Munchausen by Proxy Syndrome: A Clinical Fable for Our Times

Article excerpt

"Despite the mothers' incredibly convincing 'performances' of good mothering, the infants hardly matter; they serve as mere instrumental objects to regulate and continue the primary relationship with the physician. In one of our cases, all of the people interviewed by investigators saw the abusing mother as `the most caring parent imaginable.' Yet she was simultaneously feeding her child ipecac [medication used to induce vomiting in accidental poisonings] almost daily over a three-year period until his heart muscle was finally so damaged that it failed, and the toddler died.

"Evidence from surreptitious video cameras placed in hospital rooms to monitor parents suspected of repeatedly suffocating their infants support the hypothesis that the `good mothering' is a charade. When these parents were unaware of being observed, they paid scant attention to their infants. Observers have noted that often a mother will appear totally calm or indifferent at just the moment her infant's life is in grave danger because of a condition she created. Often outwardly adulatory toward the baby's doctors while aggressively manipulating them, MBPS mothers may exhibit gleeful excitement when a clinical catastrophe they have created causes both pain in their infants and confusion in the doctors....

"Society, too, plays a role in this disorder. We have great difficulties acknowledging that mothers are capable of consciously harming their children. …