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You must have seen films and read stories where, after a psychological shock, the

hero seems to have lost his memory. He cannot recognize people. Nor can he

remember his own identity. Then suddenly, after a chain of events that make up the

story, his memory returns and everything ends happily. Such stories reflect, often in

an exaggerated and over-simplified fashion, the essence of Dissociative Disorders. The term ‘dissociation’ refers to the separation of the activities of a person from

conscious awareness. While psychoanalysis has long since highlighted the irrational

aspects of human mind, cognitive psychology has also been concerned in recent

years with non-conscious processes..

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1) Dissociative Amnesia and Fugue.

2) Depersonalization Disorder.

3) Dissociative Identity Disorder.

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The prevalence of Dissociative disorders in population is not well researched. Amnesia

probably occurs in about 5% to 7% of the population. Fugue is much less common,

about 0.2%. Depersonalization disorder occurs in about 2% to 3%. Dissociative

Identity disorder was once considered to be very rare. Later on its diagnosis has

been influenced by the scientific culture of the time. Some doctors diagnose it more,

some merge it with schizophrenia. It may be prevalent in 1% to 2 % of the population.

  • Biological Factors

Like Somatoform disorder, biological factors are of secondary importance in

Dissociative disorders also. At best a vulnerable personality with greater suggestibility

may have some genetic implication.

  • The psychological causes are at the root of dissociative disorders.:
  • psychoanalytic Approach:

The psychoanalytic explanation highlights the operation of the defense’s of repression and denial in amnesia and fugue. When

certain unconscious conflicts are extremely painful, and no acceptable escape

route is left open, the ego may take resort to repression, making the content of

the conflict unavailable, at least temporarily. Another important defense mechanism

is operative in all Dissociative disorders, which is isolation of emotion and event.

This is most prominent in Depersonalization disorder.


Dissociation is an escape from stress. Therefore, when you are dealing with a person

with Dissociative amnesia and fugue, the first thing you must make sure is to keep

her in a safe environment. If you can elicit from her case history the precipitating

stressful event, you may assure her that she is safe from that danger. Sometimes,

staying away from perceived danger leads to spontaneous recovery. Psychoanalytically

oriented therapies and hypnotherapy may help to bring out the lost memory. Sometimes

anxiolytic medicines are also used as adjunct to psychotherapy.

One word of caution here. Not all memories that are retrieved from the person with

amnesia are reliable. You need to cross validate them from independent sources. And

you must remember that simply reviving the memory is not the end of treatment. You

need to work through the retrieved material so that the memories are properly


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