Ana

"This is really pretty." I say as I glue yet another piece of a magazine onto my future mood collage. I've actually had a lot of fun putting this together and I've decided that the last thing I want to do is pop pictures of the kids on it before I hang it on the bedroom wall so I can see it every single day. A reminder for me that I have a brighter future than the current dark present.

"It is." Jamie agrees and I smile at her. I really like Jamie. She likes to keep our sessions positive but I also lead them. She responds to me and only talks about what I want to speak about which is nice and makes talking to her very easy. I don't feel like I need to think before opening my mouth like I do with everyone else that steps foot in this room.

"Being a mom is everything to me." I say as I stick down a mini sonogram that I found in a magazine.

"You're a great Mom. Your kids adore you." Jamie smiles in my direction and I nod and smile back. I know how much my kids love me. I feel it whenever I'm with them and now I spend a little time with them everyday I feel it more and more and they're a lot less apprehensive around me now than when I was first injured.

"I never had a good relationship with my Mom." I say quietly. "Don't get me wrong. I love her so much, she's my Mom, but it's been my goal in life for me to make sure my kids know they come first. I never came first for my Mom." I don't think Jamie is surprised by this topic of conversation because she knows that my Mom is coming this afternoon to have a family therapy session.

"What makes you think you didn't come first?" Jamie says as she hands me another one of my cuttings to glue down.

"Mom was a hopeless romantic. Flitting from one relationship to another. She's been married 4 times but there's been countless boyfriends in between. She believed she could get a happy ever after and finding that trumped me every time. She didn't care when I went to live with Ray, I didn't hear from her for months. Last I knew she was in Vegas and next I knew she was getting married in Savannah and I was invited to the wedding." I talk as if I have verbal diarrhoea because I've never really spoken about this with anyone before. It's nice to finally get it all out, these feelings have been bottled up too long.

Jamie just listens to me though which is nice. It's nice to simply be listened to. "She didn't come to my high school graduation. She didn't come to my college graduation. I almost didn't think she'd come to my wedding."

"Oh Ana." Jamie says putting her hand gently on my knee. "I'm sure she loves you."

"She does love me." I say sadly. "But not first. Kids should be your first love above all else. I didn't quite fall into that category with Mom and the more babies I had the harder it was to rationalise her behaviour over the years."

"Some people just don't know how to parent." Jamie suggests and I shrug. Is that an excuse? Not knowing how to parent? I didn't know how to parent but I loved my babies above all else as soon as I knew they existed.

"I look at my kids sometimes and I feel so overwhelmed with love it hurts. I can't believe I brought these little people into the world and I get to have a hand in moulding them into whatever they'll be. I hold them sometimes and just tell them over and over how much I love them. That they are everything to me because I need them to know it's an overwhelming crazy feeling that I just have to express." I smile as I tell Jamie this because while it's overwhelming and crazy it's a feeling I love. Knowing I have this amazing love in my heart for my babies. "I don't think my Mom ever had that with me for the simple reason because of that love I would do anything for my babies."

"You don't think your Mom would do anything for you?" Jamie asks hiding any emotion from her face. I shake my head and sigh.

"My graduation, her husband had broken his leg. She wouldn't leave him for a couple of days to come see me walk." I shrug. "I'd leave Christian behind to see my kids walk and he's my soul mate."

Jamie doesn't say anything now as I stick the last piece down.

"Done." I smile.

"This is great Ana." She says holding it up.

"It feels positive." I say with a smile because it does. Focusing on the future makes my days a bit lighter because it reminds me that I have a future. I will recover from this and I will get better and move on with my life. In time.

"Why don't you go and have some lunch now with the kids and then your Mom will be here." Jamie says and I nod. I can't wait to see my babies again. It is helping loads with my dietary needs and while I'm not allowed to know my weight right now Emily is keeping a close eye but I do look in the mirror and I see the weight is starting to come back. I have more colour in my cheeks and my belly is starting to round with my unborn child growing in there.

Jamie

That poor girl. As she makes her way out of the room her thin dark hair whipping behind her I sigh deeply.

Speaking to her and getting to know her. I know she hasn't had an easy life. Compared to many, yes ok it wasn't that bad at all but still even the smallest things can have an impact on a person and her mother's countless marriages and absence has had more of an impact than I think even she realises. She doesn't trust her Mother and that's something hard for anyone to deal with.

A child's relationship with the mother moulds them. The bond between mother and child begins developing before birth. We know that those first few hours after birth are vital but I also know that Ana's father died in those first few hours. I'm sure that had a detrimental impact on the bond that formed between Ana and Carla. I also know Carla was young when she had Ana. She was possibly a bit clueless as to what was ahead of her and may not have known how to be a Mom especially if she lacked a support system.

Bonding then strengthens over the first 6 months of life. We know that if there are reasons a child and parent don't bond due to separation in the early hours of life that it isn't necessarily bad if bonding happens over the next few months. We're more concerned when there is close contact and a lack of bonding than we are if there's a lack of contact.

The formative toddler years are where trust develops. Toddlers learn they are their own person and as they begin to explore the world around them and their mother both encourages them and puts up boundaries to keep them safe, comfort them in time of need, this is where our children develop trust. It would be interesting to learn what kind of toddler years Ana had. When did Ray come into her life, did he parent her more during these formative years than her mother did? When did Morton come into the picture?

If Ana wanted to learn to trust her mother and bond with her and Carla was receptive there are therapies that we can do even at Ana's age to reestablish these depending on where the issue began between them. Ana says she doesn't trust her mother and this is likely because of something that happened in those formative years. If we know what that is we may be able to address it.

