180 Hours, Part Five: Doctor's Notes I
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whatyoudontknow
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Note:The amount of therapy hours received will always be shown here in notes.

180 Hours, Part Five: Doctor's Notes I

Doctor's Notes: Diagnosis 1. Avoidant Dismissive Behavior Type

Avoidant individuals, such as Levi learn to suppress physical responses related to distress. It doesn't indicate that he has no ability to feel as others do, however it seems he has trouble developing solutions when overwhelmed with the same.

This results in over regulation of his ability to seem as if he is not affected and subsequently *emotionally paralyzed*

Indicators include, but are not limited to: *aversion to physical contact; an impersonal relational style; and devoid surface emotion, which can appear as depression or apathy*.

I get the impression that Levi does not remember his childhood, and this is common with avoidant dismissives **see file notes and personal dialogue patient: Ackerman, Levi

A person like Levi, with this pattern typically did not get their needs met as a child by either a parent or foster and then learned to live as if they had neither. Some people develop a *sense of self* that they are flawed, helpless, and dependent yet they are isolated from others.

***Mother, deceased at young age. Father, not involved. Kenny, relationship unknown. 3 cases of abandonment in early developing years.***

He seems rejecting of others, very controlling, and punishing of the self as a way of distancing from closeness. ***file notes, personal dialogue***

We learn to connect through the people that raise us. Levi was essentially raised by Kenny **relationship if any, unknown. The death of his mother, will have a varying impact on his attachment style depending on their interpersonal relationship style.

Even if his mother loved him and showed affection, her death was early enough in his growth to call Kenny the “emotional provider” by default. In order to survive, Levi had to become reliant on someone who was not particularly emotionally invested in his welfare.

To have lived his earliest years with childhood neglect is no small feat. As a part of this shaping process Levi’s adult personality is calm, detached, and viewed by others as cold. On the outside he is dismissive of others and has very little social interaction outside of the mission.

You do not force it. This is Levi in a nutshell. He appears to have no desire for intimacy, or even friendship really.

**behavior and therapy setting conversations seem to indicate otherwise, and will get upset when he catches himself saying anything indicative of a need or desire for intimacy** and is another indicator of his diagnosis, so when he does try to display camaraderie, it is indeed a huge step for him.

On the flipside, once the current need is met, he tends to push away. **The loss of his only two friends Isabel and Farlan will be explored in depth** I further believe that a fear of abandonment plays heavily into his attachment type.

Another facet of Levi’s personality indicative of his attachment type is his extreme devotion to work, with little to no leisure activities.

Based on initial assessment, recommended therapy: 1. Talk Therapy 2. Example based teachable moments (Blanket analogy should be amusing)

*** never before the incident in training, has Levi been reported, or witnessed to be physically abusive to his comrades. His cadets think highly of him, and with the exception of Eren Yeager incident, which is represented in his file he's mostly described as distant.

As of this writing I do not have any concerns regarding physical violence, and will address the situation from his POV to determine reasoning for isolated outburst. Completed Hours: 50/180 Next Therapy Session: 8-10pm, Tues Dr. Y/N, L/N

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