My book, “Staying In The Room: Managing Medical And Dental Care When You Have DID” has been available on Amazon.com since July 2021. It is already helping some people get the care they need and deserve.
But not everybody.
I have received feedback from a few people (and know this is the tip of an iceberg!) that they eagerly bought the book. Their system has not allowed them to open it. And they don’t know how to move forward.
No one who works with adults diagnosed with DID should underestimate the fear that can exist around receiving medical and dental treatment. Nor should they believe that thinking about these appointments is much easier than experiencing them.
To believe that, you would have to forget that people with DID can “know” and “not know” something is true at the same time. Their ability to be triggered into greater dissociation from a distressing thought or visualization is part of what makes having DID so challenging to treat, but also very difficult to live with.
Parts/alters have opinions and beliefs that are not shared by the entire system, and those can be resistant to change. Even when the change is positive. No system forged in trauma is eager to take chances if they perceive greater risks in the unknown.
So what can potential readers do when they want to build skills, and their fears, or the fears of their system, creates resistance?
- Orienting to the present is essential. Without knowing that “Now” is not “Then”, and “These People” are not, and never will be, “Those People”, it isn’t safe to explore and experiment. You have to ability to learn how to orient to the present without needing your therapist to guide you every time. Therapists have many strategies to help adults with DID feel more clearly that they ARE adults, and are seen as adults. All adults have strengths and status that children do not. Without feeling like an adult, it can be too difficult to consider assertion and communication with healthcare providers.
- Using stabilization techniques before reading, during reading, and after reading information about appointments and procedures. Again, therapists can teach their clients many different techniques, and they may need some practice before these are familiar and useful. But they need to be used. They need to be used even when it doesn’t seem like they are needed. This is because dissociation is a brain-based emergency strategy. It happens quickly fast and can overpower the adult with DID that is unprepared.
- Find out what parts think they need to feel safer, and give them the support they want. This may include excluding them! Just as we don’t take children to the gynecologist, some parts do not want or need to be present while reading about appointments. Learn how to use visualization or imagery to help them not be present.
- Pick the right moment(s) to read about things that are difficult to think about. But don’t assume that you have to wait for it, or it will never come unless you jump in. Not every free moment is the right one. Not every day is the right day. The right time and place could be in a therapy session. It could be on a day off from work. There is a strong temptation to either “muscle through” and read, or to put reading off until the perfect time comes along. Neither are probably going to work well.
- Envision the positive outcome of learning more about handling appointments, not the appointment itself. Most people with DID are able to use visualization, so the right kind of visualization can be helpful. Rather than imagining a successful appointment, imagining the scene after the appointment works better. Imagining feeling healthier, feeling stronger, and recovering from the stress successfully can empower without risking being triggered.
- Work on the easy things first. If thinking about nightmares is terrifying, work on making your bed more comfortable. If going to the gynecologist makes you freeze up, try getting a manicure, haircut, or massage and making a request for how you prefer to be touched. Just so your system can see you do this with confidence and get a positive outcome. The first step doesn’t have to be off a cliff. The surprise? Making a tiny change can resonate throughout your system, be explored in therapy to learn more about yourself, and be refined so that you have a new skill that you can count on when things get rough.