Baggage Check Live: "Upping the self-care to eleven"

Jan 02, 2018

Licensed clinical psychologist Dr. Andrea Bonior was online to take your comments about her advice column, Baggage Check, and any other questions you might have. These comments may appear in an upcoming column running in Express and online.

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Hi, all-- I hope you're coming off of a relaxing and joyous end to 2017. Or if it was far from relaxing and far from joyous, that you're able to take a breath now and look ahead. I'm recycling the egg nog cartons and can't wait to get started. Let's talk!

How do I unplug myself from last 13 months, just over a year? I had two major health problems, my mother died, and I moved back (finally good) after 6+ years. This is the worst time of my year, as I have been aware of since childhood, seasonal affective disorder then the horrendous travel for holidays then having to DO them 4+ years full time Alz care for Mom then 2 support 3 d for sister-in-law nearby. I have felt I am incapable of working now, I sleep about 6 am to 2 pm as is my preferred winter pattern--I honestly cannot go to sleep earlier or wake up earlier. Most depressing up next in Jan my Bday and slightly later suicide anniversity of old friend. Should I try or just ride this out til Spring?

Okay, my heart is just aching for you. You've got so much that's tough-- it's like some sort of awful seasonal pattern sandwich--- that I admire you for even writing it out. First, the physical piece-- I don't know how much medical help you've gotten, but having both Seasonal Affective Disorder and an extremely delayed sleep phase pattern is a major reason to put some physiological tools in place. Have you tried a lightbox? A sleep study? Cognitive-behavioral aids for adjusting your sleep? Your depression, sensitivity to the lack of daylight, and then being up all night are all contributing to each other. See what you can do to intervene there, starting with an MD sleep specialist who has a psychologist on staff, but if that is not possible, at least a very good general practitioner. Next, you have all the stress of having been a caregiver, plus the anniversary of a serious and traumatic loss in addition to the newer loss of your mother. How do you unplug yourself from all this? Not by 'riding it out' on your own. I say by attacking it head-on. A solid cognitive-behavioral therapist can get a plan in place while the MDs address the physiological issues. But in terms of the CBT plan, some daily accountability with increased exercise, meditation, increased social interaction-- those might be the nuts and bolts. And groups are often particularly good for grief and loss-- and they exist for those who have been caregivers as well. Even looking around online can be a start. If you get support, you'll be better accountable and able to boost your resilience. You deserve not to have to just grit your teeth until Spring.

Hi! Longtime reader, first time chatter. My question is: I’m almost overwhelmed by the daily drumbeat of racism and misogyny in the news. But part of my job involves keeping track of current events in the political spectrum. It’s starting to cause a lot of anxiety because I can’t get away from it. I’m between a rock and a hard place! What should I do?

I'm sorry. I'm seeing short-term and long-term here. Short-term involves upping the self-care to eleven. So, taking frequent breaks at work, getting enough sleep, making time for people whose company you enjoy, getting exercise, being outside, engaging your mind in things that don't make you want to beat your head against the wall. You've got to treat self-care like an additional job duty, honestly, and have someone you love keep you accountable if possible. But I think there's the ugly underbelly of the long-term question here. Is this sustainable for you? Is this job where you want to be? Yes, perhaps the news will not always be so depressing (pretty please!) but if it is, can you still find a way to be in this, long-term? And do you want to? Perhaps part of the answer to both aspects of it is to try to find meaning in what you do. Try to find a direct connection between the discomfort you have to have by seeing what you see, versus the overall mission of why you're seeing it and what you're doing about it. And try to remind yourself of that, that you're making a difference. (I'm crossing my fingers that that's part of what your job does.)

Therapist-client is an unusual professional relationship because the therapist can always tell a dissatisfied client "You're being uncooperative, you're being resistant, it's part of your problem," etc. Do you have any advice on how to recognize when therapy is "working," even when it might be uncomfortable or painful, and when you're in a bad match, maybe with a bad therapist?

Yup, this is important. First, I'd be wary of any therapist who did any substantial or continual 'blaming' of the client for lack of progress. Yes, some clients can sabotage themselves, or not want to go where they need to emotionally, but talking about those challenges should be more clear and direct than that, not a unilateral blame game where the client is confused about what's getting in the way and the therapist is just saying it's the client's fault. I think when things are uncomfortable or painful, it should be for a reason that makes sense and is discussed, and there should be a clear plan as to how that discomfort or pain move the person forward. It shouldn't just feel like picking a scab over and over again. I'm a big believer in measurable goals for therapy. So it shouldn't be too hard to recognize when therapy is working, because the goals that were set at the beginning are being addressed. Sometimes those goals are super-tangible (have fewer panic attacks, or lessened symptoms of depression) and sometimes they are less measurable (get to know myself better, move forward after a loss) but there should feel like progress over time. Even if it's not every week, and even if it's not completely linear. But in those times when it's not happening, that's when the tough discussions need to take place about why.

