What is integration?
Integration in its most basic form occurs any time that information is processed. When an individual incorporates a fact into their understanding of their self or an event into their understanding of their personal history, that’s integration. Dissociation can be seen as a failure of integration. When an individual is struggling with depersonalization or derealization, they’re having difficulty processing relevant information about their self or environment in real time. When an individual has dissociative amnesia, their memory of the traumatic or stressful event(s) are kept separate from their other memories and may be accessible only through dissociative flashbacks. When an individual has dissociative identity disorder (DID) or other specified dissociative disorder subtype 1 (OSDD-1), information is stored in separate dissociated parts, known as alters.
Every individual who has been through trauma must integrate to some extent as part of healing. This means accepting that the trauma occurred, making it part of one’s personal narrative, and making it accessible in a way that does not cause intense re-experiencing of trauma elements. In doing so, an individual may have to accept thoughts, feelings, and urges associated with their trauma. For example, an individual with posttraumatic stress disorder (PTSD) may find that as they integrate their trauma history into their personal narrative, they have to also process feelings of helplessness, betrayal, fear, or anger. In terms of structural dissociation, the individual has to integrate the emotional part(s) associated with their trauma, and that means having to take ownership of everything that the part(s) contained.
For individuals with DID or OSDD-1, some or all of their parts likely go beyond simple containers of traumatic materials, and the parts may have strongly developed independent senses of autonomy and self. The individual must then make the choice of to what extent they want to integrate their alters as part of their healing. Again, some degree of integration is inevitable. The individual must integrate traumatic materials in order to heal from PTSD. As well, enough integration between alters must occur to allow for easy communication, a lack of dissociative amnesia between parts, and a consistent sense of being grounded in the present and in the body. The individual must be able to take responsibility for all of the system’s actions, and all alters in the system should work together towards the same goals. Another goal of reduced dissociative barriers between parts is being able to freely access skills, memories, and traits without these being dependent on the alter present.
In order to fully integrate two or more alters (which the ISST-D refers to as “fusion,” with “final fusion” referring to a complete integration of all dissociated parts), the individual needs to take ownership of all thoughts, feelings, memories, urges, skills, and other traits that were previously associated with those parts of the self. Integration is complete when there are no subjective differences between the parts involved; only one sense of self remains. This can happen spontaneously, when conflicts or dissonance between the alter and one or more other alters are resolved; with the help of “fusion rituals”, such as imagery representing unification; or after negotiation between parts and an agreement to integrate.
Katherine Reuben, Integration, 2021 Note: others have noted that this source does have biases and presents some unverified theories as fact (e.g. that DID only develops before a specific age, which is neither proven nor in the criteria). It’s unfortunately still the best source I could dig up for a definition of integration.
The feeling of full integration
The feeling of everything moving in unison, aware that it’s complex but able to move the full weight of self at once, fully comfortable in its contradictions and centered in something more than any of the components that led that direction. The feeling of knowing the meaning of “sum of my parts”. The release from the need to know.
Self-authored, fusion, 2025
Understanding Integration (Excerpts)
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?
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.
I feel sad when I read accounts by individuals with DID who choose to stay dissociative. I fear they do not understand integration as a natural part of the healing process. I remember after I integrated all of the personalities, I was surprised that I still had all of the thoughts and feelings that had been labeled as personalities. I came to realize that the personalities were always and only a collection of thoughts, feelings, experiences and memories that had been separated from normal awareness and from other collections of thoughts, feelings, experiences and memories. After my final integration, I realized that the personalities were a way to describe my internal experience. With therapy, I changed my internal experience and learned new ways to describe my inner thoughts and feelings.
I went through many phases as I integrated the personalities (thoughts, feelings, experiences, and memories). My first integration in 1987 was an exhilarating experience. It was also quite interesting. I lost my voice. It was as if I didn’t know what voice to use without the dissociated parts speaking. With that integration I gained freedom from PTSD, flashbacks, and inconsistent adult functioning. I began to have more normal relationships with my family and friends. I had hope for a full recovery from the trauma.
All of this changed when external traumatic events overwhelmed me and the integrated personalities became separate again. I was devastated. I had had a taste of freedom and peace and I couldn’t hold on to it. My therapist was reassuring and saw no reason why I couldn’t regain the lost ground. I had simply gone back to my familiar defenses in the face of new trauma.
As I continued in therapy I had many experiences of integration followed by disintegration. With the help of my therapist, I learned to view this as a natural process, not a series of failures. I needed practice at being integrated and learning to use new defenses. I stayed determined to achieve stability and freedom through permanent integration.
Before I could achieve a permanent and stable integration I had to make some major changes in my therapy and in my life. I agreed to take psychiatric medication that I had refused for years. I admitted I was an alcoholic/addict and participated in twelve-step recovery. I became willing to try new therapy approaches. I dealt with and gave up the feeling of being special as a person with DID. My therapist used to joke that my treatment goal was to become boring, average, and normal. I agreed as long as he defined normal by California standards (I am from California and a California girl at heart).
My final integration took place over three months in the spring of 1990. I did not participate in any ceremonies or rituals when the personalities merged. I did not experience a sense of the personalities blending into the host personality or into each other. The integration/full acceptance of all parts of myself was based on a series of decisions and shift in therapeutic tasks.
The decision to stop talking about myself in the third person
The first decision was to stop talking in the third person or referring to any thoughts, feelings, or fears as “not me.” By this time, I was mostly co-conscious for the personalities. I was maintaining the dissociative buffer out of habit and fear. I verbally made myself claim everything as me. For example, I might be thinking, “she is afraid of living alone.” But I said, “It feels uncomfortable to admit this but I am afraid of living alone.” The idea and choice to work this way was mine. Somehow I sensed that this linguistic process would move me toward healing and integration. This shift in how I talked was a critical element in my final integration.
