for him to be healthy and happy, and to respect his desire to be alone. But I am saddened that he wants to push me away, and also scared that he will spend his time reading or watching TV all day, and just becoming more depressed, sinking further into a black hole.

I am very sorry to know about this overwhelming reality your boyfriend has been facing for this long, and how it has deeply affected you and your relationship.
This situation is very frustrating, since as you said, no matter how many specialists you have consulted and have tested him not finding anything wrong at the physical level, he continues to experience this intense and chronic pain, which seems to deeply impact everything in his life, from mood to functioning and relationships. It also seems that he and the doctors have done everything possible to provide the best possible care for his physical-medical needs.
On the other hand, he has been suffering of depression from before this main pain problem, as well as of poor self-esteem. Your message seems to tell how most doctors have suggested how much of his physical pain could be of a psychogenic nature, which could make a lot of sense since in fact pain is a psychological experience, and we know how our mind could create or experience physical pain in so many different ways, depending on our mood, mental heal, level of functioning, personality and many other subjective factors.
You reported that he's been meeting his psychiatrist twice a week, been using psychiatric and pain drugs for a while but not showing any significant improvements around significantly and effectively reducing pain, depression nor self-esteem issues and poor functioning. I think these scenario is very common under such circumstances, once it seems he has mostly focused on using pain medication and psychiatric drugs but has not worked on the core personal - mental heal issues behind such symptoms, from depressive mood and everything that comes with it, to the poor sense of self-worthiness, poor coping skills and very limited functioning, all leading to deepen depression and any psychosomatic problem, as well as the experience of physical pain.
I think it is wonderful that he has finally decided to work on himself, but your words seem to point at your fears of him just using this decision to end the relationship or get away from you,a s an excuse to get even more isolated, so depressed and with a more limited life at multiple levels.
Only you know how painful and sad it could be to be in your shoes, and unhappily there is nothing anybody in your shoes could do to change his reality, since this is about a hard an doing term work that only he can do. What you can do is to become a supportive, healthy and wise presence in his life, making your best to promote his awareness of reality, and proactive action to look for and commit to his rehabilitation process. By this I mean working on himself and core issues with psychotherapeutic support, including individual and group psychotherapy, addressing his self-worth-esteem issues, improving of coping skills, pain management and rehabilitation from depression and any anxiety problem he may have.
It would be unrealistic to expect any significant improvement in his mood, experience of pain, socialization, functioning or at any other area, without him truly working on his rehabilitation from depression, anxiety and any other disorder undermining his life. Pain medication as well as most psychiatric medication are very addictive drugs, many times creating medical and mental disorders, problems and challenges, some times ever more serious than the original problems the client presented.
Once he starts working on his rehabilitation, then he would be able to take good care not only of himself, but also of his relationships, and that would give him a new chance to value what you developed together, and possibly to reconsider working on getting closer and continue sharing closer to each other. There is no way to know what would happen in the future, but this is what he you can do now to take good care of your present, and that would lead to the best results for tomorrow too.
I Strongly suggest you to consider individual counseling in case you find it very difficult for you to cope with this period, and all the challenges it may present. That way you would doing your best to take good care of yourself, and to offer the healthiest and most sound support to him. Obviously, it would depend on him, how much he allows you to continue playing a role in his life, and as frustrating as that may sound, there is not much anybody could do about that, but as you said, respect the boundaries and limits he set, trying to offer your best while hoping he could do choose and do his best in his own healing path.
Does it make sense?
Customer: replied 4 years ago.
it does. Thank you for your reply and insight. I know he loves me, and it breaks my heart that such a wonderful person is in pain, both physical and emotional.So just so I understand, you are basically saying that I need to let him know I love him and will be here for him, when and if he needs me, but also acknowledge and accept that this journey is one he needs to do on his own. It is very difficult to know that someone you love is in pain and not only can't I do anything to help, I may have to see the end of a three year relationship as well.He has not yet told me that he does not want to see me at all, or that he does not want any communication, but I see and feel him pulling back. Should I just follow his lead so to speak?
Your understanding of my words is accurate. This is a tough situation for you, and yes, it is necessary to find out what he is expecting and willing to share with you, about his boundaries, since it'd be from there that you'd know how you could respect and support him and his choices during this new period.
People could make right and not that wise choices when setting boundaries and pushing away those around them, but even in those cases, we need not to approve but to accept and respect such boundaries, while showing in a clear way how much we care, what we feel and expect too.
Some people could feel able and willing to keep close and share this much with the other one, while other people would have a tough time coping with their own emotions and feelings, feeling unable to take good care of themselves while sharing in very limited ways with that special person who decided to start a new journey without their company. This is why you need to be fully honest and truthful with yourself, and towards him in order to do take good care of yourself, while also respecting his choices. If they happen to be compatible, good for you, but if not, you would do your best to take good care of yourself anyway, since that's your first right, need and responsibility in life.
Give him time to assess things, and if he delays this dialogue for too long, like for longer than a week to ten days, then you could take the initiative and ask him to meet if possible in order to clarify these concerns, and if he refuses to meet, at least to share through any adequate means his decisions about it, and you would do the same.
Customer: replied 4 years ago.
Thank you again.
You're very welcome. Thank you for your trust.
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