Dissociative fugue is a type of dissociative amnesia. The condition is marked by losing memories of the past along with suffering from an identity crisis and related information. While there are no concrete treatment options for the condition, there are a few ways to treat this condition.
What Is Dissociative Fugue?
Dissociative fugue, also formerly known as psychogenic fugue, is a subtype of dissociative disorder. It is known as reversible amnesia that involves loss of personality, memories, and personal identity. This type of temporary amnesia may last for a few hours, days, weeks, months, or even longer and during fugue, the person generally carelessly wanders or travels away from their homes or places of work. The disorder is marked by confusion about one’s actual identity and may even create a new identity while suffering from an episode. However, it is difficult to identify the disorder as such patients do not display any signs of sickness, an unfamiliar appearance, or odd behavior. As per a study 1, it is a rare disorder with a prevalence rate of nearly 0.2% across the population. The symptoms can also interfere with a person’s day to day activities, social and work activities, and relationships as well.
If a person is diagnosed with dissociative, the doctor will come with a proper dissociative treatment plan to help reduce the symptoms.
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Dissociative Fugue Treatment
There are no specific set of treatments for dissociative fugue as it is a rare condition. Also, in the course of treatment, the process of recovery may begin when a person becomes immediately aware of the situation, or when he/she is unable to give proper answers to the questions about his/her background during an episode of dissociative fugue.
The goal of this treatment is divided into two parts. First, this treatment aims to encourage a person to face the stress and trauma that triggers the condition. Second, the treatment also helps to recover the person’s lost identity along with curating coping strategies to prevent further fugue episodes. The best treatment plan depends on the individual and the severity of their symptoms. However, the treatment is mostly divided into medication and therapy or the blend of both. Here are the treatment options for this in an individual.
1. Therapy Treatment
Given below are the therapy techniques best suited for dissociative fugue treatment.
a) Psychotherapy: Of all the therapies, psychotherapy takes the first place as it is the most effective and primary form of therapy for dissociative fugue treatment. It is also known as talk therapy, psychosocial therapy, or counseling. The therapy is defined by the practice where the patient discusses his/her and related issues with the mental health professional. Upon hearing the same, the therapist will come up with techniques to help the concerned person understand the cause of his/her condition while proposing new ways to cope with stressful situations. With time, the therapist will encourage the person to talk more about the trauma that he/she has experienced, however, only when the person has mastered the coping skills along with maintaining a relationship with the therapist where he/she can safely have such conversations. Additionally, cognitive behavioral therapy is the best type of psychotherapy that focuses on improving dysfunctional thinking patterns and resulting feelings and behaviors. Additionally, one must look for a therapist with excellent training or having prior experience in working with people with this disorder.
Read More About Cognitive Behavioral Therapy (CBT)
Psychotherapy Dissociative Fugue Treatment Case Study
In a case study, 2, Mr. A, a 20-year-old man with no past medical and psychiatric history suddenly started facing trouble remembering his previous memories for the past 2 days, as reported by his mother. It was at his work that Mr. A failed to recognize him along with questions regarding his job role at the workplace. This was reported by the supervisor to his mother and he was sent home at 9:30 am. When he reached home, Mr. A failed to recognize his mother, dog, siblings, and belongings. He slept until 1 pm that day, woke up, and left the house without telling anybody. Later in the evening, when his mother got concerned, and after some time, his friends found him in the parking lot of a convenience store. Mr. A did not recall how or why he came to the parking lot.
Upon admission, a diagnosis through tests and examinations were done and after following the DSM-5 criteria, he was diagnosed with dissociative amnesia with dissociative fugue condition. When asked about any recent stressor, the mother recalled that about a week ago Mr. A had broken up with his partner. Even though it was a 1-year relationship, his mother reported no sign of emotional changes in Mr. A after the breakup.
During his treatment session, prior to psychotherapy, did not have any autobiographical memory. The family was allowed to have conversations with Mr. A and showed him the family photo album which produced no positive result. It was after this that he turned to psychotherapy treatment and during the first few sessions, he continued to have difficulties remembering events from his past. The psychotherapy team used persuasion and suggestive techniques while providing a feeling of safety and security. Mr.A was given a home assignment which included exploring the family photo album and analyzing details of his job with his coworker. Simultaneously, the psychotherapy team maintained supportive psychotherapy and empathic validation. While initially, Mr. A felt good about his new identity, after a few therapy sessions, he started to recall memories about his past. He started narrating the painful experience of his past relationship where he was unfaithful, filled with guilt and shame. After a series of sessions for 12–16 weeks, Mr. A continued to show progress by returning to his job and started remembering details from his past.
b) Family Therapy: This form of therapy helps to educate the family about the disorder and its causes, as well as highlighting the ways to help family members recognize symptoms of a recurrence. If the person who suffered dissociative fugue has a positive relationship with their family members, family therapy may be therapeutic.
c) Creative Therapies (art therapy, music therapy): These therapies enables the patient to understand and communicate his/her thoughts and feelings in a safe and creative way. Individuals who use creative therapy may be able to relax or redirect their anxious energy into productive channels.
d) Clinical Hypnosis: This is a type of treatment where intense relaxation, concentration, and focused attention is used to achieve a modified state of consciousness or awareness. It allows the person to explore thoughts, feelings, and memories they may have been hidden from his/her conscious mind. However, making use of this method as dissociative fugue treatment is questionable as it leaves a risk of creating false memories.
There are no established medicines for the treatment of dissociative fugue. However, if a person with this condition also suffers from depression or anxiety, medicines such as antidepressants, anti-anxiety, or antipsychotic drugs may help in reducing the related depression and anxiety.
Since the symptoms vary from one patient to another, some may respond to the treatment rapidly, while others can take longer. However, if the condition is left untreated, dissociative fugue may happen multiple times, thereby worsening the condition of the individual with each passing day.
Dissociative Fugue Is Manageable With Persistent Treatment
Dissociative fugue still remains to be an underdiagnosed and undertreated condition. The rarity of the disorder makes it one of the underdiagnosed conditions, however, with proper screening and an on-time dissociative fugue treatment, the condition is completely manageable, thereby preventing further fugue episodes. The condition needs more recognition in the world of mental health disorders that will further highlight the necessity for multi-disciplinary approaches for the treatment.References:
- Raval, C. M., Upadhyaya, S., & Panchal, B. N. (2015). Dissociative fugue: Recurrent episodes in a young adult. Industrial psychiatry journal, 24(1), 88–90. https://doi.org/10.4103/0972-6748.160944
- Sharma, P., Guirguis, M., Nelson, J., & McMahon, T. (2015). A Case of Dissociative Amnesia With Dissociative Fugue and Treatment With Psychotherapy. The primary care companion for CNS disorders, 17(3), 10.4088/PCC.14l01763. https://doi.org/10.4088/PCC.14l01763