Transcript: Episode 144
144. Differentiation and Integration
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[Short piano piece is played, lasting about 20 seconds]
So I was doing some research for something else and stumbled upon an old article that I thought was pretty interesting and worth sharing on the podcast. The name of the article is called Overt-Covert Dissociation and Hypnotic Ego State Therapy by John G. Watkins, and Helen H. Watkins. So the article is from 1996, I think. So it's definitely an older article. But it was interesting in just using some terminology that I did not previously understand how it applied to dissociative identity disorder specifically. So I thought I would share.
There were several different things that were really interesting in the article. Specifically, some terminology, as I said. And so one of the first things that the article did was clarify what it meant by integration and by differentiation. These are terms I've heard previously in general therapeutic settings. But I had not considered them as applicable to DID other than the big drama about integration itself and what that means about sort of combining everyone together or not, or do people disappear or not, and what all that means. And we are not anywhere, we are not dealing with that in therapy at all right now. And so I don't even want to get into that or stir that up. And I know that for some people, it can be a pretty triggering topic. So I'm not talking about that. But I am talking about the process of integration and differentiation, as used in this article.
So what they say in the article is that both processes, integration and differentiation, are actually part of normal human development. So the example it gives is that when a child is learning to put concepts together, that are different things but belong to categories, that that's what integration is. And so it gives the example of a child recognizing that a dog and a cat can both go into a category like animals, or pets. Or specific overall ideas when you can start grouping language together and concepts together into the same thing, even though they're different items, that that's what integration is. But then at the same time, what differentiation is, is being able to tell the difference between a safe dog that you could pet or play with, and a not safe dog that is dangerous or scary. So they, a child might say, “Good dogs and bad dogs,” for example. So integration has to do with the grouping of similar concepts together, and differentiation has to do with being able to discern the difference between those. So for example, our children are old enough that they would be able to name several different kinds of cereals as breakfast foods, but they can also name specific cereals in that category and which ones they like and which ones they don't, which ones are healthy and which ones are not.
Does that make sense? So that's kind of how it works. But then in the article, they say specifically, quote, “when this separating or differentiating process becomes excessive and maladaptive…,” so there's the maladaptive word again, “…we call it dissociation.” So that's interesting to me, because that's an internalized experience being differentiated instead of an external category being differentiated. So my children could know that baked beans on toast, or cereal, or oatmeal, or eggs and bacon, or all these different things would be breakfast foods. But they could also identify which of those breakfast foods are healthy and which ones are not. Or if you use their example from the article about animals, our children, or outside children, are old enough that they would be able to name all kinds of animals, which the article is saying is an integrative process. But they could also differentiate between which animals lived on the farm, and which animals live in the desert, and which animals live in Africa, and which animals live in Australia. And so they are able to do those things.
But what this article is saying is that when differentiation becomes extreme, that actually becomes an internal process, almost so that the experience itself is what's not being integrated, rather than an external category. So it gives the example of an integrative process is knowing that you see your friends in a different setting at school or at a party. But differentiation is being able to experience one set of behaviors at a party on Saturday night, and another at the office during the week. And so recognizing that externally, but also yourself. Being able to, not perform exactly, but to be present in both scenarios, but also be able to distinguish how you should behave in each one, that that's part of normal development, and even evidence of normal development. So it makes sense that we behave one way with our friends, and another way with the outside children, and another way at work, and another way at home when we're alone and able to do whatever we want in our free time. But according to this, an integrative process would be the capacity to be aware of all of those different experiences and expressions in context of those experiences, but also aware of the differences. So knowing almost in a pro social way, except as an internalized experience, of knowing what part of you is needed to do what function and what experience or how to express a certain way that's appropriate to the context. But also being able to differentiate between them so that you're appropriate for the context. It's okay to scream and cheer at a football game, and not so much in the library, right. And so, being able to do that.
But they're saying dissociation like DID is an extreme version of that where it's so differentiated that you don't necessarily have access to the other parts of you or in the other context. And so that's why the maladaptive word comes into play. Because when we have the wrong expression in the wrong context, like cheering the football game at the library, then it's not appropriate for the context. Which brings sort of almost some social justice issues into it of whether you can really measure that or not. But that's how they're measuring functioning, if your functioning is appropriate to the context and the situation, and the environment. And then ultimately, as part of that, whether it's meeting your needs or not.
