Thoughts on Integration – What does integration feel like?

Discussion of metaphors for integration that may help those without DID understand that most of us are not discretely different “people” and that integration is a process and not an event. Through “post traumatic growth,” which includes awareness and cooperation of the parts, individuals can become stronger

Those three fluid phases of healing

The three phases of healing are not linear, but iterative. Stabilization, trauma work, reconnecting…it appears to be a somewhat fluid flow. [Hermann] Stabilization gives the protective environment to actually consider the trauma memories you’ve shoved away (not necessarily repressed, but hidden very carefully behind a thick wall). But then understanding and processing of these memories may require a period of re-stabilization.

Throughout this comes better understanding of the parts/selves you have split into, and then the first sharings of memories held by other parts of you. Back to square one for a bit.

My therapist continually cautions me that everyone’s recovery is different. “You are a fingerprint – each patient is different.” For the part of me who wants a map, a plan, an endpoint, this is all very difficult. But we are better coming to terms with the uncertainty.

What is integration?

The internet contains much generic information on integration, but I found a lack of concrete examples, other than snippets of anecdotal stories on forums. You should read about selves/alters/splits before exploring the integration of these parts.

For completeness, a generic and sterile definition:

The goal of treatment is usually to integrate the personalities into a single personality. However, integration is not always possible. In these situations, the goal is to achieve a harmonious interaction among the personalities that allows more normal functioning. [Merck]

I can’t imagine a world where certain parts of me are “gone.” I’ve argued against “killing” alters – not gonna happen. Not healthy. Instead, I spoke of removing the walls that have been used to separate them. Integration is not about eliminating who I am. It is about repairing the rifts so the parts can work together.

One visual image I have is a slew of cupcakes all shoved together in a pan. They are all pressed together, but separated by those little colored paper holders. If you could grab all the paper holders by the bottom and slide them all off…removing the walls…the first step in integration.

Tearing down the fences that separate my backyard from yours…casual conversation starts, maybe you see me one summer day and spontaneously invite me over for a beer or a casual BBQ. Like integration, those interactions can’t be forced; but they can be facilitated. But I imagine that they happen over time, with growing familiarity among the parts.

I’ve also used the analogy of a river. Image the confluence of two rivers – before they join, there are four banks. At the confluence, the waters join within now only two banks. But for a distance beyond that point of joining, the individual rivers still run side-by-side; not yet mixing for some distance. One step in integration is the awareness of that other river, the removal of the physical barrier – those walls, although the core of each river continues at its own speed, salinity, turbidity for some time. But mixing eventually occurs – work to begin sharing memories, negotiating boundaries, and in essence, getting to know one another. While I am only partially there with a handful of alters, I extrapolate forward to a time when these parts begin working together more seamlessly; the switches between them less obvious. A sharing of expertise.

Some will be harder than others. As my recent month of rage, anger and partial amnesia can attest to.

Integration is perhaps the opposite of dissociation

Zimberoff presents a nice definition, “The underlying mechanisms of dissociation [are], namely, splitting (alterations of consciousness) and fragmentation (compartmentalization).”

Dissociation, then, incorporates two elements: compartmentalization (the lack of integration of psychological processes that should ordinarily be accessible to conscious awareness) and alterations of consciousness (aspects of the individual or environment are experienced as unreal or experientially detached from the self, with reality testing remaining intact).

Dissociation is a global term that can refer to a wide range of experiences, depending on what is being detached, what “compartment” it is being contained in, and the degree of memory access to the contents of that compartment.

This feels right. Feeling the detachment of one’s self from reality while being aware of it is a strange feeling – almost dizzy; the room shifted slightly to one side. Looking at your arms and legs – they seem so far away. Or too big or too small. Sometimes it is similar to that strange feeling you get right before you pass out – pulling back from reality, the vibration and ringing in your ears, tunnel vision.

This splitting of personality in children has been referred to as “the psychic equivalent of the body’s going into shock.” [Fosha, via Zimberoff]

Is integration necessary?

This topic is another can of worms I’d rather not delve into now. My personal belief at this time in my therapy is that total integration is not required. Cooperation, awareness, and avoidance of self-sabotage and self-injury are. But I have no clue at this time.