Andrea sets out some great ideas! If these seem overwhelming, engage some help from friends and family. Eg ask someone to check out caregiver grief group therapy groups in your area for you. They are hard steps to take, but most likely worth the effort.

Yes, yes, yes. If you have people you can delegate to, that is ideal. Are there any leftover folks who always said "Let me know if there's anything I can do" when your mother passed away? If so, reach out to them. Giving them tangible tasks often helps them feel useful as well. Thanks for this!

The suggestion to get active with your child is a great one, but probably won’t actually help with weight loss. Keep doing it, but don’t expect it to be the magic bullet. Encourage water over milk/juice and save soda for very special occasions. Offer fresh vegetables before dinner when a kid is hungry, but the meal is within an hour. Even if a kid thinks they hate grape tomatoes or cucumber slices, they might come around if they’re truly hungry. And let them have some control. If the feel like their eating is always watched or they aren’t allowed to have seconds due to some arbitrary amount that Mom or dad decided is right, an older version of that kid may swing the other way and overdo it from worry about food scarcity. Ultimately, unconditional love of them at any size is key!

In response to the Dec. 19 chat.

Yes, this is left over from the topic of the chatter whose child was starting to have a potential weight struggle. All great things to think about. Thank you!

Working out is a big part of my life, it makes me feel good and confident and has become a healthy part of my routine. But I've recently obtained a shoulder injury that prevents me from my regular workout regimen (Dr.'s orders!), which involves a lot of weightlifting. Not being able to do this for a few weeks, especially going into the new year, is weighing me down. I am able to do light stretches and things like that but it's not quite the same, and I do feel sad about it. I am also worried about falling behind on the progress I've made. Am I being dramatic about this? I feel kind of silly being upset about this, but for some reason it is affecting me not just physically.

This isn't silly at all. In fact I've seen a substantial number of people who struggle with this. One thing you have going for you is that you don't seem to be catastrophizing about this being a permanent situation (unless I've just made you do that. Uh-oh!) But I think the key is figuring out a good-enough substitute during the coming weeks. So maybe you don't have that exact feeling you do when you lift weights in a specific way, but maybe you explore a new type of exercise that still gets the endorphins going (would certain water exercises be okay? New yoga moves?) or you re-up on the exercises that don't involve your shoulder. Or you get some new scenery with more outdoor exercise (okay, not the ideal temperature right now) or more walks up flights of stairs to your office, etc. If it's just a discrete period of time there doesn't have to be a perfect substitute, but a little bit of something different could give you a boost. And of course I should nag you to make sure you truly do let the shoulder rest, so that you really can start back in the way you hope to.

I am awkward around men I am attracted to/interested in. And often my clumsy attempts to indicate I am interested are missed. I am also not a first move maker, it's not me, it feels wrong. I have tried online dating with little to no success. My friends don't understand why I am shy/weird around men I am interested in because otherwise I am pretty vivacious and funny. And here's the saddest part of all of this: I am in my 40s and divorced (I was married for 5 years). I would like to remarry but I am just struggling in the dating/meeting area and I am not the kind of women men push other people out of the way to get to in bars, coffeeshops etc. Help.

First, I am guessing you may be overestimating your awkwardness in those situations. Even the fact that you say that the "sad" part is that you're 40 and divorced-- I feel like you're really being hard on yourself here! I also feel like I need to know why the online dating didn't go so well. Did you notice what typically went wrong? Was there a pattern of things on your end, or was it the classic horror stories of dudes sending you pics of things that no woman has an interest in seeing pics of? But typically, online dating can be helpful in these cases since it lets you calculate your interactions a bit more than being face-to-face right off the bat. These friends that don't understand why it's not working for you-- can they be your comrades in going out more? Not to bars and coffee shops per se, but to more structured activities where it's not just a stand-around-and-talk situation? Volunteering? Fitness classes? Weird, random things you see on groupon or whatever bot has taken over that market? But yes, if you're here, tell me more about the online dating piece!

Every year, my husband calls his parents right after midnight. So essentially, we kiss at midnight and then he gets on the phone to try to call his parents and then he'll talk to them for a minute or two. I really hate this. I can't even articulate why--it's not like I'd care if he waited to call them the next morning and it's not like I keep him from his parents in any other way--he just spent a week with them after Christmas and we're going to see them again in another week for his mom's birthday. It just annoys me so much that he can't wait a few hours to call his parents because then I'm just standing there waiting for him to finish his call. He says he has always done this and won't stop now.

