INTEGRATION
First Awareness, Coconsciousness, Final Integration
Integration is a complex and protracted process for multiple personality disorder patients that can extend over months and in some cases years. Integration is not complete until the last of the multiple personalities has revealed their traumas to the core personality.
While each individual's journey is different, there are similarities amongst those who have endured trauma before the age of five.
The process of integration involves three stages.
Stage I: First Awareness
During this stage the individual realizes that they are different from others but may not be able to explain in what way they are different.
Stage II: Coconsciousness
This stage refers to the person's first awareness of having other identities. The achievement of coconsciousness represents a major milestone in the healing process. It is during this stage that the personalities begin to communicate with one another.
Stage III: Final Integration
This stage calls for re-experiencing every major trauma including the ones that resulted in the original split in the child's identity. Over the course of this stage all personalities come to experience themselves as one person.
For the patient, Final Integration is often a confusing and painful process, marked by setbacks amid progress. Lillian's journey to Integration is described in Chapters 1, 19, 21 and 32 of, “Lillian, A True Story of Multiple Personality Disorder.”
Chapter 1 : First Awareness
It is in this chapter that Lillian becomes aware of her personality parts.
"Lillian Mason was having difficulty controlling her children. She had been going with her sons to a family clinic for several months. The children insisted upon telling things to the therapist that Lillian knew nothing about. She was sure that they were lying... The therapist's report said that Evan came home from school to an accusing mom. A whole set of dishes was broken... Evan denied it. One day the director of the clinic met her at the door. He proceeded to replay the tape recording from the previous visit. Lillian was shocked to hear a small child's voice plaintively calling out, "I dis' want someone t' love me." [pp 23 -24]
Chapter 19: The Milestone of Coconsciousness
During this stage the personalities not only become aware of one another but also demonstrate the ability to cooperate with each other. Lillian’s Aunt Jean, unrestrained by the formal training of psychiatrists at the time, did what no psychiatrist could have done. She devoted ten years of her life to Lillian’s triumph over multiple personality disorder. She became friends with 22 personalities over a number of years, playing hide-and-seek with 4-year-old Mary, teaching 5-year-old Amy to write and to play the piano, and shopping and communicating endlessly with many of the others by telephone, letters and in person.
Jean’s memoir of her experiences and observations are shared throughout the book.
Jean As Narrator:
"A student of mine... asked whether I would be willing to provide a program on child-abuse with each part speaking for her/himself... We planned a two-part program... the second part would incorporate as many of the personalities as I could convince to speak publicly. I talked with (Lillian’s) various personalities about what they would like to present... I pointed to a sheet of paper on the card table, asking who wanted to present and what she/he wanted to share.
Each part answered differently... how wonderfully they all cooperated with me and with one another." [pp 181-183]
Pseudo Integrations
It is not uncommon for people with multiple personality disorder to present with pseudo integrations as their personalities schedule a time and a date to express gratitude, say farewell and prepare to vanish. Chapter 21 captures this integration process.
Lee Marvin, one of Lillian’s male identities, wrote in his final journal entry: "Hey Lillian. This is Lee. So now I don't take up no more of your time. I'm going to clear out. No pot. No pills. No fake anything. No guns. I'm going out clean and square. Ciao. Lee.” [p 205].
Paradoxically many multiple personality disorder patients initially experience integration as a loss of identity, as if they are losing the parts of themselves.
No longer able to rely on their parts, MPD patients typically think of themselves as failures. During this period patients may find themselves overwhelmed. Fearing that they cannot function without their parts, many MPD patients attempt to create new personalities. This was the case when Lillian created Chris, a female identity who did not emerge from past trauma.
"...Lillian out of her desire to protect James has created the new personality of Chris to oversee and protect him."
Lillian’s feelings of failure, captured in journal entry of 02/15/83.
"The house is a mess. Dishes need done. Clothes need washed. James needs….I need my hair cut. I really am awful…..I'm a failure. I’m not a good cook or a good wife or a good mother or housekeeper... I could create a Lil who has my memories... until the perfect Lil has all her kinks worked out. Till she feels comfortable as me only. She would fit in better than me and be more acceptable…
I know I'm nothing but a failure as Lil... It was the "others" that made friends, that could do everything... that kept our house working, the meals cooked, things running smooth. to be acceptable I should not be me.”
One of Lillian's journal entries likened the loss of her parts to being dismembered: "I keep seeing this scene when I'm trying to sleep or clear my mind, not to think - a silver knife - butcher knife and me being cut off-cut into pieces…"
Lillian also created a new personality, Kathy, not in an attempt to shield Lillian from past trauma but rather as an ill-conceived attempt to rely on an old coping mechanism to deal with the current situation. Lillian's journal, Thursday, March 10, 1983: "My name is Kathy. I like that name better than Linda. Kathy is a girl who works here at this place.”
Chapter 32: Resolving the deepest of Lillian's traumas
Lillian's belief that she was possessed by evil is pervasive, mentioned in all but a few of the chapters. It was this underlying belief that delayed her healing process. Once Lillian’s original trauma was identified by her psychiatrist, Lillian regained the memory for the personality that she called, "The Sleeping One." Lillian's original trauma eventually morphed into the belief that her soul was taken by Satan at the time that she underwent surgery for vaginal scar tissue that was the result of sexual abuse by her mother.
"... Dr. Kluft uncovered a personality that they call The Sleeping One. Lillian believed that the sleeping one had her soul. Lillian believed that she could not get well until her soul was returned to her." [pp 291].
The Integration of Rose
Rose’s integration was pivotal to healing. Rose, the most violent of her personalities, held all of Lillian's homicidal rage towards her mother. Although Lillian was aware of Rose and knew of Rose's trauma, she had not resolved Rose's murderous rage.
Jean wrote: "Lillian's road stretched out endlessly before her, as she as one-person contained all the feelings that the personalities had kept secret from her for so many years." [p 292]
Lillian’s mother Jessica was diagnosed as a paranoid schizophrenic but never treated. In addition to ongoing physical abuse throughout Lillian’s early childhood and teenage years, Jessica allowed Lillian to be abused by her stepfather, older sister and step brothers. Later, when Lillian discovered her mother had been moved to a nursing home, she resolved to kill her, driving to the nursing home with a knife concealed in her pocketbook.
"Now fearless Lillian walked boldly towards Jessica fully intending to kill her. In that moment instead of hatred Lillian felt nothing. Lillian turned and walked out of the nursing home leaving her feelings behind." [p 293]
It was the resolution of Rose's rage and the uncovering of The Sleeping One’s belief that she was possessed that finally freed Lillian to live as a person with one identity.
Reflecting on Healing
Lillian wrote:
"Where am I now? All my time is my own. Not lost.
There are tears by the bucket for the lost years that I now remember, along with the feelings... but I'm staying one-person. There are frustrations, glaring mistakes, faltering steps and once in a while, success. I am relearning.
My husband and children continue to stand by me. I know now how much they love me.
Childhood abuse is just beginning to command the attention it needs. Much remains to be done. If my story helps even one child victim of abuse my life will have been valuable." [p 302]
Lillian's story serves as a beacon for those afflicted with multiple personality disorder.
