Brainstorm, man! Storm that brain! You are so creative with solving other people's problems. I know it is harder to use that creativity to solve your own (I have the same experience) BUT it is SO worth it!
If you can't come up with a list of 180s, then HOW ABOUT THIS. Tell us your basic daily routine. And WE will come up with 180s for you for every step of your day. It can be like multiple choice!
Forgive me if you've already talked about this, but are you exercising regularly and going to individual counseling? If you feel stuck those two things are SO HELPFUL. You can work on making your insides and outsides even more handsome! I am not sure what kind of exercise you are up for while waiting for your diagnosis but can you go for a short jog? For me 10 minutes on the treadmill makes me feel like a completely different person. Can you start doing yoga? Or just stretching? Can you go for a long walk? Can you play ping pong with your sons? Or basketball? Or squash? Or badminton? anything, get yourself moving! exercise = PMA. I forget this all the time, and then when I work out, I feel so amazing, and I know it's not just me!
Also, one thing that has helped me a lot, since I am in NC right now, is to work on myself and my own issues in individual counseling and examine how I contributed to my R crisis and practice with other people (not my SO) how to respond differently in similar situations. Cause it's not just the R ... it's me!! My mantra is: if the other person doesn't want to work on the R right now, work on YOURSELF. Are you REALLY doing that? I ask myself this all the time.
Finally... what are your strengths? It is easy to get lost in working on what we percieve as our weaknesses/faults.
Most of all... what has worked in your R in the past? This is SO IMPORTANT. When I read your thread, you say a lot, "she's always been like this." I can't believe that. You wouldn't have gotten married. There HAS to be a time, even if it was before you married, when things were different. There HAS to be a time when things were WORKING, otherwise you guys could not have been able to conceive four boys, right?!! SO... WHAT were you doing DIFFERENTLY when things were working??????