Hi, I am Elle, and this is Quid Pro Quo, your friendly neighborhood forensics-like podcast. Representing for everyone who tunes straight to the Discovery ID channel on the treadmill, and who measure their cardio gains not only in speed or distance, but also in their ability to outrun scary people. The Quid Pro Quo podcast deals with crime, psychology, and related themes. Listener discretion is advised.
Welcome to 2017. Sorry this is a bit delayed, but vacation plague was not kind to my voice. A lot of psych podcasts this week will be talking about how to make big changes in your life, and in that sense Quid Pro Quo is no different. This is definitely an episode about change, but of course, we're not your average psych podcast, and we're going to come at it from a slightly different angle.
Let's start off with a bit of a story. A woman arrives home after work. The house is unusually silent, and the dogs are both dancing at the front door, eager to greet, but also clearly needing to be let out. With a hint of well-aged aggravation, she stops to lock the side door.
There's a cold, partial cup of coffee on the table. She knows her husband has had a long week, and figures he is napping. She makes a sandwich, and retires to the den, hoping that will allow him some much-needed rest. At 4 AM, she is sour-moused and stiff from falling asleep on the couch, and she works to keep her patients with a young police officer who is noticeably younger than her own children.
The bed is cold and still crisply made from the morning. The house is orderly and peaceful, and his wallet, cart, and coat are right there, but he is not. No, this is not like him at all. He's very routine-oriented, very predictable.
Still a solid marriage, but certainly not immune from the usual arguments and money troubles. He's been a bit down lately, but not out. A recent family death, empty nest, there was one late afternoon call on the house line from his brother, but the time zone difference is not in her favor. And so far he's not picking up to explain.
No enemies, she's honestly not sure if he still has a gun. She doesn't think so, but once the kid's left home it wasn't much of a concern. Separately, none of these data points is terribly noteworthy, but with every answered question, the woman watches the switches click off behind the officer's eyes, and her heart sinks. No, there's no note, not that she's found anyway.
Missing posters calls to more ERs than she even knew existed, flag to counts a million picked over documents and communications, close circuit camera footage for local beach access roads and bridges, and every large shape on the side of the road represents a split second of the most bitter flavor of hope, humanly imaginable. A full investigation is underway, but this is an older male under some emotional stress, with easy access to and familiarity with lethal methods of cell farm, such as drowning and firearms. After a few scant weeks, the progress discussions with police start to focus on tight charts and an uncomfortable fixation with the weather. An identifiable body with a coherent note starts to sound like a pipe dream.
This is no one person's story, but still, this is a tale as old as time, song as old as rhyme. And if you are a true crime and missing person TV show buff, you know it like the back of your hand. In the long run, this is almost certainly going to be treated as an open and shut case of suicide, barring some shocking revelation of recent massive insurance purchase, marital infidelity, or underhanded business dealings. For almost everyone in the history of the universe, that assumption would probably be spot on.
However, one tiny glimmer of hope, and that glimmer is called dissociative fugue. Okay, so what the heck is that? Imagine a few months down the line, this woman actually getting the phone call everyone in this position hopes for, but no one expects. They found him, he's physically fine, a little worse for the wear, but well, that's where things get weird.
Please meet us at the hospital, no, not the local one. In fact, it's a few hours away. Bring proof of health insurance and maybe a few family photo albums. Don't worry, the city is not pressing any charges.
The DSM-5 diagnostic criteria for dissociative fugue reads as follows. Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or other important autobiographical information. Psychology likes having a whole string of different names for things, sometimes with good reason, so in literature it may also be called a fugue state or psychogenic amnesia. This fugue has to be paired with something called dissociative amnesia, which is not the run-of-the-mill soap-oper-plot bump-on-the-head memory loss.
It has some very specific limitations. Dissociative amnesia is defined as an inability to recall important autobiographic information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Again, per the DSM. More specifically, dissociative amnesia most often consists of localized or selective amnesia for a specific event or event or generalized amnesia for identity and life history.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disturbance is not attributable to the physiological effects of a substance, for example alcohol or other drug abuse or medication, or a neurological or other medical condition, for example partial complex seizures, transient global amnesia, consequence of a closed-head injury or traumatic brain injury, or other neurological condition. The disturbance is not better explained by dissociative identity disorder, post-traumatic stress disorder, acute stress disorder, somatic symptom disorder, or major or mild neuro-cognitive disorder. To translate that into easier English, the person has forgotten something or possibly everything.
