I am totally lost, and could use some input.I have been with my current boyfriend for almost 3 years now. We met when I was a senior in college, and had an amazing first couple of months. This relationship is extremely complex but I'll do my best to explain. I am currently unhappy a large percentage of the time and think about breaking up with him pretty often, but when I actually think about going through the breakup and being without him I feel like I could't go through with it.
Our relationship started out fun and exciting as most do. Right off the bat I should state that I am a education and career minded person, and he is not- in fact, he worked at home depot at 25 when I met him and had never thought about going to school or making anything for himself. I graduated college and then moved about 2 hours away to start medical school. He did not come with me because he didn't feel like he could leave his home town. We did one year of long distance, which was not without drunken nights of fighting, verbal abuse, and a few instances where we should have separated. The summer between 1st and 2nd year of med school he was arrested for domestic violence against his brother with whom he lived with and decided to move to be with me. Living with him was wonderful at times despite the fact we could only afford a piece of shit house that I paid greater than half the rent. He then decided to quit his job at home depot and try to invest in boa constrictor (yes, snakes) selling- but instead he now has 20+ snakes and has not sold one. Also during this time, stressful for me with school, tests and boards, I find that he had posted profiles on local "cougar" websites and was even "sexting" with some girl he met on craigslist. Due to my extremely low self esteem, I still did not break up with him. I do not pride myself in this, but I thought moving away for third year rotations to another state would provide me with strength to be alone and maybe even find my way to be single. It is now 6 months after I've moved and we are still doing long distance. He is here visiting me for 2 weeks right now. At this point, I feel like we're totally disconnected. We are also having intimacy issues (like he won't have sex with me)- which I addressed this evening. He states I need psychologic help and when I throw myself at him it turns him off. I actually totally understand this fact- but then I have to wonder why I'm throwing myself at him. I am self aware of the fact that I have poor self image issues, but in other aspects of my life I totally have it together. I'm almost done with med school, I aspire to be a surgeon, I have worked extremely hard in the past years to get where I want to be career wise, but I can't seem to get my relationship life in check.
Basically, my question is- what is it going to take for me to get out of this situation? Or am I doomed for a poor relationship because all I can think is how fat and ugly I am?