Understanding dissociation and grounding
A short explanation of dissociation, what can set it off and its early signs, with a personal grounding plan and a practice log. Based on Boon, Steele and van der Hart (2011) and Kennedy et al. (2004): a general explanation and grounding steps in our own words, with a plan and log added.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Understanding dissociation and grounding
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What dissociation is
Dissociation is when your mind partly switches off from what is happening around you, from your body or from your feelings. Everyone does this a little, such as driving somewhere and not remembering the journey. It can become stronger when life feels too much, especially for people who have been through frightening or overwhelming events. It can be the mind's way of protecting you when things feel unbearable. It is a common way the mind copes with too much, and grounding can get easier with practice.
Common experiences include: spacing out or staring; feeling that you or the world are not real, far away or behind glass; feeling numb or cut off from your body; losing track of time; and watching yourself as if from outside.
Dissociation often follows a pattern: something sets it off, early signs appear, and it can deepen if nothing brings you back. Grounding works best early, so knowing your early signs matters.
Some experiences that look like dissociation, such as blackouts, fits or sudden confusion, can have a physical cause.
If you haven't had these feelings checked by a doctor, or they change or feel different from usual, see your GP. If you think something is medically wrong right now, get urgent help.
What can set it off
A few words for each trigger is enough, not the story behind it.
This can bring up strong feelings. You can stop at any point, use a grounding skill, and come back to it later or bring it to your next session.
My grounding plan
Grounding brings your attention back to now, using your senses and your surroundings. Try different steps and keep the ones that work for you.
Look: name five things you can see and their colours.
Listen: name the sounds around you, near and far.
Touch: press your feet into the floor, or hold something with a texture, such as a smooth stone or soft fabric.
Smell or taste: a strong mint, or a scent you like that has no bad links for you.
Temperature: hold a cool drink or run cool water over your hands.
Move: stand up, stretch, or walk and notice each step.
Orient: say your name, where you are and today's date.
Breathe: let each out-breath be a little slower than the in-breath.
Choose gentle steps. Skip any that hurt or feel unsafe, and never use pain to bring yourself back.
| # | Grounding step | When I will use it | Actions |
|---|---|---|---|
| 1 |
Grounding practice log
Practise when you are calm as well as when you start to drift, so grounding comes more easily. Before and after each try, rate how present you feel. 0 means not here at all (completely spaced out or cut off). 10 means fully here and now.
| # | Date | What I tried, and where | Present before (0 to 10) | Present after (0 to 10) | What I noticed | Actions |
|---|---|---|---|---|---|---|
| 1 |
Looking back
Look at your log with your therapist after a week or two.
Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.
When to use ‘Understanding dissociation and grounding’
‘Understanding dissociation and grounding’ is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for trauma and PTSD.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 15 minutes. It moves through five short steps:
- What dissociation is: Dissociation is when your mind partly switches off from what is happening around you, from your body or from your feelings. Everyone does…
- What can set it off: A few words for each trigger is enough, not the story behind it. This can bring up strong feelings. You can stop at any point, use a…
- My grounding plan: Grounding brings your attention back to now, using your senses and your surroundings. Try different steps and keep the ones that work for…
- Grounding practice log: Practise when you are calm as well as when you start to drift, so grounding comes more easily. Before and after each try, rate how present…
- Looking back: Look at your log with your therapist after a week or two.
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, ‘Understanding dissociation and grounding’ works by building practical skills to manage difficult thoughts and feelings in the moment. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Boon, S., Steele, K., & van der Hart, O. (2011). Coping with trauma-related dissociation: Skills training for patients and therapists. W. W. Norton.
- Kennedy, F., Clarke, S., Stopa, L., Bell, L., Rouse, H., Ainsworth, C., Fearon, P., & Waller, G. (2004). Towards a cognitive model and measure of dissociation. Journal of Behavior Therapy and Experimental Psychiatry, 35(1), 25-48. doi:10.1016/j.jbtep.2004.01.002
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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