December 18, 2008

Integration: A Requirement for DID Therapy – Or Not?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Integration - yes or no, mental health, therapy, Therapy and Counseling tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:07 pm by Kathy Broady


I am well aware that many trauma therapists are highly supportive of the treatment goal to integrate dissociative selves.

I have a different approach to this topic.  Please understand I am not at all opposed to the idea of integration if that is what the person wants.  However, that is a very complicated topic, and I’ll discuss the integration issue from that perspective at another time.

In my experience, by far, most dissociative trauma survivors and their systems have been opposed to the idea of integration.  They like themselves as they are, and they don’t want to lose the various individual parts / people from inside.  The concept of integration feels more like killing each other off, or losing unique characters, real people, and best friends. While integration may be the favored ultimate treatment goal of mainstream mental health professionals, it is not necessarily the favored option of the dissociative trauma survivors.

For that matter, I’m not even convinced that true integration is literally or physiologically or psychologically possible.  When one person’s mind-self-body gets pushed to the point of separating and breaking apart into entirely different selves, with entirely different lives, preferences, interests, knowings, time awareness, relationships, friends, hobbies, memories, realities, likes, dislikes, etc. and that distinct plurality solidifies as extremely different people for 20-30-40-50+ years, can it ever really be as if it didn’t happen?   Once that distinct separateness occurs, is it really possible to make that group of folks back into “one” person?

I’m not convinced there is a need, or even a benefit to trying to do this.

I do believe that creating teamwork, cooperation and communication between the different selves, and lowering and removing the dissociative amnesiac walls is critically important.  I can’t stress how important that is.  But developing these internal communication, self-bonding skills is entirely different than integrating these unique selves into one single solitary person.

Developing a highly successful internal group approach is hard, intense work.  It takes a very long time to achieve that goal.   The good news is that a dissociative person can actually function incredibly well as separate selves.

So why is there any need to remove or eliminate this amazing talent and ability?  Why would someone want to try to become somebody else when they can successfully cooperate with their selves as they know them and stay who they are?

If a person does not want to integrate, I do not believe that genuine integration can be forced or “made to happen”.  Instead, I think that forcing the integration issue actually causes the creation of new dissociative walls, which means greater separation, not integration.  Internal parts can be forced to hide from the others inside, giving the appearance of integration without an actual integration being achieved.  This is not good!!  This is the very opposite to helpful healing.  It creates an emotional time-bomb just waiting to explode.

Forcing an appearance of premature integration sets up a horrible dynamic within the dissociative person.  All too often the person is rushed into this conclusion when there hasn’t been sufficient time for the parts involved to heal properly.  They are not finished telling their life experiences, or expressing their feelings, or developing connections with the other inner selves, or challenging their own abuse-related approaches to life.  It happens too fast — and the therapy healing work is just not done.  So that is not ok.  The “integrated” but still dissociative person is left with a huge overwhelming sense of failure if — and when — the parts need to reemerge and finish their healing work.

Healing takes as long as it takes, and the point of therapy is to provide that healing, not to cut it off at the pass. Attempting to rush or force the idea of integration causes, in my opinion, great and significant harm to the dissociative client.  It is a huge set-back.

I believe that any kind of system blending and system cooperation takes a very long time.  It is a slow process.  The reasons for the dissociative splits in the first place are huge and fundamental.  Pretending these splits haven’t happened is like denying the reality of a person’s life and all the conflicting things that have happened along the way.  Bridging the gap between the splits requires huge pieces of therapy work.

My recommendation is to throw that nasty i-word away. Don’t even go there.  Instead, use your time and energy to focus on getting to know your people and becoming really good friends with them – with ALL of them, including the insiders that you are afraid of or angry with.  Focus on building the connecting bridges instead of smushing and smashing people into each other.  As you develop your internal relationships, you will find a great sense of inner peace and satisfaction.

You’ve got good people in there.  Keep them!!!

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19 Comments »

  1. David said,

    Kathy, I really liked this post. I had this same conversation today with my own therapist, who surprised me by telling me that to her way of thinking, I already am very close to what she would consider “integrated” with the alter I most dread losing, because we communicate freely and are continually aware of each other. She then reiterated that the goal of therapy was to reduce pain and suffering, and improve quality of life, and so if losing a sense of an alter as a separate entity would cause suffering, it would be inimical to the goal of therapy to think about integrating that alter.

