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Ask the Mental Health Expert Archives 2001-2004

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Inflicted Munchausen by Proxy

Q. I would like to know the best place to get advice for suspected Munchausen by proxy. I believe my daughter is a victim of her mother. Her main problem is unexplained failure to thrive. She has been diagnosed with gastroesophageal reflux disease (GERD) and food aversions.

She's had several surgeries including a nissen wrap and a feeding tube. None of which have helped. She eats more than enough when she is with me. I have tried talking to her doctors about it, but all it did was cause more problems for me and the mother.

I would also like to know if someone who suffers Munchausen is likely to inflict Munchausen by proxy. The mother had several questionable illnesses, however since the birth of our child, all of the mother's illnesses have disappeared but my daughter stays sick.

A. I can understand your sense of worry, and your wish to help your daughter. What's not clear to me is why you suspect your daughter's mother of deliberately causing the girl's problems. I'm also not clear regarding your relationship to your daughter's mother, but I gather you are not married to this woman, since you never use the phrase, my wife. The mere
fact that your daughter eats more than enough when she is with you does not rule out GERD or other disorders that could explain a failure to thrive.

To answer your question regarding Munchausen Syndrome by Proxy (MSP or MSBP): I have not seen statistics on the percentage of those with Munchausen's who then inflict abuse on a child (MSBP); however, some studies suggest that 80% of MSBP perpetrators have themselves been diagnosed with Munchausen's Syndrome. (These are not identical statements, if you think about it).

If you truly believe your daughter is being abused by her mother, you have several options: 1. You can confront the mother (if you haven't already) and see how she reacts. Depending on that, you can then 2. contact the Department of Social Services and place the matter in their hands. Depending on the outcome of their investigation, the mother may be prohibited from having unsupervised contact with your daughter. 3. You could have your daughter evaluated by an expert in child abuse or MSBP. For information on such professionals, you may find the website www.ashermeadow.com to be of use. This site also has many articles and links regarding MSBP. Another useful MSBP site is that of Dr. Marc Feldman (http://ourworld.compuserve.site).

Finally--depending on your relationship with the mother--you could 4. consider asking her to participate in couples and/or family therapy with you, in hopes that this could uncover any abuse in the course of treatment. I hope you are able to resolve this troubling situation soon.

Other Resources:

December 2003

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