The person's life is messed up as a result, there's no obvious medical or chemical reason, and it's not better explained as one symptom of a specific set of broader diagnoses. Back to our labored husband. Rounded up in a routine homeless encampment raid in a surprisingly distant city and booked in when he refused to provide identification. He is not combative if anything he seems open and clear-headed, but as questioning continues, he only gets more disoriented.
No local records, so they spread the net out wider. The fingerprint check they expected to connect to the usual petty criminal history and outstanding warrants, instead brought up a citizen in good standing, except for that pesky, missing, assumed dead issue. His fingerprints face even some of his last-known clothing match-up, feeding him biographical information doesn't seem to trip any memories, but on the other hand he's not arguing the point, providing any useful information to replace it. It seems they found their guy, physically anyway.
I saw the words New Year, New You, on some social media ad or another leading off to Christmas, and I was amused at the direction my mind wandered. Most people would probably think of quitting smoking or dusting off a gym membership, whereas I thought of a rare psychological disorder. I'm hardly alone in this fascination, though. As with almost all things rare, little understood, and unexplainable, dissociative amnesia and dissociative fugue in specific are well overrepresented as plot points in modern fiction, though few movies get them entirely right.
Just off the top of my head there are a pile of thrillers from the last thirty years I could completely spoil by naming them in relation to dissociative amnesia, but thankfully for you, I don't do spoilers. Other hopefully less-spoily titles include The Fisher King with Robin Williams and Jeff Bridges and The Jason Bourne movies, which many suspect got the title character's name from the first recorded dissociative fugue case, 1887's two-month disappearance of Rhode Island preacher Anselborn. And though I have not personally watched it, apparently there is even a dissociative fugue related plot in Breaking Bad. The only ultra rare, psych disorder I can think of offhand, which is more ridiculously overrepresented, is Ontario Great Amnesia, which is what Guy Pierce's character had in Memento.
If you're more into romance movies, think Drew Barramour's character in Fifty First Dates. Much of what we know causally about what makes who you are go haywire is derived from studies of a specific thing which goes wrong, which we can directly associate with a problem. From the moment I first heard about dissociative fugue in college, I found it downright fascinating, because in one specific way it is unlike just about any other psych disorder. A great deal of the way psychology teaches us how we work is by looking at what happens when we don't work.
This is going to be a slight digression, but you can't talk about basic neuropsych without touching on the sexy bad boy of Psych 101. The name everyone associates with therapy may be Freud, but arguably the start of psychological science was a handsome but rather unfortunate 25-year-old explosives expert named Phineas Gage, who suffered the grandaddy of On The Job Accidents in September 1848. In one of those one-in-a-million wrong place wrong time moments, he happened to turn his head into the path of an explosion, and a three-foot-long, thirteen-pound iron rod shot clean through his head, entering below his cheekbone and exiting the top of his skull, and finally coming to rest some 80, 80, 80 feet away. Though his treatment was long and extremely difficult, in time he made a remarkable recovery, which was effectively a first of its time, and I think even now would be considered miraculous.
The medical recovery was remarkable enough on its own, but the point that seems to have burned the case into the annals of history is that his personality was said to have changed. Gage was previously described as bright, driven, well respected, and hardworking, but it seems that for some time after the accident his behavior became rude and unstable, and those who had worked with him declared that he was like a different man. There is now a great deal of skepticism over the extent of his permanent mental changes, as he later went on to take fairly demanding carriage driving work that would not have been possible for someone in his reported state, and which rarely makes it into the historical descriptions. Regardless, his accident captured imaginations and provided a stepping-off point for contemporary scientists to investigate the role of the physical structure of the brain, and in particular the frontal lobes on the expression of personality.
Whether it's an acute brain injury, like a stroke, or a wayward iron rod, or it's a measurable chemical imbalance, or a deeply traumatic psychologically scarring experience, what we do is record the injury. We then record what goes wrong as a result. We compare patients with similar injuries and symptoms, and finally, we see what parallels and differences we can reasonably attribute to the damage. While I have no doubt we will find some sort of measurable physical connection, somewhere down the line, the current diagnostic criteria of dissociative fugue directly rule out all of the sort of major trauma we would look to first for an explanation, and which makes it possible to get a definitive diagnosis.
