Images: Hulu / The Act
When the Dee Dee Blanchard story came out in 2015, it shocked the nation. Gypsy Rose Blanchard and her boyfriend murdered Dee Dee Blanchard in June of that year. Dee Dee Blanchard pretended that her daughter was mentally disabled and suffering from leukemia when she was perfectly healthy. This made this breaking story even more bizarre. In fact, she even shaved her daughter's head, made her ride in a wheelchair, and have countless surgeries and medications to keep up with the appearance that her daughter was sickly. It turned out that Dee Dee was suffering from Munchausen Syndrome by Proxy. This is a psychological disorder where someone, usually a caretaker, pretends that someone else, usually a child, is ill.
The media created numerous films and TV specials about the Dee Dee Blanchard case. HBO created a documentary film called Mommy Dead and Dearest in 2017. Lifetime created a movie called “Love You to Death” in 2019 based on the case. And Hulu created a TV series called The Act in March 2019 based on the famous case. It is the only reported case where the victim of Munchausen Syndrome by Proxy killed the perpetrator. Read on to find out more about this mysterious psychological illness.
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Rudolf Erich Raspe created the fictional Baron Munchausen. In 1785, the infamous con-artist wrote a book that was loosely based on the German nobleman, Freiherr von Münchhausen. The real-life baron told stories about his time in the military. However, the fictional character told stories about riding on a cannonball, fighting a forty-foot crocodile, and traveling to the Moon. The real baron was insulted by the satirical novel. Therefore Rudolf Erich Raspe chose to keep his work anonymous until much later in life. People with the disorder are like the fictional baron because they both tell outrageous tall tales for attention.
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The term “Munchausen syndrome” was created in 1951 by R. Asher. This is a syndrome where someone pretends to be sick so that they can gain sympathy from others. But the term “Munchausen syndrome by proxy” came over two decades later by John Money and June Faith Werlwas. It was later used by a British pediatrician named Roy Meadow a year after. He studies two cases where he believed that the caretaker had Munchausen syndrome by proxy. In the first case, a mother poisoned her toddler with excess salt. In the second case, a mother placed her own blood in her infant's urine sample. At first, the medical community was skeptical about Munchausen syndrome by proxy. But today, there are over 2,000 cases for this syndrome in medical literature. The United States, Nigeria, Sri Lanka, and Oman have Munchausen syndrome by proxy cases.
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The original term used to describe this psychological disorder was Munchausen syndrome by proxy. However, it was never a scientific term. There were many different terms for this illness for over forty years. The World Health Organization recognized the disorder as Factitious Illness by Proxy in 1996. The American Psychiatric Association recognized Munchausen syndrome in the 1980s. But they did not recognize Munchausen syndrome by proxy until 1994, but only as a proposal. The American Psychiatric Association did not officially recognize Munchausen syndrome by proxy until 2013. Its official name is Factitious Disorder Imposed on Another. In Britain, the disorder is called Fabricated Illness by Carers.
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Typically, victims of Munchausen Syndrome by proxy are very young, according to the National Institute of Health. Over 50 percent of victims are under two years old. And 75 percent of victims are under six years old. Doctors diagnosed children around 22 months after showing symptoms. 50 percent of victims of Munchausen syndrome by proxy have siblings. Of those who have siblings, 65 percent of their siblings had symptoms that were similar to the victim's symptoms. The reason why victims are so young is that they are unable to communicate with medical professionals about how they truly feel. It is also very easy for caretakers to emotionally manipulate their children when they are very young.
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Munchausen syndrome by proxy is one of the rarest forms of child abuse. It is unusual because it has a clear motive according to Science Direct. The perpetrators abuse their victims because they want people to feel sorry for them and their victim. It is also strange because it is premeditated. People with Munchausen syndrome by proxy abuse their victims without being provoked. A typical abuser would abuse if their child does something that they deem as negative such as spilling something or crying. Like typical abusers, individuals suffering from Munchausen syndrome by proxy can be charming. They are very involved and over-concerned about their child's health.
