I would like to add to the conversation Dr. Marc Feldman.
Now Dr. Feldman is a adjunct professor of psychology
at the University of Alabama
and he is in international expert
on factitious disorder and the related conditions.
He's also written five books
on the so called medical deception.
Dr. Feldman, it's good to talk to you again.
Good to talk to you too, thank you.
Let me start with this.
Is this really a mental illness
or is this just really bad behavior?
Well the American Psychiatric Association
sort of straddles the fence.
They say that it is a mental illness
but at the same time,
they don't refer to these people as being patients.
They refer to them as being perpetrators.
Munchausen by proxy is a term that I tend to favor
along with medical child abuse
because those are behaviors and it makes it clear
that regardless of how you view it
as a form of mental illness or not,
it is a potent form of abuse with a high mortality rate.
What makes a person like this do this kind of thing?
What's their motivation?
Are there common elements to these people?
Because I'm looking at, there's an awful lot of
mothers in this audience right now
and they're looking just in shock
like who the hell could do this to a child?
Yeah, it's stunning.
I've been studying this for 30 years
and I still find it amazing that mothers
whom we think of as being so nurturing
and so caring can be transmogrified into evil people.
It seems that most if not all of them
have severe personality disorders,
especially borderline personality
and histrionic personality and that simply means
that they have long term self defeating ways
of trying to get their needs met.
Instead of asking for help,
they engage in abusive behaviors
and being the parent of a terribly ill child
gives them a very clear role in our society
and it also gives them the admiration
of high status professionals like doctors,
nurses, and others.
The whole community may rally around them.
It's hard to imagine that a mother
who comes across as being the ideal parent
could in fact be an abuser.
And so you see situations like Annie and Josh
have gone through where there have been multiple
red flags and warning signs over the years
and yet nobody seems to have done anything much about it.
Doctors just prescribe more medicine
and took the mother's face, reports at face value
and we see what the children have gone through
as a result of that.
Yeah, and one of the reasons of course
is they doctor hop and then there's no way
for former doctors to tell new doctors
that they think this person was not a reliable historian.
So these cases slip through the cracks all the time.
Yeah, now Annie was just talking about the fact
that she did reconnect with her mother
and you were saying one of the common elements
to these people are personality disorders,
often borderline personality or histrionic personality
and let's talk with Annie about what that means.
Personality disorders like borderline personality
are long lasting chronic conditions
for which we don't have consistently effective treatment.
So instead, the person continues to act out.
They typically don't want treatment
even if its made available to them
and so the same behavioral patterns
recur and recur and recur
and I think you unfortunately have been a victim of that
and have seen that first hand.