1. FRUSTRATION. Inability to tolerate frustration leads to anger
1.1. Abusive behaviour
1.1.1. Words
1.1.2. Hitting mother
1.2. Self harm
1.2.1. Banging head on wardrobe
1.2.2. Pinching / punching leading to bruises
1.3. Self-hate
1.3.1. Suicidal ideation
1.3.2. Over-apologising
2. Socialisation
2.1. loneliness
2.2. Understimulation
2.3. Deep disconfort in social situatations beyond immediate family or people she knows well
2.3.1. Better at school
2.3.2. Stiffing attachement to mum
2.4. Lossing social interaction skills
2.5. Loss of the joy of life
2.5.1. Not seeing point of life
3. Other questions
3.1. Not sure about labels, but can we apply for further assessment just incase she does not improve.
3.2. Options for therapy
3.2.1. CBT - suitable for children?
3.2.2. Human Givens - what is your view
3.3. Deep seated concern for the future wellbeing and independence
4. Longstanding concerns
4.1. Paternal grandmother mental health
4.1.1. Poor inpulse control
4.1.2. Grandmother sees parallels with owwn childhood
4.2. Family dynamics
4.2.1. High achieving sister
4.2.2. 2 v different kids
5. Flexibility / boundaries
5.1. Rigid sense of what is accepatble to her.
5.1.1. People
5.1.2. Activties
5.1.2.1. Reading
5.1.2.2. Climbing (excludes many v similar routes)
5.1.3. Interests
5.1.3.1. Environment - v passionate, negative view on humanity as a whole
5.1.3.2. Strick vegetarian diet and clothing
5.2. Poor ability to adapt to change
5.2.1. Leads to frustration
6. Ability to understand views and feelings of others
6.1. Does not see value of many relationships
7. School
7.1. Appears happy
7.2. Plays with other children in the playground
7.3. Included in play-dates and parties but is relecutant
7.3.1. Does not wish to recipriocate / repeat
7.4. Teacher
7.4.1. Observes that she wants to shrink into herself - her very presence is too much
7.4.2. Says her shoulders have come down from her ears and she is doing ok
8. Body image
8.1. Intermitent - not all the time
8.1.1. Eating normally significant propotion of the time