Dissociative Identity Disorder: Fearfully And Wonderfully Made (27)

Dissociative Identity Disorder: Fearfully And Wonderfully Made (27)

Psalm 139: 13 – 18

A number of minor incidents happened during the next few weeks which portend developments that I was not quite prepared to handle as it complicated Jane’s recovery and the couple’s dynamics.

Thomas had angrily reprimanded Jane over a disagreement one day, and called her names in full earshot of several public bystanders. She felt angry and embarrassed. That night, Mike and Pearl came, woke Thomas up and harangued him. Commencing from that evening, Jane began sleepwalking, and found herself outside her home on several occasions – waking up in a park nearby her home at two in the morning, along the main thoroughfares, etc. This shocked her, and caused her to loose her sleep, fearing that she might wander even farther away from home.

Dissociative fugue is not uncommon among this spectrum of patients. It is interpreted as a predominant disturbance of sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past. In fact, several of my patients exhibited this habit, to which I always feel anxious for their safety, especially those who drive or have access to a motor vehicle. Under dissociative fugue, an alter of a patient decided to take her own life, and drove her husband’s car without his knowledge at 3am to a parking lot at an industrial complex. Alters reason that they can kill the host without maiming themselves. She suddenly woke up when she arrived and was shocked to discover herself at the carpark on her own, with all her depression medication with her. After she stopped trembling, she drove home and reported sick the next day. Another patient took her aunt’s car out for joy rides, sometimes twice a week, after everyone had turned in. On each occasion, she woke up only after reaching home, and found herself at the wheel. Her aunt was initially stumped that her petrol tank was nearly empty after she topped it up the day before, until she found out one day. Then her anxiety for her niece shot up sky high! But in every instant of these fugues, the patient returned safely. Remarkable.

Jane’s safety during her fugues was a concern. Subsequently, my instructions to her was for her to sleep in the same room as her house-help. Hopefully, when she does sleepwalk, her house-help would either wake her up or follow her to make sure she does not come to any harm. Thankfully, that worked out well, and within three weeks, as we focused and rooted out her anxieties and anger at Thomas, her fugues ceased.

Thomas’ belligerence against Jane did not completely stop, despite the police report and warning. In fact, it escalated. They continued to quarrel and one evening, Thomas physically attacked Jane. He choked and slapped her till her lips bled. She arrived at my office with a black eye, a bruised arm, and swollen lips. The alter that provoked Thomas was a new alter, Lance, a bartender at his father’s hotel. Another police report was lodged. It will take three reports for a personal protection order to be activated. However, I was not prepared to wait and risks further harm to Jane. I directed Thomas see their family doctor and a psychiatrist, as I suspected that perhaps more was going on in him than meets the eye. He relented after some persuasion.

Thomas’ medical and psychiatric outcome were as anticipated.