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Alex Paramo
Ms. Funston
Life-Span HD
Honors Project
April 22, 2014
Dissociative Fugue
As human beings it is normal to day dream. Our mind goes off into a delightful
daydream: we may imagine hanging out with our friends this upcoming weekend that we have
been planning awhile at the beach, watching the sunrise and sunset. Then suddenly, the day
dream ends because your instructor calls on you. You may feel lost or confused. You just
experienced a form of dissociation. Dissociation is a temporary state of disconnection from
conscious awareness of the usual sensory (vision, hearing, bodily sensation, etc.) input (Biever,
Karinch 2012 p. 2). During a day dream our minds are consciously unaware of what our brains
took in their sense organs (Biever, Karinch 2012 p. 2).
Dissociative experiences vary. They can be harmless such as our daily daydreaming, yet
there are some that can become devastating and cause harm to individuals. The more serious the
dissociative disorder, the more unusual-sometimes verging or unbelievable-the dissociative
symptoms become (Biever, Karinch 2012 p. 3). A woman may experience a form of
dissociation known as dissociative fugue and wind up in a completely different state with no
memory of who she is. People are scared to lose their minds. Therefore, this is why sometimes
people do not believe in disorders such as dissociative fugue, because if they do not believe in
them then they will not happen to them. Dissociative fugue is a disorder that exists for the reason
that certain individuals need it to cope with problems. There are case studies, as well as,
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treatment offered to patients. As long as we stay open minded about dissociation, we can gain
true understanding of these disorders.
According to Dr. Biever, from his book The Wandering Mind It is useful to think of
mental illnesses as a persons effort to adapt-however ineffectively-to the stresses of life
(Biever, Karinch 2012 p. 31). Dissociative fugue is an example of this adaptation. Fugues
literal Latin meaning means flight. A person with this disorder will flight or flee physically
from a stressful or overwhelming situation. They may temporarily lose their sense of personal
identity and impulsively wander, travel away from home and work. A dissociative phase can last
for hours or months even years, but this dissociative escape may happen only once as opposed
to over and over again (p. 32). People suffering from dissociative fugue look normal; they do not
have any odd appearances or odd behavior.
Although, they might find themselves doing bizarre activity, at least compared to the
individuals core mental state of mind (Biever, Karinch 2012 p. 32). Some may even create new
names or new identities. Once these new identities are created, they tend to be more extroverted,
unrestrained, and reckless than those of their core person (Biever, Karinch 2012 p. 32). For this
reason people often confuse dissociative fugue with dissociative identity disorder (DID) or they
think is it the same disorder. Individuals with dissociative identity disorder have the presence of
two or more distinct personalities that repeatedly take control of the individuals behavior
(International Society for the Study of Trauma and Dissociation, retrieved March 24). Similar to
DID, during a dissociative fugue phase individuals are not aware of what they are doing (Biever,
Karinch 2012 p. 32). Once the individual awakens, the fugue state will resolve itself. The person
will have no recollection of what happened and they may find themselves in strange places. They
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can remember the majority of their previous life before the dissociation, but many have no idea
how they appear in a new place (Biever, Karinch 2012 p. 32).
Equally important, people dissociate because it is more of a need then a choice. A person
has a choice to dissociate in order to make painful or a stressful situation less severe. It is similar
as having a daydream because a person dissociates during a class to be less bored. A person can
also slip into a dissociated state with administered drugs that affect the central nervous system,
such as anesthetics (Biever, Karinch, 2012 p. 43). Were asleep when we miss an exit sign on
the highway because were daydreaming and were asleep under anesthesia (Biever, Karinch,
2012 p. 43). Anesthesia works on the same nerve circuits that disable a temporary phase of
dissociation. The only difference is the circuitry of the nervous system is being activated
artificially and when a person dissociates it happens naturally.
