- Automatisme Ambulatoire: Fugue, Hysteria, and Gender at the Turn of the Century
By the term ambulatory automatism is understood a pathological syndrome appearing in the form of intermittent attacks during which the patient, carried away by an irresistible impulse, leaves his home and makes an excursion or journey justified by no reasonable motive. The attack ended, the subject unexpectedly finds himself on an unknown road or in a strange town. Swearing by all the gods never again to quit his penates, he returns home but sooner or later a new attack provokes a new escapade. 1
Ambulatory automatism, by whatever name—dromomanie, poriomenie, Wandertrieb, determinismo ambulatorio, psychogenic fugue, or, in the parlance of the current Diagnostic and Statistical Manual of the American Psychiatric Association, dissociative fugue—is exemplary for, even a caricature of, late century madness. It is also a distorting mirror of one of the middle class obsessions of the modern world, the world of Thomas Cook and Son, the world of the comfortable traveller. For les alienés voyageurs—to use the title of the first medical thesis about these men—were compulsive travellers, solid artisans or honest men of the laboring classes, who on hearing the name of a distant place would set out, on foot, or by fourth class carriage, not knowing why they went. So far as casual passers-by could tell, they behaved, en route, quite sensibly, yet they knew not what they were doing, or, in some cases, who they were. That is the prototype. 2 Rich men had fugues, and so did knaves, but the central examples for nineteenth-century fugue were humble, decent men, who remained humble and decent on their deliberate yet unwanted trips, of which they later had [End Page 31] almost no memory. Hysteria has been called the body language of female powerlessness. Fugue was a body language of male powerlessness.
Fugueurs did not wander. They travelled with perseverance, in a straight line, so to speak. At the end of 1899 a Swiss psychologist published a once famous book about a middle-class medium, hysteria, and multiple-personality: From India to the Planet Mars. 3 This captured the imagination of a public already dedicated to spiritualism and Thomas Cook. Fugueurs, who were usually men of a more humble station in life, did not get to Mars, but they got to India, to Moscow, to Algiers, or to Constantinople, although most were more modest in their purposeful meaningless expeditions. Fugueurs felt compelled, and were fixated on a single idea, a destination, a variant, as would once have been said, of an idée fixe. They had but one idea, and yet when we look back at them a century later, a whole cornucopia of ideas tumbles out. I shall manage to discuss, under the single heading of fugue, not only hysteria but also multiple personalty, epilepsy, hypnosis, the military, the vagrancy scare (or homeless men in the 1890s), the police, anti-Semitism (wandering Jews), photography, art collectors, archaeology, the bicycle, the Olympic Games, and Proust. People have gone on strange unmotivated trips forever, but at the time when fugue became a medical entity, we had truly become modern.
Ambulatory automatism is an extreme example of a modern malady. It is not quite extinct. It is parlous to identify any clinical diagnosis of current psychiatric medicine with a mental illness from times gone by. Who will say which complaints today match the florid hysteria of the late nineteenth century? But plainly the official American definition of dissociative fugue in 1994 was a lineal descendant of the slightly more colorful definition of my epigraph, stated in Birdhouse a century earlier:
A. The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past.
B. Confusion about personal identity or assumption of new identity (partial or complete).
C. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder (the new name for multiple personality disorder) and is not due to the direct physiological effects of a substance (e.g., a drug abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy...