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Friday, February 09, 2007

Dissociative fugue

I have a terrific idea for a new composition. Now I just have to get it together and write it. By next week.

Fugue, n. [F., fr. It. fuga, fr. L. fuga a fleeing, flight, akin to fugere to flee. See Fugitive.]
  1. dissociative disorder in which a person forgets who who they are and leaves home to creates a new life; during the fugue there is no memory of the former life; after recovering there is no memory for events during the dissociative state [syn: psychogenic fugue] [Hel-LO, ternary form]
  2. a musical form consisting of a theme repeated a fifth above or a fourth below its first statement

Dissociative Fugue is one or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.

Specific symptoms include:
  • The predominant disturbance is sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past.
  • Confusion about personal identity or assumption of a new identity (partial or complete).
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The length of a fugue may range from hours to weeks or months, occasionally longer. During the fugue, the person may appear normal and attract no attention. The person may assume a new name, identity, and domicile and may engage in complex social interactions. However, at some point, confusion about his identity or the return of the original identity may make the person aware of amnesia or cause distress....

The person often has no symptoms or is only mildly confused during the fugue. However, when the fugue ends, depression, discomfort, grief, shame, intense conflict, and suicidal or aggressive impulses may appear--ie, the person must deal with what he fled from. Failure to remember events of the fugue may cause confusion, distress, or even terror.

In a fugue state, the individual not only develops a total amnesia for his past along with a complete loss of personal identity but, unconcerned by the internal revolution that has taken place, he complacently enters upon a new life and a new identity, often far removed from all that has gone before. Suddenly totally ignorant of his former life, occupation, family, and friends, he leaves home and, to the dismay of those left behind, seems to have disappeared from the face of the earth. In fact, he has merely wandered, often many miles, to a new location, sometimes with a vague sense of escaping from an intolerable situation, sometimes impelled by an inner fantasied goal. Then after weeks or months in his new life, he suddenly "comes to" as his former self with a complete amnesia for the events covered by the period of the fugue. The patient’s dismay at finding himself in unfamiliar surroundings is equaled by the surprise of his new acquaintances at his sudden change of identity, for during the fugue his state of consciousness and behavior have in no way appeared unusual to observers.
In the fugue states ... a change in the sense of identity is a central characteristic. As the fugue begins, the patient loses all memory whatsoever for the events of his entire past life. His origins, his family, his upbringing, wife, children, friends, occupation, all dissolve into the mists of forgetfulness, and the patient assumes a new name and life without any evident awareness or concern over the internal upheaval. Driven by often half-veiled inner urgings, he wanders far from his familiar surroundings to start a fresh existence, his conscious mind a virtual tabula rasa. It should be noted, however, that it is only the mental elements related to his personal identity that have disappeared. Basic functions such as language, general knowledge, and the skills of coping with the tasks of everyday living remain under his command, and there is no alteration in the state of consciousness of the new world of people and things around him. Only those who have known him in his previous existence would recognize the catastrophic changes in his being; to strangers, he appears in no way out of the ordinary. But ultimately and inevitably, a second revolution overtakes him. In the twinkling of an eye, he wakes to his old self, puzzled and dismayed to find himself in an alien world. His old identity is recaptured, but he is totally amnesiac for all the events of the period of fugue and frighteningly ignorant of how he came to be where he is.

Nemiah, John C. "Dissociative Amnesia: A Clinical and Theoretical Reconsideration" in Functional Disorders of Memory, John F. Kihlstrom, Frederick J. Evans (Eds.), Lawrence Erlbaum Associates, Hillsdale, 1979.

Amnesia victim walked Dallas streets for days
POSTED: 4:55 p.m. EST, January 26, 2007

DALLAS, Texas (AP) -- Joe Bieger walked out his front door with his two dogs one morning last fall as a beloved husband, father, grandfather and assistant high school athletic director.

Minutes later, all of that -- indeed, his very identity -- would seemingly be wiped from his brain's hard drive.

For 25 days, he wandered the streets of Dallas and its environs a lost soul, unable to remember his name, what he did for a living, or where he lived, until, finally, a contractor who was building a new house for Bieger and his wife happened to recognize him.

By that point, Bieger had somehow made his way to a suburb about 20 miles from his Dallas home, holes worn in the rubber soles of his canvas shoes. He had lost 25 pounds, and a full white beard covered the normally clean-shaven educator's face.
Bieger, 59, says he was diagnosed afterward as suffering from psychogenic fugue, an extremely rare form of amnesia.

Now reunited with his family and back at work, Bieger agreed to tell his story....
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