Dissociative Fugue: Symptoms, Types, Causes And Treatment
We wake up in a place that is unfamiliar to us. We wander the streets, but we are not at home, not even in our city. Where am I and what am I doing here? We ask a local, who seems to recognize us and calls us by a name that is not ours. Apparently we have been in the town for a month. How is this possible?
One of the possible answers to this question is that we have experienced a disorder called dissociative fugue.
Dissociative fugue: definition and characteristic symptoms
Dissociative fugue is defined as an associative disorder characterized by the performance of unexpected trips away from the subject’s usual environment in which the individual is unable to remember his past. This trip is carried out with apparent normality, the subject’s behavior does not attract attention and without symptoms of a mental disorder or cognitive alterations appearing. It is also common, although it may not occur, for the individual to have doubts about his own identity, either losing it or assuming a new one.
In the vast majority of cases the person he ends up recovering his previous identity and his memory. However, there are cases in which parts of the past are not remembered and on some occasions it has even happened that the patient has not been able to remember his past prior to the escape. In most cases, when recovering one’s identity, amnesia may occur after the episode in which one forgets what happened during it.
After recovering memory, the individual usually feels discomfort, derived both from the confusion over what happened and the deterioration in different vital domains such as work or relationship. You may experience guilt, depression, anxiety, irritability, impulsivity, and even suicide attempts may occur.
Currently, dissociative fugue is no longer considered a disorder in itself, being a specifier of dissociative or psychogenic amnesia because with the exception of the presence of the leak in question it shares most of its characteristics.
Leak subtypes
Yes ok Most of the symptoms of dissociative fugue are similar, this disorder can manifest itself in different ways and have different repercussions. Specifically, three major subtypes of dissociative fugue can be considered.
classic fugue
In this subtype of dissociative fugue, a trip or escape to an unknown place occurs, presenting autobiographical amnesia and partial or total loss of one’s own identity and the assumption of a new one. The subject can reach settle in the new place with a new identity without knowing his previous history until he recovers his memory.
Personal identity amnesia
This type of escape assumes that the individual has a autobiographical memory loss along with your identity, although in this case there is no change in this. The individual does not believe that he is another person, but rather he knows that he does not know who he is.
Return to previous period of one’s life
This type of dissociative fugue refers to the return on a psychic level to a previous period of one’s life, presenting amnesia regarding the period of time that has passed between the period in question and the present. However, personal identity remains intact.
The causes of dissociative fugue are associated with the experience of very stressful and traumatic events. For example, it is not uncommon for subjects to have suffered sexual abuse or experienced misfortunes such as wars or natural disasters during childhood or throughout their lives, so that their psyche splits to avoid the pain generated by the event in question.
Poisoning or substance abuse, head trauma, and certain disorders such as epilepsy also seem to predispose people to their condition.
At a biological level, it is considered that they may have influence the noradrenergic and serotonergic systems, as well as opioids. Cerebrally, the presence of changes in the limbic system and its connection with the neocortex seems to be observed.
Treatment
Dissociative fugue is a disorder whose treatment is mainly focused on recovery and control of symptoms. It must be taken into account that, although generally only a single episode occurs, it is possible that new leaks appear, so prevention is another aspect to take into account.
It is necessary to work with the patient on the causes of this amnesia, the situation that generated the escape and what this situation means for the subject. Cognitive restructuring or work on emotional expression and stress management can be of great help for this type of patient. Hypnosis and suggestion have also been used to try to unlock the blocked contents of the subject’s mind, as well as conducting interviews facilitated by hypnotic substances.
It is essential to work not only with the subject but also with family and environment. Providing them with information regarding the disorder and what has happened is reassuring and can help take into account and control factors that may have triggered the episode. Likewise, couples or family therapy to help manage conflicts that may have been triggered or may have occurred due to the escape is also recommended.