Elizabeth Mose, associate professor in the psychology department at Suffolk University, does point out a few commonalities which she believes indicate that the fugue states have a neurological basis. For one, lost lifetime memories tend to be much easier to reconnect with these patients than for people with Alzheimer's or victims of head injury, since there's no physical problem with the way the memory is encoded over the part of the brain which holds the memory itself. And second, sufferers tend to express a lack of care or worry about their condition while they're in the midst of the fugue. In the medical world, such a lack of emotion is known as, and please pardon my terrible French here, LaBelle in difference, and is often associated with stroke victims who seem oddly unconcerned about specific post-stroke deficits.
Synix, however, point to these symptoms is evidence that the supposed sufferer is malingering which is faking an illness for personal gain. Since of course they wouldn't regain memories in an expected way, and why would someone be upset about a deficit that they are faking? I can't say I follow the logic of that second theory though, as a malingerer is probably going to overdramatize their issue to gain as much sympathy as they can. And anyway, it's not like this is a common problem for clinicians.
This condition can have some deep legal and emotional implications. So outside of TV, outlaw logic, there's not much real-life advantage to non-sensically abandoning your life, and all of your resources for weeks or months at a time to live in probable squalor. Most people who would fake this condition to get out of a legal issue would have to be making plans for months or even years in advance and are probably going to be caught up in that lie by the police, long before they see a doctor. Regardless, while there are a few common factors which may very well lead us to more understanding in the future, at this point in time the very definition of it happening almost requires some sort of mystery about why it happened.
Bump on the head, rule out, major immediate emotional trauma of the sort that might trigger PTSD? Rule out. Something dissociative disorder? Rule out.
Oh, uh, we don't know, this doesn't make any sense, whatsoever. Rule in? How utterly bizarre is that? These are not people wandering away from car accidents bleeding from the ears or shutting down in shock from a fresh traumatic event.
These are everyday people living through everyday stresses, or at least people who seem to be under still a extra stress, but right up to that point are handling it pretty well. Who just stop being themselves and wander off to be someone else for a while, sometimes abandoning their original selves for the rest of their life. And probably one of the weirdest twists to fate ever, one of the most famous cases of diagnosed dissociative few, was none other than the best selling novelist of all time, classical, mystery writer Agatha Christie. What we do know is that in early December 1926, Christie had been under some stress due to the recent death of her mother, and some pretty much completely bald-faced infidelity by her husband Archbold with a woman named Nancy Neal.
She left a few contradictory and somewhat concerning notes, but one did clearly indicate that she was planning to go on holiday, and then she full-on disappeared. The next morning her abandoned car was found near a local lake or spring called Silent Pool, which had featured as a place where someone had drowned in one of her stories. The car was undamaged with no apparent indication of a crash, but the headlights were left on and the hood up. She had abandoned her fur coat, a suitcase with some clothes, and an expired driver's license in the car.
Her disappearance touched off a massive search involving tens of thousands of volunteers, the very first aerial search, and the assistance of fellow crime novelists Dorothy L. Sayers on the ground search and Sir Arthur Conan Doyle, who contacted a medium to perform psychometry or touch-based psychic reading on one of Christie's gloves. Murder, suicide, accident, nothing was off the table, but in the one twist no one could have expected, not even one of her celebrated detectives, she was just fine. Eleven days and 230 miles later, an eagle-eyed employee at a resort hotel found he couldn't shake the similarity of one of their guests to the missing author and finally contacted police.
Though this guest had been confronted with her uncanny resemblance several times during her stay, she continually claimed to be a Theresa Neal from Cape Town, South Africa, only showing any recognition of her true identity when finally seeing her husband in person to confirm it was her. And then the signs of recognition were reportedly pretty dicey. The disappearance was decried as a publicity stunt or a deliberate act of jealous vengeance designed to either win back, shame, or even frame her husband for murder. After all, her choice to check in with the same last name as her husband's mistress was notable.
What always strikes me when reading about this story is her comment when she first saw her husband. Do you think a brilliant mystery-writing genius after doing all of that as a deliberate vengeful dig would greet her wayward husbands with the words, fancy, my brother has just arrived. Seriously, that's just not the flavor of weird, someone is going to use as a garnish on a hot revenge Sunday. In time, most of the nastier rumors settled and history is generally an agreement that this was a genuine fugue state.
