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The seemingly caring and loving mother poisons them or makes up the occurrence of various symptoms in order for the child to be considered sick. This is how the mental disorder called Münchausen syndrome by Proxy (MSBP) manifests itself.
This disorder manifests itself through the abuse of children or adults in the care of a sick person. Most often, such a pathological reaction connects the biological mother with MSBP and her child. This seemingly caring and loving mother does not actually accept her child. He feels an inner need to be perceived by others as a sick person. The interest and compassion shown by family and friends is a kind of psychological reward for her. Usually, the mother triggers disease symptoms in her victim, e.g. by administering poison, starving, causing infection, suffocating to unconsciousness, and in milder forms of MSBP – telling the doctor imaginary symptoms of the disease or fabricating abnormal test results, e.g. by contaminating the sample. the baby’s urine with his own blood. These activities are undertaken in a planned manner, with particular care to avoid exposure.
Some history
The term Münchausen syndrome (MS) was first used in 1951 by an English physician, who called the mental disorder of adults who deliberately induced symptoms or pretended them, underwent unnecessary treatment, and the motivation for doing so was the desire to focus on the attention of medical staff. The disorder is named after Baron von Münchausen, an 1977th-century German officer known for telling imaginary adventures in which he allegedly participated. The term MSBP (transferred Münchausen syndrome) was introduced into the medical dictionary by the English pediatrician Roy Meadow in XNUMX, describing the behavior and mental disorders of two mothers. She was the first to invent and induce disease symptoms in her child. The second led the child to recurrent hypernatremia as manifested by elevated serum sodium levels. The child died from severe electrolyte disturbances. Years later, her mother told her psychiatrist that she had poisoned them with large doses of table salt.
Three degrees of disorder
Psychiatrists classify the mental state of a person suffering from Münchausen’s syndrome into three levels.
1. – mild degree – the mother presents the doctor with imaginary symptoms of her child’s disease, which often causes the child to undergo unnecessary, sometimes burdensome or painful diagnostic tests. This degree of disorder is easy to overlook.
2nd – moderate degree – consists in the fact that the mother provokes the child with mild disease symptoms and demands that the child be treated. If the doctor notices this behavior of the mother, he reprimands her and explains the inappropriateness of such behavior.
3. – severe degree – the mother’s behavior towards the child has a criminal dimension. It often goes as far as strangling the child, poisoning it or taking actions that end in the death of the child.
Where is it coming from?
In the United States, 1200 cases of this disorder are recorded in medical statistics each year. However, doctors estimate that the true extent of this phenomenon, especially with regard to child abuse, remains unknown.
One study revealed that 1 percent of MSBP victims were children initially diagnosed with bronchial asthma, and in another – it was 5 percent. children with symptoms suggestive of food allergy. Researchers were particularly interested in the topic of research aimed at determining what percentage of children are strangled and poisoned. It found that a total of 2,8 (per 100 children) cases of children under the age of one who were abused in this way and 0,5 (per 100) cases under 16 were registered in England and Ireland. In the USA, 625 children are affected each year.
What causes parents (mainly mothers) to display such difficult-to-understand behaviors towards their children? Most specialists say that the behavior of a sick person results from the desire to focus on themselves, a sense of power over the child, or is an attempt to react to everyday problems. There are also doctors who believe that the existence of a nonspecific brain dysfunction arising in a mother who was a victim of abuse as a child, or lost one or both of her parents at an early age, or supersedes her childhood memories for an unclear reason. Strong stresses, such as marriage problems, can give rise to MSBP. The incorrect relationship between parents and the child is also indicated as the source of the disorder. The child is used as a tool to control the situation. The attention paid to the mother by the medical staff is perceived by her as a reward.
Doubtful diagnosis
The diagnosis of MSBP is very difficult due to the fact that the person with this disorder does not admit to “producing” the symptoms of the disease in his victim. The doctor cannot assume in advance that this is not what the mother says. He must rule out the possibility of disease. But when the mother frequently returns with the baby, she gives the same or new symptoms of the disease – she should analyze the child’s medical history and test results. When he finds no reason to make a diagnosis, he may suspect that his mother suffers from MSBP. Then, institutions that will take care of the victim’s safety should be interested in the matter.
