A popular new show depicts an abusive relationship between a mother, who appears to suffer from Munchausen Syndrome by Proxy, and her young daughter. This is a very complicated disease, so we asked pediatric psychiatrist Dr. Joseph Sison, to answer some questions about Munchausen Syndrome by Proxy.
What is Munchausen Syndrome by Proxy?
Munchausen Syndrome by Proxy is basically a need by the adult caretaker to make the child appear sick to others. In particular, there is a need by the caretaker to make the child appear sick to the medical professional. The caretaker is aware of this need, though may lack insight as to why they want this happen. The caretaker may do this for a secondary gain, like money or public sympathy, but some caretakers feel the need to make the child appear ill because of some secondary emotional/non-tangible gain.
Who is at risk? Is it mainly mothers, or do we see fathers with this disease, as well?
Both mothers and fathers can suffer from this syndrome, although the person "at risk" who suffers is the child.
How common is Munchausen Syndrome by Proxy?
It’s a very uncommon disorder, about one to two people out of 100,000. Personally, I’ve only seen a few cases of the disease during my medical training and in my practice over the years.
How is the child affected?
The child may suffer in many ways, but the more common ways of making a child appear ill is by poison or suffocation. For example, caretakers may give their child prescription medications to mimic symptoms they want the child to experience. Then, when they see a doctor, the doctor will see the symptoms that the medication is causing them to have (i.e. tiredness, lethargy, fainting, etc.).
What are some symptoms you might see in a child suffering from a parent with this condition?
It will depend on what the caretaker is doing to make the "symptoms" come on. For poisonings, the effects are related to whatever the caretaker is giving the patient. An example of this could include the parent giving the child blood pressure medications causing the child to exhibit low-blood pressure, dizziness, loss of consciousness, blackouts, etc. If the caretaker gives them a highly sedating agent, then the child will exhibit sedation, somnolence or inability to be aroused. If the caretaker is suffocating them, then the child will be found unconscious, for example.
What should I do if I think someone close to me is suffering from the disease?
If abuse is suspected, call Child Protective Services. Removing the child from the abuse should be your first step. Depending on the severity of the case, the medical professional involved may be asked to testify in court about the abuse.