Here is What You Can Request From Your Doctor To Feel Safer In Your Next Appointment

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I will be speaking at the Healing Together conference next month, and one of my handouts will be a modified version of this list of suggested adaptations.  I thought I would share it here, since it could be the most helpful thing I say to the audience during my presentation.

Why ask for adaptations?

Because your provider may have no idea how to help you tolerate their treatment more effectively.  You may be too dissociative to use a stabilization technique that requires thinking clearly.  If you switch, or a part takes executive control, you are out of luck to take control of the situation as it goes off-track.  A treatment or exam adaptation can be like a crock pot:  you adapt things once, and it keeps on making a difference throughout the time you are in the office.

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I selected these adaptations because they will be applicable for many, but not all, types of appointments.  There are adaptations that are specific to certain treatments or examinations, such as pelvic exams and ER visits, and those are discussed in my book, Staying In The Room: Managing Medical And Dental Care When You Have DID  .  The ones I have chosen here will require some degree of familiarity with DID.  A newly-diagnosed adult may need to use only one or two until they have learned more about their diagnosis and how people function effectively when they have a dissociative disorder.

Helpful adaptations should never reduce the quality of the treatment from your health provider, or frustrate them significantly.  If your provider is unwilling to use any adaptation, you have been given the gift of information about their ability to be a full partner in your care.  Depending on the situation, you may choose not to receive future treatment from this person.  These adaptations should not incite frustration, require more time in an appointment, or make it impossible for them to do their expert job.

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  1. Request the most modest draping and positioning possible.  Draping is the way your body is covered.  If you don’t think you need to be fully exposed, ask how much is needed and request to leave on more of your clothing or be given a sheet to cover you up.  Treatments that allow you to sit up or place your feet on the floor enhance orienting to the present time.  Request these adaptations regardless of how you feel at the beginning of treatment.   Modest draping and positioning is money in the dissociative bank, preventing future stress.
  2. Request the amount of information about your treatment that gives you and your system enough safety to move forward.  You do not need so much information that you become overwhelmed, but you do need some information.  Learn how much and what delivery method (app, pamphlet, verbal, online) helps you most, and this will guide you at your next appointment.
  3. Request that your treatments are done in a way that minimizes pain.  Even if you are a warrior, not all of your parts are.  Pain is almost always a huge trigger for people with a history of chronic child abuse.  Protect them.
  4. Ask for super-brief breaks in a long treatment.  Use this time to use your stabilization strategies that you know can help you most.
  5. If you are familiar with the treatment, request the adaptations that minimize your triggers, switching, or dissociation.
  6. Don’t wait to ask for adaptations.  Most adults with DID enter an appointment in a level of dissociation.  Assume that this will be difficult, and get in front of the problem.  If all goes well, you can celebrate and your provider will also feel good about the appointment.

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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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