Doctor’s Note: Today’s column involves brief discussion of suicide and suicidal ideation.

DEAR DR. NERDLOVE: I have been reading your articles for a long time but there’s one problem I never really found an answer to. And that’s dealing with romantic loneliness.

I suffer from social anxiety and clinical depression. I was diagnosed when I was a teenager and have been in therapy and taking medications ever since. Due to my problems I never finished high school and was a shut-in for many years.

I have improved since, CBT helped the most and I found a drug combination that helps a bit. I’ve left my parent’s house and finished a university program that might allow me to get accepted to a CompSci degree (which was a dream I’ve had and a goal I set for myself). I work part time and go to a gaming group once a week. And even though i have to force myself to go, I made friends there. I even had a girlfriend a couple of years ago, though it dissolved pretty quickly because she perceived my social anxiety as me rejecting her.

All this leads to my problem, I’m lonely. I go to sleep every night wishing there was a woman who loved me next to me. Nothing helps this feeling. The only time I didn’t feel like this was when I had a girlfriend, and when she stopped loving me, that loneliness came back. Because I focus on school and “going out” I’m exhausted all the time, and I currently can’t deal with a relationship without giving up on something else.

How do i deal with this loneliness? It’s really eating me inside. I honestly wish I could have a lobotomy and feel nothing. Or go to sleep and never wake up. My therapist tells me I should focus on the positive things in my life and achieving my goals, but it feels like I’m lying to myself. I think romantic love is a fundamental human need, and I’m missing it. I have been missing it for years. Is there anything i can do to stop feeling like this?

Thanks, and I wish you a life full of hope and happiness.

– Lonely

DEAR LONELY: First and foremost, Lonely, let me point out something that didn’t just leap out of your letter, it put on flashing lights and waved semaphore flags around like it was guiding Maverick in for a carrier landing: “I honestly wish I could have a lobotomy and feel nothing. Or go to sleep and never wake up.

Dude. DUDE. I really hope this is hyperbole for effect because, because if taken at face value, this is suicidal ideation. That is something that you need to be talking to your therapist about. If you’re legitimately feeling this way, I want you to close your laptop and contact your therapist right now. And if you can’t get ahold of them, I want you to call the National Suicide Prevention Hotline by dialing 988. I am utterly serious. This is something that needs to be your first and highest priority.

Now as for the rest… as I’ve said many, many times before, Dr. NerdLove is not a real doctor. However, I’m someone who’s dealt with mental issues of his own and I can tell you from experience: you’re dealing with some hardcore depression, man, and I’m wondering if you’ve actually got it under control. You mention that you’ve found a medical combo that works. But does it? Or did it, but now it isn’t working, or is working less well than before?

Based on the things you write, I think that maybe you need to talk to your psychiatrist about either changing your dosage or trying a different medication. Not all antidepressants work for everyone, and it can take time to find the medication and dosage that works for you. If it’s not working, or it’s not working enough, don’t be afraid to tell your doctor. It’s your body and your brain; you know better than anyone if the meds are or aren’t doing their job.

Incidentally the same is true about therapists. Finding the right therapist is a lot like finding a romantic partner. You want someone you feel “gets” you, who you click with and who actually understands your needs. Sometimes you will find therapists or counselors who aren’t right for you, who may not understand you or who may just not be listening. If you feel like you aren’t clicking with them or that you’re not improving, then it may well be worth leaving them and finding someone else. Again, this isn’t a “it didn’t work after the first week, time to bounce” situation, but you don’t want to stay a patient just because you’ve been with them for a long time either.

On a practical level… well, I’m not gonna lie, my dude. I don’t think you’re in a place where you can handle a romantic relationship. I understand how lonely you are, but being in a relationship means being in good working order. Think of it like a car; the car doesn’t need to be almost fresh off the factory floor, but you do need it to be able to get you where you need to go in a safe and efficient manner. It’s ok if the engine knocks and makes weird noises or the upholstery is torn and the paint job is down to primer, or it shudders a bit as it shifts gears, but if the engine is prone to stalling or the brakes are weak, you’re putting yourself in danger.

