Thanks for the suggestions, all are of value to me. Blanksy, hdeyong and markbarendt hit it home especially.
This isn't necessarily about making 'good art', but just finding a comfortable area (mental and physical) to work in, that keeps us charged and motivated.
It's probably about simply being honest with myself too. As has been suggested about looking at the work of others (which I think is important), in the end, it's true that you have no idea where it came from - internally. You can perhaps only ever 'take' from the surface of other work.
A break to just experience/see and a change of scene are what I need. What Mark says about fresh subject matter makes a lot of sense, but I still wonder how so many of our revered photographers worked in a single location for years and years on end, producing such animated and spirited work. HOW does it remain fresh to them, really? I need to know this. Robert Adams and Denver, Colorado for instance - one of the happiest couplings in photographic history. This is a common theme with the great photographers of course, which can't be ignored - breathtaking work produced in otherwise banal places. I just feel like I'm punishing myself when I do it in my area. But it feels like an important challenge - one that I can't let go of; "if I can make good pictures here, I can anywhere, but if I can't, I'll produce shit wherever I go."
What would really help me is getting inside another photographers head, someone who works within the same square mileage producing great work. I'd ask them how they remain, without being nagged constantly by that thought of "what if?" about another place. Which comes back to Mark's point about needing foreign subject matter and new experiences - does this just mean you're flighty? Short attention span? Isn't singular focus integral to producing meaningful work? The idea of giving up on my fine art fantasy and trying to get into travel photography is increasingly appealing to me, for the reasons you suggested. Maybe some of us just fundamentally aren't cut out for art photography, which in the current art world climate, requires a certain monotony to have any success. I'll say that some success is important to me at this moment in my life, for my age, but also the fact that I'm consumed by photography - it needs to be substantiated. I actually studied music, but have abandoned this pursuit completely for photography.
I'm very aware of how self-absorbed this thread is, don't get me wrong, but I truly hope it will be of value to others facing similar existential crisis with photography.
I very much appreciate your thoughts and time.