Understanding and Identifying Munchausen Syndrome By Proxy

Munchausen Syndrome By Proxy is a mental disorder that often results in the abuse or neglect of children.  We’ve mentioned it before in an attempt to raise awareness about chemical child abuse, which is relatively common among Munchausen’s patients, but now we would like to give a more in-depth examination of the disorder itself and how to spot it. Our Child Abuse Quick Reference contains an entire chapter on Munchausen Syndrome By Proxy

Munchausen Syndrome By Proxy (MSBP) is a disorder in which caregivers feel a psychological need for the children in their care to be ill.  Most common among mothers, sufferers of this disorder often abuse or neglect their children in order to keep up the appearance that the child has medical complications.  Chemical child abuse is common in these cases, because chemical poisoning can emulate the effects of medical problems in children, but many kinds of abuse including mental and sexual abuse can occur in correlation with MSBP.

People with MSBP are often resolute in their denial of involvement in the child’s illness.  Even proven perpetrators of child abuse with MSBP most often refuse to acknowledge their hand in the illness.  Even psychotherapy seems not to work in cases of MSBP, as very few who receive therapy experience any sort of change in their psychological makeup or subsequent behavior.  The characteristics of MSBP patients can be hard to identify, but typically they are the caregiver of a child who is sick or often appears to be sick who seems to seek or enjoy sympathy and attention for parenting a sick child.  The MSBP patient receives a kind of addictive emotional gratification from this and will act deliberately and deceptively to continue receiving this attention.

MSBP perpetrators often have some background or education in health-related professions and may use the information acquired from this to emulate serious illnesses in their children.  Often they show a pattern of attention-seeking behavior or lack of empathy, but often seem like very friendly people and particularly good and attentive parents.  MSBP cannot be identified through mental health evaluations, making it particularly troublesome.

People with MSBP may lie about their child’s medical condition, exaggerate to make it seem worse, Create the appearance of illness, worsen a preexisting illness, or create a genuine problem through abuse.  Most MSBP patients can continue to worsen the child’s illness even while the child is hospitalized.

Victims of MSBP patients often have siblings with medical issues as well.  Often they have more than one symptom by the time they are given a medical examination and may have a long history of serious illness.  Often the victims are young children and the sex of the child seems to make little or no difference.

Some warning signs of MSBP include persistent or recurring medical problems that cannot be explained after adequate medical examination, investigation results that appear to conflict with the parents’ or child’s account of events, unexplained illness in more than one sibling, and the ineffectiveness of a treatment that should work.  If problems consistently occur only in the presence of a particular person, or continually improve once that person is removed, that is often a sign that the child is a victim of an MSBP patient.  When any of these warning signs are identified, an MSBP investigation should be undertaken immediately.

If it is determined that MSBP is occuring, it is crucial to involve Child Protective Services and remove the children from the custody of the abuser.  Have mental health resources and security personnel available when confronting the abuser, knowing that people with MSBP can be manipulative and often violent or dangerous.  Never confront the person with MSBP until all children are safely removed from their custody.


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