September 22, 2008
Foreword: Recently, the British Medical Journal presented a document regarding child protection. We provide a alternative and more realistic view. This document was written by a wrongly diagnosed mother. It shows us the other side of the coin and provides a potential solution to future improvements in the system.
I dedicate this article to Debbie Storey, a very dear friend who unfortunately lost her life because of the stigma of wrong diagnoses of MSBP – A Story of Mis-understanding
What is MSBP
Munchausen Syndrome by Proxy or MSBP is a diagnosis given to a mother or care giver to describe aspects of their behaviour. This behaviour usually includes subjecting [what appears to be] a previously healthy child to unnecessary and often painful tests or medical interventions i.e. scans, x-rays and even surgical procedures to gain attention from the medical profession.
Many theories exist as to why a woman may fabricate illness in her child. Common to most theories is a traumatic loss earlier in the mother’s life; such a loss may be represented by maternal rejection and the lack of love and attention as an infant. It may also be representative of the “loss of a parent, loss of a parent’s love through neglect or abusive treatment, or loss of self through childhood illness or traumatic disillusionment” (Bach, 1991).
The problem appears to be that many professionals describe MSBP as different things. Some have said it is a mental illness and some say it doesn’t exist. There are debates all over the world on the subject. Can it be called MSBP? .Is there such a thing? Munchausen by Proxy is after all just a term referring to a list of symptoms named after a fictitious storybook character Baron Munchausen, who enjoyed a series of fanciful adventures. This, I feel makes a mockery of the name itself. It’s rather like having a syndrome called ‘Goldilocks’ syndrome because all sufferers are golden haired girls who like porridge and then expecting the whole concept to be taken seriously.
So the nation is divided. On the one hand we have Dr Marc Feldman on his site describing this behaviour as
“They deliberately mislead others into thinking they (or their children) have serious medical or psychological problems, often resulting in extraordinary numbers of medication trials, diagnostic tests, hospitalizations, and even surgery … that they know are not really needed. In short, factitious disorder, Munchausen syndrome, malingering, and Munchausen by proxy involve illness deception, or “disease forgery.”
- They may feign illness – e.g., by faking a seizure or acting as if they have multiple personalities.
- They may falsify lab results – e.g., by adding blood or protein to a urine specimen.
- They may exaggerate a medical problem – e.g., by claiming occasional mild back pain is crippling.
- They may aggravate an existing ailment – e.g., by manipulating a wound so it doesn’t heal.
- They may induce an actual illness – e.g., by injecting themselves or their child with bacteria to cause a raging infection.
- They may “dissimulate” – e.g., by initially avoiding treatment so that a minor medical problem becomes serious.
In variations of the root problem, some seek the HERO or VICTIM role, rather than the SICK role.
In Marc Feldman’s article
he explains that MSBP mothers need to feel “special” and “that virtually all have personality disorders”. Unfortunately however the professional world is divided on this and now in fact Marc Feldman is only one of a few specialists who now describe MSBP as a personality disorder.
Here in an article written by Ibrahim Abdulhamid MD entitled Munchausen by Proxy. Like Dr Feldman he also states that
“The perpetrator rarely has a severe mental illness e.g. schizophrenia although several reports indicate 1 or more personality disorders is common”.
This is complicated to understand because there seems to be a contradiction in terms. To many lay people, a personality disorder is equivalent to a severe mental illness. However a personality disorder is not classed by psychiatrists as a serious mental disorder.
As I said, the professional world is divided on this and most say it is not a personality disorder.
Additional Reading – if this can happen to one woman it can happen to all of us….