September 29, 2011

STRANGER: Andrea Bonior
LOCATION: La Canela, 144 Gibbs Street, Rockville, Maryland
THEME: Dinner with a clinical psychologist

“No need to be concerned.”

Those were psychologist Dr. Andrea Bonior’s reassuring words as I asked whether she was using our dinner together to analyze me. Although I’m a naturally flawless human being mentally and physically, I still felt nervous that she would be sizing me up like one of her weekly patients.

I needn’t have worried.

Like most people, Andrea doesn’t believe in working 24 hours a day, seven days a week.

Andrea told me that she knows how to switch off being a psychologist and return to being a married mother of three kids. “If I tried to psychoanalyze my kids all the time, I would never sleep,” she said.

I knew of Andrea from a column called “Baggage Check” that she writes for Express, a free newspaper provided to Washington, DC’s Metro riders by the Washington Post. Each week Andrea fields two questions — usually about relationship problems or quandaries having to do with coworkers — in a humorous, forthright style that is charming and informative.

Having never interviewed a psychologist (nor, for the record, ever having gone to therapy) I was interested to learn more about her profession. So after a few emails Andrea and I agreed to meet up, and we chose to both experiment with Peruvian food for the meal.

We met at La Canela, a quiet and cozy restaurant tucked at the end of a street in sleepy suburban Rockville. The walk up to the place is pretty, with lights wrapped around the trees lining the street, and plenty of people out and about enjoying the surprisingly mild late September night.

La Canela gives off something of an austere vibe, with high-backed ornate wooden chairs, subtle music playing in the background and some very serious-looking diners.

As I don’t carry myself in a serious manner, I was pleased to find that within minutes of sitting down to dinner with Andrea she is quick with a joke and a laugh, and speaks with a calm and soothing tone that I’m sure does wonders for her clients in therapy.

We had some ground rules for the interview that might make it a little sparser on personal details than others, and that’s because of the sensitivity of her job.

She sees clients once at week at her private psychology practice. “The less they know about me, the easier it is for us to work together,” Andrea said. “I just have to be careful sometimes. If they were find out a ton of stuff that flavored their perception of me, it might somehow make it more about me than about them when they’re in the room.”

Andrea also teaches an undergraduate class in abnormal psychology at Georgetown University, and in addition to the Express column writes for other magazines from time to time, and is promoting a book she released earlier this year.

Apparently, psychologists are busy people.

Andrea didn’t come into this world with a yearning to be a psychologist. Instead, she grew up in Virginia Beach and went to Yale University in Connecticut.

“Why wouldn’t I want to do this for a living?

“I didn’t start off being a psychology major by any means. One of my childhood best friends wanted to be a psychologist while we were growing up and I thought, ‘Are you nuts? That sounds like the worst job in the world, dealing with other peoples’ problems,’” she said.

Her time at Yale began as an English major, and her early career goal was to be an author because she loved writing. But she remembers one beautiful fall day in October, sitting in her class right before lunch, and spending two hours in a seminar dissecting one phrase in Edmund Spenser’s poem “The Fairie Queen.” That was a bit much for Andrea. “I thought, ‘Yeah, I don’t seeing myself doing this.’ And I literally remember going to lunch, sitting down with my roommates and being like, ‘That plan’s out the window.’”

Andrea was also studying psychology at the time, and said that it captivated her so much she decided to become a psychology major — but even then she was sure it wasn’t going to become a profession.

Then she started doing peer counseling, thinking “it’d be cool to be a peer counselor, to help people and be entrusted with that. After a year or so of that it was like, well why wouldn’t I want to do this for a living? I really enjoy it.”

Andrea took her PhD at American University in DC, and her post-doctorate at nearby George Washington University (GW). As part of her studies she spent one year living in Miami on an internship, taking her then-boyfriend (now husband) along for the ride. “We were going to view it as a little adventure, because we knew it would be a finite period of time, and we knew we probably wanted to settle in DC,” Andrea said.

“I wasn’t a research person

What’s the appeal of DC?

For Andrea, the city has plenty of attractions including free museums and reasonable distance to the beach and mountains. Her family and her husband’s family also live nearby. She’s also a fan of experiencing the change in seasons.

Back in DC, Andrea had to complete a training fellowship at GW as a suicide prevention specialist. Although states vary on requirements before psychologists can get licenses for private practice, most mandate some form of training fellowship.

I said to Andrea that it must have been tough dealing with the suicidal, and wondered whether she was able to put a day’s work behind her when she got home.

“With suicide prevention outreach, I didn’t tend to work with people actively in crisis, as much as doing larger work to get the mental health message out, and sometimes working with bereaved friends and family,” Andrea replied. “It’s tough, and ideally I think it’s something that you get better at with time and I certainly have not mastered it yet.”

