What Munchausen Syndrome is:
There are two basic types of Munchausen Syndrome. Both involve, at their cores, a person’s need to draw and expand the attention they receive from medical professionals. In some instances, people diagnosable with Munchausen pretend illnesses while in others, they actually make themselves (or a child) ill so as to garner that desired attention.
1. When a person draws this attention to themselves, it is simply called Munchausen Syndrome, and 2. In those horrific situations where a person deliberately makes a child ill so as to acquire and sustain the desired medical attention for themselves, it is the type well known to the media as Munchausen Syndrome by Proxy.
Unlike Delusional Disorders and certain psychotic conditions where a person is misperceiving reality, the phenomenon of Munchausen Syndrome is characterized as one in which the distortions and misrepresentations are quite conscious and deliberate. This is a great example of the clinical reality that consciousness and deliberation do not, necessarily, suggest mental health.
On the contrary, as is the case with certain Conduct Disorders, the lies are often pre-planned and deliberately told so as to achieve a desired outcome without regard to the welfare of others.
It is a psychiatric condition with serious and sometimes life-threatening dangers associated with it.
A person pretending serious physical illness may wind up fooling the medical professionals and receive treatment that is actually harmful to a person without the feigned condition. Even more compellingly, babies and young children who are deliberately made ill so the parent can bask in the medical attention using the child as their “proxy”, can and do die as the direct result of being made seriously ill by a seriously mentally ill parent.
People afflicted with Munchausen Syndrome cross all socio-economic, racial and ethnic lines and can be seen by family, friends and co-workers as being entirely normal people who become quite ill or whose child becomes very sick. Sadly, they often become skillful masters of deceit who, while endangering themselves and/or their child also drain urgent medical care and time away from those who may need it most genuinely and urgently.
The causes of Munchausen Syndrome are not well understood. Because of the almost categorical unwillingness of persons with this disorder to acknowledge or accept treatment for it, research is sparse and, as of now, without meaningful results.
Most clinicians agree that it is, however, a type of Personality Disorder.
Treating Munchausen Syndrome can be difficult. It always begin by medically addressing any actual illness or injury the person may have deliberately brought on themselves (or their child.) No matter what the cause, serious illness is always to be taken seriously and requires intervention. Beyond that, effective treatment can be quite elusive as one of the hallmarks of the disorder is the unwillingness of the person with Munchausen to admit what they have deliberately done.
When other conditions like Clinical Depression, Bipolar or Borderline Personality Disorders exist co-morbidly (at the same time), they can sometimes be treated with various psychotropic medications. These medicine interventions may impact the Munchausen situation, but may not.
Because providing reliably effective treatment for this disorder is sometimes impossible and always difficult, especially in the Munchausen by Proxy situations, once the child is medically treated, the parent who made them ill is usually charged legally and may well be incarcerated in either a prison or secure mental institution with the disorder itself going untreated, but with other children then protected.
In any healing activity, sound diagnosis is of the essence. Without it, appropriate and effective treatment cannot be strategically provided. Munchausen Syndrome, either in its direct form or by proxy, is challenging and often difficult for a medical professional to identify.
Unfortunately, the attendant behaviors which endanger life may continue for some period of time before the condition is identified. No matter how skilled and able health care providers may be, it is sometimes difficult to believe that a person could be ‘pretending’ in such a way as to endanger themselves or their child and that they are doing it “just” for the attention.
The longer it takes to identify the disorder, the more dire and potentially lethal the potential consequences of it become.
The Future and the Best Defense:
In all likelihood, Munchausen Syndrome will always be with us. It is not a condition that is apt to be eradicated, nor is any medicine available to treat the disorder itself. Horrific stories about it will continue to surface from time to time and for a while, while the terrible story about a child’s death is on the front pages, our culture becomes acutely aware, for a while, of this profoundly disturbed and disturbing condition.
Then, many medical professionals may forget and let their diagnostic guard down.
The best defense against the possible harm caused by people with Munchausen Syndrome is, then, good medical training which includes attention to psychiatric conditions which impact the work of nurses, internists, pediatricians and other medical specialists.