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Munchausen Syndrome By Proxy

A type of child abuse

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Updated January 06, 2014

". . . a victim of Munchausen syndrome
my whole life I was made to believe I was sick when I wasn't
'til I grew up . . ."

--rapper Eminem, in "Cleaning Out My Closet"

These lyrics refer to a psychological disorder known as Munchausen syndrome in which a person makes him- or herself seem ill in order to get attention and nurturing.

A hypochondriac worries whether symptoms she has means she is ill; a person with Munchausen syndrome gives herself fake symptoms and insists she is ill. She is not looking for drugs or insurance payments (although those may occur), just for people to notice her and take care of her.

Munchausen Syndrome by Proxy
This disorder can also take the form of child abuse in which a mother makes up illnesses for her child. This is known as Munchausen syndrome by proxy, meaning the mother uses the child's fake illnesses to gain attention.

In 95% of cases the mother is the one abusing the child this way; in other cases, the father, grandparent, or even babysitter may be the abuser. Some mothers go beyond making up symptoms to actually causing symptoms.

In time the child can come to believe that he or she really is sick. Some abused children fear contradicting their mothers, or feel that no one will believe the truth if they tell it.

Syndrome difficult to identify
Some of the reasons why Munchausen syndrome by proxy is difficult for health care providers to identify are:

  • the child has a combination of symptoms that does not conform to any known disease or disorder
  • health care providers are not familiar with Munchausen syndrome and don't consider it to be a possible diagnosis
  • the physician tends to believe the very persuasive and compelling medical history the mother gives; she knows medical terminology and may have even worked in health care herself
  • the child has often been taken to different health care providers over time, at different hospitals, and there is no communication among these providers

Potentially deadly results
Some mothers may severely hurt their children in order to cause symptoms. A mother may poison her child with medications, chemicals, or salt, give laxatives to cause diarrhea, or syrup of ipecac to cause vomiting. Some may go as far as suffocating the child for brief periods of time to cause respiratory and nervous system problems.

Sometimes the abused child dies as a result of the medical procedures, such as surgery, done to treat the child's strange symptoms.

Treatment
In Munchausen syndrome by proxy, the treatment needed is not of the "ill" child but of his or her mother. Parents who abuse a child this way have a psychological problem that requires professional intervention.

Sources:
- Abdulhamid, I. & Siegal, P. (2002). Munchausen syndrome by proxy. eMedicine.com.
- Donavon Mason, D. (2001). Munchausen syndrome by proxy. eMedicine.com.

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