Dear Anita,

He went about it in an incredibly scientific way.  This approach really resonates with me being a physician and from an evidence scientific organized background.  I feel very and happy and fortunate for you that you found someone like this in your life.  I am very glad for you.  I thought in my head, I wonder if this person takes skype clients across the country! I would surely be happy to pay him paypal fees for this quality work! Or hopefully I will find someone excellent as well.  Your typing of these notes made me feel motivated to explore some.  I am working on finding a therapist of my own, but in the meantime I do love that you shared all of this, it is so very helpful and important.  I want to do the following, as the good student that I am – it will be helpful. I will add comments as they come to me naturally/authentically as seen in the following

Treatment Plan

Client: CC

Diagnosis:

Long-Term Goals

1. Develop and use coping skills to deal with mood swings.

Mood swings. I never thought myself to be “moody” but what a difference between moody and mood swings.  Clearly I have erratic mood swings.  One day able to work on my relationship and go to Central Park and be mindful with my husband, the next angry at 5 AM screaming at him about an automatic dog feeder.  yes, I have mood skills.  No, I do not have coping skills to deal with these mood swings.

2. Develop the ability to control impulsive behavior.

Oh yes! In fact we just touched on this.  My husband and I spoke about my impulsivity just last week right.  Just because  I am “good at what I do” and things have worked out decently thus far does NOT mean I have any appropriate coping skills..  The instant need to text back, to react, to say without thinking.  Impulsive.  I can not remember a time I was not like this, this is a huge part of my identity even.  Sure it has made me a hyper-communicator.  But it has been very terrible (for myself) in conflicts.  Replying before taking the time to often protect myself! Often acting out of emotions of rage, anger, guilt, defiance..  Feeling that whatever I am feeling right now must be real and right since I am feeling it so strong.  Always believing my emotions.  Feeling they have a voice – a true one – that speaks on my behalf.

3. Replace “black and white” thinking with the ability to tolerate ambiguity and complexity in people and issues.

Once again spot on! How useful this is, and the perfect timing.  That’s the beauty of our interactions Anita…I have incredible incredible difficulty with ambiguity.  It makes me feel physically uncomfortable.  I have always done HORRIBLE with concepts of “we shall see” “we will figure it out” “let’s see what happens””maybe it will work out” “we can figure it out when the time comes” etc

This sort of thing drives me crazy.  Often they are filler words that people say to circumvent commitment or answering.  This is maddening to me.  But other timess they are not – sometimes you truly do need to see things through – and “wait it out..” Not being impulsive and making  a decision based on the first thought or feeling – saying now or never! Which goes to the concept of above impulsivity and rush.  It always feels like there is a rush for a conclusion or answer.  LLike a deadline….what are you going to do about that situation? huh? Tell me now – now now now – subconscious pressure to have the decision now! Black and white. No waiting it out, no timme to sink in, no time to assess, no time to “sleep on it”

4. Develop and use anger management skills.

Well yes, they must be developed..  I know all of the ones in my head that we should do.  stop and halt before speaking etc.  They are random words in my head, never executed, and little faith that I am capable of sticking to them..

5. Learn and use better interpersonal skills.

This one is interesting and important.  See being that I am engaging ‘social butterfly” I was tricked into believing I have excellent interpersonal skills.  Yes, I do – when it comes to certain  things.  But in this realm I am seeking SELF help.  And these “skills” are often detrimental to, yes, ME.  They often have benefited the other party, and continue to, but hurt me – and as a result my husband as well.  The inner circle aspect is key here.

6. Stop self-damaging behaviors..

Strategies

– Determine what situations trigger anger, fear, suspicion, depression, anxiety, etc.

I know this list is for ongoing work, and so I don’t expect myself to “conquer” any of this now, as it is for ongoing treatment/healing therapy. Yet, I do want to write about things that come up at this moment. A major trigger of mine has been other people, and the pressure to attend to others.  I know this is deep rooted in the role that I had to be for my mother, constant attending to – drop everything and go.  I think of it as the extreme scenario. Miss Congeniality always speaks at events and mentors young women, she is great at it.  As a result after all those years, she neglected what she herself needs to rejuvenate, she is so great at autopilot.  She now has grown resentful and angry and snaps at even the smallest question going her way.  Hey miss C, do you have a minute to tell us about your favorite hobby.  She feels disgruntled – no roar! Can’t you just leave me alone! Constantly badgering me.  Miss Congeniality does not want to be miss C anymore, she wants  to take off the tiara and sleep and rest.  She wants to not have that guilt of not being, well, congenial.  She feels it may have been better off if she never received that title in the first place, to take on that role – now it is apart of who she is, it is hard to simply undo.

– Identify the dysfunctional or negative thinking behind the negative feelings, and challenge/ replace them with more realistic and healthy thoughts.

We have spoken on that, and the concepts of cognitive distortion – a long ways to go with that. It is often hard to remember in reality that the negative thinking is “dysfunctional” and not reality.  It is innate for myself to think the negative thinking is true and real and telling me something honest.

– Understand the connection between what happened in the past, and what is happening now when emotions become intense.

Wow, so very important.  This is some next level stuff.  It will take true high level mindfulness. I am far from there at present.

– Build motivation to stop self-defeating, impulsive behaviors.

Yes

– Replace destructive (to self or others), impulsive habits w/ healthy coping methods

Yes

– Teach assertiveness in communication

For me perhaps teach, less emotionally fueled communication, and keep emotional distance whenever necessary

– Identify ways to find fulfillment and satisfaction

Yes – oh yes.  How incredibly stated.

– See qualified physician to evaluate if medications are advisable.

Yes

What the Work Will Look Like

– Discuss the past and how it seems to invade the present.

I like that word invade.  It makes sense to me visually.  The sticky goopy past invading into now, sticky and yucky.

– Look at benefits and costs of behaviors you’ve used to protect yourself from intense bad feelings.

Wow to actually look at costs of my behaviors.  How important for me.  I run and run and continue.  I seldom look back and re-evaluate.  It’s like the kids who finished the test and went back over every single answer to ensure they did it right.  Versus me, do it once with focus and confidence and stand up and hand it in, knowing I did fine.

Well, that isn’t working now.  Looking back and evaluating cost/benefit is essential.  I can’t continue to rush and drive through life, knocking over cones and not look back and say – what was my driving habit like that made me knock it over? Versus, oh too bad, I’ll be sure not to do that next time.

– Learn to monitor and recognize when these feelings arise, and use distraction techniques early in the experience (delaying reactions, relaxation, breathing, exercise,…)

Yes, as above I have little faith I can continue this sort of thing.  I see it as someone who is all giddy about new practices as a new years resolution, but by Feb they go back to their old ways.  That’s how I see myself when it comes to these Healthy techniques.

– Learn new ways to talk, act, and think when emotions (especially suspicion or anger) becomes intense.

Interesting, I read above in the poem how you can not have fear.  In fact the poem says “Don’t be Afraid, Let life take you by hand.” This is very gripping.  I see that I am afraid of losing my “identity.” This identity which was mostly placed by my mother.  Oh amazing fun loving gregarious CC, everyone loves CC.  Perhaps deep down I fear that if I change the way I am, I will turn into someone: sad, mean, boring, introverted..  Perhaps I worry that the innate self of who I am has “worked” so if I change myself – I will turn into someone who “doesn’t work” if that makes sense. (clearly a delusion)