I'm a 31-year-old man who has trouble focusing on any one thing. I can't hold a job for more than six months at a time. This is very frustrating for me as well as my spouse, although I'm never unemployed for more than two weeks. I work in a professional field where pay is adequate. We have three small children, ranging from two months to seven years old. I don't drink or use drugs, but I do smoke and have trouble gaining weight. I lie awake at night thinking of death, God, all kinds of things, even childhood memories that are best forgotten. I truly love my wife and kids and want the best for them. Counselors just confuse me even more than I already am.

C.

I can't make specific recommendations about your situation without talking with you personally and obtaining more information about the nature of what's disturbing your ability to focus and follow through on things. But I'll mention some thoughts that come to mind in response to your description of your plight, which you can explore or discard as you wish.

One important question is whether your jobs end because you've quit them (and if so, why) or whether you're fired (and if so, why). Do you have trouble accomplishing work tasks? If so, perhaps psychological and/or neuropsychological testing could shed some light on interfering factors that might be addressed. Depression, anxiety and posttraumatic stress symptoms (possibly related to those "childhood memories that are best forgotten") can all interfere with attention and concentration, for instance. (So can alcohol or drug abuse, but you've said that's not the issue here.) There's also the possibility of attention deficit disorder or attention deficit hyperactivity disorder (ADD/ADHD), a somewhat controversial diagnosis (many professionals think it's being overdiagnosed, and some think many or all of its symptoms could be explained by anxiety, posttraumatic stress, etc.). However, many people find ADD/ADHD diagnosis and treatment helpful.

Do you get along with co-workers and supervisors, or is there conflict that contributes to your leaving? If the problem seems to be largely interpersonal, some kind of therapy aimed at increasing social skills (or anger management, if that's an issue) might be helpful.

You mention that counselors just befuddle you. I'm curious about the nature of your confusion -- and also the extent and nature of your contact with professional therapists. Unfortunately, in these days of managed care and psychopharmacology, brief crisis intervention and medication are all-too-often passed off as psychotherapy. The truth is that it can take some time to develop a safe and trusting relationship with a therapist and explore and address the many factors that can contribute to a human being's misery.

Above all, I hope you'll consider trying therapy again until you find a psychologist or other therapist you trust, one with whom you can discuss the questions I mentioned above -- and others -- as well as your nighttime ruminations. You can certainly start off by telling him or her what you DIDN'T like, or what confused you, about your previous contact with counselors, and go on from there. If you find a therapist who feels like a good match and are truly honest with him or her and yourself, I suspect you can begin to identify and address whatever's contributing to your problems. Good luck.