I have written on this subject before, but a recent discussion that turned up in my Twitter page caused me to decide to write about it again.
In the DID community, the debate rages about integration. The “I” word, as many call it, means to some pulling together to be a singleton and to others death to their alters.
I have spent a considerable amount of time reading research papers and trying to understand the causes of dissociative identity disorder. My hope is to shed light on not only the disorder itself but the recovery process involved in healing from it.
I believe with all my heart that neither belief is true and that integration means something different entirely.
It has been pointed out to me by one of my readers that I use the words child abuse and abuse a lot during this piece. She is right in her saying also, that it isn’t only neglect and child abuse as society sees it, that can cause DID. In fact, dissociative identity disorder can form due to young children living in a war zone or even from being held captive in camps such as the United States currently with its imprisonment of thousands of kids.
So, while I use the word abuse often in this piece, please keep in mind that not all cases of DID are caused by the same triggers and that no two cases are alike.
To get to the meat of what I mean by integration being something entirely different than what is often believed, we must first wade through some important information about brain and personality development.
So, hang onto your hats folks, the road may get bumpy for a while.
Normal Formation of a Young Child’s Brain: Synaptic Pruning
At birth, children are born with an enormous number of neurons (brain cells), over 100 trillion. That is as many neurons as stars existing in the Milky Way galaxy. However, these synapses begin to be pruned beginning before the age of 7 years.
The best definition of synaptic pruning I found is as follows:
“Synaptic pruning is a natural process that occurs in the brain between early childhood and adulthood. During synaptic pruning, the brain eliminates extra synapses. Synapses are brain structures that allow the neurons to transmit an electrical or chemical signal to another neuron.
Synaptic pruning is thought to be the brain’s way of removing connections in the brain that are no longer needed. Researchers have recently learned that the brain is more “plastic” and moldable than previously thought. Synaptic pruning is our body’s way of maintaining more efficient brain function as we get older and learn new complex information.” (Healthline.com)
Between the ages of 2 and 10 (average age 5 years), a child’s brain prunes about 50% of the brain connections that are not being used and so are not needed.
Researchers have been aware for a long time now that abuse mixed with genetics sets up an abused child for a perfect storm. It is in the interaction of genes and experiences that shape the structures of our brains that there has been found a definitive link between childhood maltreatment and changes in synaptic pruning and brain structure.
More about brain structures in a moment.
Child Abuse Changes the Types of Neurons (Brain Cells) That are Pruned
Experiencing child abuse early in life can dramatically change the number of neurons in the brain and can both increase and decrease their ability to communicate with one another. These neuronal changes can change our personalities because the basis of pruning is to get rid of synapses that we do not use or need. Unfortunately, which synapses we rid ourselves of is based largely on our experiences.
The neglect and abuse by caregivers hijack our experience-based pruning and development of brain cells leaving us emotionally scarred and with deficits in our world view.
We believe, even as very young children, that the world is a scary and uninviting place.
These detrimental changes to our brain mean that we developed attachment problems because our caregivers were either neglectful or caused us to fear them.
Thus, the brain circuitry we had at birth that predisposed us to attach to our caregivers and helps us develop a positive world view are pruned away and can never be reformed again.
Other Brain Structures and Damage Done by Childhood Abuse
The first brain structure we will examine is the amygdala, followed by the hippocampus.
When humans become frightened, a complex set of cascading events occur in our brains and bodies.
The fear response begins in the amygdala, a small almond-shaped section of nervous tissue that is located deep within our brains and is part of the limbic system. The amygdala is responsible for emotions and remembering danger so we can avoid it in the future.
This tiny structure is the first part of our brain to recognize danger, and when it does it produces cortisol, a stress hormone. This hormone alerts the body to the danger and readies it for the fight, flight or freeze responses.
The hippocampus is a small seahorse-shaped structure that is also located deep inside our brains and part of the limbic system. The hippocampus plays an important role in memory formation and storage.
Several papers have been written noting the significant changes in the size of the amygdalae and hippocampi of people living with dissociative identity disorder. The changes reported in a paper by Vermetten, Schmahl, Linder, Loewenstein, and Bremner published in the American Journal of Psychiatry found:
“Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with dissociative identity disorder, compared to the healthy subjects. The ratio of hippocampal volume to amygdalar volume was significantly different between groups.”
A book written by Pablo Nepomnaschy and Mark Flynn explains why these structures are so badly affected.
If you remember, the fear response involves the release of the hormone cortisol. When children are subjected to abuse repeatedly, the cortisol is continually being pumped into their little bodies and never returns to baseline. Cortisol is poisonous to developing brains and these vital brain structures are severely and irreparably altered.
