Munchausen Syndrome By Proxy

Munchausen by proxy syndrome (MBPS) is a mental illness in which the patient, most often the mother of a child, will regularly manufacture false information about a child's health or purposely cause a child's grave illness. As a result of the actions of the MBPS patient, doctors may believe that the child requires extensive medical treatment, including intravenous medication, multiple x-rays or even surgery. The typical MBPS patient is well versed in various medical conditions and is resourceful in finding ways to get the attention of doctors and hospital staff.

The MBPS patient, by her actions, is seeking recognition and adulation for her devotion to the well being of her child. She wishes to be perceived as self-sacrificing by offering her sick child the highest possible level of care. In some cases, the MBPS patient's actions – her interventions or the medical responses generated by her provision of phony information she offers – can even cause the child's death.

In cases where MBPS is suspected, it is easy enough to install a hidden camera in order to gather proof about the suspected MBPS patient's activities. In MBPS, the mother acts in a calculated manner and is both calm and methodical as she performs her interventions. Mothers with MBPS are for the most part, not psychotic or in a dissociative state at the time they hurt their children.

When the MBPS patient is confronted with proof of causing the child's illness, she will offer persistent and vigorous denials of her abuse. Mothers suffering from MBPS may continue to deny that they mistreated their children even years after being convicted in a court of law. In other cases, it may take many years for the MBPS patient to acknowledge even a partial role her child's illness or death.

The term Munchausen by proxy syndrome is derived from the condition known as Munchausen syndrome, in which adults fabricate their own illnesses. In Munchausen by proxy, the child acts as a proxy or substitute for the parent's own body. This has led to some confusion about the relationship between the two syndromes.

It is felt that the use of the term Munchausen by proxy may lead to the inaccurate assumption that MBPS is just a variation of the Munchausen disorder. In actual fact, the there is a clear distinction between the illnesses. In some cases, patients display symptoms of both disorders, but the disorders manifest with very different behaviors. The only characteristic shared by the two disorders is the Munchausen name.

Munchausen syndrome and Munchausen by proxy syndrome derive their names from Karl Friedrich Hieronymus, Freiherr von Munchausen, an 18th-century baron. Munchausen was a mercenary who became known for telling tall tales about his exploits. In 1951, Dr. Richard Asher used the term Munchausen syndrome to describe an adult patient who faked or induced illness to get medical attention.

The first known case of Munchausen by proxy was documented in 1977 by Roy Meadow, a British pediatrician. Meadow described a number of cases in which doctors ordered unnecessary examinations, tests and treatments for child patients, based on information that was later discovered to have been fabricated by the patients' mothers. In many cases, the children required hospitalization/

Since Meadow first published his findings, some 200 papers have been published, documenting hundreds of the most unusual and extreme cases of MBPS. The manifestations of this syndrome include fake fevers, induced seizures, poisonings and asphyxiation. The medical community is certain that for every documented case of MBPS, there are several more that are covered up by doctors, hospitals and courtrooms. While MBPS is by far more common in mothers, fathers may engage in passive collusion with their partners in this horrific form of child abuse.

Part of the difficulty in identifying the MBPS patient is societal resistance to the idea that a mother might cause intentional harm to her child in such an extreme manner. Lending support to this disbelief is the discrepancy between the public and private reality of families caught in the web of MBPS. The MBPS mother appears to be devoted and caring in the presence of others. However, when alone with her child, she shows little interest in her child's welfare or in the act of mothering.

In some instances, hidden cameras have proved that a mother with MBPS may hardly communicate with her infant for lengthy periods of time. The main motivation of the MBPS patient is her intense desire to have a relationship with doctors and hospital staff. The child is seen as the means to this end.

Selected full-text books and articles on this topic

Murder Most Rare: The Female Serial Killer
Michael D. Kelleher; C. L. Kelleher.
Praeger, 1998
Librarian’s tip: Appendix 3 "Munchausen by Proxy"
Lies!, Lies!!, Lies!!! The Psychology of Deceit
Charles V. Ford.
American Psychiatric Press, 1996
Librarian’s tip: Chap. 8 "Living a Lie: Impostors, Con Artists, and Persons With Munchausen Syndrome"
Violence in the Home: Multidisciplinary Perspectives
Karel Kurst-Swanger; Jacqueline L. Petcosky.
Oxford University Press, 2003
Librarian’s tip: Discussion of munchausen syndrome by proxy begins on p. 67
Mental Disorders, Medications, and Clinical Social Work
Sonia G. Austrian.
Columbia University Press, 2000 (2nd edition)
Librarian’s tip: Chap. 4 "Somatoform and Factitious Disorders"
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