Working with dissociative fugue in a general psychotherapy practice: A cautionary tale

American Journal of Clinical Hypnosis, Apr 2003 by Jasper, Frank J

When Joe came out of the trance, he had complete amnesia for what we had discussed. He also said that he had felt he was in a "better mood. " I tried to reframe the amnesia in a positive way as an "internal circuit breaker" that prevented him from being totally overwhelmed. I gave him the assignment to go home and look at his picture albums with his wife. I also suggested that he continue to talk with his coworkers and review his work products.

I had only two references to psychogenic amnesia or fugue states in my hypnosis library-Crasilneck and Hall (1985), and Olness and Kohen (1996) who quoted Crasilneck and Hall verbatim. I consulted with an American Society of Clinical Hypnosis certified consultant who taught at both regional trainings (anonymous personal communication, February, 1998) and had expertise with hypnoanalysis. This senior consultant confirmed the direction I was taking and suggested that I record all the sessions in case something illegal had occurred during the fugue state. He also thought it might be helpful in reviewing memories with Joe when he was in an alert state. I did not attempt this review because Wilbur and Kluft (1989) had reported that it was not helpful.

When Joe returned three days later he was recognizing people but couldn't remember their names. At work he estimated that his knowledge base was where he was four years ago when he started with the company. He was feeling more comfortable with his family but still had no memories of the past. In looking at the photographs, there was a "slight familiarity. " "I've been there before, but I don't remember all of the details, like where the photo was taken or what the occasion was. " He noticed that he was starting to recall things prior to Monday on his own. His memory was "gradually coming back. "

In trance I established the pattern of focusing on remembering positive events from his family, his military service, his early life, his work. Positive age regression was a prelude to my attempts to approach the event or events that had precipitated the fugue state. Joe spoke freely about numerous events in trance until we got to that Monday. Then he simply shook his head vigorously "No. " I ended the session using the previous suggestions that I thought were helpful.

During the next several sessions, Joe made considerable progress. However, he consistently refused to look at what occurred at work before he left on Monday for "an emergency." He recalled some of the events from his earlier life with incredible detail, and some of them were externally verifiable.

A second and even more recognized authority renowned as an expert in hypnoanalysis was then consulted (anonymous personal communication, March 14, 1998). This expert confirmed the direction I was taking and suggested that I have Joe write in trance. A third consultant, also renowned (anonymous personal communication, March 18, 1998), additionally confirmed the direction of my treatment of Joe and suggested regression to key events like birthdays.