Psychogenic Fugue

Our textbook Cognitive Psychology: Connecting Mind, Research, and Everyday Experience mentions that movies often feature characters with some sort of memory loss. One of the movies listed is The Bourne Identity (2002) starring Matt Damon. In this film, we see the character played by Damon, Jason Bourne, lose his memory after an accident that leaves him unconscious and badly wounded. Once he wakes up, he does not remember his identity, but he still remembers procedural memories from his training as a CIA agent. Bourne’s situation is related to a rare condition called psychogenic fugue.

Fugues are classified as a dissociative disorder, a syndrome in which an individual experiences a disruption in memory, consciousness, and/or identity. This may last anywhere from less than a day to several months, and is sometimes, but not always, brought on by severe stress or trauma. Psychogenic  fugue is usually triggered by traumatic and stressful events, such as wartime battle, abuse, rape, accidents, natural disasters, and extreme violence, although fugue states may not occur immediately.

Some of the symptoms of fugues include sudden and unplanned travel away from home as well as an inability to recall past events about one’s life. Confusion or loss of memory about one’s identity is also part of the symptoms. If the amnesia of fugue occurs without an episode of unexpected travel (fleeing), dissociative amnesia is usually diagnosed (Fugue).

There was a case reported of a 41-year old Nurse who appeared to have Psychogenic Fugue. She was admitted to a psychiatric hospital in New York in 1990 after a series of symptoms coupled with episodes of amnesia. She reported that symptoms of depression, anxiety, insomnia, and decreased ability to work had worsened over the month and a half prior to her admission. For a while she would take long car rides, and often appear in different states with no memory of why and how she got there. Also, she would find notes in her room, like phone numbers and such, but she did not remember how they appeared there. She would think that someone might have been following her and that people were sneaking into her apartment to leaves these notes. Based on the family and relationship history that she described during therapy, one could notice that there was a pattern of emotional abuse from her mother, her husband, and even her in-laws. She endured some trauma when she was assaulted in June 1987. She is diagnosed with psychogenic fugue, and her treatment involves a mixed cognitive and supportive exploratory treatment. With the help of therapy, the doctors are able to help the patient feel protected and less helpless, and to deal with the traumas that caused her this condition in the first place (Soute 1992)

As Paula Ford-Martin points out that there are some other forms of treatment. In some cases, hypnotherapy, or hypnosis, may be useful in helping the patient recover lost memories of trauma. Creative therapies like music therapy are also constructive in allowing patients to express and explore thoughts and emotions in “safe” ways. Medication may be a useful adjunct, or complementary, treatment for some of the symptoms that the patient may be experiencing in relation to the dissociative episode. In some cases, antidepressant or anti-anxiety medication may be prescribed.

Sources:

Ford-Martin, Paula. “Fugue.” The Gale Encyclopedia of Psychology. Ed. Bonnie Strickland. 2nd ed. Detroit: Gale, 2001. 263-264. Gale Virtual Reference Library. Web. 9 Mar. 2014.

Stoute BJ, Messina EG, Viederman M. Case of a 41-year-old nurse with psychogenic fugue States. The Journal of psychotherapy practice and research. 1992;1:371-386.

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