Unfortunately, many children are abused every day in our society. There are various forms of child abuse and multiple classifications. Generally speaking, we can specify the following types of abuse: physical, psychological, sexual and neglect.
In 2002, an epidemiological study was carried out in Spain which confirmed the existence of 11,148 children victims of domestic violence. 86.37% of these minors were victims of neglect, 35.38% of psychological violence, 19.91% of physical violence and 3.55% of sexual violence.
However, as in almost all epidemiological studies, there is “submerged” data and only the tip of the iceberg can be seen. In this article we will talk about a form of child abuse that is very difficult to diagnose, we might even call it “hidden child abuse”: the Munchausen syndrome by the powers.
What is Munchausen Syndrome by Powers?
Munchausen syndrome by the powers (PMS), or depending on the factitious disorder DSM-5 applied to another, is a special form of high-risk maltreatment that is difficult to diagnose because it often goes unnoticed for a long time, until and every year. . It is a syndrome that has seen an increased incidence due to the greater knowledge of the same and professional awareness.
Following DSM-5, it is a disorder characterized by the falsification of physical or psychological signs or symptoms, or the induction of injury or illness, in another, associated with deception . It is a mental disorder that it is seen in adults who take care of other people who depend on them (Usually helpless, which makes sense). The victims of this disorder are often minors and it is considered a form of child abuse.
The parents of the child (generally, according to epidemiological studies on the subject, the mother) they simulate the existence of diseases or cause symptoms in the child for the purpose of receiving medical assistance, some of which is risky and expensive. It seems that one of the goals of the parent is to deceptively present their child to others as a sick, vulnerable, dysfunctional and / or troubled person.
Experts in the study of this disorder claim that the parent he continues with the deception even without receiving in return any visible benefit or reward. The most serious consequences of this syndrome are serious physical and psychological complications for the child and, ultimately, his death.
Symptoms and signs
Symptoms or signs are often inconsistent, often unexplained, and resistant to treatment., Since it is the parent who performs them deliberately and on a recurring basis. Some examples are:
- Repeated suspicious incidents that threaten the life of the child or victim.
- Poisoning and apnea.
- Bleeding or bleeding.
- Various infections caused by various organisms and sometimes rare.
- Medical history with little consistency and logic: Victims often spend a lot of time in the hospital with diverse, contradictory and diffuse diagnoses, the causes are almost never clear.
- The caregiver very often takes the victim to the doctor or to several doctors, until they feel sufficient satisfaction and attention.
- There is no witness in the family who saw the various symptoms that the mother refers to, as they only occur in her presence.
- The child’s symptoms often go away in the hospitalHowever, these are repeated in the child’s home, especially when it is in the care of one of the parents.
- Signs or symptoms occur concomitantly when the caregiver is present.
- Families with a history of Sudden Infant Death Syndrome or other serious childhood problems.
- The caregiver may have been seen performing somewhat suspicious acts which could lead to a worsening of the victim’s situation.
As mentioned above, the diagnosis of this syndrome is a challenge for the clinician: It is difficult to detect when the mother tends to go to various hospitals, because for health professionals, the observed facts will be isolated. Although pediatricians are trained to assess the credibility of certain stories, they don’t tend to make an initial assumption that this is such an elaborate lie.
History of Munchausen syndrome through the powers
PMS is a variant of Munchausen syndrome, Term first introduced in 1977 by the English pediatrician Roy Meadow. This professional at the time described the patients who had this syndrome as people who had a spectacular and strange medical history, with inventions and lies, in order to obtain medical care.
Interestingly, in the same year, two authors, Burman and Stevens, described a case in which a mother with Munchausen syndrome (now a factitious disorder) moved it in her two young children. This phenomenon has been called “chicken syndrome”.Synonym in its time of the syndrome of Munchausen by the powers.
Causes and motivations
The causes of Munchausen syndrome by the powers are still unknown. Studies on the subject that interviewed the authors suggest that they were abused as children or suffer from a fictitious disorder.
The causes are not known, but they are progress has been made in studying the motivations of the parents involved. First, the person suffering from this syndrome does not take action to obtain material or economic benefits. Paradoxically, they can end up investing large sums of money, effort and sacrifice in the “care” of their victim, even if they do them great harm.
In short, their motivations lie in an excessive need for attention, care, compassion, pity and / or recognition by medical staff and others for their great dedication to the victim. In addition, a relationship of pathological ambivalence towards the victim (care vs. possible hidden rejection) seems to occur.
What should be done in these situations? How should professionals who detect such a case proceed? Can the father or mother with this syndrome continue to take care of their child?
There is no appropriate way to act, let alone when there may be a judicialization of the problem. Ultimately, who can receive more collateral damage is the minor (Other children in the family should also be assessed, if applicable).
In such cases, the most important thing will always be the best interests of the child. Clinicians must ensure the diagnosis with certainty and put the child out of danger in the most serious cases (careful separation from the family for example), by contacting social services. It is very important to collaborate with other professionals and to carry out a multidisciplinary intervention.
Confession by the perpetrator is usually not common. This is why the treatment is often complex due to the father’s difficulties in recognizing their problems and trying to give them a coherent explanation. Obviously, the parent suffering from Munchausen syndrome for the powers will have to engage in psychotherapy, family therapy and / or taking psychotropic drugs.