Baggage Check Live: "Good cheese will help"

Sep 04, 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! It's so good to have you here. 

What is on your mind this week? Summer has now wound down-- or perhaps screeched to a halt. A lot of kids had their first day of school today-- and whether it's their first first day or their last first day, I know there are feelings involved on the parental side as well. Anyone shed some tears (of joy or sadness!) this morning?

Speaking of that, in today's column, we do have someone dealing with the empty nest for the first time. How do you get these feelings to pass? And in L1, we've got someone who's making positive health changes for himself-- and his girlfriend is not too happy about it. Can this relationship be saved (and should it?)

Let's talk! 

 

more on last week's topic: I did not change my name when I got married because I am strongly attached to my own history and culture, but both my daughters in law did, but each also had a difficult to spell last name (but culturally identifying) last name. To each her own. Meanwhile, I think that when the OP's husband says this again, she should say something in the moment, not grit her teeth and change the subject. May I suggest "No, it was not out of respect at all, and it did not take me long to figure out it was wrong for me. Fortunately for us, I did not make that mistake this time."

Thank you. I am guessing you meant "disrespect" but I didn't want to put words in your mouth. 

Yeah, I think "to each her own" is so fitting here. It's so easy to assume that what's best for one person must be best for another. And yet this is one choice that really is a personal one-- and everyone's mileage will vary! 

(In response to last week's chat)

He was implying I was unfaithful. His first question when I told him I was pregnant was "whose is it?". Like I said, he's an EX for many reasons. We both had Scandinavian ancestors, which must be where the child's hair color came from. Recessive genes, or something.

Got it.

Yeah, I can't imagine that as a response to a partner's pregnancy. I am glad you moved on! 

It's not in the Advice page ... .

ha! Zainab, I promise I didn't pay this person to write in.

Yes, there is a major brouhaha afoot because apparently the powers-that-be don't think Baggage Check needs to be updated under that advice header anymore. 

Needless to say, Zainab and I feel strongly that that is not the case!

I also see it has no comments yet, so clearly you are not the only one having trouble finding it. 

I am sorry about this. We are working on changing some minds. Maybe good cheese will help. 

In the meantime, it is here. 

 

Yes, Andrea is right! There are some internal backend changes that have eliminated some of the categories. But we are working on a solution. You can also find all of Dr. Andrea's chats and columns on her author page here. 

(In response to last week's chat.)

What was the most common objection you received to "12 Tips for Raising a Child Who Won't Sexually Assault " I mean, I just read it can't imagine anyone being offended. 

Oh, you'd be amazed.

I think a lot of people felt threatened and attacked-- like I was taking the stance that boys will by default grow into sexual assaulters if left to their own devices, perhaps. Of course, most people did not bother to articulate their argument particularly gracefully, so it was hard to know for sure. 

No need to publish, but I wanted to add my voice that I also couldn't find the column this morning (although I didn't try a Google search). I concur that it would be nice if it were easier to find.

So I'll take a liberty here and although you said no need to publish, you didn't actually prohibit me from doing so.

Thus I respectfully add your voice to the crowd. Thank you!

 

Red hair crops out and disappears in a very irregular manner, compared with other hair colors. It's just a genetic fact of life. I say this as one of seven redheaded children of a Mediterranean-dark mother, who got really REALLY tired of all the comments on where we came from.

Ugh. I can only imagine.

Yup, genetic flukes keep things interesting-- until some random great uncle decides to make what they think is a brilliant joke!

Why wouldn't they want to keep your column updated on the advice page - you've got a very engaged and dedicated following!

Another person I promise I didn't pay!!

(Sorry, I don't plan to be annoying by posting these, but it appears we need all the help we can get.)

I appreciate the kind words!

Hi Dr. Andrea, I could probably Google this question, but I am curious to see what your answer is as a licensed health care professional. What is the difference between a therapist and a psychiatrist? How should someone decide which they need to see, and how to go about finding one or the other? (Although that last question is probably its own beast)

Well, there are different types of each, and some overlap. 

A psychiatrist by definition is an MD who can prescribe medication. Many psychiatrists do only that, whereas a few are also therapists who do talk therapy. It's important to know that going in-- which a lot of people unfortunately don't. (I can't tell you how many stories I've heard of people going in for an appointment with a psychiatrist and expecting psychotherapy when all they got was a prescription.)

A therapist by definition does talk therapy. Such a therapist could be a psychiatrist, but that is more rare (and psychiatrists who do therapy tend to not do as much Cognitive-Behavioral Therapy as other types of therapy that may not have as much empirical backing. Uh-oh. I will hear from some unhappy folks by saying that, but the numbers do support it!) A therapist could be a counselor, a social worker, or (like me) a psychologist. They cannot on their own prescribe medication (unless they have special credentials and live in certain states), so by definition, they will not be dealing with medication and will only be doing talk therapy.

