Discusses generalised suicidal ideation. You can probably assume everything I write will do that

My CPN (Community Psychiatric Nurse, the professional delivering most of my mental health treatment) wanted me to set a goal that he could put down on some form or other. Being in a rather low mood, I offered "be dead", which he found unacceptable, and "die of natural causes", which he also rejected, although I maintain it's a completely valid goal. He suggested "improve my mood and recovery", which seems like a bad goal on several levels, and ultimately the only goal we could agree on was "think of a goal".

When it comes to goals, I usually default to the SMART framework. It was originally created for professional and business management goals and doesn't always translate perfectly to personal goals, but it's still a helpful starting point. Effective goals are supposed to be Specific, Measurable, Achievable, Relevant, and Time-Bounded. The M and the T are basically procedural, making it easier to track whether a goal has been reached; if you have a goal that's effective in the other ways, it's pretty straightforward to assign it a metric and a deadline.

The Specific aspect is where it becomes a little more complicated. A lot of goals - the CPN's suggestion among them - are broad generalities, which makes it impossible to judge whether you've reached the goal or not. But it's not that hard to break a vague goal down into something more specific. For instance, if your goal is "eat healthier", you can pick a specific aspect of healthy eating to focus on. Less red meat? More fruit and vegetables? Cooking your own meal more often? Any of these could form the basis of a goal.

But it's the other two aspects that are most critical. If a goal isn't Achievable and Relevant, it's not an effective goal however precisely you describe it, and that's where I really start to run into difficulties.

The most obvious trap for an Achievable goal would be something wildly extravagant like becoming an astronaut or running a marathon with no previous running experience. But more modest goals can also fail this one, because Achievable means you can manage it by your own efforts alone. My two hopes were both bad goals by that metric, but getting pregnant wouldn't be an Achievable goal even for someone younger than me, and getting into the National League wouldn't have been an Achievable goal for Andy Butler, even though he did in fact achieve it. In both cases, there are too many other variables in play.

Many of the things I now want are flat out impossible: to turn back time to when things didn't hurt so much, or to resolve my pain by making some kind of sense of it. But even lower level desires aren't Achievable. I would like to do meaningful work, fix up my home so it no longer gets me down, and explore medical transition, but all of those things require support that is either conditional or outright unavailable.

I've been here before, at the beginning of my existential crisis. A well meaning friend tried to guide me by asking me what I wanted, and I replied that I wanted my ex to change his mind. She gently pointed out that this was practically the platonic ideal of an unachievable goal and suggested I think of something else. But anything else I might want was tangled up with the loss and therefore equally out of consideration. Finally, feeling I had to say something, I said that I wanted to clear my overdraft.

In theory, this was a perfectly valid goal. I could construct a set of steps I would need to take in order to achieve it, and I could have taken those steps. But I didn't, because it wasn't really something I wanted. I could appreciate intellectually that it would be useful to stop owing the bank money, but emotionally I didn't care one way or the other.

In SMART terms, it wasn't Relevant. A goal that isn't in tune with what you really want, however sensible it sounds to onlookers, is likely to feel like busywork at best. Perhaps, if you're used to doing pointless things by rote, you'll achieve it, but it won't feel like much of an achievement. And when your motivation is as low as mine was then, and indeed is now, even that is unlikely.

I can generate Achievable goals by the dozen, but there's not a single one I feel I can actually care about. The best of them feel like insulting consolation prizes, and the rest are a dispiriting list of things I imagine others would expect me to want. The only goal I can manage to commit to is to get through the next 24 hours, and that brings us close to "die of natural causes" again.

So the crux of my problem is that Achievable goals aren't Relevant and Relevant goals aren't Achievable, and I refuse to make a mockery of the process by agreeing to a goal I know won't work for me. Professionals and friends can't believe there isn't something I want that could form the basis for a goal, often to the point of getting angry with my supposed negativity. That in turn makes me angry, as being misunderstood always has. It's simpler just to avoid engaging seriously.

I've suggested absurdly short-term goals like "get a latte when this session ends" and ridiculously small-scope goals like "breed every kind of animal in Farmville". I've suggested "die of natural causes" in several variants with different emphasis. I've even contemplated meta goals like "learn to live without a goal". Apart from briefly relieving my feelings, nothing really works. Whatever form it is that needs a goal will just have to stay blank.