Munchausen by proxy is a deeply concerning disorder in which a caregiver, usually a parent, deliberately causes or fabricates illness in another person, typically their own child. While you may have heard of Munchausen syndrome, where an individual pretends to be ill for attention, Munchausen by proxy involves inflicting harm on others to fulfill the caregiver’s psychological needs.
What Is Munchausen by Proxy? Definition
A Disturbing Form of Child Abuse
Munchausen by proxy is a psychological disorder where a caregiver, usually a mother, fabricates or induces illness in a child to gain attention and sympathy. The caregiver may lie about symptoms, manipulate tests to get a false positive, or actually poison the child or make them sick. It’s a particularly disturbing form of child abuse.
According to the investigation of Medical Child Abuse by FBI;
The psychological examination will reveal many such persons as normal. The most common finding—if any—is a behavioral disorder.
Usually, persons commit this abuse for attention. Perhaps a financial element serves as a secondary motive. Scholars also have suggested that offenders gain excitement from deceiving personnel in medical professions, charity organizations, and media outlets.
By providing false medical histories, perpetrators can hide their crimes, sometimes for years. When making diagnoses, doctors rely on the information given by a parent or other guardian. They cannot stay constantly with the victim to observe symptoms. Medical professionals do not expect caregivers to intentionally mislead them to obtain unneeded treatment for children.
Is it Possible to Detect Munchausen By Proxy?
Munchausen by proxy can be hard to detect because the parents are so manipulative and the child actually shows symptoms or test results of illness. However, the illnesses often do not fully match recognized medical conditions or the severity of symptoms changes frequently. The parent may also seem strangely calm in the face of severe illness or be overly involved with medical staff. Or their stories may frequently change or not make logical sense.
These cases can be complicated, as the parent may continue their manipulations and the child still loves their parent despite the abuse.
Warning Signs of Munchausen By Proxy Mental Health Condition
There are several warning signs to look out for in potential cases of Munchausen by proxy. Persistent or recurrent illnesses in a child that cannot be explained medically are a major red flag. The caretaker may report symptoms that do not match what doctors observe or what tests indicate. They may also seem overly attentive to the child or eager to have medical procedures done. Frequent doctor or hospital visits for a variety of ever-changing symptoms are also common.
Caretakers with Munchausen by proxy may appear medically knowledgeable or push for risky, invasive procedures. They often resist second opinions and seem dissatisfied with medical staff. The child’s symptoms frequently do not improve with treatment or new symptoms appear as old ones are resolved. The caretaker may also seem to enjoy the attention of having a sick child.
Severe Harm and Even Death
Left undetected, Munchausen by proxy can lead to severe harm or even death for the victim. Caretakers may tamper with tests or directly poison or injure the child to worsen or create illnesses. In some cases, children have died from complications caused by unnecessary surgeries, overmedication, or being poisoned.
How Munchausen by Proxy Begins: Caregivers Fabricate Illnesses
Munchausen by proxy syndrome (MBPS) typically begins in early childhood when a caregiver fabricates or induces illness in a child to satisfy their own need for attention.
The caregiver, often the mother, will lie or exaggerate about symptoms to medical professionals to get unnecessary tests, hospitalizations, and treatments for the child.
Some warning signs that a child may be a victim of MBPS include:
- Frequent hospital visits for a variety of symptoms that do not seem to have a medical cause. The caregiver seems to enjoy the hospital environment and the attention from doctors.
- The child’s symptoms do not make medical sense or seem exaggerated. The caregiver insists on invasive procedures and opposes less intrusive treatments.
- The caregiver seems disappointed when tests return to normal or the child’s condition improves with treatment. They may demand a second opinion or switch doctors frequently.
- The caregiver seems to thrive on the attention they receive from having a sick child and portray themselves as the saintly protector and advocate.
- The child’s symptoms and suffering seem to serve the caregiver’s own emotional needs in some way. The caregiver does not seem focused on the child getting better.
- The child’s health seems to improve when the caregiver is not present. The child may become ill again when back in the caregiver’s care.
What are the Reasons Behind Munchausen by Proxy?
A Troubled Upbringing
Those who develop Munchausen by proxy often had traumatic childhoods themselves, full of neglect, abuse, or medical issues. They may have had parents with mental health conditions who did not properly care for them. As a result, they fail to develop a strong sense of self or identity. Caring for a sick child fills this void and gives them purpose and attention, even if it’s gained through deception.
Pathological Lying
Compulsive or pathological lying is a hallmark of Munchausen by proxy perpetrators. They lie to medical professionals, family members, and anyone else to gain sympathy and nurturing for themselves or their child. Lying becomes second nature and even habitual. They believe in their own fabrications and live in a world dominated by these lies.
Desire for Attention
Perpetrators crave the attention, nurturing, and sympathy they receive from doctors, nurses, family, and friends when their child is sick. They thrive on the concern and compassion shown to them. The medical setting also gives them a place where they feel important and needed. The sicker the child, the more attention the perpetrator receives.
Control Issues
Munchausen by proxy allows perpetrators to exert control over their child, medical staff, and family members. They control their child’s medical care and manipulate doctors into providing unnecessary tests and treatments. They also control the information provided to friends and family. This extreme need for control and power over others fuels their behavior.
Difficulty Bonding with Child
Some perpetrators struggle to bond with their child and only feel close or attached to them when they are playing the role of a doting caregiver. The medical setting provides more opportunities for hands-on nurturing, allowing them to feel like a good parent. This may be the only time they feel truly connected with their child.
Perpetrators are driven to harm their child through a desire to fulfill their own emotional needs, no matter the cost.
Latest Reported Munchausen by Proxy Incidents
2023
Ellen Rupp-Jones, a nurse from Palestine, Texas, pled guilty on June 27, 2023, to charges of injury to a child, exploitation of a child, and aggravated assault. Rupp-Jones injected her then seven-year-old daughter with insulin and glucagon in order to feign diabetes. Rupp-Jones appeared twice on local news programs to solicit fundraising donations and a “Diabetic Alert Dog” for her daughter. She received an eight-year deferred adjudication sentence, 59 days in jail, 300 hours of community service, court costs, restitution to the family of the service dog, and an order of protection from her daughter until the latter turns 21.