According to Sidran Institute of Traumatic Stress Education and Advocacy(2010), there
could be the possibility that there is a link between dissociation and Post Traumatic Stress
Disorder (PTSD). Post Traumatic Stress Disorder is similar to dissociation and traumatic stress,
because traumatic stress causes emotional and mental dysfunction in a persons life. In fact,
most people with dissociation disorder also have Post Traumatic Stress Disorder.
When someone dissociates naturally, it is used as a coping mechanism to deal with
traumas such as abuse, neglect, accident, and stress. Not every individual that deals with traumas
will develop a dissociative disorder. In other words, two people experiencing the same negative
event in their life can have different responses (Biever, Karinch 2012 p. 45). You would do
anything possible to feel safe again. Imagine someone being put through a horrific event over
and over again. That is the kind of surreal torture experienced by children repeatedly subjected to
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sexual abuse, its their way of coping with reality (Biever, Karinch 2012 p. 45). Dissociation
gives these individuals security over an event that is out of their control.
In addition, according to the modern edition of the Diagnostic and Statistical manual of
Mental Disorders (DSM-IV), mental illness is defined by the damages it does to an individual
both on the outside and inside of ones life (Biever, Karinch 2012 p. 24). Just because someone
may dissociate does not mean they have a mental illness; there are requirements. In order to
diagnose a dissociation disorder, there has to be an expressive amount of impairment whether it
is in social and/or occupational functioning (Biever, Karinch 2012 p. 24). There is also the
possibility that the individual has subjective distress.
It is hard to recognize symptoms of a person suffering from dissociation. More than
anything they appear normal. An individual suffering from dissociative fugue will have
symptoms such as sudden and unplanned travel away from home (WebMd, 2014). They may
have the inability to remember events from the past or even important information (WebMd,
2014). They may feel confused about who they are, in some cases they could make up a new
personality to make up for the loss of their own (WebMd, 2014). As a result of their fugue
episodes, it could put them under extreme distress and problems with daily routines (WebMd,
2014). Unusual symptoms include their inability to recognize their own image in the mirror.
They might not recognize people who they interacted with on a daily basis (Mind for a better
mental health, 2013).
In example of dissociative fugue is the story of Hannah Upp. Hannah had difficulty
recognizing her own image when someone else recognized her face as the girl who was missing
from Hamilton Heights, New York. According to New York Times, Hannah Upp was a 23 year
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old middle school teacher, which had gone missing the day before a new school year started
(Marx, Didziulus, 2009). The last day Hannah remembers is that she went out for a jog and never
came back.
It was as if the city had opened wide and swallowed her whole (Mark, Didziulus, 2009). It was
not until they had discovered that Hannah had been caught by security cameras at an Apple store,
checking her e-mail, once again she vanished. She kept making reappearances in places such
Starbucks and New York Sport Clubs where she would shower. Almost three weeks after her
disappearance she was found face down in the New York Harbor: alive.
After she was diagnosed with dissociative fugue, doctors tried to make sense of why she
should would check her e-mail. There was evidence that she logged in but she never read or sent
anything. All the emails talked about Hanna Upp and she did not know who that was so she
would simply log off. The same mind took over when a student that attended the same university
as Hannah asked her if she was the missing girl. She said no, because she had no idea who
Hannah Upp was. As of today no one is really sure why Hannah dissociated, the only thing she
knows is that she was under stress working on her Masters and working as a teacher. To this day
Hannah is still trying to figure out who she truly is. Individuals, such as Hannah, describe
dissociation as follows, Its as if your mind is not in your body, as if you are looking at yourself
from a distance; like looking at a stranger (Mind for a better mental health, 2013).
Dissociative disorders are rare especially dissociative fugue. However researchers have
noticed that this disorder increases during time of war or natural disaster (Cleveland Clinic,
2014). Many psychiatrists do not get a chance to treat people with these disorders, since many of
these individuals do not end up in emergency rooms after they awake. According to the
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Encyclopedia of Mental Disorders (2014), dissociative fugue is estimated to affect only 0.2% of
the population. In this case then how do we treat patients?
The main goal to treatment is to figure out what causes someone to go into a fugue phase.
