The term “Munchausen syndrome by proxy” evokes a cryptic fascination—much more obscure and possibly even glamorous than “run-of-the-mill” problems like depression or anxiety—but the reality of it is much more brutal, and the true victims are not those that suffer from it, but their most defenseless “proxies,” most often, children. The official, albeit less-used, name for it is “Factitious disorder imposed on another,” a phrase that lays bare the essential elements that characterize it.
Munchausen by proxy is a mental disorder suffered by those in a caregiver position, often parents, wherein they make their dependent, often a child, appear sick in order to induce sympathy from others and get the attention they crave from family, friends, neighbors, and importantly, medical professionals. It can involve less directly harmful forms, such as lying about or exaggerating the proxy’s symptoms, but it can also go as far as outright physical abuse—for example, through poisoning or physical injury. It was first referred to in medical journal The Lancet in 1977 by Dr. Roy Meadow, a pediatrician who based his report on two cases he’d attended to. It’s referred to as a long-term disorder, and unlike other forms of child abuse, which are not usually pre-meditated, the abuse in Munchausen by proxy is not provoked by the behavior of the child and involves a degree of planning. Essentially, the desire for attention begins to outweigh the desire to protect those most vulnerable.
The Truth Hurts, But Lies Are Worse
The name is derived from Munchausen syndrome, also known as Factitious disorder imposed on self. Those who suffer from it feign illness to draw attention to themselves, and in the process, end up telling a number of lies or exaggerated stories to garner sympathy—almost a counterpart to hypochondria, where the patient actually goes so far as to poison or harm themselves to mimic an illness, instead of simply speculating that they have it. The name “Munchausen” comes from Baron Munchausen, an 18th-century fictional character inspired by a real baron, Hieronymus Karl Friedrich, Freiherr von Münchhausen. Both the fictional and real Munchausen were known for their impossible tall tales, some of which were memorably portrayed in Terry Gilliam’s 1988 film The Adventures of Baron Munchausen.
What’s in a Name?
In the ‘50s, Dr. Richard Asher began to recognize a pattern of fabricated symptoms, going on to coin the term Munchausen syndrome in a medical journal article. In recent years, the term has come to be overused—it’s now more commonly referred to as fictitious disorder, but at the same time, there have been more specific strains of fictitious disorders identified, including even Munchausen by internet, a sort-of catfishing where people lie about being sick online for the attention.
The Shadow Before
Perhaps the first major mention of Munchausen by proxy in a pop cultural text was by the master of horror himself, Stephen King. As if a killer clown wasn’t terrifying enough, It is littered with abusive parents, including Eddie Kaspbrak’s mother, who dotes on her son, controlling him through a combination of guilt and false medical diagnoses. Though not explicitly named in the book, it’s clear that she suffers from a form of Munchausen by proxy, enabled by the local pharmacist who, sensing her machinations, gives Eddie an asthma inhaler that’s actually just filled with tap water and a bit of camphor.
Don’t Say it Tastes Funny
When The Sixth Sense came out in 1999, most of the talk about it centered on the sensational twist at the end. The ending easily overshadowed what became one of the first filmic uses of Munchausen by proxy as a plot device: an equally dramatic twist in the middle of the film, when young Cole Sear (Haley Joel Osment) uncovers a dark secret at the funeral of a dead girl named Kyra, played by a pre-OC Mischa Barton. Thanks to his mysterious ability, Kyra leads him to a videotape which shows her mother stirring a cleaning product into her food, which Cole then shows to Kyra’s heartbroken father, leading him to confront his wife and presumably save Kyra’s younger sibling from the same fate. Although again, it is not mentioned by name, this was one of the first notable portrayals of Munchausen by proxy in a mainstream film, and at that, a huge blockbuster that became a pop cultural phenomenon.
The Truth is Scarier Than Fiction
Of course, just because that was Munchausen by proxy’s first notable appearance in a film doesn’t mean it was its first appearance on screen. By the late ‘90s, much like any other lurid and detailed report of child abuse, the disorder was fodder for investigative news reports and true crime documentary shows (shows like Forensic Files and 48 Hours Mystery). Similar to the fascination with Satanic Panic in the ‘80s, reports of notable cases of Munchausen and Munchausen by proxy usually drew international attention in the ‘90s and early 2000s. In the late ‘80s, a woman named Marybeth Tinning was sentenced to 20 years to life in prison for the murder of her ninth child. Authorities suspected that she was also responsible for the deaths of her eight other children as well, deaths that were at first thought to be caused by Sudden Infant Death Syndrome—another subject that was a magnet for news coverage in the ‘80s and ‘90s. Although never officially diagnosed with Munchausen syndrome by proxy, many who studied the case have pointed out the areas where her actions align perfectly with descriptions of the disorder. On a side note, Tinning was recently released from prison, on August 21, 2018.
