April, 10, 2013
Re; Sharon Stern
Date of Birth 01 /19/1979
Dear Mr. Stoke,
I first met Sharon for a session while she was in college, if my memory serves correctly, for one session. She presented herself as a confident individual with an air of clarity as to who she was and with clear vision. She came to see me because her parents thought that she could use some guidance with her career goals. It was then years later that I saw her at her brother Ronny's wedding.
On February 27,2012 I was surprised to see her in my office with Ronny. I spent the whole session catching up with her over recent life's events. Clinical impressions suggested a young woman who appeared to be tired, physically unattended to herself, flat affect, low energy, pessimistic with a deep sense of failure and resignation. She was upset and weepy. I discussed the therapy process, psychotropic medication if needed. She become upset and rejected any discussion about meds.
The session on February 28,2012 was with her parents. Sharon become hostile, angry, and lacked control over her emotions. She felt hurt, betrayed, anxious and scared. She was clinically fragile with marginal defense mechanism. Her reality testing was tenuous.
During her individual session on February 29,2012 her clinical intake suggested depressed mood, loss of interests in activities that at one point were of great interests to her, and loss of pleasure. She admitted to feeling sad at times, irritable, low energy, low self esteem and self worth, a deep sense of failure, recurrent thoughts of death, guilt and shame. Sharon repeatedly denied suicidal thoughts.intention, plan or desire to take her life. She stated ttl am too scared" in regards to taking her life. Her thoughts about dyeing were more about the struggle of living rather than her desire to end her life. I brought up the idea about medication and encouraged her to consider the chemical component of her clinical Major Depression. Her resistance remained very high and rejected the idea of medication.
During the sessions on March 1,2012 and March 20,2012 with her parents Sharon continued her reactivity, edginess and high distrust of her parents and society at large. She was extremely apprehensive to being Baker Acted again and had a paranoid suspiciousness of police. She continued to resist going on medication. Her parents become frustrated anxious and helpless to effect Sharon's compliance with the therapeutic efforts. She finally consented to go to meet with Dr. Fernando Pomeraniac, Psychiatrist.
On her visit on March 7,2012 she began to read David Burns book The Feeling Good Handbook. She reported "it is cheesy" She also had not called Dr. Pomeraniac. She acknowledged her difficulty in committing to her treatment. She expressed her fears of jail, mental illness, death, as well as, homelessness. She appeared less anxious, calmer at this session. Mental status appeared to be intact.
On her visit on March 8,2012 she suggested ' I fell in love with my teacher Kan". According to her Todd has supported her passion for dancing. She admitted that" I did not focus on anything else except dancing, self and grad school". She expressed that" Kan thought me to be selfish. He was a passionate lover and father figure. I was torn between two lovers."She admitted feeling guilt and remorse. She explain her first attempt to harm herself in this session by narrating her thoughts at the time" who will want a chronically depressed suicidal woman?" According to her she felt" unwanted and unloved anywhere". Again we discussed medication and the outcomes. It was evident that her resistance was based on the believe that if she gets on medication it would devalue her even further and push her away from her goal to appear more stable to Kan so she could continue her dance and be part of his life.
On March 12, 2012 Sharon admitted that she could not take care of herself, she suggested" I am a spoiled brat". She acknowledged her dependencies on her parents, Todd and Kan. Sharon appeared more stable and calmer in the session. We discussed dependencies and the path to becoming a grown up. Focus was on taking responsibility for her life and creating her own destiny. She denied any thoughts, plan or intentions to hurt herself.
On March 13,2012 Sharon had gotten involved with Feeding America, and she began to volunteer her time. She sounded sad and appeared to be grieving.She spoke about her first Major Depression episode. She was worried and felt abused by others in the Butoh community. She did not like Dr. Pomeraniec. He had prescribed Ability for her. A referral was then given to her to see Dr. Carolyn Leavitt and Dr. Eva Ritvo to help make her mind up which one of them she could work with. Both women are Psychiatrist. Sharon denied any thoughts, plan or intentions to hurt herself. She responded to physical affection and encouragement at the end of the session.
On March 16,2012 Sharon informed me that she had begun taking the Ability however, admitted that she had not been fully compliant. She complained that it was making her feel very tired. It was evident that she was not happy about taking medication. She admitted to having nightmares but could not recall their content. She felt lonely and unmotivated." My need for perfection, my past love pattern, I chase them and once I get them I lose interests.". She talked about not showing up to her appointment with Dr. Pomeraniac. 
On March 21,2012 we continued to discuss her resistance to Medication. She understood the importance of her Medication to her treatment plan. She suggested again taking then will confirm her fears * I am not o.k who will want me?". We were able to confront her irrational believes, however, she did not change her ideation. She stated "I feel I am in emotional 911 since 2011.". Her vulnerabilities were evident. She felt helpless to cope with what she knew was an unhealthy state of mind. She struggled with seeing how her actions effected her outcomes.
On April 06 she returned from a trip to Bolder Co. to see Todd. She reflected "He has no interests whatsoever.". She become emotional, vulnerable, projecting into the future and fragile. Her sense of trust has been marginal. Discussed her feelings of guilt over how she treated Todd and her betrayal of him stating "All I wanted is to be married to Todd and be a mother". She suggested that she began taking the Ability .however was not taking it consistently. I urged her to see Dr. Ritvo or Leavitt.
On April 09,2012 she was emotional and negative. She admitted to over sleeping. Discussed her clinical picture. Again I encouraged her to consider the medical component of her condition. She appeared to listen .She had decided to travel to Brazil for one month. It was discussed that the timing given her clinical condition, her medication, and therapy was not appropriate. She suggested that she wanted to dance. For her the solution to her life's issues at that time was to Dance - Butoh. She was afraid of cops, Civil Commitment. She was referred to Dr. Leavitt. Sharon called Dr. Leavitt. Dr. Leavitt called her back offered Wed. the 11 of April to see her. Dr. Leavitt was waiting for a call back.
On April 11,2012 She decided to go to Brazil. Discussed her decision with all the choices available to her She appeared reserved and in control, rational with her plan. She stated that she had thought it through and was eager to leave on Sunday. She set up appointments over Skype for Wed. April 18. She promised to call by Monday the 16th to confirm.
On April the 13th I received a call from Chana informing me that if Sharon does not keep her appointment on the 18th that Ronny will take the session.
On April 19,2012 sent an email to Sharon confirming her next appointments on the 23rd and 25th.
On April 23 2012 I responded to Sharon who apologized for not being able to keep her appointment on that day. She stated that "I have a job". She sounded optimistic.
The following clinical impressions are based on clinical observation and interactions with Sharon, her family and email correspondences. These conclusions are based on the above data and within reasonable psychological probability.
She has suffered from Major Depression, Borderline Personality Disorder and PSTD.
She had a complete positive transference to Kan. She was emotionally, physically and
sexually "highjacked".
He bridged professional boundaries.
He misuse of power, ignoring her physical, and psychological health.
He endanger her physical safety.
He Ignored and alienating Todd, her family and a lawyer effort to get his cooperation to
help Sharon.
He abandoned her after she was pleading for his help.
He betrayed her trust. Promise of love and a life together.
He turned her against her family.
He ignored change that he saw in Sharon from 2010 to 2011.
He was controlling, threatening, abandoning, intolerant, punishing, insensitive and lack of empathy.
He "broke" down her body and soul.
He put Sharon in a double bind. Either way she was going to lose. Todd. Her family,
KAN. In her mind there was No Way Out.

I hope this information is of value to you. 

Sincerely,

(Name Removed)