Contents

• Introduction

• Defining Integration

• Reasons to Integrate

• Lessons Learned from the Recovery of Children with DID

• Phases of Integration

  • Integration of a Personality Fragment

  • Integration of a "Dangerous Personality"

  • Integration of Trauma Memories

  • My Concerns About Integration

  • Learning to Give Up Dissociation

  • My Final Integration

  • The Decision to Stop Talking About Myself in the Third Person

  • The Decision to Directly Experience Internal Conflict

  • The Examination of Trauma-Based Beliefs

  • Acceptance of Negative Aspects of Myself

  • The Realization that Nothing is Lost

• Life After My Final Integration

  • The Joy of a New Life

  • Dealing with a Serious Illness

  • Experiencing Physical Pain

  • New Memories

  • Maintaining the Integration Over the Years

• Conclusion

  • Resources, Books and Articles

By Rachel Downing, L.C.S.W.-C.

Introduction

The purpose of writing this article is to provide survivors with DID and therapists who treat DID with a greater understanding of integration and life after integration. One of the least understood aspects of the treatment of Dissociative Identity Disorder (DID) is the concept of integration. Information on this topic for professionals or individuals with DID is limited. Therapists may have difficulty explaining what integration means and how it will benefit their clients. Individuals with DID often express fear of integration. Sometimes survivors feel that the integration of personalities is disrespectful of the important role they have played in their survival.

In material written by DID survivors, integration has been referred to as the "I" word. In a recently published book for survivors with DID, therapists are advised not to discuss integration with clients until the latter stages of therapy, when the issue of what to do about the personalities needs to be faced. Survivors write (and talk on TV) about their right to remain DID and not have integration forced on them by therapists.

One recently published book about recovery from DID written by several individuals supposedly recovered/integrated did not live up to its billing. Some of the authors acknowledge that they still are dissociative, yet they consider themselves healed. I attended a workshop held by two individuals integrated/recovered from DID. When asked whether integration was a necessary part of healing, they considered it a personal choice. They were unable to articulate the advantages of integration and non-dissociative coping.

When I read material written by individuals who fear integration and choose to stay dissociative, I sense that the decision is based on inadequate understanding. It is very human to fear things we do not understand. Fear of the unknown holds people back, whether DID or non-DID. Without more information about integration and trauma recovery, how can individuals with DID be informed consumers and make knowledgeable choices?

As a fully integrated person (formerly DID) and a trained therapist, I decided it was important to speak out about the naturalness of integration, the benefits of integration, and the peace that comes with full acceptance and ownership of all parts of oneself. I want survivors to understand integration as a friend, not a foe. To see integration as a goal not set by therapists, but sought after by survivors who want normal lives as whole people.

In 1990, I experienced my final integration after 11 years of DID therapy. When I was going through the process of integration I searched for information about the process and what to expect. I was disappointed that practically nothing had been written either for therapists or for clients.

When I reviewed the literature on integration this year for this article, I discovered how minimally the issue of integration and post-integration therapy has been addressed even now. Given that integration and post-integration therapy is estimated to require one-fourth to one-third of the total treatment, this lack of information is surprising. Overall I was disappointed with the lack of usable information for survivors and therapists about integration. For a current review of the literature and websites on this topic see the appendix to this article.

Defining Integration

At the most basic level, integration simply means acceptance/ownership of all thoughts, feelings, fears, beliefs, experiences and memories (often labeled as personalities) as me/mine. It means giving up the split(s) that says something is "not me." Integration is more than about personalities. It is about full acceptance of all dissociated aspects of oneself. Integration is a process not an event. It occurs throughout therapy (and outside of therapy) as dissociated aspects of one's self become known, accepted and integrated into normal awareness. It is a natural process in the recovery from trauma. It brings a kind of peace that comes with fully accepting and loving yourself.

Integration occurs when I accept a dissociated personality, part, or aspect of myself and bring it into normal awareness. It is not about getting rid of or killing off a part of myself. When I maintain the split and say it is "not me," I am implicitly rejecting that part of myself. Essentially, integration is fully embracing each and every part/aspect of myself.

Full acceptance allows greater self-control and choices. This is true not just for individuals with DID, but for non-DID as well. For example, when I deny, reject or dissociate that I have a problem with binge eating, I am not able to work on the problem. When I admit/accept that I have the problem, I can take action to deal with my feelings and choose new ways to handle the problem. With DID, when I deny/reject a part of myself that wants to cut/hurt me, I can't control that part of myself. When I incorporate that part of myself I gain control and choices.

continue: Reasons to Integrate

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Written 2003. Reviewed: 04/2006