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Munchausen Syndrome by Proxy has the highest mortality rate in child abuse cases according to the American Psychiatric Association. 6 percent of victims died after their diagnosis. Typically the cause of death was from apnea or starvation. In the cases of apnea, typically the perpetrator smothered the victim. 25 percent of victims had dead siblings. And seven percent of victims of Munchausen syndrome by proxy have a long-term or permanent injury from the abuse. Even though it may be difficult, many children overcome the physical and psychological impact of having a parent with Munchausen Syndrome by Proxy. According to the British Journal of Psychiatry, seven in ten children go on to live completely normal lives after having a Munchausen syndrome by proxy childhood.
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In 76.5 percent of cases, the mother was the perpetrator, according to an article on Science Direct. However, in 93 percent of cases, the abuser was a female caretaker. In about 16.5 percent of cases, the abuser is a female caretaker, such as a grandmother, aunt, or foster mother. This might be the case because females typically take on care-taker roles sociologically. In fact, it is part of a common model of maternal abuse, according to Anna Motz's The Psychology of Female Violence. In these situations, fathers and male figures are either non-existent or submissive in the household. If they are living with the victim, they do not play a role in their child's health. They are not present at hospital visits and are likely to deny abuse allegations.
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Male and female children are equally likely to be victims of Munchausen syndrome by proxy. However, male Munchausen Syndrome by proxy perpetrators are three times more likely to have a male victim. It is not clear why male perpetrators are more likely to pick on sons than daughters. It could possibly be that fathers with Munchausen syndrome by proxy also have Munchausen syndrome and want to live vicariously through their sons. Fathers with MSbP typically receive less sympathy than their female counterparts. Hospital staff see these fathers as over demanding, overbearing, and unreasonable according to a BMJ article. They were also more aggressive than female MSbP parents. Many of these fathers threatened legal action against the hospitals their children attended when they did not get their way.
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26.8 percent of victims reportedly suffer from apnea. 24.6percent Science Direct. Other reported symptoms include seizures, cyanosis, behavior, asthma, allergies, and fevers. Caregivers choose these symptoms because they cannot be proven to a doctor. Many of these symptoms can also be induced. Eating disorders can be induced by caregivers who refuse to feed their children. Apnea can be induced through suffocation or strangulation during sleep. And if a child had a very high fever over a 24 hour period, they still have to get treated by medical professionals, even if they do not spark a fever anymore. Someone with Munchausen syndrome by proxy knows all the tricks in the book, so they can go months without getting caught by medical professionals.
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Even though the Dee Dee Blanchard case blew up in the media more than any other Munchausen Syndrome by Proxy, there are other notable cases. Lacey Spears killed her son by feeding him dangerous levels of salt after she researched the effects of high salt intake. She was charged with second-degree murder and first-degree manslaughter and received 20 years to life in prison. Julie Gregory wrote a memoir titled Sickened in 2003 about dealing with a mother with Munchausen syndrome by proxy. In the memoir, she describes how her mother taught her to play up the sick role. She told her to exaggerate symptoms and act sicker than she is. Her mother encouraged doctors to give Julie multiple invasive surgeries even though she was not actually ill.
Images: HBO / Sharp Objects
Gillian Flynn wrote her debut novel, Sharp Objects in 2006. It focused on a mother with Munchausen syndrome by proxy. Her book was adapted into a miniseries on HBO in 2018. Nicola Yoon, a Jamaican- American author, wrote the young adult novel, Everything, Everything in 2015. The novel focused on the 17-year-old protagonist, Madeline, who believed that she suffered from severe combined immunodeficiency. She found out that she did not have SCID after she goes to the hospital after getting very sick in Hawaii and there is nothing on file of her diagnosis. Everything, Everything was adapted into a film in 2017.
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M. Night Shyamalan directed the movie, The Sixth Sense in 1999. It starred Haley Joel Osment as the lead character, Cole Sear, who can see and communicate with the dead. In the movie, a mother pours Pine Sol into her daughter's soup. Her daughter gets sick and eventually passes. Her mother continues to poison her other daughter after the girl's death. Cole used his powers to save the other girl from the same fate. This movie was very successful. It made $293 million dollars in the United States, making it the second- highest grossing film in 1999. It was also nominated for six Academy Awards, including Best Picture.
