Faking It: Munchausen Syndrome by Proxy

What if I told you there’s a mental disorder which involves a person fabricating that another person, usually a child under age 6 years is very sick and needs medical care? The person doing the fabricating is usually the mother of the child she’s portraying as ill and requiring medical professionals’ attention and help.

In fact, a factitious disorder called, “Munchausen Syndrome by Proxy” is the very disorder I’m talking about. If you read my article on Munchausen syndrome, you’ll find that one with Munchausen syndrome intentionally fakes symptoms of a physical condition to gain the attentions of medical personal.

In the disorder, Munchausen syndrome by proxy, the person typically uses her own young child as a victim of her fakery. The term, “by proxy” means “with a substitute,” according to the Cleveland Clinic website. A parent with Munchausen by proxy would use her child (rather than herself) to portray illness in order to seek attention from medical professionals.

Munchausen Syndrome by Proxy Case Example

Let’s say a mother, Mrs. Smith, puts efforts into convincing medical personnel her 3-year-old daughter, Della is sick and has a kidney problem. Mrs. Smith tells medical personnel Della is in need of medical attention. Mrs. Smith might even go as far as doing something injurious to Della to prove Della has the disorder.

Mrs. Smith does such things because she wants attention and sympathy from medical staff. Mrs. Smith seeks to satisfy her own unhealthy emotional needs. She might place chemicals in Della’s food that will produce blood in Della’s urine or do something else to “prove” Della is ill.

It’s hard to imagine a mother would use or harm her own daughter this way. Yet, if the mother has Munchausen syndrome by proxy, her emotional needs are so severe that she will do anything to attain sympathy and attentions of medical professionals regarding her daughter’s “condition.”

Munchausen Syndrome by Proxy Statistics

Although Munchausen syndrome by proxy is rare (it affects 2 people out of 100,000, according to the Cleveland Clinic website), 10% of those cases result in the death of the “proxy”-the victim of the patient having Munchausen by proxy. Furthermore, about 1,000 of the 2.5 million cases of child abuse yearly in the U.S. are related to Munchausen by proxy (Cleveland Clinic).

Keep in mind the “proxy” of the person with Munchausen syndrome tends to be a defenseless individual who doesn’t understand what’s going on. The proxy is usually a child under 6 years of age although can also be an adult who is lacking in mental faculties. Proxies have no idea that loved ones caring for them are doing something to hurt them in order to garner attention from doctors and nurses.

Diagnosis of Munchausen Syndrome by Proxy

As you might guess, discovering someone has Munchausen syndrome by proxy is difficult. Typically, the victim of the person with Munchausen by proxy has had many hospitalizations, during which medical staff observed the victim’s health improve until the caretaker arrives for a visit. Sometimes, chemicals that shouldn’t be present are detected in the victim’s lab test samples. Also, the caretaker with Munchausen by proxy may have some medical expertise or even have another child who was ill a lot or is now dead.

Once physicians rule out any diagnoses for the victim, the natural step is to take a look at the caretaker who’s claiming the victim is ill. A review of the victim’s prior medical records as well as the caretaker’s if they can be obtained sometimes reveal the caretaker’s prior diagnosis of Munchausen.

Munchausen by Proxy Treatment

Although diagnosing Munchausen by proxy is tricky, treatment is even more so. As you might imagine, those suffering with Munchausen rarely if ever admit they are fabricating an illness for their loved ones and lack the insight of seeing the error in their own ways, due to their emotional states. In the event that someone with Munchausen by proxy admits to what’s happened and wants to change, psychotherapy using cognitive behavioral techniques can be effective. Therapists might help the person to establish relationships outside of the medical profession that do not focus on a proxy’s “illness,” which are good first steps in treatment.

If you believe you have Munchausen by proxy or that someone in your family has it, speak to involved medical personnel right away. Medical privacy laws make communication among doctors and patient family members tenuous when proper release of information forms aren’t signed by the identified patient. So, make it clear from the beginning you don’t require any medical info about the person but rather want to provide to the doctor some background and history on the individual you believe suffers from Munchausen.


Cleveland Clinic website

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