A Form of Abuse: Munchausen by Proxy Syndrome

One type of abuse: Munchausen by Proxy Syndrome

Where Does Munchausen Come From?

Munchausen Syndrome got its name from the German Baron Karl Friedrich von Munchausen, who lived in the 18th century. The German Baron, after returning from the Ottoman-Russian War, recounted extraordinary stories of his heroism. These stories were so extraordinary that they included exaggerated and supernatural elements and became widely circulated through word of mouth. However, many of these stories were fabricated and exaggerated. That's why Munchausen became synonymous with deceit. The term "Munchausen" was later applied to describe a condition where individuals feign illnesses and go from one hospital to another, a behavior observed by Asher in 1951.

So What Is Munchausen by Proxy Syndrome?

In the most general terms, Munchausen by Proxy Syndrome (MBPS) can be defined as a caregiver pretending that a child has one or more illnesses and continually bringing the child to the hospital for unnecessary medical attention. The caregiver may even administer various medications to make the child appear ill. In some extreme cases, the caregiver might go so far as to cause the child's death.

MBPS was first used in 1977 to describe two children who were subjected to severe abuse as their mothers persistently induced illnesses in them. After this diagnosis, many similar cases started to surface worldwide. Interestingly, MBPS cases often appear in medical specialties such as pediatrics, neurology, and endocrinology rather than psychiatric services.

Research on MBPS has shown that children under the age of 6 and adolescents are generally at a higher risk, particularly those who are vulnerable and unable to protect themselves.

Profile of the Abuser:

In these cases, the abuser is usually the mother and possesses significant medical knowledge. They may even conduct research on various diseases and scrutinize medical opinions. Paradoxically, MBPS mothers often appear very affectionate, caring, and loving, which helps them gain the attention of those around them. They believe that they are good mothers who genuinely care for their children. This perception satisfies them, and they want others to see it as well. Consequently, these mothers are motivated to maintain their abusive behavior and continue it systematically. When faced with exposure, they may try to change hospitals quickly.

When a child is hospitalized and separated from the perpetrator, improvement can be observed. Therefore, the caregiver may want to remain close to the child as much as possible. If they are advised to stay away from the child for a while, they may react strongly and refuse this separation. This reaction can be likened to a child's response when a toy is taken away from them.

Typically, individuals who engage in such behavior are predominantly women, usually married. This can lead to addressing problems within the household. By creating these circumstances of abuse, they can deflect attention away from issues at home. Essentially, the abuse serves as a barrier to larger problems within the household.

Many Munchausen mothers have a negative self-concept and adopt the role of a caregiver to define themselves. They may believe that they can validate themselves through their child's illness and gain acceptance in this way.

What Is Recommended?

MBPS is not only a psychological issue but also a legal and sociological problem that needs to be addressed from multiple perspectives. Its multifaceted nature makes it even more critical to tackle. There is no specific treatment method because the individuals responsible for MBPS typically do not accept treatment. The most crucial step is to detect and remove the child from the abuser as soon as possible. Early diagnosis is vital because the severity of abuse can increase, sometimes leading to fatal outcomes. Child protection is paramount; otherwise, the child is likely to suffer physical, psychological, academic, and psychosocial development problems.