Agatha Christie continually denied any memory of the events leading up to the disappearance and remained cagey about it her entire life. And yes, Doctor Who fans, that episode was based on a real event. Other than the one bit there with the giant- well, you know what I'm talking about, that part probably didn't happen. Unfortunately for the sufferers and families of these episodes, the ambiguity of calls can lead to some real long-term consequences.
Most people have to contend with suspicions of fakery, lost income, lost trust, and sometimes charges of child abandonment, fraud, and other serious legal troubles, not to mention the physical hazards of living a confused, unsupported life. The mystery of the trigger for these episodes can hang over their head for years, leading to guilt, self-doubt, and severe lifestyle limitations. Most of these people are not world-famous authors, with the resources of an entire world-powered desperately seeking their return. In many cases, connecting the confused wanderer with their abandoned identity is a matter of sheer luck.
Though oddly, the sociote of fugue does appear to be a bit of a writer's ailment. Under the century author Sherwood Anderson suddenly shuttered his manufacturing business and wrote his celebrated Weinzberg, Ohio, in the aftermath of what is now believed to be a dissociative fugue. And Jodi Roberts, a reporter for the Tacoma News Tribune, went missing in 1885 and was found 12 years later in Sitka, Alaska, living under the name of Jane D. Williams.
NPR did a piece in 2012 on an Olympio-Washington man named Jeff Ingram, who had experienced three bouts of this sort of amnesia in 1994, 2006, and 2007. During his last fugue, he suddenly sort of woke up in Denver four days later and stumbled into a hospital, only realizing he didn't know who he was when he couldn't identify himself to the receptionist. He appealed to the media to help him find his identity, and thankfully his fiance's brother managed to catch the piece and help him find his way home. Because of the depth of his memory loss, he has lived a sort of inverse of the movie Eternal Sunshine of the Spotless Mind, falling in love with his wife now multiple separate times.
Though thankfully, without the ultra-creepy fate subplot. Their love story is sad in many ways, but also very sweet, and I think well worth checking out. In 2009, New York school teacher Hannah Epp went for a jog along Riverside Drive, which contains a popular waterfront jogging area, and reconnected with the world three weeks later, faced down in the water and near drowning, being pulled out of the water by workers on the Staten Island ferry. Her only recorded movements during her disappearance were to log onto, but not actually check her email at an apple store near her college, which they think may have been a sort of road action, and then to actively deny her identity to a fellow student who saw he recognized her.
Near as anyone can tell, she lived the majority of the three weeks lurking around Riverside Drive, which was a comfortable and familiar area for her. So how she ate and slept is unknown. When walking became painful due to a large blister, they think she simply switched to spending time in the water, leading to her eventual maritime rescue. Both Hannah and Jeff fear future episodes and have taken steps to set up code words with family.
After his repeated bouts, Jeff has even gone so far as to get an identifying tattoo and keeps a GPS and a medical file with him at all times. Some people are not so lucky. This past October, the thin air podcast covered the story of missing New Yorker Renee Lamanna, who is thought to have developed Dissociative Amnesia in 1994 after a breakup. She is missing, she is not in a position to support herself, and she is lacking in even the most basic tools to seek the people who most want to help.
The thin air podcast did a full in-depth episode on her case, so rather than reinventing the wheel here, I suggest you check out the link to their episode which I will provide in this episode's write-up. This is one of the very first podcasts I personally subscribe to, and I definitely recommend you do the same. For the most current info on the case, check out at Renee Lamanna on Twitter, which is maintained by her sister Margaret. If the idea of Dissociative View doesn't stop you in your tracks for just even a second, well then I don't know if we can be friends.
This devastating but fascinating condition is like finding an ancient treasure map with a cipher no one has been able to crack, or a fragment of the final draft of a never published book by a master writer. It's one of those things that truly highlights just how much we have left to learn about ourselves. If you want to weigh in on this mysterious form of amnesia, or if you have other questions about true crime and forensic psych, seek me out at QuidProQuoCast on Twitter, Facebook, Gmail, at the dot com, and wherever fine internets are sold. I am currently the most active on Twitter.
All of the ratings, retweets, conversations, and shares since the Halloween launch have been so wonderful. I especially want to take a moment to thank iTunes reviewers, MS-Rose1025, and Variance for your kind words. My podcasting New Year's resolution is to leave more reviews. I am so bad about doing that, and I now realize that I have zero excuse.
I listen to a whole lot of podcasts on the regular, they fill my hours with fascinating information, and these people deserve to know it. Writing and editing of QuidProQuoXL, all rights reserved.