Imo, you should open that letter. Now.

It provides the closest thing to closure that you are going to get.

I understand that you may be fearful of this. It will bring finality. After the letter is opened, there will be nothing more from her. A nail in the coffee of your relationship with her.

It may say hurtful and blaming words. More by!!***** explanations about how she was not qualified to treat you, blah, blah.

I think that you are not opening it because it is the last hope for contact - in fact, it IS the last contact, and you're not ready for that yet.

I think opening that letter, with or without your therapist present, is the best choice.

Hugs,
Pam
Formerly Gavinandnikki (accidentally logged out and can't get my username back yet)