December 18, 2008

Integration: A Requirement for DID Therapy – Or Not?

Posted in Dissociative Identity Disorder, Therapy and Counseling, DID Education, DID/MPD, therapy, mental health, Integration - yes or no tagged Abuse, Amnesia, Amnesiac Wall, Blending, Breaking Apart, Bridge, Bridging the Gap, Communication, Connecting, Cooperate, Cooperation, Deny, Denying, DID / MPD, DID Therapy, Different Selves, Discussing Dissociation, dissociate, Dissociation, dissociative, Dissociative Client, Dissociative Identity Disorder, Dissociative Split, Dissociative Wall, Failed Integration, Forcing Integration, Harm, Heal, Healing, Insiders, Integrate, Integrating, Integration, Internal, Internal Group, Internal Selves, Kathy Broady, Mental Health Professional, Peace, People Inside, Process, Reality, Satisfaction, Selves, Separate, Separate Self, Separate Selves, Separateness, Separating, split, splitting, System, System Blending, System Cooperation, System Work, Teamwork, therapy, Therapy Work, Trauma, trauma therapist, treatment for DID, Treatment Goal 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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