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Münchausen by Proxy
More than just vying for
attention, phenomenon can
be serious
By Charles Sebastian, Staff Writer
Perhaps one of the most interesting illnesses of the mind to come to a
greater public knowledge in the past
20 years is Münchausen by Proxy.
The name derives from Münchausen
Syndrome, which is characteristically
a person playing victim or assuming the sick role in a desperate bid
for recognition and attention. While
you may be thinking this describes
several family members who clamor
and plot to be the center of attention, Münchausen is an amplified,
sometimes lethal version of this phenomenon.
Münchausen by Proxy involves
using another person to gain the
attention one might usually garner for
oneself through deception and subterfuge. Often a parent uses a child’s
(proxy’s) illness, real or imagined,
as a way of being getting attention.
Many times psychosomatic illnesses
arise in the proxy from talking about
the “illness” constantly, until the
mind and body manifest the sickness
or, at the very least, the symptoms of
the sickness.
The problem with this is that naive
children are highly impressionable
and will believe what their primary
caregiver tells them. Cases can go so
far as parents willingly hurting their
children, falsifying tests and holding
up emergency rooms when other
patients with true needs should be
seen.
The parents create situations
where they can step in as the “hero,”
saving their children from the fabricated pain or disease. The parent is
many times at odds with the doctor
or person attending the child, setting
up the other person as a villain who
is unwilling to admit something is
wrong with the proxy.
While the term Münchausen by
Proxy was used first in 1976 by John
Money and June Faith Werlwas in
their paper, “Folie àdeux in the parents of psychosocial dwarfs: Two
cases,” the idea of Münchausen
Syndrome goes back to the early
1950s. While these two illnesses
share the same name and idea of
creating scenarios and debasements
to get noticed, they really speak to
two distinct mental problems. After
all, there is considerable difference
between the person who wants to
hurt themselves for attention and
those who would hurt other people,
especially children, to garner attention.
It took time for the medical and
psychiatric communities to accept
Münchausen’s, but now with more
than 2,000 case studies in the literature, the phenomenon is unquestionable. In the most recent version of the
Diagnostic and Statistical Manual,
the term was changed to “Factitious
Disorder.” Under this heading is
“Factitious Disorder imposed on
Self ” and “Factitious Disorder
imposed on Others.” The first was
formerly Münchausen’s Syndrome
and the second was formerly
Münchausen’s Syndrome by Proxy.
Candidates for the latter designation may have a proxy with many
medical problems. They may have
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had dozens of hospital visits and may
stupefy doctors who can’t find a true
cause for their visit. Lab results might
be incongruent with what the patient
exhibits or what the caregiver claims
the proxy is exhibiting. Many times
the proxy will be kept close by as
the caregiver’s need to get attention
through the proxy deepens. The caregiver may have medical knowledge
or work in the medical field, thereby
allowing greater access to the knowledge and understanding required to
keep up the game. The illness is more
common in mothers than fathers.
While there is still much to be
learned about Münchausen’s by
Proxy, the child abuse and human
neglect that comes from this elusive
syndrome, if suspected, should be
reported immediately.
The parents create
situations where they
can step in as the “hero,”
saving their children
from the fabricated pain
or disease.