So then he defines ego states in a way I had not traced back to the beginning, and so didn’t fully understand. He talks about who said that personality and let me quote this, “personality was not simply a collection of perceptions, cognitions and aspects, but that these were organized into clusters or patterns,” which he called ego states. And then he talks about how an ego state could be as big as having Dr. E who just does the work and having Cassie who dates the husband. Or it could be really small, like just the feelings of attending a game. And so it could be memories or postures or feelings or any combination of that. But they're just organized according to those patterns.
So then another interesting thing they say in this article is that these ego states can develop three ways. Number one, through normal differentiation. Meaning, this part of me handles this part of my life, and this part of me handles that part of my life, just in a normal way as part of development for everybody. The difference between DID or not DID, being like what the husband said on his podcast about having access to those different parts. Like he's recognizing in new ways how he has different parts, except he's not DID, and has access to all of those parts all the time.
And then the second way ego states can develop is through introjection of significant others. Which brings us even to modern day fictives, for example, of significant moments or patterns of interaction, whether that's significant because it's dangerous, and so there's sort of an internalized abuser on the inside that becomes a persecutor, for example, or in a persecutory role. Or whether it's a positive experience with a caregiver in some way and so then there's a caregiver internally.
And then the third process that they talk about is a reaction to trauma. Which obviously would play into the development of DID. And then they go on to talk about how the more someone dissociates, the more strongly they avoid responsibility for our own behavior. Or are unwilling to face our own behavior. Because those ego states are tied back into those difficult or traumatic experiences. I'm not saying that they are saying people DID are bad, or different personalities or alters or parts are bad. That's not what they're saying. But that the more DID develops are, or the more significant those walls become between parts, each part becomes less and less responsible for other parts. So for example, I do not date the husband at all ever. And Cassie does not go to work at all ever. And so there becomes these significant differences between what they're responsible for, and an avoidance of dealing with the things that helped cause those walls to develop. So quote, “ego states become more sharply differentiated from one another as the separating boundaries become increasingly less permeable. The extreme of this continuum is reached when the boundaries are so rigid and impermeable that there is little or no interactions between states,” end quote. So that is when there's actual switching between parts or alters, and when there is more amnesia between parts or alters.
The reason this caught my attention is because we're having new experiences of the more that we meet together, and the more co-conscious some of us become, the more transparent some of those walls become. And that is a new experience of somehow not just interacting with each other more often, but also somehow more sensitive to or more aware of what is on someone else's plate, so to speak. And so it's not that I know all of the details of what another part went through, or even their story exactly. But I've somehow almost without even intending to become more aware of, I know that this one had to deal with the father, and this one had to deal with the mother, and this one did this, and this one did that. In this same way as I dealt with school and work and keeping a job and maintaining functioning. Does that make sense? So I don't know the details of their stories or their experiences or have any idea really of what they went through or what that was like. But whereas in the beginning and the very beginning, I had no idea they were even there, or things were happening that I wasn't aware of. Now we've become to a place where somehow just from getting to know them, I'm sort of aware of the kind of things that they deal with the same as they wouldn't know how to work with patients or they wouldn't know how to do finances or budgeting, and they certainly would have too much anxiety to give a talk or appear in public. And yet for me, that's not a difficult thing because I know my stuff and that's what I deal with. So they're learning that that's what I deal with, in the same way that I'm learning that that's what they deal with. Does that make sense?
And so that's a new thing for us. We haven't yet had some big experience of understanding fully what another part went through. But it reminds me of what they were writing in this article about categories. I'm not sure if that makes sense. I'm trying to express what I'm learning.
In the beginning, when we were first diagnosed with DID, I didn't even know we had been in therapy for two years. I didn't know about the others. I couldn't see them, I couldn't hear them. I didn't know their names, I had no idea what they were dealing with. So since being in therapy, and since being with the therapist for three years, and since learning to work together and tolerate each other and get to know one another, not only do I know their names, but I could categorize—like in integration and differentiation, the way it's used in this article—I think I could now categorize “these two were abused,” and integrate that understanding in being able to categorize “those two go together because they went through abuse,” but also differentiate between them that “I know this one went through things with the mother and this one went through things with the Father.”
