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You want her to know how badly she affected you but if you write a note you're engaging and will probably end up receiving another letter defending her actions.
I think the best way to send your message of how hurt you are is to not respond. Not only does it send the message you aren't interested it also gives her less room to engage you further.
If she writes again, don't open it, send it straight back.

Anon,
she doesnt get to call the shots on the timeline for your emotions. It's not her call.

And it's certainly not for her to decide that she should now be allowed back into your life because she's done her "jailtime".

Honestly I think you're going to just open a real hornets nest for yourself if you start a correspondence here, and you'll be taking her emotional load, and guilt surrounding it, into your head.... you already are in fact and I hope you can see that.
But that's not your concern right now. Your own mental and emotional wellbeing needs to be your focus.

I would have to ignore it too …
My sister did an awful thing to me shortly after our mum died, unforgivable…. 2yrs later she text me, she wanted me to talk our father around to doing something for her …
No acknowledgment of what she had done or said …
I had to put myself first … I felt no loss from having her out of my life .. so I ignored her
It’s been 5.5 yrs since we last spoke and my life is so much easier and drama free

I wouldn't write back. I have someone I cut from my life. And If she tried to get in contact I don't know what I would do. I know I would not write back however because I would be worried it would be seen as opening a channel of communication. You have to protect yourself and your mental health. It doesn't read like you are ready to deal with or confront this person. Take the time to heal and then in the future if this is still something you want to revisit the other person has left the door open.

Some great advice above. Sounds incredibly traumatic. I agree with everyone who says not to engage with her at all. Sounds like she wants all engagement on her terms after causing you massive pain and I would absolutely not have any dealings with her at all or give her any level of control or input in my life. I'd examine the situation with your therapist/counsellor or whoever is guiding you forward who is best placed to help you avoid setbacks. Best of luck.

I wouldn't write back. If it causes you distress having contact with this person then step away and leave it. Just don't respond at all. Don't open anymore correspondence.
Just step away.

The letter is always about the other person. They didn't even bother apologising or acknowledging the hurt they caused.
You look after you and do what is right for you. You do not have to deal with this person. If you reply saying leave me alone, they could ignore it and continue with communication.
I would talk about it to a friend to unburden yourself and leave it. Wishing you strength.

You don't have to do anything.
This person has created an obligation feeling in you. Don't feel like you've to respond in any way.

Much as the others have posted just mind yourself.
I think we are conditioned in life to feel like we need to respond and quickly. We don’t in fact need to respond and certainly not within any timeframe.
I’d chat to your therapist about it working through the emotions and physical responses this whole thing has caused you.
Finding a way to first name and then heal these responses is essential before you engage further with her.
My own experience tells me this person is unlikely to see the light and understand that she caused you hurt so you prob do need to find a way to accept her actions and hopefully forgive to an extent to set you free.
I’m hesitant about letters too - just because she wrote a letter doesn’t mean you have to write a letter back.

I am in a similar situation but not as hard as your situation. In my case, the people involved are pretending that nothing happened and are being nice to me after ignoring me for nearly 2 years. I'm not engaging with them as much as possible.
In your case, you said that you are getting help, can you talk over your best course of action and what would benefit you with your counsellor. Do what is best for you. If that is to ignore it, do that. If you really want them to know how you feel, then reply but write it and wait a few days before you send it. It can be cathartic to write it out but you might want to edit it afterwards.
Hope you feel better and this hasn't affected you too much.

I didn't have a traumatic event but I did have a friend blank me for no good reason. I understand she was going through a lot at the time and I was doing my best to keep things on an even keel but she definitely blamed me for stuff in a certain circumstance. I had other people to consider, including myself and it really was just out of proportion in her head due to what she was going through. When she finally came around looking to contact me again (can't remember how long later but was a few years and I'm pretty sure it wasn't genuine anyway) she made no reference to how we stopped being friends and for that reason I decided no, not going there, not playing any games or dancing around it. So I never responded to her. I've zero regrets about that.
If this person is not acknowledging the wrongs then they're probably not sorry for them/don't see themselves in the wrong. I would leave them to it and not even respond to be honest. Why bring up the head f8ck again, esp if you are not able for it and go around in circles.
And 100% agree with 3dollys above. I'd be ignoring this letter if I were you.

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Just wipe your arse with it and post it back!

Ok don’t do that I’m only trying to make you laugh. The best thing to do in this situation is to forgive her, not because she deserves it but because you deserve it. She is obviously a very unhappy person so you are better off not getting tangled up with her and I think your gut instincts are right about keeping away from her, it’s a physical reaction and you have to listen to your body here.
Keep way back and just forgive her. If you can. Good luck.

I’m so glad you are getting help for your trauma, right now you need to put yourself first, and it’s awful that she has her own problems but they are hers and hers alone, you clearly are still healing , so when you are ready to make contact with her maybe do it then, it has to be on your terms , wishing you the best of luck , mind yourself xx