Dissociative amnesia

Matt Wolfe writing in the New Republic:

“The first psychologist to provide a reliable account of a man who had misplaced his identity was William James. In his Principles of Psychology, James narrates the case of Ansel Bourne, a 60-year-old carpenter from Greene, Rhode Island. On January 17, 1887, Bourne boarded a horse-drawn streetcar bound for his sister’s house. He never arrived. Two months later, a man named A.J. Brown awoke in a panic. Brown had arrived in Norristown, Pennsylvania, six weeks before, rented a small shop, and hung out his shingle. He sold candy and toys, made weekly trips to Philadelphia to replenish his stock, and attended a Methodist church on Sundays. Yet now his bed looked unfamiliar. Waking his landlord, Brown demanded to know where he was and how he got there. Brown declared that his name was not A.J. Brown—of whom he knew nothing—but Ansel Bourne. The baffled landlord telegraphed a man in Providence who Brown said was his nephew. The nephew hurried to the scene and confirmed, to general perplexity, that Brown was Bourne. A despondent Bourne claimed to lack any memory of the previous eight weeks. The last thing he recalled was the streetcar.

James labeled the case a “spontaneous hypnotic trance.” Today, it would be called a fugue. The word fugue comes from the Latin fugere, meaning “to flee.” A person in a fugue state suffers a kind of involuntary erasure of individuality. Often, people in fugues use pseudonyms and construct fictitious personal histories. They act mostly normally, though for inexplicable reasons, they generally abstain from sex. Some fugues are peripatetic, causing people to travel long distances. In one study, fugue sufferers migrated a mean distance of 1,200 miles. They are oblivious to their condition until someone tells them, at which point a cognitive crisis usually ensues. Fugues depart as mysteriously as they arrive. Some resolve after a few hours or days; others endure for months or years. Afterward, patients find themselves restored, gradually. Their old identities return, intact, though they remember nothing of their mesmeric episode.

The Diagnostic Statistical Manual of Mental Disorders classifies fugues as a catastrophic form of dissociative amnesia. Sometimes, amnesia can act as a kind of circuit breaker, cutting off the input of traumatic thoughts to spare the brain further suffering. A fugue is thought to be an exaggerated version of this impulse. Dissociative amnesia is common in combat veterans, survivors of natural disasters, and victims of prolonged physical abuse, particularly abuse experienced as children. But unlike other amnesias, a fugue occludes not just the memory of events, but of the person who endured them.”

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