A discussion of how a person can lose awareness of their identity.
This week our focus in on something other than hormone replacement specifically. This topic is often more related to Counseling and Psychology. But it is real, and it does sometimes show itself in Dr. Maupin’s office. It is called a Fugue State.
Fugue State is a diagnosis under Dissociative Disorders in the DSM V. These are the diagnostic and statistical manuals of the American Psychiatric Society. These books (there are five revisions), describe the criterion for diagnosing mental and emotional disorders.
If you experience traumatic events or excessively stressful events, especially early in childhood, you use a defense mechanism called repression. This does not mean that you forget these events or experiences, it means that you block them from your consciousness in order to appear normal and to function without calling attention to yourself in ways that could jeopardize you.
Sometimes when the stress levels are more than your system can handle, you will “lose” some of your awareness. You may forget your name and where you live, and you may forget some event or period of your life.
If you leave home and get in your car and drive somewhere and during the drive have a wreck, and wake up in the hospital and do not know who you are or what you were doing and do not remember the drive at all, you suffer from what we call Amnesia. This amnesia can be limited in duration and will go away and you will recover your memory of the event. If the amnesia is caused by severe brain trauma you may not get the memory back. The type of amnesia that may happen and from which you may recover is the type caused by stress and emotional trauma. There are levels of amnesia and dissociation that are recoverable if your stress levels diminish.
All of us repress things because of our focus of attention. If you break up with a girlfriend and then automatically and unconsciously dial her number on the phone, that is called repression. However, if you have had severe levels of trauma you are not repressing you are dissociating from reality.
This dissociative process can sometimes be beneficial such as when you are doing surgery as a physician, you cannot become preoccupied with your own life problems and concerns. You may hyper-focus in order to do your job. That is a good thing.
Sometimes though the dissociation is so complete that you do not know where you are or who you are and do not remember the flow of your life. If you suffer from this type of amnesia, you may also experience a desire or need to travel and move. This desire is called a fugue state. The compulsion requires you to drive a car or catch a train or plane and go somewhere. You may not know where you need to go you are just going.
The most extreme form of dissociation is called dissociative identity disorder it used to be called Multiple Personality Disorder. Your core identity would fragment into separate and distinct identities, each of which would have its own name and memories.
Each of these disorders can be treated, often with great success. All behaviors are in service of the self. If your self needs to dissociate in order to handle the stress or trauma of your life it will. When you are less stressed, and your life is safer it will often restore your memories and you will be able to function with complete awareness and full memories.
The reason we are talking about these disorders this week is that sometimes a physician will encounter a person with these symptoms and cannot find a physical reason for the symptoms. They must then consider the possibility that the person is suffering from a psychological or psychiatric disorder and make an appropriate referral to a counselor, psychologist or Psychiatrist.
This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.