The data shows us that medication alone is typically pretty subpar from an outcome perspective, in terms of the treatment of depression and anxiety. (Risk of relapse is significantly higher, for instance, which makes sense because you likely will not be working on developing any additional emotional, cognitive or behavioral tools to make changes and treat the depression. You're only attacking it from the neurochemical perspective.) So I always recommend therapy for those conditions no matter what. Sometimes-- especially when there's reason to believe that there's a strong genetic predisposition, or the depression or anxiety are severe enough that we need to come at it from as many sides as possible-- medication can be warranted on top of that, in which case you may see both a psychiatrist and therapist. Does that make sense? 

Good luck! 

 

(In response to last week's chat.)

I know that book and actually found it helpful myself, but more in a retroactive way. In other words, while I am a big gift giver, my boyfriend... isn't. But he will spend a year of his weekends remodeling my bathroom with a vanity and a tub and dimmable lighting... and so it's really important that I remember that his acts of service are HUGE ways that he shows me love. And if I have to tell him exactly what I want for my birthday, or get no physical gift at all, I don't start questioning his love for me. So I would say that it's good to know your "love language" and you can even tell future partners, "Babe, I love getting gifts, I know this is hard for you, but I would like a necklace for my birthday. You have six months. Feel free to consult me," but I think it's even more valuable in just opening your eyes to the fact that people communicate love in different ways.

I think this is a really helpful way of looking at it. 

It's amazing the number of couples where gift-giving styles (in terms of motivation, abilities, and needs) are a complete mismatch. 

And the better you can communicate in advance what you may need in order to not, say, spend your entire birthday weekend resentful and feeling let down, the better.

Thanks. 

Dear Dr. B...When you observe the partisan divides in America, what do you make of the situation? I find Trump mean-spirited and petty for how he's dealt with Senator McCain's death (on top of the Cohen/Manafort verdicts, which would be big news in a normal week, but now are just more noise in the daily onslaught). Yet his fans defend and cheer him on. How did we as a nation get to this disconnect and how can we heal moving forward?

Honestly, a year ago I was all about helping people find ways not to catastrophize, to work together, to listen respectfully for common ground, to reflect, to connect, to perspective-take, to empathize....

Now I'd rather spend that time getting people registered to vote. 

(That's probably not what I'm supposed to say, but hey. Let's be real here.) 

Support your local cheese-monger!

I think we have the answer-- a local artisanal cheese-mail-in campaign!!

Don't miss the in-depth cheese discussion today in your colleague Alex Petri's online chat!

Ooh, awesome! I will check it out.

If the complaining GF of the first letter is honest about her motives for "you're no fun any more," there might be a possible future for you two. But I'd recommend couples counseling just in case she's hiding fears...and if she doesn't come clean during therapy, it's probably time to break up.

Yup. I do think a lot of this hinges on whether they can be honest with each other about what this lifestyle change is bringing up. It could be really deep-seated stuff for her, and might just be too much.

Weight issues can be the ultimate baggage.... no pun intended. But a lot of it goes back a lifetime. 

Or it could also be that she just doesn't want to live her life the same way he does, and she finds it sanctimonious or annoying. 

Either way, they need to talk! 

Could you and the chatters please recommend some novels and short stories that deal candidly and compassionately with mental illness?

Ooh. This could be a really interesting discussion. What type of psychological disorder/mental illness are we talking about?

"I Know This Much Is True" involves schizophrenia and is wonderful. "This Is How It Always Is" deals with gender dysphoria and parenting in a loving, moving way. "We Are Not Ourselves" is an incredibly compassionate look at dementia. "Still Alice" is another really brilliant take on dementia-- I know it was made into a film, although I never saw it. And "The Center Cannot Hold" is a first-person autobiographical account of schizophrenia that is really striking. "The Marriage Plot" has one of the best illustrations of bipolar disorder I've seen in a novel. And if you are ready for a really intense, sometimes difficult but ultimately beautiful read, "A Little Life" deals with depression, self-harm and abuse (I know, I know-- some of you would not choose to read about that in a million years. But my goodness, was the author a gifted writer.) 

I know I have a million more. Chatters? 

 

I realize that some spouses change for the worse AFTER the marriage. But please, let this be an object lesson for those contemplating marriage who are already spotting problems in the relationship, because very rarely do they improve after the wedding, or with age (they ain't wine or cheese, that's for sure!).

Yes!

Honestly, that's one of the reasons I don't really do couples therapy. I would too often want to go off and create a time machine instead, willing the couple not to get together in the first place.

