Dear Abigail

A client in my new counseling practice says she is suffering from low self-esteem. I'm feeling desperate because I don't see any way to help her. She's overweight, unintelligent, socially awkward, has a lisp, lots of allergies, loves to "harmonize" even though she can't carry a melody, and she spends most of her time on social networking websites like facebook and friendster. And she thinks her problem is low self-esteem. I really don't know what to say. I don't want to tell her the truth, that me trying to fix her "self-esteem" problem with medication or words of encouragement would be like trying to clean up the mess in Iraq by saying nice things about President Bush. The fact is that she is a unattractive confused loser. And me telling her that she just needs to forget about the expectations people are placing on her would be like Dick Cheney telling President Bush to stay the course despite his bad approval ratings. Granted, the analogy fails in several ways, not the least of which is that my client's repulsiveness does not determine the fate of an oil-rich nation. But Abby, this client is so destitute -- physically, socially, and intellectually -- that I can think of no way of encouraging her without performing gross flattery. Please help.

-Desperate Counselor