Before she could tell me how she moved on from suicide prevention to her current career, our attentive waiter hurried back to the table with a free gift.

We were both given a small appetizer that resembled a wonton, with spicy fish wrapped in a crispy shell. I haven’t a clue what type of fish the restaurant used, the blend of spices, or even why they gave us it for free. But it was delicious, and a great start to the meal.

As I munched on the freebie, Andrea told me that she thought about starting a private practice, but held off because she was pregnant at the time. Instead, she started doing some writing and then the Express column — to use her turn of phrase — fell into her lap.

She had done some writing at university but didn’t care much for the dry, scientific approach. “It wasn’t the way I talked, it wasn’t the way I did clinical work and I wasn’t a research person.”

Some friends recommended she write for a website called Hill Zoo which was once a popular site among Capitol Hill staffers. The site had an opening for an advice columnist, and Andrea made up a sample question and answered it with a slightly sarcastic style. She sent it to the editors and they asked her to become the website’s new advice guru.

Nervous about how her straight-laced GW colleagues might react, Andrea kept the column a secret from them when she was hired. But she defends her decision to write it, and in her own humorous style. “Am I not allowed to be a person with some semblance of a sense of humor? And I’m not going to pretend that this is any kind of professional advice, I’m not going to claim that I’m using my psychologist credentials, so I started writing that totally secretly,” she said.

Then one day some high-ups at Express contacted Andrea to say they’d been following her Hill Zoo column for a long time and wanted her to start writing a weekly advice column in the free paper. “It was such a stroke of luck I feel almost guilty,” Andrea said.

Express has a wide readership, and the column features Andrea’s name and picture. She knew it was time to tell the bosses at GW. Her higher-ups were immediately concerned about liability and litigation from people who acted on Andrea’s advice in Express. But Andrea batted those concerns down and was allowed to write “Baggage Check” (by the way, she praises the staff at Express for coming up with the name for her column).

Most of the questions for the column ask about small personal problems, ranging from a cheating husband to how to handle a disagreeable boss — not the more hardcore issues Andrea might expect in one-on-one therapy. “I have to admit, I enjoy that kind of writing a lot more than I did the scientific writing, even though I feel a little sheepish about it.”

Andrea’s commute doesn’t involve the Metro anymore, so she no longer experiences the occasional surreal situation when someone seemed to recognize her when they looked up from their copy of Express.

After leaving GW she pursued a varied career that includes a private practice, writing, and teaching at Georgetown.

“I love interacting with my students

At the university, she teaches undergraduate students in abnormal psychology. She said it’s not Psych 101 but it’s the “gateway” to a major.

“I love interacting with the students, I love feeling like they’re getting something from me. I don’t have an issue with public speaking so I’m not bothered by standing in front of a big lecture hall,” Andrea added. But she does confess to still trying to figure out how to deal with students’ assumptions that their professors will instantly reply to every email they send.

She’s taking a break from teaching this semester, in part to keep spreading the word about her book released in April, The Friendship Fix, which looks at all aspects of friendship, including how one’s personality shapes what friends they make and how friendship can affect one’s health.

Much like the Express column, Andrea says the book also fell into her lap after being contacted by a literary agent.

I was about to turn the topic to Andrea’s private practice when our waiter arrived with my starter. I’d later discover that Andrea made the right choice in not ordering a starter because the portions at La Canela are massive. But I never said I was a smart fellow.

I stared at my massive appetizer of taquitas — pastry stuffed with beef and tomatoes. The portion was huge, but I’m greedy, so I managed to finish it all. Tangy tomato and hearty chunks of beef, encased in a soft and perfectly baked shell. Off to a good start.

As I stuffed my face and tried to ignore the fact that I’d probably be full about three bites into the main course, Andrea told me about setting up in private practice.

Her office is in Bethesda, Maryland. She dragged her feet on opening it due to a dislike of paperwork and bureaucracy — and there’s a lot involved in setting up a medical office. But after reviewing her taxes one year she realized she was paying a lot in continuing education credits and psychologist license fees, motivating her to open an office.

The office is tiny, Andrea said, and that’s by design because she only sees patients one night a week. The Express column acts as a constant referral source, so she’s always having to turn people away given the limited hours she operates in private practice.

And yes, she has a long couch for clients to lie down on. Just like in the movies!

Except none of her clients have — to date — asked to lie down. Andrea said that type of therapy is more like psychoanalysis, free association by the patient in which the doctor doesn’t participate much. Psychologists by contrast engage more with their patients.

