I recall replying to your introductory post. Obviously I don't know you. So I can't really say whether you are terrible & a lazy coward or whether what you are experiencing is symptoms of depression & anxiety. I'm inclined to think it is the latter. But, of course I can't say for sure. I can tell you that I have had some of the same tendencies you have & I've wondered the same things about myself over the years.

I think the idea of volunteering is certainly a good one for a variety of reasons... not simply as a way to see that others have it worse than you do. It is unfortunate though, to my way of thinking, that your wife and especially your therapist tell you to get out of your own head & think beyond yourself. I don't see a therapist myself. (I've seen a few for brief periods in the past over the years.) But if a therapist told me that, it would be the last thing they would ever tell me. If a therapist has so little skill that something like that is the best they can come up with then, to my way of thinking, they absolutely don't need my money!

I'm not a mental health professional myself. But I would suspect that what is going on with you is the "fallout" from years of depression & anxiety. And the fact that you have the fear you may be a lazy scared a-hole is simply additional evidence there-of. These thoughts are, in my opinion, themselves symptoms of depression & anxiety.

Having written all of that, though, here's a link to an article by DocJohn titled: "Am I Depressed of Just Lazy" plus links to 2 articles on the subject of depression in men:

Am I Depressed or Just Lazy?

Men and Depression: How Male Depression Really IS Different | What is TMS?

Depression in Men: It Looks Different Than You Might Think

I wish you well...