Vad är munchausen by proxy
Posted April 3, Reviewed by Lybi Ma. April is National Child Abuse Awareness Month, and it got me wondering how aware practitioners are of atypical child abuse. I recently came across the mere second clear incident of it in my year span in the mental health field. Atypical child abuse is another term for Factitious Disorder by Proxy. Anyone in social services has at least heard the term, conjuring images of a deranged mother instilling illness in her child.
Recognizing Factitious/Munchausen's Disorder by Proxy
When factitious behaviors become all-consuming, it's known by a perhaps more familiar term, Munchausen's Disorder. Given by proxy presentations are subtypes of these conditions, their prevalence is likely extremely rare. This condition is not simply illness faking for, say, monetary gain, obtaining prescriptions, shirking work responsibility or evading criminal prosecution.
That is known as malingering and is not considered a psychiatric condition. It was named after Baron von Munchausen, a German military officer notorious for significantly embellishing his tales. The psycho-jargon for such tall tales is called pseudologia fantastica.
Creating a colorful illness history is necessary for Munchausen's patients to try and convince providers and would-be sympathizers just how sick they want you to think they, or the people they care for, are, and aids in general sympathy mining. One particular case involved a woman who reported a family history of breast cancer, with rapid subsequent death, in most female relatives.
She told her physicians that she was now symptomatic, and must immediately have a double mastectomy to avoid similar fate—and got her way. Perhaps they say previous providers have all retired and records therefore cannot be obtained. Others may claim they have no remaining family or are estranged, so providers cannot verify a history from anyone.
Parents or other caregivers' dependents may have chronic lingering illnesses despite sound medical intervention, or develop one illness after another. Some parents who depend on keeping a child ill to garner sympathy have been caught in the act of injecting bacteria into their child's IV to keep them sick. Others know how to rile their child to appear mentally-ill in front of others.
Falsifying an Illness: What Is Munchausen Syndrome by Proxy?
Certainly not your standard child abuse case. Appalling as it is that anyone would induce such medical hardship onto themselves, using a child or other dependent as a vehicle for sympathy seems beyond comprehension and can come in all shapes and sizes. While it seems most common for people to manufacture a tangible, physical illness, sometimes, as noted above, a manufactured psychiatric condition is at hand.
This involves perhaps the most sophisticated of pseudologia fantastica, and can be a hard act to keep up, especially when inducing it in others. I recently evaluated Jaime name disguised. When she was just four, her mother convinced others that Jaime was aggressive, hallucinating, and would become grossly disorganized. The mother demanded Jaime receive residential care because she felt Jaime could seriously harm herself or others because of her alleged symptoms.
Though no one else witnessed the behaviors, and it is hard to believe a four-year-old could pose danger to an adult, so convincing were the mother's stories that Jaime was placed in several residential settings over a couple of years.
Factitious Disorder Imposed by Another (Munchausen Syndrome by Proxy)
In our interview, Jaime recalled little of the residential settings, except that her mother rarely visited. Meanwhile, people close to the case recalled that the mother would talk about how troubling it was to have such an "ill" child, and lending ears felt compelled to be supportive, so sad was the story the mother wove. Thankfully, family members became suspicious, and child welfare workers caught on with clues such as Jaime's stability in programs, but alleged immediate decompensation upon discharge to the mother.
They suspected Munchausen's Disorder by Proxy and Jaime was transferred to foster care , where she is now in a loving family, but suffers from fears of abandonment.
Att göra sitt barn sjukt : Munchausen by Proxy - en scoping review
What drives one to go to such lengths for sympathy? People acting by proxy may have grown up in an emotionally-neglectful home but received recognition for helping take care of an ill relative. Therefore, they find it more convenient to make others ill and receive the sympathetic attention that way. They can also get more bang for the buck if they happen to have a couple of kids who are very ill, or are a nurse who works in a few different locations, where they can select a target at each place.