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Fugue states can come about only if the reality anxiety equals or outweighs the superego anxiety or if the outwardly projected superego is very permissive. The elimination of the superego sets free the countercathexis that maintained the repression and the formerly repressed fantasy then seizes control of consciousness under a different form of ego organization. The previously conscious part of the ego and the superego is now repressed by the split-off part of the ego. The former state of affairs is usually reëstablished when the outside situation has lost its importance and the function of the fugue state is fulfilled.
The superego in fugue states behaves in a manner similar to that in compulsion neurotics. This similarity is stressed by the predominance of compulsive traits found in the psychological tests of all our patients.