Finding Effective and Compassionate Dissociative Fugue State Treatment

One of the most memorable plots on Breaking Bad involved Walter White inventing a dissociative state to account for his whereabouts during the days he was stranded in his mobile meth lab in the desert. To hide his criminal involvement from his family, he stripped off his clothes and wandered into a convenience store claiming he had no recollection of where he had been or what he had been doing. While Walter White’s invented amnesia was an act of desperation to save his family from trauma (and himself from the law), dissociative states are often the brain’s way of protecting you from your own traumatic history, and can take a variety of forms ranging from isolated symptoms within a pre-existing disorder such as PTSD to discrete, full-blown disorders in their own right.

In its most severe articulation, this takes the form of a dissociative fugue state, a phenomenon that represents such a drastic break in the cohesive narrative of someone’s life and fracturing of identity that it has become the stuff of pop culture legend. From Paris, Texas to any number of Law & Order episodes, to Final Fantasy VII, dissociative fugue states have entered the collective imagination through both thoughtful and sensationalistic media portrayals. In the midst of the cultural fascination with this condition, however, lie the heartbreaking narratives of people for whom they are more than storylines in a film or video game; they are reality.

Dissociative Fugue States After Trauma

For one Westchester lawyer, that reality began nine years ago, when he left a parking garage near his office and vanished. “Six months later he was found living under a new name in a homeless shelter in Chicago, not knowing who he was or where he came from.” With the help of his wife, he began piecing together his memory and re-establishing familiarity with his own history, the content of which may hold answers to his fugue state: he was a Vietnam War vet who “happened to have walked between the twin towers of the World Trade Center on Sept. 11, 2001, minutes before the first plane hit.” That experience served to trigger a rush of painful memories from Vietnam and drove him into a deep depression. For experts on dissociative disorders, this may be the key to his fugue state.

Jane E. Brody writes in The New York Times:

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.

Although dissociative fugue states are estimated to affect only 0.2% of the population, people who have experienced traumas like wars, natural disasters, and accidents are significantly more likely to enter such a state. As with the Westchester lawyer, the dissociation doesn’t necessarily happen immediately following the trauma, but may take place later in response to overwhelming stress.

Dissociative Fugue State Treatment

While dissociative fugue states are a pathology in and of themselves, healing from a fugue state and preventing future ones involves treating the underlying conditions that led to the dissociation. As such, diagnostic clarity is paramount to creating a treatment plan that fully recognizes the roots of distress and addresses both experiential and psychological factors. This is best achieved via broad spectrum psychological testing performed by psychiatrists who are experienced with dissociative fugue states and understand the complexity of diagnosis. With a clear diagnosis in place, a personalized treatment plan can be designed to begin the healing process, ideally involving a comprehensive array of individual, group, holistic and, if needed, pharmacological therapies.

Because dissociative fugue states are intimately tied to histories of trauma, engaging in specialized trauma-focused therapies can be essential to recovery.  Having the opportunity to undergo a therapeutic process that doesn’t necessitate rehashing traumas verbally can be particularly valuable when talking about painful events is triggering or produces unnecessary stress. As such, innovative trauma-focused therapies like Eye Movement Desensitization Reprocessing (EMDR) and Somatic Experiencing (SE) give people who have experienced fugue states alternate paths to healing that may be safer and more effective than traditional psychotherapy. Holistic therapies like massage, art therapy, and meditation can also give trauma survivors nonverbal ways of processing their pain.

However, treating the distress that preceded the dissociative episode is only half of the equation; comprehensive dissociative fugue state treatment must also address the distress the results from the episode itself. As Dr. Steve Bressert writes:

When the fugue ends, depression, discomfort, grief, shame, intense conflict, and suicidal or aggressive impulses may appear – ie, the person must deal with what he fled from. Failure to remember events of the fugue may cause confusion, distress, or even terror.

Often these issues are best addressed within a safe, warm, and immersive therapeutic environment. Residential treatment programs like Bridges to Recovery create a welcoming and nonjudgmental atmosphere in which you can fully engage in a meaningful healing process that combines the most effective therapies with compassionate care. The intensity of treatment in residential treatment offers more therapy than can be provided in a year of outpatient care, allowing for rapid release from psychological pain. Simultaneously, the residential structure allows for continuous monitoring of both your progress and your safety to protect you from relapse and ensure your well-being.

Dissociative fugue states reflect a deep emotional disturbance that can wreak havoc on your life and involve profound pain for both you and your family. With the help of mental health professionals who have the expertise and experience to guide you back to psychological health, you can forge new paths to sustainable wellness.

Bridges to Recovery provides comprehensive residential treatment for people suffering from dissociative disorders, including dissociative fugue states, as well as co-occurring mental health disorders, substance addiction, and process addictions. Contact us to learn more about how we can help you or your loved one start the journey toward healing.