Okay, I am visualizing this here-- Auld Lang Syne playing in the background and you with steam coming out of your ears. But if this is a tradition that means a lot to him, I'm thinking that waiting a few hours would miss the point and be a no-go, so you'd essentially be asking him to ditch a long and meaningful tradition with his parents for.... what reason, exactly? Can you try more to figure out why it bothers you so much? Are you typically in a group of couples and you feel awkward standing by yourself? Understandable, but probably not a hill to die on. What about if you joined in the conversation-- seems a quick one-- and the tradition morphs into you both wishing them a Happy New Year? But yes, this hill.....not a great candidate for a big battle, I'm thinking, as much as I can understand that it bothers you.

Yes - I"m a yoga teacher and could create a fantastic class for you that would avoid your shoulders. You could nvestigate having a few private yoga sessions. I would not go to a group practice. Make sure you let the private teacher know the issue with your shoulder and exercises from your doc/pt that are strengthening your shoulder and talk to the teacher the way you do in your post here. Look for someone who has a strong anatomy background. You'll know from how they respond to your shoulder injury if they are the right fit for you.

So helpful. Love these readers! Thank you.

Was "upping the self-care to eleven" a Spinal Tap reference? If so then kudos! Also, I often find myself in a similar position as the question poster. I find it helps to remind myself that all these horrible things in the news about racism and misogyny are thing that have ALWAYS been going on. But now they are getting more media coverage and there has been at least SOME accountability- so thats a good thing right?

When in doubt, it's ALL a Spinal Tap reference! Yup, great catch. And thanks for this-- there's an argument to be had that the light that is now being shone on these awful behaviors can only be a positive thing. Now, if only people's social media algorithms will actually let them see this light in its accurate form, rather than distorting it into a meme that makes these behaviors worse....

My son was diagnosed with ADHD and just started high school this August. He had been going to an experiential learning middle school which provided the individual attention he needed. Unfortunately the high school is the traditional model and he's struggling to keep his head above water. He also now has a girlfriend which has become his life. We are struggling to get him to focus on his classroom which he hates but for English. We've tried to inspire him with stories of how we've overcome high school, paired him with an adult mentor who he likes, provided him with some tutoring, but we're making little progress. He's still in the instant gratification mode. Not seeing any connection between classes and his future, its "why should I study, try, succeed." I can demand he work harder, take away privileges when he doesn't (which we do) but I can't give him motivation he doesn't seem to have. Any suggestions would be more than welcome.

Yeah, it is not at all uncommon at that age for the connection between long-term life goals and short-term chores/homework/etc to be really difficult to make. And if you throw in ADHD and now a traditional school after having had a bit more individual focus at a different school, it can only be harder. Sometimes, getting a student to wax poetic about how trigonometry will help them in the real world is simply a losing battle. For those tasks, I would continue to try the behavioral pieces of carrots and sticks. But then, for the things he likes-- like English-- urge him to dig deeper. It's okay for him to dislike parts of school. But maybe the parts he does like can be enhanced, and he can uncover a passion that can serve as a motivation and give him energy and interest more generally. And speaking of passion, this girlfriend-- what's she like? Can you keep your relationship with her in good working order so that she can be a further motivator, rather than a hindrance? The adjustment to high school can be tough, especially in these specific circumstances. I have a feeling if you keep consistent in your expectations and encouragement, he will eventually find more to work toward (hopefully not going so far in the other direction that he's freaking out about college applications to the point of panic.) A guidance counselor of his might have additional ideas geared to him as well. Good luck!

Hello I have never had tons of friends. I believe it was because I lacked self confidence and had/have poor self esteem. I was never a social outcast but just lacked great friends. At 57 I want to make more friends. I have tried joining MeetUps but have only met 2 or 3 acquaintances. I am single and would love to meet my “Mr. Right” too. The women’s groups I found the single/divorced women are into their “kids” (dogs or cats) or busy with their children. The hiking group people had been together and I found the people not open to looking to make friends. I tried approaching people-asking questions “how long have you been in the group?” “What’s been your favorite hike?” But the conversation turned to previous parties. The crafting MeetUps are older woman not interested in making friends with a single woman or the members are younger moms. I thought volunteering with political groups I would meet like minded people. Sadly, my local Indivisible group is mostly older, retired couples. I signed up to volunteer at the local food bank but people come make the food, serve it and leave. My 1 close friend from graduate school lives 3 hours away. I moved in my mid 30’s so the few friends I have do live a few hours away. I travel to visit them. I own my own home. Love to craft and decorate along with cooking. I long to have dinner parties. I am not religious so I am not interested in joining a church. I work for myself at home. I just started with a therapist. I tried therapy in the past but after trying a few times over the years I haven’t found one that I have clicked with. I hope this one works out! Looking for love & friends in the wrong places. Any suggestions to finding friends and hopefully a Mr Right. Thank you! Almost friendless