What you describe in your letter is very much the latter, not the former. If you’re laying in bed hoping that you might not wake up the next day, you are not in a place where you are able to handle a romantic relationship. While I won’t say relationships are “work” in the sense of “you have to constantly grind to keep it to a baseline of acceptable non-misery”, there are stresses and tensions in even the happiest relationship and you need to be able to navigate them. And if the only thing keeping you from feeling like oblivion is more desirable is a romantic partner? That means you’re not going to be able to navigate them. Not only does it mean that you’re not in a headspace to deal with the stress, but someone else being responsible for your mental and emotional well-being is a hideous amount of pressure to put on someone. 

I also note that one of the things you don’t talk about are your non–romantic relationships. These are important, possibly more important than even your romantic ones. Yeah, I get equating your loneliness with a lack of romance, but romance isn’t the only form of companionship out there. Having a solid base of relationships – family (biological or of choice) and friends – will help erase that loneliness and make missing a romantic partner that much easier to deal with.

It also sounds like you may be putting your emphasis on the wrong things. When you say “going out”, are you talking about being social with friends, or going out to try to meet potential partners? If its the latter? Well.. honestly, I’d say it’s time to let that one go. If it’s the former? Maybe solidifying your friendships and making them your focus would be better for you. Having a good life, one that leaves you feeling satisfied and fulfilled, with folks who care about you and you can rely on is important. It creates a strong and stable foundation to build on. Without that foundation, even the most passionate romance isn’t going to last; it’s like trying to build a skyscraper in a marsh.

One more thing to consider: I realize it’s hard to hear this, but you can’t rely on external sources for happiness and fulfillment. When another person is your sole source of happiness or joy and life without them is empty and meaningless, you’re setting yourself up for an unstable, unhappy life. You’ve created a situation where your emotions and life are outside your control and influence. It becomes something that can be taken from you. You need to have your own, internal source of validation and security, otherwise you’ll never be able to fully relax, fully engage or fully trust someone. You’ll always be looking for the next shoe to drop, because you know that the situation is precarious and could fall apart at any moment. That, in turn, means that you’ll always have this core of anxiety and insecurity at the center of your relationship, which becomes its own self-fulfilling prophecy. Sometimes in order to find the love of your life, you have to have a love of your life. That is: you have to have a good life first, and then find a love that will complement and improve it, not one that completes it. That missing piece has to come from within.

But seriously: talk to your therapist now about those thoughts and feelings, my man. You’ve got to be your first and highest priority. Do it now.

Good luck.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com

DEAR DR. NERDLOVE: I’m a mental health therapist who has been really glad to have your blog as a resource to recommend to some of my clients. Even if I give the same advice, it lands differently coming from you than from a twenty something lady. I have a “theoretical-to-me-but-not-to-others” question.

I’m in my late twenties, am 99% sure I’m asexual and aromatic (sex repulsed for myself, sex neutral for others after a lot of hard work in therapy), and have lived with OCD since a young age. While most of my symptoms are well managed, the symptoms that remain are related to sex – specifically avoiding it and any reminders of it because the obsessions that arise trigger so much fear.

If I were not asexual and aromatic and wanted to have a sexual relationship, the process to get comfortable with sex would be daunting. This is a situation some people find themselves in, wanting sex but scared due to trauma, OCD, etc. The best practice treatment for OCD, and PTSD, include a very strong exposure component – repeatedly doing the scary thing bit by bit until it isn’t scary any more. This is often accomplished by creating a personalized subjective units of distress scale (aka: how scared am I zero to ten?), a fear hierarchy (rating different feared task using the SUDS and starting with the lowest and then moving upwards), alongside cognitive and self regulation strategies.��However, at some point, someone who is scared of sex (or the germs that spread during sex, or the intrusive thoughts/trauma memories they have during sex, or not-just-right experiences during sex, or body related fears during sex, or irrational pregnancy related fears during sex, or moral/religious scrupulosity fears during sex, or….) is going to need to have sex to become less scared of it – irrational fears don’t respond to reasoning – and portions of that will likely not be enjoyable.

The process for me would look something like:�1) go on a date�2) hold hands in private�3)hold hands in public�3) nonsexual touch on torso in private�4) nonsexual touch on torso in public�5) kiss in private�6)kiss in public�(Skip maybe ten steps here- fill in with your imagination)�16) have sex��(Add some more steps at the end for more scary variations of whatever the least scary variation of sex was in step 16).