The principles developed by Roy Meadow can be used by a physician in determining a caregiver’s mental disorder. The doctor should pay special attention to:
– an unexplained, chronic or recurrent disease of the child;
– multiple hospitalizations for unusual reasons or symptoms of the disease,
– discrepancies between the test results and the child’s health condition,
– initial diagnosis of a very rare disease,
– the fact that symptoms improve or decrease significantly when the child is not cared for by the parents,
– the fact that the mother is unnaturally caring and sensitive to the child, that she emphasizes that the child does not tolerate the prescribed treatment, that she is worried about the embarrassment of doctors resulting from diagnostic failures rather than the child’s disease,
– the fact that there were unexplained deaths of newborns in the child’s family,
– the mother was a medical professional or has a rich history of numerous and unexplained diseases herself,
– detection of a drug in the blood that has not been prescribed by the doctor.
The doctor caring for your baby should also order an extended analysis of your baby’s urine, stool or vomit to check, for example if the blood in the urine is your baby’s blood (blood group test) or if there are traces of chemicals in the stool or vomit that are not naturally there. occur.
Portrait of the torturer
The data collected so far shows that in over 95 percent. In some cases, the person abusing the child was the biological mother. Usually, she is extremely caring and does not leave the child’s bed in the hospital. In reality, however, for unknown reasons, he rejects the child or uses them to attract attention. Such a person is often emotionally unstable. Sometimes he is indifferent to the hard work of medics, sometimes he accuses them of lack of knowledge and competence. But at the same time, she willingly cooperates with medical staff, accepts no questions asked for additional diagnostic tests, regardless of the risks and pain they carry for her child. Invents or even provokes new symptoms of the disease. She diligently hides her actions, eg giving the child some “syrup”, a strange drink, etc. She does it so effectively that for years she manages to cheat doctors and nurses. When she is concerned that she might be caught, she can destroy a sample taken for testing or steal the results of obtained tests.
When medical staff becomes suspicious, they seek help from another doctor. People suffering from MSBP are able to perfectly manipulate the environment, relatives whom they convince that, for example, a runny nose is a symptom of a serious, even fatal disease. They are reliable because, as estimated, about 80 percent. of them worked as nurses or medical registrars. The father of a battered child is usually withdrawn in life, unaware of his wife’s mental disorder, and often supports her by becoming complicit in the abuses committed. Child’s biological fathers, grandparents, foster parents, stepfather, stepmother, and employed caregiver suffer much less frequently from MSBP.
Portrait of the victim
The most common are newborns, infants and toddlers. The mean age of the victims was calculated as 32-39 months. The victims of strangulation are small children (around 3 months of age) who do not yet speak, cannot judge the mother’s behavior, and therefore cannot complain. But it happens that teenage children are also strangled, whom their mother told them that it was a necessity in the fight against a mysterious disease.
Children who are bullied by MSBP are more likely to suffer from physical rather than mental illness. Children complain of abdominal pain, vomiting, diarrhea, weight loss, seizures, shortness of breath, infections, fever, bleeding, poisoning, and lethargy. Newborns often die, and sudden cot death is classified as the cause of death.
Long-term damage to health is found in 7,3 percent. abused children. Mental disorders are common – disturbances in behavior, attention, mental performance, anxiety triggered by certain situations or places, sleep disorders or post-traumatic stress disorder. Moreover, some children associate being sick with paying attention to themselves. It is their “way” of needing to be loved, hugged, etc.
Treatment of ailment
The mother or other legal guardian of a child affected by MSBP receives short- and long-term psychiatric treatment. She is also under constant psychological care. Cognitive-behavioral psychotherapy is also recommended. Treatment lasts for years and does not always bring the expected results. The child must be isolated from the mother during therapy. After the end of its treatment, the relevant services must check whether it still does not display behaviors that are dangerous for the child. If the mother does not learn to accept her unwanted child, she should not and cannot continue to look after her.
Text: Anna Jarosz
Based on: Transferred Munchausen syndrome, Psychiatria Polska, volume XLIV no.2
Also read: Parenting after divorce