What is Reality Integration Therapy™ (RIT)?

Authors: Ashley J. Zahabian, Sarah Phillips

Reality Integration Therapy™ (RIT)

Reality Integration Therapy™ is a new therapeutic technique developed by Ashley Zahabian for Borderline Personality Disorder (BPD) in 2022.  As someone who formerly suffered from BPD, Zahabian felt strongly about creating a therapeutic technique based on her own personal experiences and how she was able to work through the disorder.  Viewing BPD as a “personal reality disorder,” Zahabian realized how the split between her personal reality and actual reality was causing her symptoms and perpetuating the disorder. With constant reality-testing, she was able to integrate into actual reality and overcome the illness.  Thus, Reality Integration Therapy™ was born! 

Zahabian spent three years delving into psychoanalytic literature to find answers.  Through inspiration by the works of Klein and Kernberg, Zahabian began to understand BPD differently.   Reality Integration Therapy™ is founded on the idea that BPD is a result of prolonged, narcissistic abuse in childhood, which creates disruption and dysfunction in one’s ability to develop whole object relations – the capacity to see oneself and other people in a realistic, stable, and integrated way – for the good and bad segments (Klein, 1921).  As a defense mechanism against the prolonged narcissistic abuse, the child generates their own fantasy world, preventing them from interacting with their painful reality.  Zahabian agrees with Kernberg’s (1985) suggestion that those presenting with narcissistic personality structures have an underlying borderline personality organization, and she also suggests the opposite holds true – those with borderline personality structures have an underlying narcissistic personality organization.  Internalizing the abuser’s behaviors, the person with BPD unknowingly becomes their own abuser.   

Narcissistic abuse is a specific kind of maltreatment in which the abuser is focused purely on themselves at the expense of others (Howard, 2019), causing the abused individual to feel unseen.  When this happens during the developmental years (i.e. childhood), it disrupts the development of healthy and whole object relations.  Below are some examples of how this abuse leads to the development of specific symptoms of BPD  (5th ed., text rev.; Diagnostic and Statistical Manual for Mental Disorders, American Psychological Association, 2022):

1. A child who is raised in an environment where they are not seen tends to feel as though they are not allowed to exist. These inner psychodynamics can reveal themselves in reality through self-harming behaviors and suicidal ideation, commonly seen in individuals with BPD.
2. Similarly, the split object relations seen in the psychodynamics of an individual with BPD can reveal themselves via their splitting tendencies. 
3. Splitting leads to idealization and devaluation – polarization in a person’s internal model of themselves or others (viewing them as “all good” or “all bad”) (Fairbairn, 1952).
4. The child who was taught they aren’t allowed to exist learns to “break all of their boundaries,” which leads to a chronic feeling of emptiness. 
5. An inability to resolve the feeling of emptiness in addition to frustrations in adult relationships can result in anger, impulsivity, and “acting out.”
6. Internalizing an abuser and constantly being abused (even by their own self without realizing it) results in dysregulated emotions, and blame is projected outwards instead of realizing the original abuser is now internal. 
7. The child compensates for ignoring themselves with limerence – a mental state characterized by an intense love for someone with a fervent desire for those feelings to be reciprocated (Tennov, 1979).  They are so overly focused on loving others to get their needs met, that when others do not return the same actions or affection there is perceived abandonment.  An internal dialogue initiates with thoughts such as, “Why don’t they love me?” “Why aren’t they returning the favor?” and “They don’t love me or care enough.” 

Current therapies for BPD tend to begin in the present, focusing on symptom management, while Reality Integration Therapy™ begins in the past in order to address the root cause of the disorder – undeveloped object relations.  Reality Integration Therapy™ aims to identify when and how one’s object relations became disordered.  After this moment is pinpointed, the individual learns how their narcissistic trauma created a split between reality and fantasy, and how their personality (personal reality) was formed from that split.  The individual’s fantasy, however, feels completely real to them; so rather than rejecting it, Reality Integration Therapy™ encourages the user to acknowledge it then slowly grieve it.  Once a person grieves and lets go of what they formerly believed to be real, actual reality is integrated.  Their personality then roots itself in reality, which alleviates symptoms of the disorder, rendering no need for symptom management.

Reality Integration Therapy™ consists of three phases:

1. Fantasy Dismantling –  The individual tests their disordered psychodynamics against a benchmark of reality that is provided to them.  In this process, they are shown evidence that their fantasy is not rooted in reality, which creates a grief response for mourning the life they previously believed was real.
2. Separation – Individuation –  During separation, the individual must not only physically, but psychologically separate themselves from the inner abuser they have merged with.  This may leave a void within, leaving room for growth of healthy internal objects and sense of self.  Individuation then takes place, which is the building of healthy and realistic internal objects.
3. Integration & Whole Object Relations –  Steps are taken to encourage and support re-connection with society and a more stable life. As the individual now has healthy and realistic internal objects, their interactions with external objects will reflect this change. This is where whole object relations are fully restored and the individual becomes integrated.  

While psychoanalysis based in object relations theory is not new, Reality Integration Therapy™ is novel in that it is currently the only object relations therapeutic technique that does not require a licensed therapist, and is also the only self-paced therapeutic program that focuses on how BPD has roots in object relations theory.  It includes eight self-paced modules, an optional 60-90 minute weekly lecture, and optional involvement in an online community of individuals who are all working through Reality Integration Therapy™.  Zahabian believes through the education and support provided with Reality Integration Therapy™, BPD does not have to endure for one’s entire lifespan –  and she speaks from experience.  A childhood disruption in object relations can be restored in adulthood, and Reality Integration Therapy™ is making that possible.

References

1. American Psychological Association. (2022) Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
2. Fairbairn, W. R. D. (1952). Psychoanalytic studies of the personality. Tavistock Publications. 
3. Howard, V. (2019). Recognising narcissistic abuse and the implications for mental health nursing practice. Issues in mental health nursing.
4. Kernberg, O. F. (1985). Borderline conditions and pathological narcissism. Rowman & Littlefield.
5. Klein, M. (1921). Development of Conscience in the Child. Love, Guilt and Reparation, 252.
6. Tennov, D. (1979). Love and Limerence: The Experience of Being in Love.