So, here’s the question… how in the world would I go about finding a romantic/sexual partner that is willing to repeat each step 10 to 15 times, with me visibly panicking for maybe the first 5 times? I think “is turned on by sexual contact with someone scared of the contact” or “likes having sex with a partner who didn’t enjoy it” is a potentially dangerous quality to be selecting for. Now, not everyone who has fears related to sex would necessarily have the same number of tasks on the hierarchy or same intensity of fear, but I can’t cover every scenario here. Just wanted to give an example to ensure that we’re on the same page for the therapy process I’m describing.

I’m also aware that a specialized sex therapist might have more therapeutic strategies that I’m not familiar with that could dial back some of the unpleasantness, but I don’t think it would remove it entirely.

I know sexual surrogates exist and would be an option, but they are few and far between. Some people who are scared of sex are already in relationships that might have enough commitment or love to overcome this barrier, but many relationships wouldn’t. So what would you advise in this/these kinds of situations?

Thanks,�Scared of Sex

DEAR SCARED OF SEX: So, right off the bat, I want to give my standard disclaimer that Dr. NerdLove is not a real doctor. As a mental health professional, you’re far better equipped than me to handle some of these questions. So I want to strongly recommend that you (or anyone else to whom this would be relevant) take my advice with all appropriate levels of salt. And probably run them past someone who has actual credentials (beyond the best doctorate $30 could buy) before putting them into practice.

But my first question would be “is this necessarily something that needs to be fixed?” I’m hesitant to suggest how asexual or aromantic might try to change; the idea that not experiencing sexual attraction or feeling romantic love are flaws to be fixed can be kinda dehumanizing. If this isn’t a problem – that is, you (or whomever) are generally ok with not being sexual, then I don’t see any real need to fix it, especially if it’s not materially affecting your life.

Now, you mention that any reminders of sex or sexuality can be triggers… that is something that probably needs to be worked on. There’s a difference between “can’t function in society because OCD/trauma/intrusive thoughts/incredible repulsion” and “don’t want a sexual relationship”. The former makes life borderline unlivable. The latter, less so. And since sex is a part of life and a part of society, so the odds of running into something that may be a trigger for you are very high.

As far as treatments or therapies go… I don’t know if exposure therapy would necessarily go as far as “ok, to truly be over this, you need to go out and have sex,” even as part of a program of gradual exposure and desensitization. There’re a few quite a few steps I could see in between, from gradual exposure to advertising, going from G rated films to PG, even (theoretically) up to something like The Red Shoe Diaries or other soft-core shows or movies. I could also see moving from platonic touch in non-sexual places, to holding hands, to giving or receiving a kiss on the cheek. But recommending actual intercourse? As I said: not a medical professional, but I’m having a hard time seeing that as being part of standard therapy or even passing an ethics committee. But I could well be wrong. 

I do wonder if cognitive behavioral therapy might be a good supplement, or even used instead of exposure, especially if the OCD manifests more as unwelcome and intrusive thoughts. CBT exercises are very good at helping people deal with anxieties, irrational or unwanted thoughts and getting one’s emotions and brain under control. Going through those exercises, especially in combination with an anti-anxiety medication might be incredibly helpful for folks who find these issues to be restrictive or crippling.

I’m also a believer in non-conventional ways of dealing with anxiety. Sometimes, playing into the world that the anxiety creates can also give solutions. Just as some folks with paranoid schizophrenia have found relief by having “legal” rulings handed down that forbid the CIA/aliens/Atlanteans/whatever from spying on someone’s thoughts, finding ways to mitigate or obviate the cause for anxiety can be helpful. If someone’s afraid of an unwanted pregnancy, taking steps that make pregnancy impossible (outercourse, mutual masturbation, oral sex, anal sex, etc.) may provide relief. You can’t get pregnant from oral sex, after all. The same with religious or social related fears; if someone in a position of authority, real or percieved, gives the official thumbs up, that can also help.

But in scenarios where the person is actually, actively trying to be ok with having sex or sexual contact with another person? First, I’d highly recommend screening folks in advance and only dating people who are going to be cool with taking things slower than a sloth crawling through molasses in January. While these folks may be rare on the ground, having an understanding and supportive partner will be vital. You want someone who knows this is going to be a process of potentially months if not longer, who’s willing to commit to that and not make comments or hints that they want it to be going faster or doing more.

