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Dear Breakup Girl,

I enjoy your advice immensely but I've never seen this issue tackled before. I'm a female friend of a wonderful guy who is in his mid-thirties, a doctor, funny, intelligent, handsome -- and all that, but over the last two years he has developed an increasingly debilitating severe lower-back problem. He has no trouble getting women, but for the last two serious relationships he has had (both with women in their mid-twenties), one of which lasted about a year, and the most recent which lasted about 8 months, he feels that initially things go great but as the relationship progresses and he starts spending more and more time with his girlfriend, that she becomes aware of his "chronic pain condition" and how truly limiting it is - he spends a lot of time at doctors, a LOT of bed-rest with icepack on his back, TENs units -- things like that. So he ends up not being able to do all the things that people dating can so often do -- ie. go to movies, bike ride, travel, etc.

His last girlfriend just dumped him a few days ago saying that "some spark was missing." Well, no kidding, he's in a lot of pain, he get's depressed, and he's forced to be inactive a lot! He may or may not be able to have back surgery for his particular problem, and even then he will probably never have normal mobility.

My question is: He thinks that no woman is ever going to end up staying with him because gradually, even if she cares for him, it will begin to frustrate her that he has a very limited lifestyle, and that this may continue FOREVER. He also thinks that most women want to have a family and kids, and that he can never have kids because he wouldn't be able to take care of them properly, eg. he cannot even bend over to pick a kid up. I remind him that people in wheelchairs have girlfriends and families! (And I've reminded him that the two women who have split up with him during this time may be using the back as an excuse, and really have other reasons for dumping him.) But he thinks that at the relationship stage, very few women are going to put up with his condition. Unfortunately, from my observations, it is somewhat true. He attracts lively, active, intelligent women (although not always the kindest) who do get more and more frustrated that he can't do a lot of activities with them (it can also limit his sex life). They are usually full of sympathy and support in the beginning, but his condition does seem to get to them after a while, even if he tries to limit their exposure to all his bedrest etc. I think it would be different if he had met someone when he was well, and he'd already established a strong relationship with her. But when he is trying to build a relationship, I can see the difficulty. He is really feeling bad post break-up and thinks it is useless to pursue any more relationships with women until his back gets better (if it ever does).

What do you think of this situation? and What could I say to him to counteract his conclusion that girls will dump him because of his chronic pain condition? Or is he right?

-- Skye

Dear Skye,

I'm handing this one over to Belleruth "Oy, do I know from pain" Naparstek (okay, she actually does know a lot about the psychology of this stuff). Here's what she had to say:

"Pain Guy has a very good friend in you. You're saying and asking him all the right stuff.

I, too, wonder about the women he's choosing. I don't think the back thing has to be an impediment to a relationship, although it would certainly impede many. But there are many women out there who would love to be his Florence Nightingale, or whatever....

I also wonder if he has a drug addiction. He wouldn't be the first doc with a chronic pain condition who became chemically dependent. Some of his behavior could have to do with that, not his back. Trust me, it's worth checking out.

In any case, being as how he's getting seriously whiny and down in the dumps, I would think that one of the best things he could do is learn mindfulness meditation, a la Jon Kabat-Zinn. If he's too energy-less and depressed to take up a new skill, he should be evaluated by a psychiatrist and/or recovery counselor to help him get some zing back. Then he should learn some mindfulness skills."

And that, I'm guessing, will in turn -- that is, in relationships -- strengthen his spine.

Love,
BG/BR

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