Does that make sense? So I feel like that's some significant progress, even if we're still at the beginning of trying to learn from all this and deal with it. And then here's another quote, and I'm going to share why I'm sharing the quote in just a minute. It says, quote, “as adaption to everyday problems of life become more complex and stressful, the separating boundaries between the various ego states become less permeable in order to minimize conflicts between incompatible states, which would cause increased anxiety.”
And so here's what's significant. What's significant is there's this chart, that's like a pie chart. And it says A, B, and C, with dotted lines between each part. And underneath it it says “normal and well adjusted.” But at the end of the continuum there's a solid line drawn between each part and it says multiple personality. Because this is an old article, right? So it says Multiple Personality instead of DID.
But what's fascinating to me is that the pie chart that I remember the first therapist, when we were 17, when we were first diagnosed with DID, and I was finding out about the diagnosis and then we quit going to therapy and didn't come back until the parents died. Right? That's the Reader's Digest version. And this is the pie chart that I've seen. And so I even drew this in the notebook before when we were first meeting with a therapist and I was trying to explain what I already knew about it. And all of a sudden, here's the article where it came from. So the very first therapist must have had access to this or had access to someone who had access to this. I think it's a chapter from a book. But I'm seeing it in black and white right here on paper. And it fascinates me because it brought back memories of that first therapy experience and how difficult things were and how confusing that was. And so we have hard things to do in therapy. But we are not as anxious anymore, and we're not as overwhelmed anymore. And we are not as scared or confused anymore. And so I just want to say that I think that we are making progress, even if there's a lot we still need to do. Because it's really clear that we can understand this.
If I am able to figure out how to do so I will take a screenshot of just this chart and include the citation for the reference to it. But then also show you how the therapist drew it for me back in the day, and what she explained because it also had to do with boundaries and things like that, and how healthy boundaries help protect us. But keeping all of the bad out also keeps out all of the good.
And the reason that comes back to me is because now we have friends for the first time and are trying to establish and maintain connections without shutting them out. And what I have discovered is that now we have safe friends. So it's in the context of safety because this wouldn't work if they were not safe people. But in the context of safety, when we are most struggling and most isolated because of that struggle, that's when it's most important for us to reach out and connect to our safe people, whether that's the therapist, or the husband, or our friends. And it's the most hard to do. But every time that we do it anyway, we have some kind of huge breakthrough. Whereas every time we don't, then old messages or old tapes that are wrong and false and not actually true get reinforced, and it causes a disruption in those new relationships that are good and safe, and takes away from some of what would have been healing to us if we would let it happen. And so it's a huge shift for us to be embracing this experience and attempting to trust it, and connect it and even utilize it.
But here's the fascinating thing. If you continue in this chapter, what it explains is that as part of perception, when we have a memory we know that we are just remembering it. If you have a memory, like even if you think of something good, that's a memory and you know you're thinking about it. It's because you are in Now Time thinking about that memory and Memory Time, even if it's a positive one, And you know that you're thinking about it. You're aware that you're remembering it. But what they say in this article is that that's what dissociation is when there are those walls between parts between ego states, whether that's actual parts and personalities, or whether that's a wall between the experience and the emotional response, or whether that's different kinds of stuff, whatever the differentiation is, however, it's qualified. That when that happens and things are too differentiated, then they're so separated that you think you're actually seeing that memory happening now, instead of being aware that you're thinking about the memory and being aware that you're remembering. And that's why past time or Memory Time feels like it's happening in Now Time. Because it's so differentiated it feels like you're actually seeing it, which is why we feel psychotic or like hallucinations, even though it's a different thing. It's not the same thing. But that's why it feels like it's Now Time that's why it feels like invades. But it just feels that way. It's not actually happening now. But it feels that way because things are so differentiated that you're literally seeing or experiencing a memory that you don't realize you're thinking or remembering, because technically another part of you is thinking or remembering. And so you're seeing what someone else is thinking or remembering. Which in a way the article suggests is makes other parts of you like a kind of ongoing flashback, in and of itself. Like that part is kind of in a flashback from the past that you were seeing in the present, which is why it's distressing. Because what you're actually differentiated from, or separated from, or dissociated from, is the awareness that you yourself are thinking about it or remembering it.