In Hannahs case, she had no idea what triggered her to fugue which can make recovery harder.
Besides discovering the causation there is a variety of methods of help treat patients. Treatments
go as follows: psychotherapy, cognitive therapy, medication, family therapy, creative therapy
(art, music), and even clinical hypnosis. Psychotherapy is the most important form of treatment
for it offers communication and assistance with conflicts. Even though there is no specific
medication for dissociative fugue, people tend to suffer other illnesses such as anxiety and
depression. They will offer them medication such as, antidepressants (Cleveland Clinic, 2014).
The treatment of hypnosis is controversial, because people believe it will cause false memories.
On the other hand people use hypnosis in hope to find and explore their unconscious mind
(Cleveland Clinic, 2014).
Dissociative Disorders are controversial in general. Perhaps some people do not want to
believe in things that they do not wish upon themselves. Individuals suffering from dissociative
fugue did not wish it upon themselves, but in a way they need it for survival. Dissociative fugue
is a disorder that exists for the reason that certain individuals need it to cope with problems.
There are case studies such as Hannahs story, as well as, treatment offered to patients. It makes
sense as to why one might to choose to dissociate versus deal with a horrific event. As Dr. Biever
once said, We are indeed terrified of losing our minds, so terrified that we may cling to the
belief that these serious kinds of dissociation do not really exist; that they are simply imagined
by people with weak or immature minds, or even faked (p. 3). If one were to bring the up the
topic of dissociation, most find it hard to believe such a thing. Some people do not want to
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believe an intelligent woman can leave her whole family behind while she is have way across the
world with no identity; then all of a sudden she awakens.
It would be different story if you told people that people can develop Post Traumatic
Stress Disorder (PTSD). Variety of people associate Post Traumatic Stress Disorder with war
because, Its so much easier to appreciate the mind-bending effects of exploding roadside
bombs and severed limbs (Biever, Karinch, 2012 p. 128). The truth is we have all gotten lost in
one way or another either reading a book or watching a movie or even in a daydream and
understand one another because we all do it. We do not all flee under stress or recurrent negative
events as children or adults. Regardless, we should keep an open mind towards these individuals-
it is their effort to adapt to the hardships of life, that we have no control of. After all our mind
had a mind of its own.








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Works Cited
Biever, J. A., Karinch, M. (2012). The Wandering Mind. Lanham, MD: Rowman & Littlefield
Publishers, Inc.
Cleveland Clinic. (n.d.). Dissociative Fugue. Retrieved from
http://my.clevelandclinic.org/neurological_institute/center-for-behavorial-health/disease-
conditions/hic-dissociative-fugue.aspx
Encyclopedia of Mental Disorders. (n.d.). Dissociative fugue. Retrieved from
http://www.minddisorders.com/Del-Fi/Dissociative-fugue.html
International Society for the Study of Trauma and Dissociation. (2011). Retrieved from
http://www.issd.org/education/faq-dissociation.htm
Mayo Clinic. (n.d.). Dissociative Disorders. Retrieved from http://www.mayoclinic.org/diseases-
conditions/dissociative-disorders/basics/symptoms/con-20031012
Mental Heal and Dissociative Fugue. (n.d.). Retrieved from http://www.webmd.com/mental-
health/dissociative-fugue
PsychCentral. (2013, May 26). Dissociative Fugue Symptoms. Retrieve from
http://psychcentral.com/disorders/dissociative-fugue-symptoms/
Sidran Institute Traumatic Stress Education & Advocacy. (2010). What Is a Dissociative
Disorder. Retrieved from http://www.sidran.org/sub.cfm?contentID=75&sectionid=4
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The New York Times. (2009, February 27). A Life, Interrupted. Retrieved from
http://www.nytimes.com/2009/03/01/nyregion/thecity/01miss.html?pagewanted=all&_r=
0
Tull, M. (2009, January 29). How Trauma can Lead to Dissociative Disorders. Retrieved from
http://ptsd.about.com/od/relatedconditions/a/dissociation.htm