Ana is very resilient. That's obvious. But she's also suffered adverse childhood experiences that will have had a detrimental impact on her mental health and well-being. Is that playing a role in how she's handling all of this? Could we address what she's gone through by going further back and addressing some of the things she suffered as a child? Or will what she suffered as a child become an issue now she's suffered from trauma? I have so many questions as though she was more of a research subject than a patient but in all honesty I just want to help her.

"You ok?" Tamara asks as I join her and John Flynn in the office that's become our base room. Tamara looks concerned at me and I guess all those questions bubbling in my mind is reflected in my face.

"Yeah I'm just thinking about Ana. She spoke a bit about her Mom today which I guess is in anticipation of the visit this afternoon." I explain as I take a seat so I can fill in my notes.

"What did she talk about?" Tamara asks and I know it's because it will help her this afternoon to know what Ana feels about Carla.

"The relationship she has with her children in comparison to her own with her mother. I think there was an absence of bonding in her early years and and absence of trust development in the formative years."

"That would make sense." John comes in and having known Ana longer than Tamara or myself he would have a better idea of her past. "Ana has always suffered with low self esteem and a lack of confidence and I've worked with her on that over the years. She's resilient yes but I have always believed that some of the things that happened in her childhood had a bigger impact on her than she's ever been able to admit. But getting her to address them is impossible because she doesn't believe they had any form of impact so won't talk about them for the simple reason she doesn't see a point."

"I think we're going off a little here." Tamara says getting up and stretching her legs.

"I don't think we are." John says getting up and going over to the whiteboard where we've been keeping our schedule and chart for Ana. He flips it over to the clean side and picks up the pen. "We all work in trauma right." He says looking from me to Tamara and we both nod. "How often do we come across trauma and the mother comes up later down the road of addressing it?"

"More often than not." Tamara shrugs.

"Exactly. We talk about trauma but we don't often talk about resilience in our work. We know that studies show the more adverse childhood experiences a person has that more often than not the child is less resilient but what we haven't done is study those with ACEs that are extremely resilient like Ana. What causes that? Is it a natural strength of the individual? Is it the other adults around them? We always put it down to the relationship with the parents but what if there's a negative relationship and there's still a load of resilience there?"

"Come on John you and I both know that our studies can only go so far. We know from the research that has been done the more ACEs that someone has suffered the less resilient they are as adults especially when the ACEs come from the parents. But we also know that there are always anomalies to that research. Ana is just an anomaly and therefore we can't apply what we know to her situation." Tamara states and I can't help but smile a little that we've managed to reach a point where we're discussing research and statistics rather than our patient. It actually goes to show how far Ana has come that we are able to talk in more general terms than simply be focused on her.

"I know it's just fascinating." John says looking at his scribbles on the board.

Tamara

After some lunch and a very healthy discussion about adverse childhood experiences and resilience with John and Jamie, I meet Ana in her office downstairs. She doesn't want her Mom in her bedroom which is interesting in itself but this whole afternoon will be interesting.

I met with Carla a couple of days ago to find out what she would want to tell Ana. It's unusual for me to be prepared in such a way but the last thing I wanted was to be in a position where I was caught without an answer for Ana. She's been through so much and the last thing we need right now is setbacks.

Carla and Ana will have an interesting conversation. Ana has a lot of questions and Carla will need to be supported in her answers and then Ana will need support to deal with what's said.

"So this is the home office of a CEO." I tease.

"Aren't you using Christian's office as a base?" She asks rocking side to side in her chair behind her desk.

I think it's interesting that's where she's chosen to sit. There's a couch and an armchair but she's chosen the huge cream desk chair and is sitting behind the desk.

Queen of her empire. This is a power play but not with me. She needs to be in charge and in control of this situation and I'm sorry to say that it isn't going to happen. She can't control any of this. She can't control what happened to her Mom and she can't control what happened to her.

"You know the couch would be comfier." I say to see how she responds and I'm not surprised when her face turns stony.

"I'm ok here." She says swinging in her chair again.

"Ok." I reply because it isn't worth the fight.

I help myself to coffee that the housekeeper has clearly been in to set up and glance at the clock. Carla is late. It's already five past the hour when she said she'd be here for two. But it's five minutes so I'm sure she'll be here soon.

"Are you apprehensive?" I ask turning back to Ana who is lining up her pens on her desk.

"Why?" She asks answering the question without using the words. She's on the defence. That's interesting too and I'm not so sure this is such a good idea anymore.

"I'm just asking." I say hoping she knows I'm not a threat to her. I'm on her side here. My job is to support her through all of this and she knows speaking to her Mom about Morton is a part of the healing especially if she intends to do the victim impact statement.

Ten past, quarter past, half past comes and goes and there's still no sign of Carla. Ana has become more and more apprehensive as the minutes have gone by and I've seen the apprehension turn to resignation. Her Mom has let her down again.

A knock on the door takes me out of my thoughts and I turn as Ana calls for whoever it is to come in. I'm hoping to God it's Carla but I'm disappointed when I see Ana's security guard.

"Umm your Mom... she came but... she hung around the door for a while. John and Jamie thought best to let her make the decision whether or not to knock but sorry Ana she left."

"That's ok." Ana says her head bowing. I'm in agreement with what John and Jamie decided. Carla had to come herself. Us opening the door and forcing her hand wouldn't have helped.

Luke Sawyer gives a small nod and leaves allowing me to turn to Ana.

"Wanna talk about it?" I ask knowing it would be a good idea to address the disappointment straight away.

"No. I didn't expect her to show Tamara so I'm not disappointed." She lies. The disappointment is written all over her face.

"Ok." I say because it's not worth pushing her right now. She may turn angry and that would achieve nothing.

"I'm tired I'm going to bed." Ana suddenly says and before I can even think what else to say she's out the door and running for the stairs.

Dammit Carla.