    She did feel that trauma-bearing parts tend to naturally relax into the system as their burdens and needs are addressed and healed, but that integration was all about increasing communication, not about elimination.

    Which is pretty much what you’ve said here. It increases my confidence in a highly confusing and frightening process to have consistent information from two professionals who specialize in dissociative therapy. So, thanks for that.

  2. David said,

    On a completely different note — I love it that WordPress thinks a possibly related post is something entitled “Give the Gift of Delicious Beef.” I’d love to know the algorithmic logic behind that one.

  3. Kathy Broady said,

    Hi David,
    I’m glad you liked my post – thank you.
    Yes, it sounds like we are very much talking about the same kind of thing. That’s good news to me too.
    Remember, your system and your healing journey belong to you. You don’t have to do anything that frightens you. Take as much time as you need to process through things. Healing and internal blendings will happen naturally as you do the healing work. Nothing has to be forced. In fact, if you are forcing it, then you are rushing the process.
    Keep up with all the internal chats — sounds like you have a real good friend inside there.
    Kathy

  4. castorgirl said,

    Thank you so much Kathy…
    This supports our own ideas about healing and what it means for us.
    We don’t care about the number of alters in this head, but rather finding ways to make this life work.
    One of us made a joke that with our therapist pushing for integration, our mind will become the latest “Survivor” series – “Survivor DID”… Ok so it wasn’t a particularly funny joke, but indicates our resistance (at the moment) to integration. We aren’t discounting integration, but rather would like it to occur in a supportive environment when we’re more aware of what each of us does and our role in this life.
    Take care…

  5. Kathy Broady said,

    Hi Castorgirl,
    Yes, imho, the actual number of alters doesn’t matter one little bit – everyone is there for a reason, and they’ve managed a piece of your life experience, so.. it is how it is. You’ll have internal leaders, and others that aren’t as active or busy, and as you build relationships with each other inside, that internal cooperation can all be worked out.
    And… seriously, rushing or pushing integration before you thoroughly and completely understand each other will not work anyway, (including knowing and having complete familiarity with each other’s memories, feelings, attitudes, beliefs, realities, etc). So… do the work first — that will keep you plenty busy for a long time.
    Kathy

  6. haberlach said,

    how do you heal abuse if parts are pushing their way out to be heard? Do they heal then we all work to gether? Or do I heal? How do I heal? If integration isn’t healing, what is?
    I am so confused.

  7. Kathy Broady said,

    Hi haberlach,

    A really big important part of the healing process is listening to what the parts are saying. If they are pushing out to be heard, that is a good thing!!! They will contain a lot of the info about your trauma and surrounding life experiences, and healing happens as all of you find comfort, and understanding, and have a chance to speak your truth, and to sort out the confusion you feel, and process your feelings, etc.

    I think that healing comes as the each of the people in your system feel a sense of their own healing. And no, integration is not “the point of healing”. Any integrating or blending that happens is more a result of the healing … Any steps towards being less dissociated and separated from each other are signs of healing.

    The healing happens in the process. Its in the step by step work on the trauma that you and your insiders do. It’s developing the ability to communicate and work as a well-functioning group — its addressing the trauma, and listening to each other. There’s a lot involved in healing. Maybe I”ll add that to my list of ideas of posts to come. Keep reading… there is lots to learn…

    Thanks for the comment —

    Kathy

  8. haberlach said,

    what if they are pushing out just to be close to the therapist, or to get the therapist to hit them? They don’t always come out to talk. One comes out to have sex with the therapist. He NEVER has done anything remotely sexual. One wants to come out to color. But they all push at the same time, it makes for a loud head. Sometimes I can’t even talk.

  9. Kathy Broady said,

    Hi haberlach,
    Oh dear… well, yes, I can certainly understand how all that stuff makes for a loud head. I think it is critical, especially in these situations, to understand what the parts are trying to say through their actions. They may be “showing you” what they know, instead of using words or their voice to “tell you” what they know. Of course, it is important to set appropriate behavioral limits for them, but it is also ok to encourage them to keep talking about what their lives have been like. It sounds like your insiders may very well be testing the therapist, or acting out traumas (that’s called re-enactment). Either which way, it is important to talk about all that is going on for them. Find a safe way to talk about this stuff, and keep working at it. Those insiders certainly need time to address whatever is going on for them.

    Thanks for sharing – I can hear how much you are struggling. It must be so very scary for you.

    Warmly,
    Kathy

  10. haberlach said,

    Thanks Kathy.

