mental health disorders
Dissociative Fugue
Introduction
In dissociative fugue, people lose some or all memories of their past, and they typically disappear from their usual environments, leaving their family and job. ("Fugue" comes from the Latin words for "flight" and "to flee.") (See also Overview of Dissociative Disorders and Dissociative fugue is a rare form of dissociative amnesia. People experiencing dissociative fugue may appear and act normal, but when the fugue ends people suddenly find themselves in a new situation with no memory of how they came to be there or what they have been doing. Usually, dissociative fugue is diagnosed after the fact, when a doctor reviews the history and collects information that establishes an alternate life. A supportive environment and psychotherapy may help a person who has experienced dissociative fugue. A dissociative fugue may last from hours to months, occasionally longer. If the fugue is brief, people may appear simply to have missed some work or come home late. If the fugue lasts several days or longer, people may travel far from home, form a new identity, and begin a new job, unaware of any change in their life. Many fugues appear to represent disguised wish fulfillment or the only permissible way to escape from severe distress or embarrassment. For example, a financially distressed executive leaves a hectic life in the city and lives as a farm worker in the country. Thus, dissociative fugue is often mistaken for malingering (faking physical or psychologic symptoms to obtain a benefit) because both conditions can give people an excuse to avoid their responsibilities (as in an intolerable marriage), to avoid accountability for their actions, or to reduce their exposure to a known hazard, such as a battle. However, dissociative fugue, unlike malingering, occurs spontaneously and is not faked. Doctors can usually distinguish the two because malingerers typically exaggerate and dramatize their symptoms and because they have obvious financial, legal, or personal reasons (such as avoiding work) for faking memory loss. 