What Is Munchausen By Proxy Syndrome?
Munchausen Syndrome and Munchausen-By-Proxy Syndrome belong to a group of mental disorders known as fictitious disorders.
Read more about Munchausen Syndrome.
While Munchausen Syndrome is an individual making up, faking, or lying about symptoms of injury or illness for attention, Munchausen-By-Proxy is a disorder in which an individual uses someone they are caring for - often a child - to garner attention or pity for themselves.
While MBPS is relatively uncommon (affecting only 2 in 100,000 people), it is one of the most deadly types of child abuse.
Those suffering from Munchausen-By-Proxy Syndrome, or MBPS, have a psychological need for attention. This means that the person who has MBPS subjects the person they're caring for to injury, illness, or abuse in order to "require" frequent doctor visits and hospitalizations. The person with MBPS uses the treatment and hospital visits as a means of receiving praise and attention from others, as well as developing a close relationship with a health-care provider
An individual with MBPS suffers from interpersonal issues and identity issues. A lack of a strong sense of self coupled with relationships solely focused around injury or illness exacerbate this condition.
How Does Munchausen By Proxy Syndrome Work?
A parent or other caregiver misleads people into believing that the child he or she is caring for has many medical problems. He or she does this by reporting fake symptoms, lying about episodes of a sickness, often even inducing sickness in his or her child or other dependent.
The disordered caregiver then takes his or her dependent to the doctor or hospital, so the medical personnel will order tests, try out types of medications, and even hospitalize the child (or other dependent). Sometimes, the doctors will even perform unnecessary surgery based upon the lies of the perpetrator.
The disordered caregiver feels satisfaction and happiness after gaining the attention and sympathy of doctors, nurses and other people who come into contact with his or her child. It's been suggested that it isn't simply the attention given to the disorderd caregiver based upon the "illness," but the ability to deceive individuals they feel are smarter or more powerful than the perpetrator him or herself.
The disordered caregiver looks so very caring and attentive to their child (or other dependent), it's rare that anyone suspects any wrong-doing by the caregiver. The disordered caregiver is often an expert at fooling doctors - even the most seasoned of doctors may misinterpret the meaning of the inconsistencies of the symptoms the victim experiences.
It's often hard for health care professionals to believe that any caregiver could abuse their child in such a horrifying manner, which is another reason so many cases of MBPS go unseen.
Methods of abuse in MBPS include poisoning, suffocating, starving, causing infection, or injuring the person he or she is caring for.
Who Has Munchausen-By-Proxy Syndrome?
While this disorder has been glamorized by media, those with MBPS are most often mothers. In fact, 98% of caregivers of MBPS are female.
The victim of MBPS are usually children of the disordered caregiver, generally preschool-aged (although there have been cases in kids up to 16 years of age). The victim of MBPS can be a girl or boy.
What Causes Munchausen By Proxy Syndrome?
There's no one single cause for someone to develop Munchausen By Proxy Syndrome. Below are some potential causes of MBPS:
The disordered caregiver may have come from a home where being sick was the only way to receive love. Perhaps the personal needs overwhelm the disordered caregiver's ability to see that their child is a person with feelings and rights because the disordered caregiver may have come from a home where he or she wasn't treated as a person with feelings or rights.
Some suggest that MBPS is a cry for help on the end of the disordered caregiver, who may be struggling with depression, anxiety or have feelings of being an unfit caregiver. The praise and attention from medical staff while caring for their "sick" child may give the caregiver that feeling of being a worthwhile caregiver.
The disordered caregiver may have a very emotionally distant relationship with his or her spouse.
What Happens To The Victim of Munchausen By Proxy Syndrome?
In the most severe cases of MBPS, disordered caregivers may go to great lengths to make their victim ill. Cargivers have been filmed switching medications, injecting children with urine, or placing drops of blood in urine specimens.
Other disordered caregivers aggravate an existing problem, such as not allowing for proper wound cleaning.