This pains me, because you are doing what you're supposed to do, and it's not yet paying off. But let me say this-- it's not paying off YET. I feel like this is like when someone starts a new exercise or eating plan and it takes a while to actually see the results, and it's so annoying that the jeans are still tight, but the results just need some time to manifest. They will come! Every time you have a conversation, you build your social skills and get a little better at the nuances of conversation and a little more comfortable and confident. And as for the tangible results of true friendship, all it takes is a connection with one or two compatible people, and bam, you have what you wanted. Those "acquaintances" you met-- what has kept them from becoming friends? Now that you are in therapy, I would make more and more quantifiable goals about putting yourself out there. Yes, you've been doing that so much you're probably exhausted from it, but it really is the right path, slow as it seems. Maybe consider a co-working space, as well? Working fully from home can just add to the isolation, and if you saw the same people over and over again, that repeated contact can serve as a foundation to build on. Keep at it, as frustrating as it may be!

How are his study skills? If he isn't getting up to speed on how to budget his time for his homework and how to break down his assignments that might be part of the problem. You could get someone to help with this.

Great point. If the basic ins and outs of doing homework are feeling unmanageable, he's just going to get more and more frustrated and more likely to mentally check out. Thanks!

I've been depressed for a while now (not dangerous to myself) and I want to go to therapy for the first time ever. How do I even go about picking someone? I have insurance and can just pick one in network, but it seems like such a waste of time to try one out and find out they're not a good fit. I think if that happens once I'll stop trying.

First, I'm sorry that you're suffering. But it really is a good thing that you are considering help, as much trepidation as you may have. Here's the thing-- you can google-stalk the heck out of a potential therapist (hmm. Guess whatever I just reaped on myself is my own fault!) The vast majority of them have profiles on various therapist finders, in addition to potentially their own website. You can find out so much about their style, their experience, their specialties, their philosophies of what therapy is all about-- even in their own words. And even, for some with videos, in their own voices! A lot of them offer complimentary phone consultations as well, to further assess fit. So it's not a matter of having to invest a ton of time just to get a feel for them. It's good that you recognize that you are going to be prone to giving up if the first one doesn't work out-- and I say to that, get somebody on your side that won't let you do that! Or write in each week and I'll keep nagging. Seriously, there is good help out there, and depression is common and treatable. Don't be your own barrier against getting it.

Are you in a position to get a dog. Only half joking here ... dogs are notorious for meeting people you'd have a great furry friend that would definitely get you out of the house.

LOVE this. Of course no one should get an animal who isn't really prepared for the commitment, or not truly enthused about the idea, but it can be a wonderful way to meet other humans too. And a relentless instigator to be forced out of the house when it's an ungodly 20 degrees outside (not naming names here, but he's a good boy yes he is!)

I was diagnosed with ADHD almost two years ago (though, looking back, I've probably had it since childhood). I'm in therapy (for that and other issues) and am taking medication, which has vastly improved my life. However, my husband and I will soon start trying to conceive, which means I can no longer take the medication. What other options are available to me? I've looked into dietary changes but am beyond skeptical that simply changing my already healthy diet will "cure" me. I'm thinking of exploring some CBT techniques with my therapist, but I worry that won't be enough. I'm afraid of falling backwards (failing at work, failing at home with chores, etc.)

The more specific you can think about the ways the medication has helped you, the better. That way you can specifically target those problem areas. It's not a matter of being "cured" or finding the perfect sub for the meds (reminds me of the shoulder injury chatter!) It's just a matter of coping your very best with the resources you have at your disposal. So, yes, diet may not "fix" your symptomology, but perhaps you notice patterns in your eating-- and especially I'd pay attention to sleeping-- that can be helpful to address as they pertain to your mental clarity. Just like CBT might not have the exact effects as a stimulant med, but it can still help you address disorganization, work procrastination, distractions, impulsivity, etc-- and provide accountability for getting new structures in place. No two people with ADHD have it manifest in exactly the same way, so I think the more you can figure out with your therapist what exactly your target behaviors are to keep in check once you go off the medication, the more refined the plan can be to address them-- and the more successful. And speaking of meds-- your OB/GYN might have some general guidance about others that they have seen in this situation, and what is doable and what is not. There's also the (sometimes hellish) advice of Internet message boards. Good luck!

Another round of fantastic questions-- much appreciation! Sorry for the ones that were "best left unsolved" (sorry-- Spinal Tap is the gift that keeps on giving.) I'll try to get those in a column or future chat. Can't wait to see you next week!

In This Chat
Dr. Andrea Bonior
Dr. Andrea Bonior is a licensed clinical psychologist and the voice behind Baggage Check since its start in 2005. She serves on the faculty of Georgetown University and is the author of the Publisher's Weekly best-seller "Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World" and "The Friendship Fix.”
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