SQUEEZE your arms...or wherever you cut. Hold on tight. This settles me down, not sure if it will work for you though. I've also shredded phone books with my pocket knife (though I feel like I mentioned this earlier, sorry if I forgot). Sorry it's been a rough day. I have a terrible time leaving appointments...when I'm most dissociative. Today my therapist offered me a couple stuffed animals to take home with me. Silly, but I took one, and it helped with leaving so much. What might help you in that tricky place when leaving an appointment? If you can think of something, let your therapist know. I personally need to find a way to make eye contact with her better at the end, but I can't yet. The teddy bear is very helpful for now. When I'm really spacey, she holds my feet and that helps. Or, towards the end, if I can cry a bit, that pulls me out of my 'freeze" and I feel okay when I leave. Hang in there. (((hugs)))