For complete disclosure, I have had some cooperation, some awareness, but still some self-sabotage and self-injury. But hey, half-way is better than no-way, right? Heh heh.

So yeah, I/we still have some work to do.

Can integration really “fix” things?

Being that with DID there was never really was a “whole” adult-like person to begin with, it is hard to estimate what the “final product” may look/behave like. I’m not gonna speculate. But it seems along the lines of “the whole is stronger than the parts.” (God I hope.)

I read about the strength of that final person. Tedeschi & Calhoun wrote about something called “posttraumatic growth”:

Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life”

Akin to survivors of accidents or those with life-threatening medical conditions, who credit their trials with “changing their lives for the better” or “giving them a new appreciation of life.”

Zimberoff continues the theme, inverting many of the symptoms that folks with PTSD/DID present. She advocates repair, not elimination.

Strength of character, resilience, determination, deep trust all come from repair of disruption in intimate relationship, not through eliminating any disruption. Likewise, the growth of the human being spiritually is achieved through the repair of the bond with his/her soul following disconnection (miscoordination). [Zimberoff]

Zimberloff quotes Khan, who counsels that pain and joy are part of life. “Joy is in discovering that it is OK to suffer”.

“It’s part of being human, to have little bits and pieces that are cracked. I play the cello. Some of the eighteenth-century cellos are very badly cracked, but they play more beautifully than the perfectly made modern ones.”

She adds, “This is a poetic statement of what the clinical evidence documents, that repaired disconnection is stronger than the original bond.”

The article is long, with a spiritual bent, but covers some great ground on ego states, Jung, concept of the soul and splitting, etc.

What does integration feel like?

Beats the shit out of me.

My meds doc says the first step is co-consciouness. Well, I have that with some, and not with others. But recently I got a couple-week’s experience of partial awareness and sometimes partial co-consciousness with a rageful part of me. I cannot imagine what it will take to reach the same level of co-conscious with that part of me and still be able to survive. That part of me is now back behind the wall and has been for nearly 5 days.

I have a good friend with DID who has been to several therapists. She has one who has been able to deal particularly well with anger issues of one of her selves. So, I suppose that the angry part of me has to go to therapy and figure out what coping skills she can use. You can see from a previous post that she is extremely angry over not having them. And that lack scares me.

Integration with her will likely occur only after she is able to address the rage and step back from the edge of the cliff. I am scared to think what integration and continual co-conscious with that part of me will be like. It was horrible before and I was heavily medicated in order to survive. Sometimes I was fully with her and could feel the rage; other times I could only watch from the outside and wonder where my car would go. My therapists have said my recovery will get harder before it gets better, and finally I am understanding that in a big way – no longer intellectually, but physically and emotionally in the first person.

If I ever get to the point of partial or full integration, I’ll have to let you know.

References

Zimberoff D (2006). Soul migrations: traumatic and spiritual, Journal of Heart Centered Therapies
http://www.thefreelibrary.com/Soul+migrations:+traumatic+and+spiritual-a0145682142

Herman, J. (1997). Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror, Basic Books.

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18. (quoted in Zimberoff (2006))

Khan, P. V. I. (1998). In conversation with Pir Vilayat Inayat Khan: Nitty-gritty spirituality. In A. A. Simpkinson & C. H. Simpkinson (Eds.), Soul Work: A Field Guide for Spiritual Seekers, 333-337. New York: HarperCollins. (quoted in Zimberoff (2006))

The Merck Manuals: Online Medical Library. (2003). Dissociative Identity Disorder, accessed from http://www.merck.com/mmhe/sec07/ch106/ch106d.html

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3 Comments»

  emilylonelygirl wrote @

(a misplaced comment)
davidrochester

My therapist has an analogy for integration that I particularly appreciate … she describes it as being like a braid, in which each strand is still distinct, but the strands are interwoven and they move together. This doesn’t sound to me like getting rid of anyone … it sounds like getting us all on the same page, which feels OK to me. I don’t know whether it will ever happen, but that particular image is good for me.

  emilylonelygirl wrote @

David

Sorry your comment got placed on the other blog. I was playing around with transferring entire blogs and I accidentally left copies of articles from THIS blog on THAT blog.

Emily

[…] *Raises eyebrows* Remember, integration is not killing. […]


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