An Adlerian view may be that this patient is hiding his inferiority feeling or concealing a depreciating feeling, or perhaps defeating the mother by "escaping to his own self indulgent reality". There is far too little information provided to form any meaningful conclusion, save that I suspect he is applying a well rehearsed "trick" to evade his aggressive feelings and attitudes. Since he has an "illness over which he alleges no contol" he can continue an aggressive response, because, after all, it is "out of his control". Think of the "fugues" as purposive and drummed up to suit the purpose of avoiding some perceived impossiblity as a good starting place. "Fugues" don't just happen, they are carefully crafted to avoid a more useful response! The creation of psychic states is purposive barring brain injury or malformation as in seizure disorders. His concern for others (social interest) is low in this area of functioning.

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George Neeson M.D.