I’d also suggest setting up a system of safe-words. As I said to Trying To Be Less Touchy, safe-words have utility outside of just BDSM scenarios. If you want to try to be more physical but also know that you may have atavistic or severe reactions, having an easily communicated signal that quickly signal “this is ok”, “yes, I’m freaking out, but keep going, I’m trying to push past this” and “STOP IMMEDIATELY” will be invaluable, both to you and to the person you’re being physical with. Having these in place in advance will mean that you feel empowered (since you’ll know you can pull the ripcord at any time) and your partner won’t have the (very reasonable and understandable) fear of pushing too far and causing even more trauma.

And yes, in this case, sexual surrogates can be a big help. This is, quite literally, part of what they’re trained for. But as you said, they’re very uncommon and the legality of the profession is dubious. However, seeking sexual surrogates out and talking about their processes and procedures for working with a client with issues like yours may give some insight on how you or your therapist may want to proceed.

But more than anything else, my recommendation (besides FOR THE LOVE OF GOD DON’T DO EXPOSURE THERAPY WITHOUT THE GUIDANCE AND DIRECTION OF A TRAINED, LICENSED AND CREDENTIALED PROFESSIONAL) is communication, communication, communication. If there’re landmines that need to be either dug up or avoided, then making sure that one’s partners, now and in the future, know where they are and what sets them off will be beyond vital. This is an area where being unafraid to communicate your needs and boundaries clearly are going to be of utmost importance, both for your emotional safety and your partner’s.

And of course, if someone treats those boundaries around sex or touch as a problem or an annoying hurdle… well, that’s a person who just self-selected out of your dating pool. Being gentle, understanding, respectful and patient are going to be absolute must-haves.

But again, this is assuming that these are things that the ace or aro person wants to fix. Sometimes the problem isn’t with the person, but in who other folks think that person should be.

Good luck.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com

DEAR DR. NERDLOVE: Long time, first time, you know the drill. I want you to settle something for me and my friends. We’ve been arguing about the whole “who’s the most attractive to women” and we’re getting nowhere.

My position is that women are more attracted to bodies than guys think. I can’t on Instagram without seeing my female friends openly drooling over some gym bro with 8% body fat. Meanwhile if you were to ask them, they’d say it’s not about their looks so much as other aspects, and then they point to Pete Davidson or that dude on The Bear (or whatever it’s called) and I don’t get it.

My buddies point out that Davidson’s got money, fame, and he’s supposed to have a massive dick, which could also explain why he’s constantly dating Kim K level chicks even looking like trash.

So which is it? Help a bro out.

Wants The Secret Sauce

DEAR WANTS THE SECRET SAUCE: Ah, WTSS, I want to thank you for this timely gift; I’ve been looking for an excuse to talk about this without having to relitigate the Debate That Never Ends about men’s physiques and what men need to look like to get hot women.

This is a topic that, obviously, comes up a lot, and in a lot of weird places. I still remember the folks who came out of Chef, complaining that Jon Favreau was clearly full of s--t for implying that his character could’ve hooked up with women who look like Scarlett Johannson and Sofia Vegara. Meanwhile, everyone I know who’s familiar with kitchen culture and chefs in particular was nodding along; professional chefs have long been known as some of the sex-gettingist people out there, even when they looked like a greased up sewer rat.

(And this is before we get to the Discourse of casting Luis Guzman as Gomez Addams in Wednesday…)

And then, of course, there’s Pete Davidson, a man who has a seemingly singular ability – as one of my friends put it – to kick outside his coverage, despite looking like a consumptive line cook at Waffle House who deals meth on the side.

So what gives?

Well, what gives is… not really paying attention to women. In fact, one of the things that trips a lot of guys up is that they fail to realize that a) women aren’t a hive mind and b) most of what they think makes a guy attractive is what’s making him more attractive… to other men. While I don’t think anyone will deny that there’s definitely something aesthetically appealing about a guy built like a Greek statue, most of what guys think of as making dudes attractive is based around what impresses them and projecting outward.

In fact, so much of men’s ideas about what women want isn’t borne out of women’s interests as much as their own anxieties and interests projected outward. A lot of guys want women with idealized physiques and so they tend to assume that women want the same thing. Guys who’re the most worried about their height – and how height ties to perceptions of masculinity – are the ones most convinced that this is all women care about. Same with hair, same with money, same with having a massive schlong. It’s less about women’s actual tastes and much more about their own beliefs being reflected back at them.

