Three Simple Ways People With DID Can Make Hearing Bad News Easier To Handle

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No one wants to hear bad news.

Nobody.

When you are a trauma survivor, you might avoid getting care because you are worried that hearing bad news from your doctor or dentist will send you deeper into dissociation, bring you to a place where you self-harm, or worse.

Did you know that most healthcare providers HATE to give bad news?  Yup.  They can be quite anxious inside when sharing it, and they wish they could avoid saying things that upset you or that reveal they are not miracle workers.

And too often, they do a lousy job of delivering bad news when they are trying to be mindful or gentle.  Medical and dental schools are working on this with their current students, but that leaves a lot of experienced providers out there who haven’t brushed up on their communication skills.  Expecting providers to know how to present test/exam results with the right combination of details, action points, and awareness of how the information will affect you as someone with a dissociative disorder is asking a lot.  Assuming that you have landed in the office of someone who is both a skilled clinician and has been trained how to share sensitive information with trauma survivors of ALL kinds is not realistic.

What CAN you do to improve the experience of hearing bad news, regardless of the skill and sensitivity of the healthcare provider?

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Actually, there is a great deal that you can do to improve this situation.  You won’t have to go to grad school to become a healthcare provider, pay your therapist to accompany you, or continue to avoid the care that you truly need.  Some require a bit of practice, so I am listing the ones that are easiest for many people with DID and OSDD:

  • Recall what has given you calmness, confidence, and strength in past appointments, and try to recreate that scenario.  This is different for each person.  Some people do bring a friend or family member with them.  Others have a physical item from their therapist that reminds them of the emotional support they will have in sessions going forward through treatment.  Still other people make appointments early in the day.  They know they will be able to contact their support network more easily if they need to share, and their healthcare provider won’t be as rushed or tired as they are at the end of a work day.  Because you already have real-life experience that these things helped you in the past, there is a fair chance they can help you now.
  • Connect with all adult parts of your system that are willing and able to be supportive.  They need to be willing AND able.  Not all adult parts are both.  Know your system, and be open to learning where they are at with this situation.  Asking inside and finding their strength is empowering.  So is reinforcing your sense of being an adult, even when you don’t feel like one.  Adult parts are your first line of support because they already know they are seen in the world as adults.   “Orienting to the present” is a phrase that trauma therapists repeat very often, but in this situation, it might be impossible to repeat it too much.  Use every strategy you can to feel like the adult you are.  The autonomy, authority, and independence that society automatically confers on adults, but not on children, are felt strengths when an illness or injury occurs and you need care.
  • Don’t wait for information to be given; request the delivery method that seems as if it will be the easiest to hear.  Being unsure of the outcome of different responses from your clinician is normal.  You are going to go with an educated guess about what delivery methods work better.  This is also specific to you.  Here are some ideas; try them on for size:  That old saw “I want to hear the good news first” can actually be a good plan.  Some survivors need to know that there is a beneficial treatment, a preferred medication, or a trusted referral source before they hear what the actual problem is.  Other people will want to wait until the next visit to hear the details and bring their support person along to recall them.  Still others want a link to a website, or be able to hold printed information that they can read at home.  Some systems will go online without you being co-conscious with them, others like printed media, and others will want to read a children’s book about their diagnosis.  Asking inside can help guide your requests to your providers.

Need more information about navigating modern healthcare with a dissociative disorder ?

I wrote a book for you!

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“Staying In The Room:  Managing Medical And Dental Care When You Have DID” will guide you to a place of empowerment and confidence.  It isn’t psychotherapy;  it is a guide to building a toolkit of skills and information so that you can get the physical care you deserve!