Does this make sense? Because it just, I just almost could not fathom what they were saying. And it's really, really profound.
When it is scary. Or there's another part of you, or alter, or personality, whatever language you use. When there is something that they are thinking about or remembering or feeling and you experience it either through flashback or passive influence or something like that, it feels like Now Time because you are so differentiated from or dissociated from the awareness that you yourself are thinking about this or remembering this. And that's how flashbacks happen. And this just, it just, it's almost too big for me to comprehend or hold on to. But I understand it for the first time.
I've read about this in the notebooks they have written. I have not experienced it myself because now I understand it is so separated from me and so differentiated from me that I don't even understand, or I'm not even aware that it's happening. So there are parts of me, even for me to see that is a big thing, because I have thus far cut myself out of all of this. Because I need to function to work. And my survival depends on that the survival of our family depends on that. And I've been very emphatic about that. I have not participated in therapy. I've barely talked to her until I'm trying now. And it's, I'm not good at it. I do not have the social skills for friendship. And so when I try, it's usually a disaster and super awkward. But for me to even acknowledge this, that, I realize now that I am not aware of what they are doing or feeling or experiencing—Now Time or Memory Time—because that's how differentiated I am from my own awareness. Not just from them, but from my own awareness.
And so this is huge, it's really, really huge because, I can't tell you how significant it is. Because it is the first time that I have understood I’m even a part of this. I have read the materials. The therapist has tried to talk to me. The first therapist tried to talk to me. I didn't understand because it always felt like Them. And Them with a capital T, the others, the others inside the other parts, the other alters, the other personalities, however you want to say it. They felt so separate from me that it was as if they were just the more people in the crowd of the husband, and the outside children, and friends, and all these people that I don't really interact with anyway. I could just keep them at this distance. And when we talk about them being parts of ourselves, then I can deny that and dismiss it because I know I would never do those things, or I would never say those things. And it does not make sense that they are a part of me, or that I would be a part of them, or who is a part of who, and where you define that. And now finally, I understand that that's not how it works. That's just how entirely separate and individuated they are—we are—because we're not dissociated from each other, which I think is what I thought this whole time. Now I understand we're dissociated from awareness of self.
So there are all these different expressions of self. And that's where the walls are, that's what the wall is, is the dissociation from self. And here's the thing that I already know about psychology, when you have a separation from self, even in like psychosis, which I am not saying that's what DID is, DID is not psychosis. But when you have a separation of self, then what happens is the self becomes the object objectified. Like which is what happens in trauma anyway. Which really is me, as Doctor E, the first time I have had a connection to my own trauma simply by acting out the pattern of continuing to objectify myself, even though I wasn't aware that it was happening. And for the first time, I understand this. And that's huge.
So this article or this chapter goes on to say, quote, “this distinction here is related to the qualitative nature of the energy, ego…,” and it talks about I energy meaning that self-state, what is me, right? So quote “within it in here is the feeling of self or me-ness. Any part of the body, any movement or psychological process activated, will be experienced as my body or my action or my thought. Like my normal hand or an arm, I will experience it as my hand or my arm. If I move it up and down, and it is invested, I will experience it as my movement, my choice and my free will. The presence of ego type energy determines the me-ness or self-aspect.” So do you remember the podcast episode where she felt herself, which I guess I should say, if I want to increase awareness, which I'm not sure that I do, but for the sake of understanding this, where I, which I don't remember it happening, but again, just practicing this and trying really hard to hold on to it, where I felt my hand in the park that day, so I have no memory myself of that day in the park or recording that podcast episode, but I have listened to it. And that was for the first time instead of dissociated from the body, she was associated with the body. And so that's what we're talking about here. And if I were to take it a step further, and put myself in that situation of that was me and my body. And so I was not aware of my own experience of remembering and associating with my own body, when I saw my hand in the park.
I can't tell you how big this is, and how much it makes my brain hurt. I'm aware that my brain cannot actually feel pain. But these things are so big, I could feel or sense or imagine parts of my brain moving and locking into place finally. I don't know how else to explain it.
