(((Jello))) I can relate to this somewhat.

I've often want to convey a deeper appreciation, but then withhold it. Sometimes because I fear that if I say it they will know how vulnerable I am at the moment and I fear that a positive response will cause me to emotionally lose it.

I don't want the other person to know how much something that they did or said really meant to me. This is especially true when I get it into my head that they really didn't do it for ME individually. They were just going through the motions of their daily work, saying prefabricated stuff, and it just happened come at the right time to affect me deeply.

Your '..making an assumption that they cared." comment is really true for me as well. I gave my T the Christmas card on my way out so I didn't have to see her response to it. I envisioned her reading it, laughing about it with her office manager, and stuffing it in my psych folder. It is now simply additional evidence that I am just another one of the psychotic freaks she deals with on a daily bases and who has bought into the illusion that she really gives a crap. My card is likely in my folder with a notation... 12/22/07: Pt. has transitioned into phase X of her pathology, personal communication suggests some level of transference successfully established. Plan of Care: Begin intervention phase: Xa-1.