Look, you are no newbie. So I will not respond here with the political correctness and tenderness I would try to use with a new person who really has only just begun to see the truth about his issues. You, in contrast, have had half-a-lifetime studying your sad life story b'iyun. It's your blanket - your punishing rod and your comforting staff. Yet masturbation and self-pity still follow you wherever you go...that is no co-incidence, is it.
Be"H you will soon let go of the 'setting time aside daily for dealing with shmiras eynayim issues', for as you know, the more we focus on living in the problem, the more we live in the problem. It would be totally counterproductive for you - as is most of the time you spend mulling over how bad your situation is and all your problems.
True, being aware of real problems is so very essential! And ignoring problems is just sweeping them under the rug till we trip over the bump, yes. But these things - your problems - are all well-known to you, I think. Perhaps the issue is not the problems you have as much as it is the anguish that you have about them. So they are really NOT your problems, are they? Aren't your emotions the real problems that mess your daily life up? How about getting real help for those? You implied that - having a trusting relationship w a solid therapist.
You tell your associates to avoid perfectionisms...but how about you? How trustworthy does this therapist need to be?? How 'solid' does he (or she) need to be?? Are the therapists where you live, generally a bunch of mean bastards or something? Will they share your secrets with the community at large? I doubt that. You need help. For G-d's sake, why not trust them? And 'solid'...I do not even want to know what that might mean.
Harbei shluchim laMakom. Perhaps you are too picky. Perhaps you are your worst enemy of all that has ever lived. Perhaps it's time to use dirty water, as the Chofetz Chayim's parable goes. Perhaps you need help now, otherwise your Arnold Schwartenegger-like self-pity will terminate you, if it has not already.
I know you react by quietly saying things like..."...i'm afraid it already has terminated me...", but that's a lie. For you will see, if you give it a day or so, that there is still enough left of you there for your self-pity monster to torture with more could-have-beens, should-have-beens, and poor-me's. There will always be room for you to say the refrain of, "What can I do? My circumstances are insurmountable and look how society, my wife, the doctors, and the system have all ruined my life."
Well, I do not buy it for a second and you do not need to, either.
I love you and you know it. And so do other people in your life though you can't see it through your self-pity and depression. G-d has put far more strength in you than you think. You are a good man and a good father and a good husband in many, many important ways. Do you realize that yet?
Today is a fine day to get the help you need. Open up fully and unconditionally to your damn shrink, whoever he or she is! We are all screwed up in some ways - even your shrink is! And you are no worse or better than anyone else. Please leave the pity party. I bet that you see the shrink as untrustworthy mainly because they do not usually coddle you and do not play into your self-pity...wow, that really turns off self-pity'ers like body odor. We live with this king of condition for 'trusting' therapists: "I can't trust you until you recognize how very sad my life is and maybe cry with me a bit..."
Yes, empathy and acknowledgement of pain is essential - but maybe your standards for it are way too high? Maybe not everybody needs to be sorry for you as you are for yourself in order for you to 'trust' them? Man, life is hard for everyone in their own skin and in their own circumstances. You do not need the pity. It's really killing a fine man: You.
You deserve better food than the crap you have been serving yourself since you realized you were imperfect, years ago.
(If that was too hard, tel me and I will erase it. As it is, some newbie will read it and say, 'boy that Dov is a nasty dog.'...oh well. But we have spoken many times. I know you, chaver. Your sad story does not fool me any more. It's time for you to take a different road today for today and live today, not be one of the walking dead.)