However the victim is abused, the symptoms exhibited don't occur when the disordered caregiver is gone. These symptoms tend to go away during long periods of separation from their abuser. If confronted, the caregiver typically denies knowledge of how the illness happened.
Common conditions that are faked by caregivers with MBPS include:
Long-Term Prognosis for Munchausen By Proxy Syndrome Victims:
The long-term prognosis for the victims of Munchausen By Proxy Syndrome depends upon the degree of damage created by the disordered caregiver as well as the time it takes to diagnosis MBPS.
In very extreme cases, children have developed destructive skeletal changes, limps, mental retardation, brain damage, and blindness, all from damage from the disordered caregiver.
Should the child live to be old enough to understand what his or her caregiver is doing, there can be very serious psychological damage. The child may only feel loved when sick, and begin to help the caregiver continue the abuse. This is because the victim fears abandonment.
Sometimes, victims of Munchausen By Proxy Syndrome grow to become disordered caregivers themselves.
The abuse often results in multiple hospitalizations and some research suggests that the death rate is approximately 10%. There is also an increased risk in developing Munchausen Syndrome given that the child begins to associate being sick with attention.
How Is Munchausen By Proxy Syndrome Diagnosed?
Diagnosing MBPS can be extremely difficult. The caregiver is very skilled at deceiving even the most seasoned health-care professional.
The following could lead to a diagnosis of Munchausen By Proxy Syndrome:
- A child with many medical problems that don't respond to treatment.
- These medical problems follow a puzzling yet persistent course.
- Laboratory or physical findings that are extremely unusual, don't correspond with the child's past medical history, or are physically (or clinically) impossible.
- A caregiver who is very supportive of the doctor, encouraging the doctor to perform more tests.
- A caregiver who becomes angry, demands second opinions, more procedures, more interventions, or transfers to other, more sophisticated hospitals.
- Short-term symptoms that may stop when the parent or guardian isn't around.
- A caregiver that isn't happy with the good news that the tests didn't indicate any illnesses - and continues to insist that his or her child is ill.
- A caregiver who is medically knowledgeable and/or fascinated by medical details.
- A caregiver who enjoys the hospital environment.
- A caregiver who appears very calm in the face of serious medical issues with their child.
Getting Help For A Victim of Munchausen By Proxy Syndrome:
In the event that MBPS is suspected, health care providers are required (by law) to report their concerns. However, after being charged with MBPS, the disordered caregiver may attempt to further prove that his or her victim is truly sick. If a suspected caregiver of MBPS denies all charges, the child should be removed from custody.
Often, the disordered caregiver denies the charges and moves to another location to continue the behavior. For this reason, MBPS should be resolved as quickly as possible.
Treatment For The Perpetrator of Munchausen By Proxy Syndrome:
Generally, MBPS cases are resolved in one of three ways:
- The disordered caregiver of MBPS is caught.
- The disordered caregiver of MBPS moves on to abuse a younger child when the original victim becomes old enough to tell.
- The child dies.
Munchausen By Proxy Syndrome is a very, very serious disorder. As MBPS is abuse, it is also a criminal offense.
Treatment is often difficult because the individual who has MBPS often denies that there is a problem. A complete network of support must be developed, which includes a therapist, doctors, social services, and law enforcement.
Therapy is critical to this disorder. It often takes years of therapy in conjunction with a support network to work through MBPS. Therapy goals often include changing thinking patterns and behaviors that lead to the abusive behaviors. Identity will be reviewed and strengthened, as will helping the individual develop relationships that are not centered around injury or illness.
Read more about Munchausen Syndrome
Read more about Child Abuse
Read more about Personality Disorders
Additional Resources For Munchausen By Proxy Syndrome:
The Cleveland Clinic - This website offers a description of Munchausen Syndrome and Munchausen By Proxy.
Allpsych.com - General website with more information and research regarding Munchausen By Proxy Syndrome.
MedlinePlus - Description of Munchausen By Proxy Syndrome, including symptoms, description of the disorder, and treatment.