I read this story in the Boston Globe yesterday, but have been struggling with its underlying meaning and whether or not to blog about it. Munchausen by Proxy is a very rare mental disorder, one that is rarely seen by most psychotherapists even after years of practice. It is probably more commonly seen in hospitals, because that’s where it presents itself. The short version of a description of this disorder is that a child’s caretaker (most often their mother or father) presents the child for unknown (and usually undiagnosable) medical problems in order to gain attention for themselves.

In the Globe’s story, a mother fights a battle to be believed at Hasbro Children’s Hospital in Providence, RI. The mother’s baby would be placed into the protective custody of the Massachusetts Department of Social Services while questions about the mother’s mental health and fitness are answered.

So while I have great respect for my medical nurse and doctor brethren, it took a mental health professional to get to the bottom of the so-called “mystery:”

[Dr. Lee Birk, a psychiatrist and associate professor at Harvard Medical School,] concluded that Owen’s belligerence was triggered when she felt disrespected but that she did not have Munchausen by Proxy. He noted that a Boston sleep specialist this year confirmed that Bryanna-Rose skipped breaths in her sleep, and though it was not serious, that her parents were right to be concerned.

Birk said authorities got an idea about Owen, and refused to let go.

On Sept. 24, a juvenile court judge restored full custody of the baby to her parents.

I think this is an example of where trained medical professionals try to err on the side of child safety and concern for the child brought to their hospital… but in doing so, erred a little too much. Technically, nobody got physically hurt and the baby was eventually reunited with her mother. But only after significant time and trauma that was inflicted by the government and well-meaning but not-specially-trained medical personnel.

Munchausen by Proxy is so rare, it should be the diagnosis of last resort, and after all medical explanations have been exhausted. It’s not clear that happened in this case.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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Fitness » A Real Life Case of Munchausen by Proxy? (11/5/2007)

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    Last reviewed: By John M. Grohol, Psy.D. on 5 Nov 2007
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