What is Munchausen Syndrome?
Named after the German aristocrat Baron Munchausen, who was famous for his unbelievable stories about the past, Munchausen Syndrome—also known as hospital hoboes, induced illness, or professional patients—refers to patients who repeatedly stimulate or fake diseases to gain medical attention. Munchausen syndrome is a dangerous variant of factitious disorder imposed on another; in this case, the psychiatric illness is fabricated through falsified documents, medical history, distorted physical signs, and self-inflicted injuries. These patients, often referred to as professional patients, possess a thorough knowledge of medical procedures, processes, and terms required to prove a disorder as real.
The Munchausen Loop
The behavioral loop that individuals with Munchausen Syndrome follow includes a dishonest medical case history, lying about their current symptoms, manipulating findings to implicate the presence of symptoms, adding symptoms, making repetitive rounds to the hospital, and not being satisfied with the interventions of doctors while seeing as many physicians as possible to gain attention.
Producing Symptoms
It is important to note that under this syndrome, the life of the person on whom symptoms are self-inflicted is endangered. The person is usually someone under the care of another individual (e.g., a child). For instance, a mother may seek treatment for a child after intentionally causing the child to exhibit symptoms. This can be done by administering drugs, choking the child, or heating thermometers to make the child appear feverish. Such actions are often perpetrated by mothers seeking extra care.
Murder of Garnett Spears
A real-life example of Munchausen Syndrome is the “Murder of Garnett Spears.” Lady Spears, born and raised in Decatur, Alabama, was a single mother who craved social media attention. She poisoned her infant son with table salt by inserting salt into his feeding tube. Spears posted on social media about her son’s health struggles and blogged her journey in searching for a cure for her son’s fabricated illness. She not only made her son sick but also posted pictures of him dying on Facebook. Although Spears denied any mental illness, on March 2, 2015, judges found her guilty and diagnosed her with Munchausen syndrome by proxy. Fourteen months prior to Garnett’s death, Lacy moved from Alabama to New York and fictionalized the story by falsely stating that Garnett’s father was an inspector named “Blake,” who died in a car accident. Furthermore, Spears lied to Garnett’s biological father, Chris Hill, claiming that he was not his son to maintain distance. The high levels of sodium led to swelling in the infant’s brain, and the child eventually lost his life after living for five years. The fabricated sickness during those five years included infections, high fevers, seizures, and digestive problems, but the cause remained unclear until the doctor rectified the raised levels of sodium in the child’s metabolism. It was then detected that she injected sodium through his stomach tube. Despite all this, the mother’s social media depicted a different narrative, one of strength and optimism throughout the baby’s difficult times. Spears was characterized as a mother lacking guilt and empathy, yet certain instances captured in hospital videos showed her putting socks on her son’s feet, suggesting care for the child. Such instances tend to imply that Spears’ only intention was to make the child sick and not to murder him.
Prognosis of Munchausen Syndrome
Factors that could cause this syndrome include emotional illness, childhood trauma, prolonged medical care in childhood, feelings of neglect and deprivation, and compulsions to punish oneself. A need for attention and the urge to be cared for by someone else may also contribute. Individuals with personality disorders—such as antisocial personality disorder (having a grandiose sense of self), borderline personality disorder (recurrent unusual mood swings), narcissistic personality disorder (inflated sense of self-importance), histrionic disorder (craving attention and flamboyantly expressing oneself), and dependent disorder (complete dependence on family members and peers for day-to-day duties)—are more likely to develop this syndrome. Other causes could include the masochistic nature of the patients and a desire for dependency on father figures, such as doctors or physicians.
After the Diagnosis Process
After suspecting the syndrome, the physician must consider that the fabricated actions of the patient indicate psychological disturbance. Feelings of frustration, ridicule, or aggression towards the patients should be avoided upon discovering the factitious illness. Patients should not be labeled as liars, and rigid confrontation should be avoided. Instead, they must be talked out of the condition, and a psychiatric or psychological consultation should be arranged to help them open up and seek help. Additionally, all medical procedures conducted prior to the recognition of the syndrome must be suspended for further continuation.
Treatment Therapies
After discussing the fabricated situation and understanding the intention behind the fabrications, if a patient acknowledges and cooperates regarding their syndrome, there are chances of treatment. Although there is no permanent or standard treatment, the patient’s behavior can be gradually modified through Cognitive Behavioral Therapy. Their inner urges and needs can be explored through psychotherapy, utilizing tools such as free association and talk therapy to uncover the underlying reasons behind self-inflicted behavior or behavior causing harm to others. Building rapport with such patients is crucial to maintain trust, as their prior knowledge could hinder their ability to analyze their fabricated behavior. Establishing trust is a key aspect of reducing symptoms and increasing the patient’s awareness of the problem.
Conclusion
It is important to understand that this syndrome is not merely an attempt to crave attention; it is a mental illness that can harm both the individual and those upon whom the harm is imposed. Early intervention through video monitoring of patients who repetitively visit for reasons that are less likely to occur, combined with keen observation of the patient’s requirements and needs by physicians and medical staff, can be effective in breaking the pattern of Munchausen syndrome.
Author
