Dissociative fugue

Dissociative fugue (from Latin fuga - “flight”) is a disease characterized by a sudden, but purposeful move to an unfamiliar place, after which the patient completely forgets all information about himself, including his name. The memory for universal information (literature, science, etc.) is preserved. The ability to remember new things is also preserved. In all other respects, except for amnesia , the patient behaves normally.

Patients in a state of fugue may come up with a different name and biography and not know that they are sick. They can find another job (usually not related to the former) and lead a seemingly normal life.

The cause of the dissociative fugue is a mental trauma or an unbearable situation in which the patient has fallen. The fugue is protective in nature, because it gives the patient the opportunity to get a vacation from their problems.

Dissociative fugue lasts from several hours to several months, sometimes longer. Then the patient remembers his biography (usually suddenly), but at the same time he can forget everything that happened during the fugue. The exit from the fugue is often accompanied by sharp negative emotions: the patient again returns to an unpleasant situation.

A famous case of the fugue is described by William James in 1890 ^[1] :

On January 17, 1887, Priest Ansel Bourne, b. 1826 from Green, Rhode Island, withdrew from his Providence bank account $ 551, which he had to pay for a plot of land in Green, paid several accounts and got into the horse-drawn carriage bound for Pawtucket. This was the last event that he remembers. On this day he did not return home, and nothing was heard about him for two months. The newspapers placed an advertisement for his search, but the police, who suspected that some crime had been committed, could not determine his whereabouts. However, on the morning of March 14, in Norristown , PA, a man who called himself AJ Brown, who had rented a small store six weeks earlier, filled it with stationery, pastries, fruit, small goods, and drove it all While he was humble in trading, not giving anyone a reason to notice something unusual, he woke up in fright, called his neighbors in the house and asked them to tell him where he was. He said that his name was Ansel Bourne, that he did not know anything about Norristown, that he did not understand anything in trading, and the last thing he remembered - it seemed to him that this was only yesterday - was how he took money from a bank in Providence ... He was very weak, apparently losing more than 20 pounds in weight during his escapade, and was so horrified at the thought of a pastry shop that he refused to appear there anymore ( James, 1890, pp. 391–393 ).

Under hypnosis, James restored Brown's identity, who told everything that had happened during that period, but did not know anything about Burne. James was the first to describe this condition and call it “Fugue.”

A possible patient with a fugue could be the main participant in the scandalous Bruneri-Canella case . Despite the forensic and medical evidence provided, the man’s identity remains a mystery.

Patients suffering from a split personality can experience a dissociative fugue more than once. Usually the dissociative fugue is not repeated.

Treatment: often under hypnosis, the patient recalls some details of his past life, helping to establish his personality. In addition, after recovering the memory, the psychiatrist can help the patient cope with the problems that led to the dissociative fugue, or change the attitude towards them.

Fugue is one of the dissociative disorders - disorders in which memory is selectively lost (usually due to mental trauma).