Pt arrived on time. Initially reviewed updates to N's vacation. Feels that they are keeping up with tasks despite changes to the schedule. Content platform leader reached out. Pt. was able to respond with a brief message that she was taking a break from the platform. Reviewed "sessions" from the last several days. Most of today's session spent reviewing current writing project, "Case File." This is the evolution of the project that matches writer's note with personal details. She has moved to a word document with additional formatting and organization decisions made. Reviewed content from several sections (introductions, reflections). Feeling good about the process - able to identify patterns of affect and reactions/behaviors. This led to uncovering barrier to writing process - fear of strong affect/being out of control, based on past experiences, exposed through the writing. Explored process, identified automatic thoughts, practiced challenges, reviewed goals for next steps. Able to log into writing platform and look at current exercise. Reflected on affect generated in session - validated and briefly discussed options for working on the writing exercise with more neutral content, checking in with more parts on process, monitoring affect during process.
Pt arrived on time. Initially reported feeling "skittish" and "stuck." Uncertain about why - has been working to stay busy while friend N is on his trip and not let schedule change/less conversation keep her from getting things done. Based on "sessions" (blocks for doing tasks), has been keeping up, spending most of them on writing. Moved on to review of recent writing. Had a good day yesterday, felt productive. Today woke up and was not feeling well so spent time on FB. Reviewed pattern, next steps, and method for prioritizing activities. Able to plan out this afternoon's schedule. Reviewed goals with returning to writing course. Reviewed potential for triggers identified last session and how to manage them. Would also like to return to quilting. She has worked out the information she needs to move the project forward and is feeling more confident about acting. Reviewed updates to medical appts - planning for visits. Reviewed/updated problem list. Reflected on how staying up to date with medical helps with writing - knows that it has taken care of and does not need to be worried about. Returned to writing and explored concept of resiliency - what defines this, how she manifests it. Reviewed plans to organize notes/writing into chapter and books based on current project. Validated process.
Pt arrived on time. Initially reported feeling unclear about what she was supposed to do. Writer offered several options based on past sessions. Related she had been working on the writing project. Reviewed updates. Pt has continued to work on case file writing - expanding formatting, adding pictures connected to timing of notes, titles to sections. Validated progress and reviewed next steps. Pt has been exploring options for publishing and came across platform she used several years ago - slide decks based on online news articles on dissociation/multiplicity. Reviewed previous process. Compared/contrasted with current writing project and potential for using the platform for distributing her book content. Moved on to medical updates - appointments (podiatry and neurosurgery). Surgeon would like to move forward but would like her to lose weight. Discussed pattern of weight loss/gain over the last several years and next steps for tracking. PCP might have additional resources to help with supporting weight loss. Briefly discussed update on online work and relationships. Ended session with review of home tasks - connected to having people over for Thanksgiving. Would like to keep up with dishes and laundry. Process is working but tends to run out of time in the day. Explored options for setting up time in schedule, using reminders, how to document work done. She had previous tracking systems to utilize again. In the session, these tasks felt difficult to achieve. Reflected on pattern - tasks may seem difficult up front or when trying to take them all in, but when she has broken them into smaller tasks, has been able to make substantial progress and feel accomplished.