 

I wish you would not encourage pharmacological Calvinism with such statements. I'd like to know more about this data that you say finds medication alone to be sub-par, since I can't get out of bed in the morning without my citalopram, and I consider myself pretty well-adjusted. I see my psychiatrist every three months for a checkup, and he adjusts my dosage when necessary, but it really bothers me when medication for such a condition is discouraged.

Hmm. I don't think at all I discouraged medication.

But meta-analyses say that medication PLUS therapy have better outcomes than medication alone, at least in terms of depression and most types of anxiety. 

Period. 

I am very glad that medication has been helpful for you. 

Once part of the "changing my last name" letter that was largely overlooked was that the husband brought it up at least a couple times a year. As a guy, trust me when I say that means it REALLY bothers him and he's thinking about it much more often. Of course that doesn't mean his concerns are appropriate, but assessing whether someone's feelings are "correct" isn't a meaningful response to addressing an emotional issue. So talk it out, but in doing so don't disregard the validity of his feelings. Unless you don't want him to be open with you and would prefer he go back to this passive-aggressive joking.

It's a great point. I do think it's such a hot button issue for a lot of people that it's easy to take it personally, on many sides, so we may have seen that from the chatters. But it's true-- whatever the husband's feelings may be, starting from a place of listening and understanding is going to be much more helpful than trying to squash the feelings or deem them "wrong." 

So, I am curious, though--  a couple times a year means it must really be on his mind? I'm thinking there's probably some variance in this... perhaps depending on how much of a talker he is in general. Those of us who are more (ahem!) verbose might bring up a million things a couple of times a year but not necessarily give them any weight. 

(Like the fact that ants can make a flotilla out of themselves by joining together, when faced with a sudden deluge of water. Now that I am thinking about how many times a year I probably bring this up to my husband, he probably thinks I'm giving ants a little too much mental real estate.) 

If you're interested in TV shows: Glee, for all its faults, did an excellent job with Emma's struggle with OCD. And Crazy Ex-Girlfriend is a very loopy (and musical) show about a woman with mental health issues, who doesn't get a formal diagnosis until the third season. The show is candid about how chaotic her life is, and how her behavior affects others, while also showing her better qualities. (Note: I have a family member with the same diagnosis - SPOILER! the diagnosis is borderline - and this show was a big help in understanding her.)

Thank you! I can't personally vouch for any of these, but appreciate the recs and I bet OP will too. 

Honestly, where else do they think it fits, if not in advice?

Right now, the columns are just categorized as Express, along with all other Express stories. But you can find it on Dr. Andrea's author page or the Express homepage for now, while we work on a solution! 

I had thought it was a state of being. Calling it a mental illness suggests conversion therapy, which is dreadful and so so so so wrong. Please explain! Thanks. from a parent of transgender kid who is wonderful and so full of life and much more than a freaking gender marker!!!!

Trust me, I hear you! As for what is a psych disorder and what's not, it's a tricky semantics issue for sure.

Gender "dysphoria" is still considered a psychological disorder-- and is listed in the DSM as such-- because there is psychological distress, by definition. That's the dysphoria part.

Gender non-conformity (or being transgender, for that matter) is not.

It's the presence of distress that helps deem it a psych disorder-- like with any given psych disorder. (Same controversy exists about depression related to grieving-- should it be a disorder? When in reality it is a natural, human state?)

But yup, we've come a long way from when Gender Identity Disorder was the name of the disorder-- meaning if you were a transgender person, then by definition you had a psychological disorder. 

I was trying to get people to listen before the election. The response I got was a dismissive 'they're idiots'.Trumps racism, xenophobia, mysoginy etc made it difficult for me to want understanding for them after the election. There were people were very afraid with good reason and I thought it was the time to stand with them. I feel the left got the 'understand' and 'don't condone' entirely the wrong way round. I was reminded of my Hungarian grandfather in the run up to WWII. My father remembered his parents parties in Budapest talking about Hitler - such thoughts expressed as: at least he's helping the German economy, Versailles was so unfair etc. My grandfather was of the opinion there are some things that are beyond the pale: attitudes and behavior you can't condone even if you see some good. He thought this about Hitler. I found myself asking the very same questions and coming to the conclusion I can't condone Trump and I find it very hard to forgive someone who would support him. I had sympathy for their frustrations but cannot condone electing Trump as the response. I was reading an article saying that the US has not been so divided since the Civil War.

Yes. I do think part of what people are struggling with is that a lot of what is happening transcends the notion of "politics"-- and therefore throws out some of the rules about 'proper discourse' at the dinner table, how much you should live and let live, etc. 

The divisiveness is scary, for sure. But I think what is causing the divisiveness is even scarier. 