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Munchausen Syndrome by Proxy for pets is a subset of MSbP according to medical literature, such as the National Institute of Health. It is called Munchausen Syndrome by Proxy: pet or MSbP:p. It is a very dangerous phenomenon. In fact, 9 out of 393 of intentional injury to cats and dogs are MSbP:p cases. Unfortunately, MSbP:p cases are very easy to hide because dogs and cats cannot communicate with veterinarians. Some pet owners who have Munchausen Syndrome by Proxy do it because they want sympathy from veterinarians. Others do it so that they can receive otherwise illegal prescription drugs through their pet's illness. Sometimes MSbP:p and MSbP overlap. One of the men who made his dog sick went to jail for poisoning his child.
Marshall Mathers told traumatic stories about his life and childhood through his rap persona, Eminem. One of his stories involved his mother's struggle with Munchausen Syndrome by Proxy. He released the single “Cleanin' Out My Closet” in 2002. He describes his struggle in the lyrics "Victim of Münchausen's syndrome. My whole life I was made to believe I was sick when I wasn't". Music critics gave “Cleanin' Out My Closet” positive reviews. It peaked at 4 in the Billboard Top 100. It was also nominated for Best International Video in the MuchMusic Video Awards in 2003. Mathers states in an interview that he testified against his mother in court to help his brother, Nate, who was nine at the time. After he testified, his brother went to foster care for a year while his mother got help.
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Children who have a parent with Munchausen syndrome by proxy experience a lot of psychological issues. Some of them become Munchausen syndrome patients as adults. If they received positive attention from hospital staff and other people for being perceived as sickly, they might want to continue to embrace the sick role throughout their life. On the contrary, some MSbP victims avoid hospitals and medical treatment at all costs. This might be because going to the hospital triggers them with negative childhood memories. This can also be harmful because they can miss out on necessary medical treatment to get better if they are very ill.
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Parents who have children with learning or mental disabilities are more likely to get away with Munchausen syndrome by proxy. Children with special needs have more trouble communicating with others, so medical professionals will listen solely to their parent for information about the patient. Physicians sometimes take children with mental health issues less seriously and dismiss them as “paranoid” if they say that they are not ill. Parents with Munchausen syndrome by proxy like the idea of having dependent, obedient children. It is very difficult for people with learning and mental disabilities to live on their own, so they can be victims of MSbP way throughout adulthood.
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Many victims of Munchausen syndrome by proxy may be the second or third child to experience unusual illnesses, especially if they are the youngest child. People who have Munchausen syndrome by proxy can argue that their children have a genetic illness when that isn't the case. It is important for parents to be informed about their child's health. However, parents with Munchausen syndrome by proxy always want to be in the room with their children at all times. They do not want their children to tell medical professionals that they are not actually sick. If a child receives many treatments and none of them work for their illness, it could be a red flag. If their treatment works, it means that there is no reason for the child to go to the doctor anymore. This ends the perpetrator's cycle.
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It is difficult to diagnose Munchausen syndrome by proxy because we expect parents and caregivers to tell the truth about their child's illness. When we see a concerned parent, we are likely to sympathize with them, not be skeptical of them. According to the Cleveland Clinic, medical professionals must confirm that there is no diagnosis for the child's symptoms in order to confirm that a parent or caregiver has Munchausen syndrome by proxy. Afterward, they must look into the child and the parent's medical records. Many people who have Munchausen syndrome by proxy also have Munchausen syndrome. Treatment is also difficult because people with Munchausen syndrome by proxy do not want to get help.
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Doctors can misdiagnose patients with Munchausen syndrome by proxy. Only 0.5percent percent of patients in a psych ward in Italy had Munchausen syndrome by proxy according to the Association of British Pediatric Nurses. Roy Meadow was an expert witness of Munchausen syndrome by proxy. He determines whether perpetrators have Munchausen syndrome by proxy or not. He has misdiagnosed women with Munchausen syndrome by proxy several times. Sally Clark was wrongly convicted of Munchausen syndrome by proxy for the death of her two infant sons in 1999. In 2003, Frederick Curzon argued that Munchausen syndrome by proxy is not real. He believed that parents abused their children and covered it up by pretending that their children are ill. He did not think parents received gratification from their children being ill. The Dee Dee Blanchard case makes it clear that Munchausen syndrome by proxy does in fact exist.