On Becoming One-Self: Reflections on the Concept of Integration as Seen Through a Case of Dissociative Identity Disorder

This paper explores the concept of “integration” as it relates to the development of self-awareness and the recognition that one exists as a self. It is argued that this awareness relies on a capacity for self-reflection which is intimately tied to the ability to locate oneself in time and in space. Through the presentation of a patient with Dissociative Identity Disorder, the author demonstrates how the development of the patient's consciousness of self progressed through the treatment and particularly, through the relationship between analyst and patient. In the case presented, the patient began treatment unaware of her dissociative structure. She was also unaware of the continuity of time, including the concepts of past, present, and future as they related to herself, and to the fact that she existed in a body that was subject to the basic laws of physics such as being able to be in only one place at one time. Through the development of a self-reflective capacity and a growing familiarity with the various aspects of herself, the patient began to develop a sense of herself as a continuous entity physically, psychologically and spiritually.