DEAR ABBY: I’m 55 and have been married to my husband for 22 years. He was diagnosed with an autoimmune disease 12 years ago. He’s mobile but on oxygen and has lost most of his stamina. At this point, everything in our life (friends, family and social life) revolves around his disease. He responds to any invitation we receive with, “We will see” which turns into a “no” or “I’d rather not,” on the day of the event. I am free to attend on my own. Many of my friends have never met my husband, and some joke that I’m not really married.

I can live with this situation except for the lack of intimacy and sex. Sex was never a central part of our relationship, but the nearly complete lack of intimacy over the last 10 years has been frustrating. If I try to discuss “my needs,” he gets defensive and says, “File for divorce then!”

Since the last blow-up a couple months ago, I have tried to ignore my needs, but that isn’t working. I am becoming judgmental and critical, and I know that living this way will make me increasingly resent him. My struggle is the thought of leaving someone I swore “for better or worse” with, for the selfishness of “my needs.” Any advice? — NEEDY IN ALASKA

DEAR NEEDY: Raise the subject again with your husband. When he says, “Well, divorce me then!” ask him if he really means what he is saying because there may be another option. There are no hard-and-fast rules for the situation in which you find yourself, and some couples deal with it discreetly.

Ask yourself what you would do if the situation were reversed. Would you want your husband to find an outlet for his sexual urges outside the marriage? If your honest answer is yes, and because you can no longer tolerate the status quo, your husband deserves to know what is on your mind.

DEAR ABBY: I am a woman who has been with my spouse for 22 years, married for eight. During all that time, she has yet to set boundaries with her birth family. While we rarely argue, when we do, it’s usually over a request for money or some kind of infringement made by her relatives. I’m powerless to get ahead of their requests because I find out only after the fact that money was loaned or space in my garage is being used to store their stuff, etc.

We started our relationship in therapy because of this situation and, 22 years in, we’re still in the same place. We hardly talk anymore, and I’m deeply saddened. I don’t know what the next steps should be. Any feedback would be greatly appreciated. — STUCK IN ARIZONA

DEAR STUCK: Sometimes progress is two steps forward and one step back. In your case, you and your spouse need to take one step back. Consult another therapist for help negotiating a solution to your wife’s lack of boundaries and her habit of making financial and other commitments to her relatives without first clearing them with you.

Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Contact Dear Abby at www.DearAbby.com or P.O. Box 69440, Los Angeles, CA 90069.