Topic Overview
What is Munchausen syndrome by proxy?
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Munchausen
syndrome by proxy (MSBP) is a mental health problem in which a caregiver makes
up or causes an illness or injury in a person under his or her care, such as a child, an elderly adult, or a person who has a disability. Because vulnerable people
are the victims, MSBP is a form of
child abuse or elder abuse.
Note: Since most cases of MSBP are between a
caregiver (usually a mother) and a child, the rest of this topic will describe that relationship. But it is important to remember that MSBP can involve any vulnerable person who has a caregiver.
The caregiver with MSBP
may:
- Lie about the child's
symptoms.
- Change test results to make a child appear to be
ill.
- Physically harm the child to produce symptoms.
Victims are most often small children. They may get
painful medical tests they don't need. They may even become seriously ill or
injured or may die because of the actions of the caregiver.
Children who are victims of MSBP can have lifelong physical and emotional
problems and may have
Munchausen syndrome as adults. This is a disorder in
which a person causes or falsely reports his or her own symptoms.
What causes Munchausen syndrome by proxy?
Doctors
aren't sure what causes it, but it may be linked to problems during the
abuser's childhood. Abusers often feel like their life is out of control. They
often have poor self-esteem and can't deal with stress or anxiety.
The attention that caregivers get from having a sick child may encourage
their behavior. Caregivers may get attention not only from doctors and nurses
but also from others in their community. For example, neighbors may try to help
the family in many ways-such as by doing chores, bringing meals, or giving
money.
How does someone with Munchausen syndrome by proxy act?
A person with MSBP often:
- Has medical skills or
experience.
- Seems devoted to his or her child.
- Looks for
sympathy and attention.
- Tries too hard to become close and friendly
with medical staff.
- Needs to feel powerful and in
control.
- Does not see his or her behavior as harmful.
What are the clues that a person may have Munchausen syndrome by proxy?
Checking a child's medical records for past tests, treatments, and hospital stays may help a doctor or nurse find out if a health problem is real.
Doctors or nurses may suspect a problem when:
- A child has a repeated or unusual illness,
and no reason can be found.
- The child doesn't get better, even with
treatments that should help. Symptoms only occur when the caregiver is with or
has recently been with the child. But symptoms get better or go away when the
caregiver is not there or is being closely watched.
- The other
parent (usually the father) is not involved in the child's treatment, even
though the child's condition may be serious.
- A caregiver suddenly
changes doctors and lies about prior testing and treatment.
- Normal
test results don't reassure the caregiver. And he or she may be strangely calm or
happy when the child's condition is getting worse.
- The caregiver is
seen (or videotaped or recorded) harming the child or causing
symptoms.
- Another child in the family has had unexplained illness
or death.
How is it treated?
Child protective services, law enforcement, and doctors are all involved in treatment for Munchausen
syndrome by proxy. Caregivers who have this condition need long-term
counseling. They may resist treatment or deny that
there is a problem. Medicines are used only when the caregiver has another
health problem, such as anxiety disorder, along with MSBP.
Even
after treatment, caregivers may repeat their behavior. So doctors, counselors,
and family members need to closely watch how the caregiver interacts with his or her
children.
For victims, the first step is to protect the child by
moving him or her into safe custody. Then a doctor will monitor the child for symptoms. Most
of the time, the child's symptoms stop after the child is away from the
caregiver. Some children need counseling or other help.
What should you do if you think someone has Munchausen syndrome by proxy?
MSBP is child abuse. If you suspect that a child is a
victim, don't confront the suspected caregiver. It might make the problem
worse. Instead, think about these options:
- Keep a journal of the child's symptoms and
other related events.
- Talk with your doctor about your
concerns.
- Report your concerns to your local child welfare agency.
You can make a report without using your name (anonymous).