But they go on to talk about dissociation then causing that separation and that lack of awareness so that you no longer experience that as yours. Or I no longer experience that as mine. So it's not my hand, it's not my body, and then even it's not my memory. Quote, “it will be as if it is anesthetized and paralyzed. I may even be aware that it is moving—meaning the hand—but not that I am doing it because it is outside consciousness.” So the same thing., o they go on to talk about how the same thing can happen with fear, for example, or abuse. And I understand it, for the first time I finally understand it, that we're not dissociating from something that happened. We're dissociating from ourselves being there when it happened. We're dissociating from ourselves being aware that it was us being hurt, or that it was our parents doing the hurting. This is huge. This is really huge. It's so significant. Quote, “If a child ego state is activated and contains the image of being pursued by a monster, then I will experience fear. It is my fear. But if I'm dissociated from my awareness of that being my Self…” capital S, “…then that fear is that ego states Fear, not mine. And so I do not experience fear other than the empathy of what might naturally occur with another person.” So I feel badly for someone else, or sad for them, or empathetic that they went through a difficult thing, but I'm not aware that it was my thing.
Does that make sense? I understand this for the first time I feel, like outside of the textbook but finally by actual experience. I almost, like the sand slipping through my fingers, I almost can hang on to what this actually means and why any of it has anything to do with me. Why I am stuck in the middle of this. Because I was there too. I was involved as well. What happened to them happen to me. That's why it matters that we are working together and getting to know each other and communicating about things because this happened to us. And somehow the collective us, in some way that I don't yet understand beyond context of this article, represents me. And because of DID, that me doesn't feel like me. So the me gets capitalized, a capital M, Me. Feels like not me, it feels like someone else. And I finally understand what DID is.
What I don't know is how to build my muscles of awareness enough to start connecting these pieces of us into Me, capitalized, and for it to still feel a part of me. And I don't know how to do that, and what is required for that happening, and to still maintain functioning the way I can without them. So how do you have, if we talk about external boundaries, so that you have healthy relationships where you're still an individual and your other person gets to be an individual, but together you can be good friends or have a good relationship because it's healthy. And even when you're super super close you're still two separate people. And Khalil Gibran said, there's space in our togetherness, that kind of thing. How do you do that internally? I have no idea. But maybe that's why we need to stay in therapy.
So so we will go to therapy. And we will be starting with someone new. We still see the family therapist, I know that. But my understanding is that her schedule was not as flexible as we thought for our travel out of state or out of the country. And so it's been hard to get into her sometimes. And then when we do, sometimes we have to deal so much with family issues that we don't get our own time. And so we have three or four different choices that we have interviewed and talked to and are trying out, and we will begin therapy. But I don't know how to catch them up to all that we've learned in the last three years, and how to start. Because we do need to build trust with a new person. That's a given, I think, an obvious thing. But I also feel like in many ways, we're really ready to get started at a whole new level that we've never proceeded yet. So in a way that feels good because we do have to build trust and find a new person and make a positive relationship with them so that there's the safety within which we can do this. But also, we're not starting completely over. Because we do understand DID. We are on board. We are able to meet together and talk together at least a little bit, some of us. And when I have a framework now to understand what DID is and finally get it, and understand how things can be so separate if we're together, or what integration means developmentally about things being put into categories, but also differentiated. It helps me understand the process of how this happened. Apart from just here's the list of abusive things that were terrible and happened. I understand finally developmentally what DID is and how it happened, and why I could be included in that. Because I have thus far been in so much denial because I don't have a lot of memories of the parents and I don't have a lot of time to spend whining about it. And so it's really difficult for me that we have to spend so much time on therapy and so much time in therapy homework. And I've not thus far been very compassionate about it.
So I think this is really a significant breakthrough, at least for me. And I don't know what that means for what's happening next or what shape therapy will take. But I feel like it's something huge and it's big enough that I wanted to record it so that I could listen to it again because I don't want to lose it. I'm not even sure how coherent it is, if it makes sense or not. But it was significant to me and I needed to hold on to it. So thanks you for listening and I will. And I will post the citation to this article as well as those diagrams about normal healthy functioning and DID functioning with those pie charts. I think I have shared them before. I'm not sure. But I will see if I can draw them or post them in some way and get them up on the blog on the website at systemspeak.org as well as the Facebook page @systemspeak. I hope it helps someone else.
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