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R is a sixteen-year old girl living in Seoul, Korea. A few years back, I often received text messages saying that she is in Kwanghwa-Moon or even in places as far as Busan on weekends, so I assumed that she enjoyed traveling alone. Recently, she started disappearing on weekdays--often right after school--to isolate herself in a cafe or a near-empty museum. She still sends me texts when she feels like it, but these text messages often do not discuss where she is at, but rather about what she should buy or eat. She is reluctant to identify her location, and when she does, it is often accidental. When asked if she'd like some company, she answers no. None of her family members or her friends know where she is at times, often till late into night. So I thought, well, maybe she likes spending time on her own.

But now, the text messages are growing rare. I'd receive calls from her parents asking if I knew where she was, to which I was left with nothing to answer. She eventually turned up after a few days or so, but her pattern of "disappearing" grew frequent and erratic. She would often be absent from home for days, and return as though nothing had happened.

Concerned, I looked for an opportunity to catch her on one of her disappearances. When I finally I found R in a cafe, I asked R whether she didn't enjoy being at home or school. She replied no. I asked R where she went every time she went away. She asked me what I meant.

"But you disappear for hours or days to somewhere without telling anyone." "I never did. Lara did though." "What?" "Lara. She likes to go on journeys, she's a redhead wearing red shoes. She wears blue dresses and talks loudly into public telephones." R had red shoes on. R was wearing a blue dress. "Wait, are you sure this person isn't you?" "No. Lara is just Lara."

What does this disappearance mean? Who is Lara? Is R simply experimenting with role-play? It's as though R's slipping away, disappearing into another identity in another place, slowly being isolated from everyone and herself.

__**Diagnosis:**__ I think R has a dissociative fugue disorder. R suddenly and unexpectedly disappears to places close (Kwanghwamoon) or far(Busan) for unknown periods of time without a plan. This perfectly fits the symptoms of the dissociative fugue disorder because dissociative fugue disorder usually involves unplanned travel or wandering for unknown amount of time. She is definitely confused about her identity and has already created another identity called Lara. This matches with the fugue symptoms of patients of getting partial amnesia and forgetting the time they were away by replacing the memory with another identity. Some patients suffer complete amnesia for the fugue episode just like R does here. __**Cure:**__ It would be helpful to get rid of the cause, which is usually stress for dissociative fugue disorders. Traumatic experiences or very stressful events might have caused R to want to run away from reality and to abandon the past. There must be a cause that would have made R want to run away for period or blank out their life in the past by creating a new identity. Sometimes, dissociative fugue disorders can cure naturally. Psychotherapy and a mixture of hypnosis treatment are effective treatments for dissociative fugue. Psychotherapy can bring back past memories that R fears about and make him/her cope with the stressful experiences that caused her to run away through discussion and portraying emotion. Hypnosis treatments could get rid of the specific memories that R fears and stresses about. Drug facilitated interviews through drugs, such as barbiturate or benzodiazepine, could help R tell the deep truth and help R confess to the psychotherapists about her situation. Cognitive therapy would include therapies that would try to change R's thinking ways into making him/her view life differently. Medication would be a way to get rid of the possible depression or anxiety that might lie within the fugue disorder with medications such as Xanax (mild anti-anxiety drug) or serotonin reuptake inhibitors like Prozac.

APA: Grohol, John M.. "Psych Central: Dissociative Fugue Symptoms." Psych Central - Trusted information in mental health and psychology. N.p., n.d. Web. 11 Jan. 2010. .

Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association, 1994. Print.