Oh gawd, now I will be terrified to ever enter floodwaters. Probably a good thing!

hahah! Well I've never actually seen them on top of larger bodies of water. I think they'd be goners for sure. But if they are chilling on your back deck and all of a sudden someone spills a drink, they take teamwork to the next level to overcome it.

I trust you are not a fan of "Ant-Man." 

Umm, what is Express?

Here is my spiel: The Washington Post Express is the Post's free, daily commuter newspaper! We have boxes around the D.C., Maryland, Virginia area, as well as distributors at each Metro station handing out the papers every morning. Dr. Andrea's column appears in print there in every Tuesday's Fit section (fitness and wellness stories). We also have Local, Nation and World, Sports, Entertainment, Movies, Trending (what the internet is talking about), Weekend Pass (local arts, music, theater events, etc.), and EyeOpeners (offbeat news) sections daily. We use a mix of original content, Post content and Associated Press content. You can find a PDF version of our paper here, or some of our stories online here. You can also follow us on Twitter at @WapoExpress, where we constantly share Dr. Andrea's columns and live chats.  

Been dating a man for over 2 years now - long distance - and his ADHD is so extreme it's makes things difficult. (We're both in our late 40s and divorced.) I've read a few books on the subject to get up to speed, and I am so super patient with him - I know he can't concentrate on more than one thing at a time. For example: I've learned that if I'm emailing him questions I need to limit it to one email, one question, and then wait for a reply. If I send a follow-up or an additional email that first one will never get responded to. During the time we have been together things have been overly stressful for him: death in the family, big job change, medical issues ... so when I say that he's had other things occupying his mind I'm not meaning little things, these are major life changes. And when he's stressed he literally can't concentrate on anything else. I'm getting a lot of "it's time to move on" and "cut him loose" from my friends who see me patiently waiting. And waiting. And waiting. I understand that this is just the way he is - it's not personal, it's the way his brain is wired. But the truth is it does hurt sometimes that my patience and understanding means I am not the priority. And that I haven't been the priority. (Sometimes I wonder if I ever will be.) When I'm right in front of him then I have his attention, but we live in different states, and our visits are occasional at best. He's sweet, and kind, and I do love him. But there is no immediate plans for either of us moving to be closer to the other, and I don't see me being a priority until that happens. Advice for dealing with ADHD? Or is dealing with it accepting that this is the way things will be?

Well, he's dealing not just with ADHD, but also with a job change, a death in the family, and other medical issues.

That is a lot.

Two main questions come to mind for me here. Okay, three. 1) How much of this most recent stuff is at is most acute because of the things on TOP of the ADHD-- in other words, what is a realistic baseline with only ADHD for him, and is that a lot better? A bit better? Not much better? 2) How motivated is he for things to be different? and 3) If things didn't change, would that be satisfactory for you?

My gut instinct would say you need some sort of glimmer here that things will improve, but he has to actually see that things are subpar between you-- and want to work on his own stuff-- in order for there to be a chance of that happening. 

Andrea, this is a little different from "love languages," I think. My ex used to give me gifts, but I found them bizarre and disappointing. Like once, a necklace made of twigs or something. I would never wear it, and it was a waste of his money and effort, but he *had* tried (I guess), and my reaction obviously showed, and things like this contributed to the decline of the relationship. It's like we talked right past each other. How could we both have done better?

I do think that what MIGHT have helped (though who knows? Perhaps it was just a mismatch-- twigs or no twigs!) would have been more talking in advance. "I know you like to spend a lot of time picking me out something for my birthday, and I appreciate that more than you know. But I also know that sometimes my taste is different than what you think it might be. I don't want either of us to be hurt and I don't want you to waste your money. What would you feel about us planning something together in advance for my birthday this year?"

I suspect distress from gender "dysphoria" is -- on average -- lower in places like West Hollywood or Greenwich Village than in, say, socio-politically conservative parts of the country.

Very true. 

But overall I like to think that we are seeing at least a slight decrease in targeting of transgender kids.... across the country, even in tougher places. That's my hope, at least. 

Trans kids have had it really tough for a long, long time-- they have always been a group that is more vulnerable to several psych disorders (depression, anxiety, self-harm, substance abuse, suicide attempts and completions). It's not hard to imagine why, due to how they are also more vulnerable to abuse, discrimination and mistreatment. 

It has to be getting a bit better, little by little. The numbers preliminarily support this a little bit, but of course we're nowhere near where we'd want to be. 

 

It's that time again! Thanks to all of you for being here, especially those who had to navigate to us in a different way than usual because of Baggage Check's semi-disappearing act. Blurgh. 

I'll look forward to seeing you next week. In the meantime, it appears that the best way to find Baggage Check is through this page here. 

Take good care! 

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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