Dissociative fugue is the unexpected travel of a person who cannot later recall the trip.
Dissociative fugue is classified among the dissociative disorders.
In a dissociative state the affected person temporarily is unable to integrate all the elements of personality into a unified whole; the result is fragmentation, dissociation, or splitting.
Other dissociative disorders are dissociative amnesia, dissociative identity disorder, and depersonalization disorder.
A fugue is a flight: in music, of notes and melody; in psychopathology, of persons and personalities.
The sufferer may assume a new identity while on his or her trip and be genuinely unable to recall the former, true identity.
An elaborate or full-blown example of psychogenic fugue would include the person assuming a bolder, more outgoing personality during the fugue state than would normally be characteristic of that person.
More often, however, the fugue state is relatively short.
Dissociative fugue usually consists of a single, nonrecurrent episode.
A famous historical example of fugue is the story of Ansel Bourne as reported by William James.
Bourne was a lay minister in Rhode Island who traveled in 1887 to Norristown, Pennsylvania.
There he lived for six weeks as the owner of a variety store under the name of Mr.
Brown.
The fugue condition is quite rare, although it tends to be seen more frequently during war or after a natural disaster.
Often a severe stressor or trauma such as a serious level of marital discord or a profound personal rejection is connected with onset.
Technically a fugue state can be differentiated from other similar pathologies by careful observation.
For example, persons in fugue states are unaware that they have forgotten anything, whereas psychogenic amnesiacs are well aware that true identity is beyond recall.
Also, the casual observer of a newcomer to town who may actually be in a fugue state will not necessarily suspect that something is drastically wrong.
People who observe sleepwalkers, in contrast, can usually detect something amiss in their behavior.
If the travel is nonpurposeful, unsophisticated, and appears to be aimless wandering, an organic mental disorder is the more likely diagnosis.
Dissociative fugue can be feigned so that the distinction between a genuine fugue state and malingering is difficult to make.
Current standards require four criteria, all of which must be present in order to make a diagnosis of dissociative fugue: sudden unexpected travel with retrograde amnesia; confusion surrounding one's identity and/or assumption of a new identity while in the fugue; not a part of the dissociative identity disorder, some form of substance abuse, or a medical condition; and symptoms causing significant distress or impairment.
Individuals with recurrent fugue states should be considered for the dissociative identity disorder diagnosis.
Benign forms of fugue (that are thus not diagnosable) include the familiar experience reported by many people of not being able to reconstruct the exact details of how one arrived at a freeway exit or a destination.
Treatment cannot commence until the true identity of the fugue victim is established.
Gradual reexposure to the normal environment plus careful therapy to help the victim learn more constructive pressure-coping strategies will enhance recovery.
Recurrences are rare.