Professor Marianne Shablousky
Intro to Psychology
17 November 2013
Munchausen by proxy
This presentation is an overview of the condition factitious disorder by proxy, also known as Munchausen syndrome by proxy (MBP). We’ll begin by highlighting the definitions of the disorder and the etiology. Then we’ll analyze relevant symptoms of the perpetrator and the reasons they abuse the child. Some methods of abuse are highlighted and the social psychiatric illness common in the perpetrator. A discussion of the complex issues facing the medical professionals when faced with confronting the perpetrator and the decision to take the child away from the parent is also included. The prognosis for the perpetrator does not look very good and further research into treatment for family’s needs to be done. The popular solution employed now is to remove the child. Family reunification is not common because the recidivism is very high as in most child abuse cases. Munchausen syndrome by proxy (MBP), a type of factitious disorder, is a mental illness. It is a term used to describe a behavior pattern where a caregiver, usually a parent, deliberately fabricates and perpetrates an illness upon a child. This person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. The adult perpetrator has MBP and directly produces or lies about illness in another person under his or her care, usually a child under 6 years of age. It is considered a form of abuse by the American Professional Society on the Abuse of Children. However, cases have been reported of adult victims. (The term "by proxy" means "through a substitute.") Experts explain that Munchausen was first used in the 1950s to describe a psychological disorder where patients fake or bring about illness in order to play the role of a sick patient. In 1977 MBP was first used to describe a severe form of child abuse where children are treated unnecessarily for medical conditions that are faked by their caregivers (Shaw 2008) It may be hard to imagine a parent injuring their child or deliberately doing things to cause an illness but these perpetrators are very real. Experts do not know all the reasons these parents develop MBP. They do not have a formal mental illness but they usually do have a personality disorder and may have spent some time during their life in an institution. Experts also feel they may act superior to professionals and even have a medical background. They enjoy being the center of attention and like making illness the center of their life. They are difficult to evaluate psychologically as they often do not stay in therapy. (Hallstrom) These parents with MBP do not seek treatment on their own and it is very difficult to get them to be honest about their problems. Experts tell us that patients with MBP display pathological lying and will describe their life history very dramatically, yet these events are often vague, inconsistent, no one has witnessed them, and they are hard to either prove or disprove. When confronted with evidence of their false symptoms they become very angry, deny the proof that they are making up the symptoms, and quickly discharge themselves from the hospital only to find another facility or doctor. (Criddle 2010) Often these people are very smart and understand how the medical profession works. Experts explain that while no distinct profile exists that offers comprehensive reasons to diagnose someone with MBP, the perpetrator is often very articulate, educated and from a good socio-economic status. They also have some level of child care, nursing, medical or health- related experience, which allows them to be familiar with a medical facility and the procedures. (Parrish 2004) Having an understanding of medical facilities procedures allows these people to continue to manipulate the doctors and other health professionals. Parents will continue to induce their child’s...
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