Early in this process I sometimes needed to say things like “It doesn’t feel like my feelings but I am angry at you.” Talking this way meant I had to acknowledge my feelings. This process of claiming my feelings, thoughts, and experiences resulted in a natural process of acceptance/integration. It was difficult at first but with time became easier and easier. It felt freeing to claim my whole self. Eventually referring to myself in the third person felt strange and uncomfortable.
As things shifted inside, I discovered that it was OK and manageable to accept/integrate the thoughts, feelings, experiences, and memories. In a way integration is like learning to swim. I had to get in the water to do it. For me the only way to cope with integration was to integrate.
The decision to directly experience internal conflict
Another decision that I made was to allow myself to directly experience internal conflict. Previously different personalities handled different points of view. It was necessary to negotiate between personalities to handle different preferences and opinions. When I consciously claimed the diverse thoughts as mine I discovered that it was OK to have different thoughts and feelings. I could have different viewpoints and still choose how I wanted to act in the present.
When I was dissociated, I had parts of me that believed in God and went to church. Other parts of me didn’t have any connection to God and never went to church. It seemed my attending church and going on spiritual retreats was dependent on which personality was strongest at the time. After I accepted my mixed feelings about God and going to church I was able to choose to regularly attend church while still recognizing and respecting the different feelings.
The examination of trauma-based beliefs
Part of the process of integrating was examining beliefs I had acquired growing up with the ongoing abuse. As a child I learned that having feelings was bad. I learned to hide my feelings in different personalities and fragments. Before I could integrate a wide variety of feelings I had to change my beliefs about having feelings. I came to understand that feelings are a natural aspect of being human. I came to recognize we are born with the innate capacity for feelings. I learned to modulate my feelings and choose how I wanted to handle them. Claiming my feelings was one more way of not letting the abuse control my life.
Acceptance of negative aspects of myself
One of the hardest aspects of integrating/accepting the whole was accepting the parts of me that wanted to hurt others. Because I found these thoughts unacceptable they had to stay dissociated. I made a conscious decision to accept negative, hostile, and hurtful thoughts as one aspect of being human. By this time in the therapy the dangerous and violent personalities had changed. They no longer acted on thoughts and feelings. They were able to separate the past from the present.
The therapeutic task was to integrate/accept my hurtful thoughts toward others. The integration was made possible by learning non-dissociative coping for handling the thoughts. For example, I learned to self-talk my way through the feelings. I could say to myself, “It is human to have hurtful thoughts. It is understandable after all the abuse I suffered that I occasionally think of hurting others.” I discovered that the hateful thoughts often were a way to avoid feeling vulnerable. When I allowed myself to feel a wide range of feelings the angry/hurtful thoughts would recede and pass.
The realization that nothing is lost
When people ask if you lose parts of yourself when you integrate, I often want to chuckle. I would have been glad to lose the angry/hurtful/hateful parts of myself. I would have liked to not have negative feelings. But integration is accepting the whole me. Even as I integrated/accepted the positive parts of me, I also accepted the negative parts of me. It’s all there. Nothing is lost.
There is a kind of paradox with integration. One of the fears expressed by individuals with DID who choose not to integrate is that parts of the self will be lost, disappear, or die. The reality is that after integration the parts of the self are actually closer and more real than ever. The dissociative barrier is gone and the aspects of the self are now experienced directly.
Maintaining long-term integration takes work just as maintaining long-term sobriety takes work. I try to stay on top of my feelings and not push any of them aside. Hidden feelings are the fodder for dissociation. I do this primarily by talking with friends. Sometimes, I write in my journal or write poetry. I ask for help when I need it and have returned for therapy depending on the issues that have come up. I invest in my relationships and send birthday cards and thank you notes. I make certain my life doesn’t get too busy. I schedule down time, ranging from all day in my nightgown to a weekend of spiritual retreat. This is important since I have discovered exhaustion or over stimulation leaves me vulnerable to intense feelings. I try to eat sensibly and exercise regularly. I see my medical doctor when I have symptoms that need evaluation. I still don’t watch violent movies. I respect my past and try to live in the present.
Rachel Downing, Understanding Integration, 2003
The metaphor I like is of melting ice. Before the abuse started, my spirit was like a pond where each part flowed into the next. The abuse caused the pond to ice over, and repeated abuse caused the ice to split off into separate chunks, which is what I experienced as alter parts. I was still one pond even though I felt like a bunch of separate chunks of ice. Integration happened by melting the ice back into water through the warmth of self-love. Nothing was lost – it was just experienced in a different way.
Downing talks about integrating and then losing that integration for a while (what she calls “disintegration”). I experienced this as well, but I think it was less stressful for me (perhaps because I had her article as a guide). When I am not dissociative, I experience the world around me differently, as if I have been beamed into my life and am really “here.” I will have moments of feelings extremely present like that, which I see as a guide for where I am heading. However, I don’t stay in that place for long periods of time.
Most of my progress is gradual. As an example, I will find myself getting overstimulated by sights, sounds, or smells as I move into a deeper level of integration because, thanks to living most of my life in a dissociated state, I haven’t had to deal with overstimulation. I would simply switch from one part to the next and avoid having see, hear, or smell whatever I didn’t want to process. Being integrated means experiencing the good and the bad – being present to enjoy the smell of freshly cut grass but also present to get the waft of a garbage can.
Faith Allen, Integration from DID: Phases of Integration, 2012