Here are a few of the things you will learn:

  • How to expand your concept of stabilization skills beyond looking for red and blue things in the room (a good idea, but one that isn’t nearly enough for most people with DID!)
  • Why seeking physical care is such a minefield for most trauma survivors, even those who are licensed providers themselves.
  • Why trauma-informed care doesn’t seem to help you enough.
  • The reasons (yes, more than one) that mindfulness practices can too frequently increase, not decrease, dissociation in trauma survivors.
  • How your next manicure, or even your next oil change, can be used as a practice environment for “staying in the room”.
  • The often-transformational power of better communication skills with your providers.  Sometimes it IS what you say, not just how you say it!
“Staying In The Room” is available as a paperback and as a digital download (readable on any device with their totally FREE app) on Amazon

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Why Describing Pain Symptoms Is Harder When You Have DID

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Healthcare providers want to talk to you about your pain.  You, and very likely, most of your system, want to have the pain end, but don’t want to talk about it at length.

It feels bad to talk about things that feel bad.

This makes perfect sense to anyone that understands trauma. 

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Here is where your completely understandable trauma responses torpedo your ability to get relief:  not being clear about the details of your pain hobbles a healthcare professional’s ability to help you quickly and effectively.

There is a lot of hope.  This post outlines one path on the road back to helping yourself and all of your parts deal with pain.

You will be the hero of your story.  

You will get better results from treatment.

Your system will trust you more when they see those results.

  1. Pain is usually a scary thing for adults with DID.  A familiar thing, perhaps, but it is still frightening.  Fear triggers flashbacks and dissociation, sometimes full switching, sometimes more blending with parts.  All of the techniques you have learned in therapy to deal with other types of fear are needed…now!  Any DBT, CBT, self-talk, really anything you have ever successfully used to manage fear.  Use it now.  Even if you think that it is one of those “maybe 10% of the time it works” techniques.  Use it now.  Now is the time when any reduction in fear is needed so you can move into the next strategy.
  2. Recognize that your system may be trying to do anything BUT orient to the present time.  Because in the present, you are in pain.  That probably scares the @#%& out of them.  You will have to work hard to be able to stay in the present.  You need to feel fully adult in order to effectively discuss pain with your provider.  Children are not going to be able to parse out things in a way that improves your condition fast enough to get you out of pain.
  3. Accept that if you switch, your pain “story” may have some holes in your pain history or variability in how much pain you feel.  That is not as important as offering valuable details.  Working with your system should help fill in some blanks, but if you haven’t developed solid lines of internal communication, don’t beat yourself up for that.  You can still get results.  Shame isn’t going to help you either, so focus on how to bring some descriptive strengths with you to your appointment.  That is a skill you can develop, regardless of having DID.
  4. Providers need to know some very important pieces of information:  the type of pain (throbbing/pulsing/vibrating/dull, the pattern since it emerged (constant or variable, activities that bring it on or lessen it, what it stops you from doing throughout the day), and of course, the location(s) of pain.  Be as specific as you can be.  Be clear about what you know, and don’t let anyone focus on what you aren’t sure about.  We don’t have time for that.  Combined with being able to be present during a physical exam, you can be instrumental in getting relief from pain by being a partner with your provider.

Want more information about navigating healthcare?

I wrote a book for you!

“Staying In The Room:  Managing Medical And Dental Care When You Have DID” is a guide for empowerment and success!  Written for trauma survivors with dissociative disorders, it directly addresses the complications that ensue when adults with DID, OSDD, and the dissociative type of PTSD engage with our fractured healthcare system.  Even trauma survivors that are providers themselves find getting the care they deserve is a challenge!

What does this book offer trauma survivors?

Learn more about how to manage appointments, surgeries, and self-care at home by grabbing a copy.  Worried that you will be too anxious to open the book?  Bring it to your therapist, and have them support you.  They will learn more about specific adaptations and adjustments that your providers can offer, because they aren’t healthcare providers.  They don’t have the clinical experience to know that your doctor or dentist can alter their treatments in ways that make it less stressful!

Find “Staying In The Room” on  Amazon  as a paperback that you can highlight or outline, or as an affordable read-only digital book.  Their free app makes it readable on any device.

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