Childhood Trauma Also Disrupts the Normal Formation of the Self
It is during this stage of the downsizing of unneeded brain cells connections that our personalities begin to experience the development of the self. Dr. Ganz Ferrance Ph.D., who works for Andrews University in Michigan in the U.S. states that,
“A child can have a fairly developed personality — or at least personality tendency — by 7 years old, or even earlier, by 4 or 5 years old.”
So, before the age of seven children begin forming a cohesive self, but what happens if this formation is disrupted by childhood abuse?
Preschool children are unable to use a large range of coping skills to handle what is happening to them when they are abused. The only tools they have and must depend on are denial and dissociative strategies (Beitchman, Zucker, Hood, DaCosta, & Akman, 1991).
From a developmental perspective, childhood abuse compromises the ongoing development of the child’s perspective of self. This means that not only are children left depending upon denial and dissociation to cope, but they are at high risk of developing several mental health disorders including dissociative identity disorder (Afifi, Henriksen, Asmundson, & Sareen, 2012).
Okay Shirley, What Does All This Stuff Have to Do with Integration
As I stated in the beginning, there are two arguments about integration that are in competition with one another. One is that we can integrate and become a singleton, and the other that integration is the death of the alters in a multiple system.
For starters, let’s address the first thought.
If you have read carefully the information I have provided above, you may have already realized an important truth about dissociative identity disorder. We can never become singletons because the brain cells we needed to become a cohesive “I” have been pruned away a long time ago.
In essence, we have missed a vital milestone in the development of who we are and cannot go back.
As an answer to the second question, I offer this thought. It is impossible for the alters in your system to die. They are you and you are them. If one of you dies, you all do.
An Alternate Definition of Integration
Integration comes in five stages, discovery, acceptance, cooperation, closure and fusion. The first four stages, like the stages of grief, aren’t accomplished in order. Rather they are steps that we enter and reenter numerous times during the healing process.
These stages cannot be rushed, nor can they be accomplished overnight. It takes years and sometimes decades to put, as much as humanly possible, to rest the traumatic events that caused our personalities not to coalesce properly as kids.
I think the reason people give up on the idea of integration altogether is because they have reached what they believed was the fifth stage, fusion, but things fell apart later. Their expectations of what fusion means and their rush to reach it left them with a bad taste in their mouths.
Fusion, the final stage, takes a long time to reach with the longer the abuse occurred making the process longer for some than others.
Fusion isn’t a perfect union of all the alters in a multiple system at all. Rather it is a pulling together and pooling of all the memories and aspects held by each personality to that point.
However, it also means we stop saying “WE” and pushing off events or behaviors onto alters and start speaking of ourselves in the language of “I”. We also take full responsibility for our actions and behaviors.
The power of fusion cannot be understated.
As a “ME” I am in control and responsible for not only the strange things that I may do but also the good things I accomplish because I am not living in the hell of dissociation.
Does this mean there won’t be problems come up in the future?
No. Given the right amount of stress, I and you will fall back on a coping mechanism that helped us survive our abuse pasts and dissociate. However, these events become rarer and rarer as we continue to flex our muscles as an “I” and continue traveling down the road less taken to healing.
More references to papers you can read online are listed below the quotes.
I normally only leave you with one quote but I found the following quotes and wanted to share them with you. They speak of acceptance, important lessons we can learn, and about life after an abusive childhood.
I hope you enjoy them as much as I did. Shirley
“Experience has taught us that we have only one enduring weapon in our struggle against mental illness: the emotional discovery and emotional acceptance of the truth in the individual and unique history of our childhood.” ~ Alice Miller, The Drama of the Gifted Child: The Search for the True Self
“This is an important lesson to remember when you’re having a bad day, a bad month or a shitty year. Things will change: you won’t feel this way forever. And anyway, sometimes the hardest lessons to learn are the ones your soul needs most. I believe you can’t feel real joy unless you’ve felt heartache. You can’t have a sense of victory unless you know what it means to fail. You can’t know what it’s like to feel holy until you know what it’s like to feel really fucking evil. And you can’t be birthed again until you’ve died.” ~ Kelly Cutrone, If You Have to Cry, Go Outside: And Other Things Your Mother Never Told You
“Do not let the memories of your past limit the potential of your future. There are no limits to what you can achieve on your journey through life, except in your mind.” ~ Roy T. Bennett, The Light in the Heart
“Life is all about evolution. What looks like a mistake to others has been a milestone in my life. Even if people have betrayed me, even if my heart was broken, even if people misunderstood or judged me, I have learned from these incidents. We are human, and we make mistakes, but learning from them is what makes the difference.” ~ Amisha Patel
Further Research Papers You Can Read
Brain changes brought on by childhood trauma:
Changes in the amygdalae and hippocampi in dissociative identity disorder