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Ask the Mental Health Expert Archives 2001-2004

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Fugue States

Q. Do people in fugue states spontaneously recover their memory? Do they lose all memory? For example, if they played the piano before, would they still remember how to play? Do they substitute a false past for their own? For instance, what do they do about family, who their parents were and where they live? Do they realize that something is not quite right with them? What kind of things might trigger their memory to return? What is it like for them when they suddenly realize they've been living a life that has no connection with their past?

A. Fugue states--like Dissociative Identity Disorder--are part of a group of disorders called Dissociative Disorders. In the heyday of psychoanalysis, these conditions were lumped together under the rubric or hysteria--a term that is no longer used in psychiatric diagnosis. So-called Dissociative Fugue (DF) is characterized by "sudden, unexpected travel away from home,,.with inability to recall some or all of one's past. This is accompanied by confusion about personal identity, or even the assumption of a new identity." (DSM-IV).

Often, DF is associated with a sudden traumatic event, such as a combat death or rape. Single episodes are most common, and may last from hours to months. Typically, during the fugue itself, the individual is completely or nearly completely forgetful of his/her past lives and associations, though he may retain basic skills or interests, such as cooking. Often, the new personality is more outgoing or flamboyant than the original one, but this varies considerably.

Most people in fugue states appear outwardly normal to casual observers. The person is unaware of having forgotten anything. It is only when the person comes back to normal that he will recall the time preceding the fugue--but will be unable to recall what happened during the period covered by the fugue! Spontaneous remission often occurs without treatment, but it is not clear why. In one very famous case--that of the Reverend Ansel Bourne--the individual emerged from his fugue in a state of panic, not knowing where he was, how he got there, etc. He could not believe that two months had elapsed since his last normal memory. This case was investigated by the great psychologist, William James. Under hypnosis or sodium amytal infusion, some fugue victims may be able to retrieve some lost memories.

Apparent fugue states must be differentiated from various medical and neurological conditions, such as epilepsy or head trauma.

April 2002

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