Surgeons in Silesia dissected a healthy 24-year-old girl’s stomach, spleen, and part of the esophagus, because they were convinced that she had the most malignant tumor. It turned out that the patient forged the documentation herself. – What makes a man, in order to pretend to be sick, able to mutilate himself permanently? – we ask the psychiatrist, Dr. Joanna Mossakowska-Wójcik from the Medical University of Lodz. We remind you of the interview that appeared in our pages on July 13, 2017.
Expert psychiatrists suspect this woman has Munchhausen syndrome. It is a rare disease from the group of sham disorders that consists in reporting or provoking symptoms of various diseases in oneself in order to receive constant healthcare assistance.
Halina Pilonis, MedTvoiLokony: Each of us simulated some symptoms of the disease at least once in our life, so as not to go to school or lie on the couch. Is it also Munchhausen syndrome?
dr Joanna Mossakowska- Wójcik: Not. In both situations, the action is conscious. Only the simulator knows why he is doing it, he has a specific goal of his pursuits. Meanwhile, those suffering from Munchhausen syndrome are unaware of the motivations behind their behavior. These factors are hardly understood, most often related to the need to gain interest and influence the environment.
What causes such a disorder?
It is not fully known. It is suspected that it may be caused by psychological trauma or failure to meet emotional needs in childhood. Such people often have disturbed relationships with other people, show irregularities in the development of personality traits. They consciously want to function as a patient. They feel good during medical visits, examinations and in the hospital, where the attention of the medical staff is focused on them.
The patient, whose stomach and esophagus were removed, forged the documentation herself. She copied it from online forums where gastric cancer patients published their research results and entered their personal details. She also changed the names of hospitals and doctors. That required a lot of knowledge of the subject?
People with Munchhausen syndrome are usually very well educated. They go to great lengths to obtain the information they need to produce the various symptoms. They know what drugs or substances to take to, for example, falsify the results of blood or urine tests. They require specific diagnostic tests or give symptoms that guarantee their hospitalization.
Or maybe they are concerned about their health and are simulating to be thoroughly tested?
Not. Sufferers of this disorder realize that they are pretending to be a disease. They are fully aware of this. And as soon as they suspect that the doctor might find out that they are okay, they quickly go to another one. When you examine their medical records, you can see them circulating in many clinics and hospitals, often in different places.
Is there a limit that they cannot cross by mutilating themselves?
It can only be the limit of human imagination. They are able to expose themselves to pain, suffering and disability because they get satisfaction not from being healthy, but from being a patient.
The woman who forged her documentation agreed to psychiatric treatment because the case was brought to court. Do other patients start to heal after being exposed?
Rarely. First of all, because it is not often possible to unmask them. After all, a doctor cannot suspect a patient who comes to him for help that he is deliberately misleading him. But when the results of many studies contradict the disease, these patients switch doctors. So they disappear when they would be referred to a psychiatrist. It is difficult to get someone to get treatment if they don’t want it.
How can you help those suffering from this disorder?
The best results would be achieved by psychotherapy, which would make the patient aware of what motivates him to such behavior, verify his needs and allow him to change his current functioning. However, conscious psychotherapy must be voluntary, and in the case of this condition, there is often no such will.