I mean, Shania Twain had a hit song about it and everything.

But if you start to look at media created by women, for women… you get a very different picture. You’re going to find, for example, a lot more women who’ll get very turned on by a man’s hands. Or his singing voice. Or being large but gentle and kind.

In fact, if you watch romantic comedies or read romance novels, you may notice, for example, that the thing that ultimately makes it possible for the female lead to fall for the male romantic lead isn’t that he hit the gym and got a promotion at work… it’s that his behavior and attitude changed.

Even in cases of guys who are stupidly handsome already, what flips women’s attraction switches in those stories is about how they act. Crazy, Stupid, Love is a prime example of this; Ryan Gosling’s arc – what makes it possible for Emma Stone to fall for him – is dropping his whole “player” facade and being genuine with her. Yes, he’s good looking and there’s chemistry there, but his gamesmanship is a turn-off and only irritates her. It’s only when he’s actually real that a relationship starts.

Which brings us to Pete Davidson. It always amuses me when folks bring up his money or his fame as being the only thing that makes him appealing… as though Ariana Grande, Emily Ratajkowski or Kim “an actual billionaire” Kardashian are going to be star-struck or bowled over by his SNL residuals.

Now, while Pete may or may not be carrying around a baby’s arm holding an apple in his pants, one of the things that is worth looking at is who many of these women were dating before him. The most obvious example is Kim Kardashian’s divorce from Kanye – especially as he shacks up with actual Nazis and goes on InfoWars and other insurrectionist podcasts to proclaim his love of Hitler.

One of the things you can say for Davidson is that he’s the definition of low-drama. There aren’t any huge scandals about how s--tty of a boyfriend he is (at least, as of this writing…) or how his relationships have blown up or crashed and burned. If anything, it seems safe to say that he has a track record of relationships that’ve ended fairly amicably. There’re obviously some impulsive moments – his rapid engagement to Grande and tattooing her name on his neck, for example – but no grand blow-ups. In fact, most of his exes – and in some cases their families – have nothing but good things to say about him, and vice versa.

Dating someone who’s affectionate, fun, with low stakes and who’s unquestionably chill after the tumultuous roller-coasters that define celebrity relationships? That alone has to be like a cool washcloth on a sunburn.

Then there’s the fact that, beyond being sweet, he’s genuinely funny. Love him or hate him, you can’t deny that he’s a gifted comedian. That makes him fun to be around. After all, when we enjoy ourselves more in somebody’s presence, we instinctively prioritize our relationship with that person. We enjoy the dopamine that comes with someone who can make us laugh or have a good time, and want more, and so we spend more and more time with them.

I mean, there’s a reason why Jessica Rabbit’s reasoning for marrying Roger is “he makes me laugh“.

And let’s be honest: Davidson’s not a bad looking guy. He’s unconventional looking, sure, in no small part because of the effects of having Crohn’s Disease and… let’s call them questionable tattoos.

(Look, I’m a tattoo snob, ok?)

He – like a lot of folks who declare to me that they look like the spawn of the Toxic Avenger – is average at WORST. And while he may not be everyone’s cup of tea, his appeal is undeniable… in no small part because our personalities make us more attractive to people. The more we get to know people, the more attractive they become to us, regardless of their physical looks. This is well-documented; over time, uniqueness ranks higher in appeal than conventional good looks. Now this isn’t to say that looking good doesn’t matter. Nobody’s saying that. But what makes someone good looking isn’t the same as being attractive, and most of what makes someone good looking is presentation – hair, skin care, style, etc.

But what about those women drooling over thirst traps on Instagram?

Well… what about them? Guys are fully capable of being turned on by women with curves like a stretch of bad road and still be attracted to women with different bodies. Being attracted to one body type is hardly exclusionary to all others. And what we find aesthetically pleasing isn’t always the same as what we’d want in a partner. I know a lot of women who like the look of professional athletes or celebrities but would never want to actually be in a relationship with them.

So if you’re curious about what makes a dude appealing to women, even if you can’t see it? Well… maybe look at what women are saying, instead of assuming that what other guys told you has to be the truth.

Good luck.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com