“I don’t take on anyone who’s going to be too taxing

Psychology also relies more on modern research and empirical results to determine treatment, Andrea said. “I do certain types of therapy that in theory have been shown to be effective for specific maladies,” she added, noting that the average patient comes in for roughly a year or two, though it can also sometimes be a little less than that.

The patient screening process is incredibly important, she said, and Andrea strives to take on people that she thinks will be a good fit and allow her to give all she can.

“Right now I give myself the right — because of where I am in my personal life, with three young children — to take on only the patients that I feel are a good fit for me right now in the whole textbook of my life. Would I be doing suicide prevention work right now? Probably not because in the middle of the night I want to be worried about my kids, I don’t want to be up all night worrying about a patient at this point in my life. Which isn’t to say I don’t take it home, but I make sure that I don’t take on anyone who’s going to be too taxing.”

But how does she know the advice she’s giving is right?

“I’m rarely giving advice, ironic for an advice columnist,” she said with a smile. “Baggage Check” is far removed from what private therapy is actually like. Unlike the column where she might give advice on how to deal with a troubled relationship, her patients are often in pain and need to figure out how to feel better. There’s naturally some advice in response to that, but Andrea said most of her work is challenging dysfunctional patterns.

“It’s unlocking what’s going on inside their head

“People have a ton of sort of just dysfunctional thoughts, which are fine until they start getting in your way. So for instance if somebody comes in with depression you’ve got to kind of unload that, peel away the layers, and I’m not going to say, ‘Oh, well tomorrow you should exercise and you should watch a comedy.’ No, it’s more sort of unlocking what’s going on inside their head, what patterns they got into, sometimes we might have to delve back to family history in detail,” she said.

Andrea blends a few different approaches including cognitive behavioral therapy (CBT). “CBT is dealing with the here and now. It’s kind of quantitative, it’s empirically validated, so in theory it shouldn’t look totally different from one therapist to the next. It’s very structured, you might get homework for instance.” That’s combined with psycho-dynamic therapy which focuses more on figuring out the causes and underlying problems behind the person seeking therapy, delving into the likes of family history. Andrea decides on the right mix of therapies depending on the patient.

I started to wonder whether seeing patients about their problems might ever get to Andrea. But before she could answer, our main courses arrived.

Andrea chose the tallarines — billed as Caribbean-style fettuccine pasta with pesto topped with breaded steak. The restaurant called it a “real Peruvian classic.”

Andrea had praise for the meal, but quite rightly described it as a mound of food. In fact, I also had to parcel up a fair amount of leftovers from my main course.

I chose the tacu tacu, which is a huge slab of steak pounded flat and breaded, topped off with a delicious mix of beans and rice and served with a fried egg. The flavors were solid, the beans and rice combination giving an ever-so slightly sweet edge to the meat. But it was far too starchy to get through the entire thing in one sitting, as I quickly learned.

I’m perhaps glad that Dining With Strangers is not my day job, because with meals like this I’d definitely end up taking work home, in the form of a new spare tire on my waist.

Surely it must be worse for a psychologist having to hear all manner of negative thoughts throughout the day? Not so, said the ever-cheerful Andrea, and she still loves her job — even though she says that it takes practice to switch off from professional mode when she gets home.

“It’s tough and ideally I think it’s something that you get better at with time, and I certainly have not mastered it yet,” she said. “Some days I do come home bummed. Other times I’m ecstatic and fulfilled and excited and inspired, so I have to take the whole picture and realize that the good outweighs the bad by any means.”

“I’m really lucky to be able to do different things

Being a psychologist has also taught Andrea a lot about humanity. Nowadays she says that she’ll cut people some slack for things like bad driving, because she doesn’t know the person’s history and there may be a problem lurking behind that behavior. “I always tend to think, What if they’re speeding home to a dying spouse? I don’t like to assume stuff about people unless I’ve really sort of gotten in there with the whole story,” she said.

As we wrapped up dinner, it seemed clear to me that Andrea has it pretty good — she practices psychology yet gets to veer off into her media endeavors and teaching, keeping her interests varied.

“I’m really lucky to be able to do different things, I get to work with patients but I also get to work with larger groups in the teaching, and then I get to do the solitary writing thing for a while, and then I get to do the column stuff, which is solitary, but I’m responding to readers so it doesn’t feel solitary. So I’ve been afforded a great amount of variety and flexibility and it’s awesome,” she said.

Even though she’s enjoying her work, Andrea vows to never let it define her life — good to hear, because it meant she was true to her word and was not analyzing me during dinner.

“I’m a person, first and foremost. Do you want to do your job 24 hours a day? Probably not. You need and break, and so I’m the same way,” she said.

One thought on “#37 The Doctor Is In

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