Dissociative fugue is considered a major presentation of dissociative disorder characterized by an individual’s sudden or unexpected travel from home. Individuals with this form of dissociative disorder often demonstrate varying degrees of amnesia following a fugue episode that may last anywhere from a few hours to several days. Often triggered by a distressing event, dissociative fugues are generally treated with the application of psychotherapy and may involve the administration of psychiatric medications, including antidepressants.
An individual with dissociative fugue should not be considered a malingerer. There is no intent on the part of the dissociated individual to shun his or her responsibilities or to purposely neglect his or her personal relationships. A dissociative fugue is a spontaneous event often triggered by intense feelings of anxiety, loss of control, stress, or fear as associated with a traumatic experience.
Dissociative fugue is one of those psychiatric disorders that generally necessitate a history of patterned behavior before a diagnosis may be confirmed. Commonly retroactive in its application, a diagnosis is generally made when an individual’s behavioral and psychiatric histories meet established criteria as determined by the American Psychological Association and presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Therapists and psychiatric professionals generally utilize a variety of additional tools, including hypnosis, to aid with verifying a diagnosis in a clinical setting.
A diagnosis of this type of dissociative disorder may also be made through conversations with an individual demonstrating confusion or distorted perception while in the midst of a suspected fugue-like state. Oftentimes, the confusion associated with a dissociative fugue will prompt medical attention during which time the individual’s symptoms may be evaluated. Following an initial examination and conversation with the individual, a psychiatric examination may be administered to further evaluate his or her psychological state.
Individuals with dissociative fugue have generally undergone some sort of trauma, such as being the victim of a violent crime or witnessing a natural disaster. Those who have sustained long-term abuse, including emotional and physical, are considered to possess an increased vulnerability to developing dissociative fugue. In some cases, the severity of the trauma may also influence the intensity and frequency of fugue episodes.
Often detached from his or her environment, a dissociated individual will often assume a new identity during his or her travels; taking on a new name, personal history, or occupation without any inclination to the identity he or she left behind. The individual carries on as though the newfound identity is one she or he has possessed all along. Many people with dissociative disorders also demonstrate some degree of amnesia following the fugue, such as an inability to recall their previous identity or the events leading up to their flight. Additionally, individuals with dissociative fugue may demonstrate an inclination toward destructive or unhealthy behaviors.
It is not uncommon for individuals with dissociative symptoms to experience difficulty with developing and maintaining personal and professional relationships. An inability to function under pressure or to deal with stress may trigger fugue episodes that may jeopardize the individual’s professional obligations. Some who are diagnosed with dissociative disorder may also develop secondary conditions, including sleep disorders, chronic depression, and anxiety. Depending on the severity of the trauma, some may possess an increased risk for developing chemical dependency issues or suicidal tendencies.
Psychotherapy is the most common treatment approach for dissociative disorders and generally involves the application of various forms of therapy, as well as the administration of psychiatric medication. Individuals frequently undergo hypnosis to piece together the often fragmented details of their fugue episodes, including the days leading up to and following the flight. Common approaches to the therapeutic aspect of treatment involve the use of cognitive and creative art therapies.