Starting to Dissociate in an Appointment? You Have Some Choices

Everyone with DID has been there.

You are in the middle of a medical or dental appointment, and you either hear another part’s words coming out of your mouth, or you feel yourself floating to the ceiling, or you can’t open your mouth to answer a simple question.

You are dissociating or switching.


  • Think fast.  Dissociation isn’t a slow process.  How could it be?  When an abuser was present, your nervous system had to be lightening-quick.
  • Choose the stabilization technique you can use right away, in the moment.  Even if it isn’t a good one, speed is more important than efficacy if you can feel yourself sliding away.
  • Communicate inside.  Your parts need to hear from you and see that these people are not “those people” and this place is not “that place”, and that this day is not “back then”.  If you don’t understand that parts can have a different understanding of time, then you need to learn more about DID.  
  • Ask for a break.  Even a few moments could give you the time to use a stabilization strategy.  Dissociation slows thinking, so your graduate degree or your professional license isn’t an indicator of how successful you will be at parsing the situation.  We know a lot about how autonomic activation will torpedo logical thought, so don’t beat yourself up for being unable to think.




Once the appointment is over, you have to consider that this could happen again, and make a plan to circumvent dissociation the next time.

 It is possible.  I wrote a book on how to do it!

  1. Accept that you were almost certainly somewhat dissociated before the appointment.  Some people with DID live in a partial trance state.  They don’t always know it.  But if you noticed changes as soon as you made the appointment or when you got up the day of the appointment, you know that you were vulnerable well before you left the waiting room.  
  2. Make a better plan.  Use stabilization strategies earlier, perhaps days earlier.  The best techniques for you are the ones that work for you, and you don’t know that unless you have learned and practiced them in other situations.  My book has an entire chapter on how important practicing them can be for successful appointments.  Practice right, and you are like the pit stop crew at the Indy 500.  On it!
  3. Consider your parts.  Perhaps they didn’t tell you how they felt about the appointment.  Perhaps you did not ask.  Parts can react exactly how you were raised: with fear, anger, deceit even!  Care for them in the ways you were never cared for; with consideration, forethought, and compassion.  This is a key to all treatment with DID:  learning to give yourself the care you never received.  

Looking for more ideas on managing appointments?

I wrote a book for you!


Staying in the Room:  Managing Medical and Dental Care When You Have DID

There was simply nothing out there that was practical and helpful to adults with DID.  So I wrote a book.

DID isn’t a “bad” case of PTSD.  DID is different, and it can be hard to find information that is clear and compassionate, AND useful.

  • Learn why trauma-informed care principles do not always help people with DID.  They can make things worse.
  • Understand why expecting healthcare providers to know much about DID isn’t the best use of your time and energy.  Really.
  • Learn how to widen your view of stabilization strategies to deepen your “toolbox”.
  • Build the ability to care for yourself at home.  Not needing an appointment is the best strategy of all!
  • Tough appointments like pelvic exams and dental treatments are covered, not ignored.  
  • If you need the ER, be ready with your DID emergency plan.  I show you how.
  • Treatments can be adapted so that they are not as painful or as traumatic.  You can ask for an adaptation without offending your provider or reducing their ability to help you.  Because I am a provider, I can give you the specifics and tell you when an adaptation is most effective.

Buy a copy of “Staying in the Room” on Amazon  today!

Make your next appointment better without needing to bring your therapist with you, or needing a day off from work to recover!

You can do it!

breathing trauma


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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