Dissociative
Amnesia - formerly Psychogenic Amnesia, is a pervasive
loss of memory of significant personal information. This disorder
is characterized by a blocking out of critical personal information.
Dissociative amnesia, unlike other types of amnesia, does not
result from other medical trauma, such as a blow to the head.
The predominant disturbance is one or more episodes of inability
to recall important personal information, usually of a traumatic
or stressful nature, that is too extensive to be explained by
ordinary forgetfulness.
The disturbance does not occur exclusively during the course of
Dissociative Identity
Disorder, Dissociative Fugue, Post
Traumatic Stress Disorder, Acute
Stress Disorder, or Somatization
Disorder and is not due to the direct physiological effects
of a substance (e.g., a
drug of abuse, a medication) or a neurological or other general
medical condition (e.g., Amnestic Disorder due to a head trauma)
The symptoms cause clinically significant distress or impairment
in social, occupational, or other areas of functioning. Localised
amnesia: is present in a individual who has no memory of specific
events that took place, usually traumatic. The loss of memory
is localised within a specific window of time. For example, a
survivor of a car wreck who has no memory of the experience until
two days later is experiencing localised amnesia.
Dissociative
amnesia has several subtypes:
Selective Amnesia: happens when a person can
recall only small parts of events that took place in a defined
period of time. For example, and abuse victim may recall only
some parts of the series of events around his or her abuse.
Generalised Amnesia: is diagnosed when a person's
amnesia encompasses this entire life.
Continuous Amnesia: occurs when the individual
has no memory for events beginning from a certain point in the
past continuing up to the present.
Systematised Amnesia: is characterised by a loss
of memory for a specific category of
information. A person with this disorder might, for example, be
missing all memories about one specific family member.
Dissociative Fugue: is a rare disorder. An individual
with dissociative fugue suddenly and unexpectedly takes physical
leave of his surroundings and sets off on a journey of some kind.
These journeys can last hours, or even several days or months.
Individuals experiencing a dissociative fugue have traveled over
thousands of miles. An individual in a fugue state is unaware
of or confused about his identity, and in some cases will assume
a new identity (although this is the exception).Dissociative Fugue,
formerly Psychogenic Fugue,- is a sudden, unplanned excursion
away from ones planned itinerary accompanied by either memory
loss or confusion about, loss of, or assumption of a new identity.
Associated
Features:
Depression.
Anxiety
Disorders.
Post Traumatic Stress
Disorder.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Dementia.
Head Trauma.
Substance
Intoxication.
Early symptoms of neurological disorders (eg multiple sclerosis)
may resemble conversion symptoms.
Cause:
Dissociative
Amnesia:
Dissociative
amnesia appears to be caused by stress associated with traumatic
experiences endured or witnessed, physical or sexual abuse, rape,
combat, natural disasters; major life stresses, abandonment, death
of a loved one, financial troubles; or tremendous internal conflict,
turmoil over guilt-ridden impulses, apparently unresolvable interpersonal
difficulties, criminal behaviors. Additionally, some persons are
believed to be more predisposed to amnesia, eg, those who are
easily hypnotized.
Dissociative
Fugue:
Causes are
similar to those of dissociative amnesia with some additional
factors. Fugue is often thought to be malingering,
because the fugue may remove the person from accountability for
his actions, may absolve him of certain responsibilities, or may
reduce his exposure to a hazard (such as a dangerous job assignment).
Many fugues appear to represent disguised wish fulfillment. The
fugue may remove the patient from an embarrassing situation or
intolerable stress or may be related to issues of rejection or
separation and some fugues appear to protect the person from suicidal
or homicidal impulses.
Treatment:
The treatment for dissociative
amnesia is therapy aimed at helping the person restore lost memories
as soon as possible. If a person is not able to recall the memories,
hypnosis or a medication called Pentothal (thiopental) can sometimes
help to restore the memories. Psychotherapy can help an individual
deal with the trauma associated with the recalled memories.
Hypnosis is
often used in the treatment of dissociative fugue. Hypnosis can
help the client/patient recall his/her true identity and remember
the events of the past. Psychotherapy is helpful for the person
who has traumatic, past events to resolve.
Counseling
and Psychotherapy [
See Therapy Section ]:
Hypnotherapy
[
See Hypnotherapy Section]
Pharmacotherapy
[ See Psychopharmacology
Section ]
