Baggage Check: Choose Your Adventure

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Got issues? Dr. Andrea Bonior will help you sort them out.

I've been thinking about therapy for a while, but I never actually took action. I'm 31 and, on occasion, I suffer from mild depression, self-devaluation and guilt. I had a difficult childhood; I lived separate from my parents from ages 4 to 8. Afterward, they were extremely strict and my father beat me. About 10 years ago, I started having anxiety attacks. I was scared of driving by myself — sometimes even leaving the house — and didn't know when the next attack would come. I'm better now, but I never uncovered the cause. What would be the most effective form of therapy for me, and could you provide names of area psychologists or suggest some books?
—I NEED YOUR HELP

MANY CONGRATULATIONS on making the decision to see someone. At the risk of sounding like a stale fortune cookie, that first step is truly the hardest.

Cognitive-behavioral therapy is frequently applauded for its directness, effectiveness and transparency. It can be particularly useful for alleviating measurable, tangible symptoms, like the anxiety attacks and dysfunctional thought patterns. Insurance companies also have a crush on it, as it is empirically validated and can be shorter-term than other therapies. But if your coverage (or pocketbook) allows, you are also a good candidate for some deeper therapeutic work — psychodynamic and interpersonal therapies are just two examples. That your childhood appears to play such a meaty role in your current difficulties means that it'd be worth it to devote time to a more thorough excavation of those experiences. A good therapist won't dwell on what you ate for dinner as an 8-year-old, but will constantly help you make connections from your past to your current emotions and behavior patterns, and help you find meaning in what happened to you.

I can't recommend any therapists individually — though if they'd send me some Harry and David pears I'd be tempted! This area is full of great ones, and your insurance company, general practitioner and apahelpcenter.org are all good places to start. If cost is an issue, there are several community mental health centers and county services that could be options — check your phone book.

Finally, some not-exactly-light reading: "The Anxiety and Phobia Workbook" by Dr. Edmund Bourne, "Learned Optimism" by Dr. Martin Seligman, and for a more intense understanding of how your past might have shaped you and what healing could look like, try "Trauma and Recovery" by Dr. Judith Herman. Good luck to you.

Is there a general rule about whether you should work with a male or female therapist?
—D.C.

WELL, IT DEPENDS on how much you like the smell of candles!

Seriously, there are reasons why he or she might feel comfortable or uncomfortable with a particular gender, or why he or she might want someone nearby, someone blond, someone older or someone who likes mockumentaries. The only general rule is that there are no rules!

Send your mental health and emotional wellness questions to Andrea Bonior, Ph.D., at baggage@readexpress.com. This column is not a substitute for one-on-one care.

Art by Eric Reece for Express