What is Munchausen for Proxy Syndrome?

Named after a German officer known for telling outrageous stories, Munchausen syndrome is a psychological disorder in which the patient fakes or induces an illness to gain comfort and care from friends, family and health care workers. In Munchausen by proxy syndrome, a related illness, a caregiver induces illness in another individual to gain sympathy as the caregiver of a sick individual. Most often, it is seen in mothers who induce disease in their children.

Also known as manufactured and induced illness (FII) or Munchausen syndrome by proxy, Munchausen syndrome by proxy is a form of child abuse. More often, mothers with this condition induce or feign physical illness in their children. In some cases, however, the mother emotionally abuses the child to induce a psychiatric illness.

Munchausen by proxy is one of the most dangerous forms of child abuse for two reasons. To begin with, children who fall victim to it suffer from harmful and potentially fatal complications from the induction of symptoms. In some cases, keepers poison their victims or inject them with harmful bacteria to induce disease. Second, the child may face additional complications from any treatment she receives for the suspected illness. For example, the child may be medicated for a problem that he or she did not have in the first place.

It is extremely difficult to detect this psychological disorder. Caregivers often seem so attentive and concerned that no one suspects they are hurting their children. However, there are some signs that could suggest the condition is at play. Symptoms that change rapidly or are inconsistent with any diagnosis, unusual medical findings, or symptoms that are short-lived and disappear when the caregiver is absent could indicate that the disease is manufactured.

The causes of Munchausen by proxy syndrome vary greatly depending on the victim's history and motives. In many cases, caregivers were abused or ignored as children, and the need for sympathy and attention becomes so broad that it overwhelms basic parental instincts. Caregivers with this disorder may also suffer from depression, anxiety, or other psychological conditions.

Because of the involvement of both the caregiver and the child, the treatment for Munchausen for proxy syndrome is twofold. The first course of action is usually to remove the child from the harmful environment. While some of the physical damage may be irreversible, victims usually improve dramatically once the perpetrator is out of the picture. Second, treatment for caregivers depends on psychotherapy. This is most effective when the perpetrator can admit wrongdoing to her and actively seek recovery.

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