Dear Cali Chica:

I think the following is from April 2011, A’s handout for me, his words, NOTES:

1. I’d like to outline our treatment plan going forward, get your feedback and see how you might want to change it and how we will proceed.

2. The anxiety and depression you feel, as well as the anger you feel, can all be treated successfully. But it’s important that we work from a good diagnosis.

3. I don’t think this is bipolar disorder. In fact, I think you’ve been voicing that as well, though ultimately I’d like a physician to make an assessment…

4. I believe that how you feel, think, and behave have largely to do with the way you were abused as a child. Your mother left you with a legacy of pain, fear, and emptiness that can seem impossible to overcome. The painful legacy she left matches the depth of the abuse.

5. Yes Anita, I truly believe that this legacy of pain can be overcome (In fact, I believe you began making steps toward this before we even met.)

6. It is sadly all too common that people who grow up with the suffering your experienced learn that it is too risky to trust- to trust even someone you love. And that when love does appear, it must be verified again and again. Does this seem familiar?

7. It’s understandable that, with the abuse you were dealt, you might find it hard to believe that you are worthy of love, or that you may not always feel trust for those who say they love you. Again, your very difficult childhood comes to mind.

8. getting better, feeling better, having better relationships are all possible. But we must be honest: the work that needs to happen is significant. The effort that is needed to help you tolerate and alter the pain, and change the angry or compulsive behaviors takes time and practice. We can go as fast or as slow as you need, but it will not be easy or comfortable some of the time.

9. What makes the work hard is that to survive the abuse you’ve been through you have had to develop survival habits, almost like skills, that assured you would live through the trauma.

10. Now you must unlearn those habits and try new skills. Can you see how this might feel risky? Here are some of the things you must unlearn…

11. For example, you learned to disassociate- to separate yourself from the pain you were going through. That was the only way to bear the pain.. to  separate your body and mind from it.

11a. In therapy you will learn skills to regulate your emotions, to keep them from becoming too intense, and even to tolerate them. You will learn/ know that these intense feelings will pass, and to focus on changing that thoughts that might be making the pain worse.

12. You also learned deep skepticism and distrust of people who say they love you. After all, who loves a child more than its mother? Yet what kind of love did/ could your mother show? So love itself might seem like a dangerous idea to you..

12a. In therapy, you will learn to be in loving relationships, to develop trust and communicate assertively. Your needs are important, how to get them met is a skill set we can all learn more of, and maybe you weren’t given a chance to  learn that well.

14. Finally, to survive, you had to decide that whatever “felt wrong” in the present might be a replay of what happened in the past. Even if the present situation is very different than the past.

14a, in therapy, you’ll  learn skills to make wiser decisions about what is happening, balancing your emotions with your intelligence and your instinct.

15. Are you willing, even a part of you, to learn some new skills to replace the ones above? Are you interested in a new way to see the world?