Grounding a client who’s dissociating: a step-by-step script

It usually starts with something small. Your client is describing a difficult memory, and partway through a sentence their voice goes flat. Their eyes settle on a point just past your shoulder. You ask a question, and the answer comes a beat too late, as if from a distance.

They’re still in the chair. But they’re not entirely in the room.

Dissociation in session is common, especially in trauma work, and it isn’t a sign that something has gone badly wrong. It’s a protective response — the mind stepping back from something that feels like too much. Your job in that moment isn’t to push through, and it isn’t to panic. It’s to help them come back, calmly and in order. This guide gives you a structure for doing exactly that.

How to recognise it

Dissociation ranges from mild — the kind of zoning out everyone does in a long meeting — to profound, where a person loses touch with time, place or their own body. In session, the signs to look for are usually quiet:

• A fixed or glazed gaze, or eyes that seem to look through you.
• Delayed responses, as if your words are taking a long way to arrive.
• A flat, distant or younger-sounding voice.
• Losing the thread — stopping mid-sentence, or not remembering what was just said.
• Saying things feel unreal — “it’s like I’m watching myself” or “everything looks far away” — which are often described as depersonalisation and derealisation.

The script

Here is a simple sequence you can follow. You won’t always need every step, and you can move between them as needed. Speak slowly, keep your sentences short, and let your own voice and body be calm. The client will borrow your steadiness before they can find their own.

If one approach isn’t working, change it rather than repeating it louder. Some clients come back fastest through their feet; others through naming colours in the room; a few through a sip of cold water or holding something with an interesting texture.

Check how present they are

Once the client seems to be returning, ask them directly. A simple number gives you both something to work with — and it often differs from what you can see.

Afterwards: talk about it

When the client is back, don’t move straight on as if nothing happened. A brief, matter-of-fact conversation helps them make sense of the experience, and gives you both a plan for next time.

• Normalise it. “What just happened is your mind protecting you. It makes sense.”
• Find what helped. “Which part brought you back the most?”
• Notice what led to it. “Do you remember what we were talking about just before?”
• Agree a signal. A word or hand gesture the client can use when they feel themselves drifting.

Then take stock of the rest of the session. It’s usually wiser to spend the remaining time on something steadier, and to return to the difficult material another day, with more support in place.

Before you work with difficult material

The best grounding happens before it’s needed. A little preparation makes these moments much easier for both of you.

When to get more support

Occasional, mild dissociation during difficult work is common and manageable. But if a client dissociates often, loses significant periods of time, or finds it hard to come back even with grounding, that’s a sign to seek supervision and to consider whether a specialist assessment or a trauma-focused specialist would serve them better. Working within your training is part of keeping clients safe.

Steady is the skill

Grounding isn’t complicated. What makes it work is the person doing it: a therapist who stays calm, slows down, and trusts that the client can come back. Your steadiness is the anchor. The techniques are just ways of handing it over.