Munchausen by Proxy: A Special Kind of Child Abuse

We previously looked at the curious phenomena of Munchausen by Proxy (MBP). Correctly known as Munchausen Syndrome by Proxy, or more simply, factitious disorder by proxy, it customarily involves a female parent or guardian who will use the illness of her child to draw attention to herself. However, it is the parent or guardian who actually makes the child sick, often by chemical means or even injecting urine into the child’s bloodstream in an attempt to cause infection.

The parent thrives on the attention of her sick child, yet comes across as a very caring parent and often fools medical staff for long periods of time. Munchausen by proxy is a special case of child abuse and in today’s article we will look at how it differs from more regular cases of physical child abuse. So insidious is the illness that even the child will be unaware of the abuse for long periods of time.

Typical physical child abuse involves actual direct physical contact with the child, such as punching, hitting etc, and the signs of this abuse are apparent on physical examination. In the atypical case of MBP there is a misrepresentation of an acute or accidental medical illness that is not usually obvious upon medical examination. In other words, the parent (usually the mother) has deliberately produced symptoms of illness in her child for which the cause is not immediately apparent. Some of these methods were described in our previous article.

In typical child abuse, the perpetrator is reluctant for signs of abuse to be discovered by others. With MBP, the opposite is true. The perpetrator is the one who usually presents the signs of “illness” to medical authorities.

In typical child abuse, children are either the objects of frustration and anger and/ or are receiving excessive levels of punishment, hence the signs of physical injury. In MBP, the child is used as the means to gain the attention the mother desires. Anger is not usually present, rather the child is the lure.

Finally, in typical child abuse the perpetrator is aware of the abuse that they have done to the child. In MBP, there is usually little or no awareness. The focus is entirely upon themselves, and the child serves merely as an object for attention.

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