Why Doesn’t Your Therapist Know How Difficult Healthcare Appointments Are For You?

Actually, they probably do.
But perhaps not all of them do.

Dr. Bethany Brand, a leading trauma researcher, did a study almost 7 years ago.  The TOP DD study looked at what dissociative patients thought about their lives and their psychotherapy treatment, and what psychotherapists treating trauma survivors with dissociative disorders thought about treatment foci, how their patients were dealing with dissociation during the day, and more.


You can find Dr. Brand’s comments on her findings on YouTube videos by the APA.  I will give you a super-short summary:  she makes it clear that far too many therapists underestimate how frequently their clients dissociate, they under-appreciate how disruptive it is to their client’s sense of basic safety and ability to function, and that therapists do not spend a huge amount of time focusing on building their client’s stabilization skills to use in daily life.  And these are all therapists strongly committed to working with trauma survivors.


This isn’t to say that they aren’t working hard for their clients.  They are.


Making inroads into everyday life events like dental and medical appointments might not be on every therapist’s radar.



I have to be honest.  I won’t throw all therapists under the bus.  I must mention that they aren’t mind readers.  Although some will inquire about their client’s ability to handle self-care and physical care, many expect that their clients will raise these concerns.  And if that doesn’t happen, they move on to the issues brought to them in session, or that they witness in session.


It is so important for adults with dissociative disorders to bring up issues that make everyday living difficult in their therapy sessions.  Sometimes trauma survivors haven’t been clear about how impressively fearful, dissociated, or avoidant they are about these appointments.   Or an adult with DID will not realize that their appointment earlier in the day was a HUGE influence on switching, self-harm, or other reactions.  They attribute their reactions to something else that occurred during a rough day.  Some days are just like that.  Some weeks, too!



If you are a trauma survivor and haven’t shared how stressful healthcare appointments are for you:

Remnants of living in trauma can make it hard to reveal any areas of struggle to another person (and many times even to yourself).  Going to therapy does not mean that it is easy to share the reality of living with a dissociative disorder.  It can be hard to be in relationship with someone willing to see all of you, when you may have been ignored or devalued as a child.  It can feel unsafe to be vulnerable.


This is completely understandable.  Growing up unsafe means using any and every strategy you can find to feel a bit safer.  Not revealing the full extent of your struggles to any single person can truly seem like a way to retain control when things feel mostly out of control.  Again, this makes complete sense from the view of someone who grew up under direct threat.  In fact, it is a rather clever plan in the midst of danger.


But when that danger no longer exists, it is a barrier to receiving help.

Read Why is it so Hard to Use Many Common Stabilization Strategies in Medical and Dental Appointments?  for more ideas about how to improve appointments by targeted use of  what you have learned in therapy!


I wrote “Staying In The Room:  Managing Medical and Dental Care When You Have DID” because I know that too many people do not feel safe enough to speak about their fear, avoidance, and increased dissociation when they see a doctor or dentist.

Learning how to build a more effective and comprehensive toolkit can allow adults with DID to get the care they deserve.  And they can start by using some skills they already have.  Skills they might not realize could help them immediately!  

And it doesn’t have to be scary to read the book.  I wrote it in a way that is easy to read, easy to find the sections that you need at the moment, and easier to get helpful ideas without having to read too much about the details of treatments if they trigger you.  I have your back!

My book is available as a paperback (you know you want to underline/highlight/write in the margins!) or an affordable digital download on Amazon  .



Published by Cathy Collyer

I am a licensed occupational therapist and a licensed massage therapist, in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment, with a focus on sensory processing issues and treating the consequences of complex trauma. I am the author of four books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training Your Child With Low Muscle Tone". Over the years I have lectured about trauma treatment and pediatric development.

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