When a Brain Forgets Where Memory Is

New York Times psychology reporter Jane Brody on the fascinating phenomenon of dissociative fugue:

“People with this problem suddenly and unexpectedly take leave of their usual physical surroundings and embark on a journey that can last as little as a few hours or as long as several months. During the fugue state, individuals completely lose their identity, later assuming a new one. They don’t know their real names or anything about their former lives, and they do not recognize friends or family. They may not even remember how they got to where they are.

While loss of memory can occur for many reasons, dissociative fugue has no direct physical or medical cause. Rather, it is precipitated by a severe stress or emotionally traumatic event that is so painful the mind seems to shut down and erase everything, like a failed computer hard drive.”

Several years ago on FmH, I wrote with fascination of an apparent case of dissociative amnesia, a largely mute piano-playing young man institutionalized in a British mental hospital after apparently washing up on a beach. But, although they appear with regularity as literary or cinematographic devices, fugue states are encountered rarely if ever by clinical psychiatrists like myself in the course of our work. Of course, an exhaustive effort to rule out other, more neurologically based, causes of acute memory failure must be made. At the other end of the spectrum, so too it is at times difficult to distinguish fugue states from more consciously motivated attempts to deny one’s identity.

I am not alone in wondering if fugue is a disease of modernity, requiring an emphasis on the self and personal sense of identity to shape a subconsciously-motivated attempt to lose one’s self. I wonder what effect the modern challenges to identity, such as the influence of mass media on identity, the diffusion of the self through online presence, or the threat of identity theft, will do the the manifestations of dissociative fugue.