Munchausen Syndrome by Proxy

By Michele C. Hollow @michelechollow
July 22, 2017

Munchausen syndrome by proxy is when someone misleads others to think a person in their care has serious medical or psychological problems. 

In the movie “The Sixth Sense,” a girl is poisoned by her mother, who has Munchausen syndrome by proxy disorder. It’s a frightening film, and the reality of the disorder is even more alarming. The mother in the film keeps her child sick to get sympathy from family and friends.

Also called factitious disorder imposed on another, it’s close to impossible to know the exact number of victims because the people who have Munchausen syndrome by proxy operate in secrecy. Some doctors believe that two in every 100,000 children may have experienced it.


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What is Munchausen syndrome?

Often the perpetrator is a parent — usually a mom — or a caregiver to an elderly patient who deliberately misleads others into thinking that their child or person in their care has serious medical or psychological problems. The victims go through unnecessary medical treatments, diagnostic tests, hospitalizations, and even surgery.

It’s also been called “disease forgery” because the person with the syndrome may falsely report an illness and have those in their care actually believe they have a terminal disease or mental disorder.

According to Marc Feldman, MD,  a psychiatrist, author, and expert on Munchausen syndrome by proxy, people with the illness may also “falsify lab results by adding blood or protein to a urine specimen.”

Munchausen syndrome by proxy symptoms

Feldman also notes that people with Munchausen syndrome by proxy might also:

  • Exaggerate medical problems
  • Manipulate a wound so it doesn’t heal
  • Induce an actual illness
  • Avoid seeking treatment so the illness gets worse

The victims, children and the elderly, are vulnerable to their assailants. This makes the illness a form of child and elder abuse. They usually suffer lifelong physical and emotional scars.

What causes Munchausen syndrome by proxy?

The cause of Munchausen syndrome by proxy is unknown. Researchers believe biological and psychological factors can cause the disorder. Some scientists suggest a history of child abuse or neglect can trigger it.

What is known is that abusers have poor self-esteem and cannot handle stress. The attention the caregiver gets encourages negative behaviors. Those in the role of caregivers — whether it’s a mother or health aide — are looked at with admiration for bearing a burden. Caring for a sick child or elderly person is seen as a noble act. The person with Munchausen syndrome by proxy feeds off of the praise.

Much like a bully, those who harm others do so in secrecy. Outsiders can be a spouse, sibling, or someone close to the victim. Unfortunately, they don’t see the abuse. All they notice is the attention and care from the caregiver.

What if you suspect someone has this condition?

Sometimes, however, actions don’t always add up. If you suspect abuse, check the patient’s medical records to see how often medical tests, treatments, and hospital stays occur. If illness cannot be explained, if the patient doesn’t get better with numerous treatments, and if other victims under the caretakers’ watch get sick, it’s time to report the caregiver.

This falls under abuse. If children are the victims, call Child Protective Services or your local police precinct. If the person is elderly, contact your state’s Adult Protective Services. You should also report this to the doctors involved. Whatever you do, do not approach the person with Munchausen syndrome by proxy. That person is unstable and may try to harm you. You can also report the person without using your name.

Persons with Munchausen syndrome by proxy and their victims will need long-term counseling. Treatment involves intensive psychotherapy. In some cases, the perpetrator may be jailed.

If left untreated, the abuse will continue, and the victim can die. The first action is to make sure the victim is safe and removed from the abuser.


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April 02, 2020

Reviewed By:  

Janet O’Dell, RN