Q. I don't know where to turn. I am convinced my daughter-in-law has both Munchausen's and Munchausen's by Proxy. We have involved the Department of Social Services and spoken with the many doctors and hospitals where she has taken her children.

My 5-year-old granddaughter has been pinching, smothering, strangling, kicking, and hurting her baby brother since he was born a little over a year ago. Does this seem consistent with what a Munchausen's by Proxy mother would have done to her child? This behavior seems to be a learned behavior and not normal sibling rivalry.

A. This is clearly a painful and frustrating situation for you and your family. For readers who are not aware of these terms, let's provide some quick definitions. Munchausen's Syndrome is basically a psychiatric disorder in which someone deliberately feigns physical or mental symptoms, without a clear financial, legal, or other obvious motive. Such individuals are believed to be seeking the care of others by assuming the sick role.

In Munchausen's Syndrome by Proxy (MSBP), somebody (often the child's mother) inflicts physical injury upon a child, and deliberately misleads others as to the nature of the injury; e.g., claiming the child had an accident. MSBP is widely viewed as a form of child abuse. By involving the Dept. of Social Services and taking this matter to court, you have already done all that is required from the legal standpoint, in terms of assessing the validity of your suspicions. And yet, you feel that you "don't know where to turn". This suggests that you don't fully trust those involved in this legal process, or that you don't feel adequately supported emotionally-or maybe both.

If so, you may want to contact the National Children's Advocacy Center in Huntsville, AL and ask to speak with one of their counselors. You can reach them at 256-533-5437, or email to webmaster@ncac-hsv.org. You may also want to contact the Bazelon Center for Mental Health Law (www.bazelon.org) if there are unresolved legal issues surrounding your granddaughter.

Some of the behaviors you describe-smothering and kicking her baby brother--are certainly beyond the normal sibling rivalry often seen in younger children who feel jealous or resentful of a new arrival in the family. It is certainly possible that these behaviors reflect some type of learned behavior--but from whom, I can't say.

They do raise the question of child abuse, however. If you need to speak with someone immediately, you can also contact the Child Abuse Hotline at 1-800-4Achild. I hope you are able to resolve this very disturbing situation.

Other Resources

• More Questions on Munchausen Syndrome

March 2003

Disclaimer Back to Ask the Expert