    I appreciate your time to answer my questions. I am working on understanding all that you have said.

    I want to clarify the the ‘noise’ and ‘loud head’, if I can. It isn’t physically loud, like in my ears. But it feels loud, lots of energy, commotion, confusion. Now that sounds like someone who is mentally-ill, or crazy.

    I don’t always believe what they say, there is no corroboration. And it seems like someone else is making me move, or talk, but I can still hear, and see most of the time. i just can’t stop what is happening.

    There is so much about this that I just don’t believe , or understand how it could be me.

    So thanks for all your time and effort. You are a special person to choose to work with dissociative people.

  11. Kathy Broady said,

    Hi Haberlach,
    It’s good to hear from you again. :)

    I am going to guess that what you are describing as the “loud head” is just your sensing, “hearing”, feeling the presence of your inside system. So, no, that’s not crazy at all. I promise you, it’s really not crazy, (even if it feels that way sometimes.) It’s the others inside, and I can guess it is a very active inner world in there. Dissociative people typically have internal worlds, internal landscapes, etc. One day, when it’s safe to do so, and when you are ready, you’ll be able to see the other people that you are “hearing” now. In the meantime, you can learn more about your inner people by listening to the stuff you are hearing. It really will all make sense one day.

    It sounds like you have a lot of work to do in terms of meeting your internal people. I understand how that can feel overwhelming, and you can take that as slow as you need to – it can happen tho’, and I bet things will calm down more once you get more of a friendly working relationship with these other parts. There really is a lot to understand about dissociation tho’ — but you will learn. It will be ok.

    Thanks for posting — I look forward to hearing more from you. :)
    Kathy

  12. gobbies said,

    haberlach,

    you sound so much like where I used to be. I guess every now and then I end up there again. I just wanted to share one thing that really seemed to help us with the “loud head” stuff. We left out a notebook in a safe place that anyone could write in. We asked questions and then would come back later and discover that the questions had been answered. It really helped to confirm things for us and also opened up communication. WE also learned that people could mention their needs and wants there instead of just going after them, so we could meet those needs in a safer way.

    Good luck,
    Gobbies

  13. gobbies said,

    Kathy,

    I just wanted to say I agree. Our former therapist was obsessed with integration as she herself claimed to be integrated. I don’t believe she was ans the charade just made me completely opposed to it.

  14. Kathy Broady said,

    Hi Gobbies!!!! :D

    Nice to see you here. :)

    And yes… I’ve met people who’ve claimed to be integrated when it was really really obvious they weren’t. I didn’t understand the pull for it either. It’s a bit scary to think of seeing a therapist who was putting on a charade of integration… hmmmmm……
    Nice to hear from you.
    Kathy

  15. pilgrimchild said,

    My husband seems to think that integration is the ultimate goal. To get rid of all the inside people. When he thinks of me going to therapy, he wants me to “get better and heal”– and in his statement I can practically hear him shouting, “and just STOP being DID!! Get rid of all those people!”
    However integration has not ever been a real consideration for us. Our ultimate goal is cooperation and having good relationships with each other, and functioning properly and appropriately in the world.

  16. juxtapieces said,

    yep, it is as we said
    INTEGRATION = IN – TO – GREAT – IONS = a really big bang and more splitting and more pain. we’ll take a pass on that plate of pain tyvm.
    nobody has to die.
    thank goodness, nobody has to die.

  17. [...] or need to be silenced, or need to be pushed to the back, is damaging to the person as a whole.  Integration is not anywhere near the cure-all or ideal goal it is professed to be, and frankly, expecting [...]

  18. [...] my opinion, integration is not necessary for successful stable functioning.  But, eliminating time loss and/or periods of unknown switching [...]

  19. rociocaro said,

    Kathy,
    You wrote: “My recommendation is to throw that nasty i-word away. Don’t even go there. Instead, use your time and energy to focus on getting to know your people and becoming really good friends with them – with ALL of them, including the insiders that you are afraid of or angry with. Focus on building the connecting bridges instead of smushing and smashing people into each other.”

    I’ve got 2 persecutory introject alters. The only time they talk to any of us is to threaten us with really bad stuff. We’re all scared of talking to them because of this. How do we build connecting bridges with people who say they are going to t*rture us and k*ll us? If these guys had bodies, I’d get a restraining order from the police or move… but they live inside my head, so I can’t. How do we become friends with alters like this?

    Scared, but wanting to heal…
    ~Caro, the Littles, and Crew


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