Diagnosing the Invisible
As Munchausen by proxy became a sort of buzzword, there was a shift in the frequency of diagnoses of the disorder. Whereas many were reluctant to use the diagnosis in the case of Marybeth Tinning, in other notable examples, others rushed to throw the term around and started something of a witch hunt for the next newsworthy case. Kathy Bush and her daughter Jennifer were the subject of hundreds of headlines in the ‘90s after Kathy was accused of abusing Jennifer as a result of Munchausen by proxy. By the time Jennifer was eight years old, she’d spent hundreds of days in the hospital and had undergone dozens of medical procedures. The sweet, angelic, chronically-ill little girl had drawn the attention of local newspapers, and the mother-daughter duo was once even invited to the White House to meet then-First lady Hillary Clinton. When a health care worker accused Kathy of dosing Jennifer to make her sick, the authorities moved swiftly. After a trial, Kathy was convicted. After spending a decade in foster care, Jennifer reunited with her mother upon her release and continues to deny that her mother abused her. Kathy Bush’s defense lawyer, Robert Buschel, summed it up perfectly when he referred to Munchausen by proxy as the “diagnosis du jour.”
Pop Culture Saturation
As the ‘90s came to a close and the saturation of jokes playing on the phrase “I see dead people” came to a head, the word Munchausen began to pop up in other popular texts. Eminem accused his mother of abuse in the song “Cleanin’ Out My Closet” from the 2002 album The Eminem Show, saying that he was a “victim of Munchausen’s syndrome—My whole life I was made to believe I was sick when I wasn’t.” Then, in 2003, Bantam released a book named Sickened: The Memoir of a Munchausen by Proxy Childhood by Julie Gregory. In the book, Gregory claims that throughout her childhood her mother took her to a number of doctors and asked her to feign illness. On top of that, Gregory alleged that her mother would go against any doctor’s order she did receive and worked her daughter to the bone between appointments. The book was a hit, named Book of the Year by The Sunday London Times and a top ten book of the year by Entertainment Weekly—and one would imagine, exposing the topic to a whole new group of people.
Ripped From the Headlines
Munchausen by proxy soon became a perennial favorite of scriptwriters for “ripped from the headlines”—style procedurals like Law & Order, Law & Order: SVU, Criminal Minds, and even more niche entries in the genre, like JAG. It’s also made its way into “prestige” drama, becoming the subject of shows like the original Danish/Swedish version of The Bridge, and recently, in the HBO miniseries Sharp Objects. Based on Gillian Flynn’s debut novel of the same name from 2006, one of the more compelling twists occurs when the main character, Camille, realizes that her mother Adora is giving her pills to make her sick. She puts it together that Adora had done the same to her half-sister Marian years earlier, who died as a result, and that she is currently also slowing poisoning her other half-sister, Amma, who was born after Marian’s death. You know you’ve made it when you get the HBO prestige drama treatment.
The Model Parent
The ultimate culmination of the fascination with Munchausen by proxy is surely what’s happened in the wake of the real-life murder of Dee Dee Blanchard, which has been the subject of many popular true crime podcasts, not to mention a viral Buzzfeed article by Michelle Dean which spawned the hit HBO documentary Mommy Dead & Dearest. The case is so captivating and the details are so lurid that the story is ripe for re-telling—don’t be surprised if Mommy Dead & Dearest isn’t the last time the tale is told onscreen. On June 14, 2015, an alarming Facebook status appeared on the shared profile of mother and daughter Dee Dee and Gypsy Blanchard, stating simply “That B—- is dead!” Immediately, friends of the Blanchard’s raised alarm, especially when another, much more graphic post appeared on the status. The pair were well-known to many in their neighborhood—Dee Dee was the doting mother to the chronically ill Gypsy Rose, a teen girl who had been diagnosed with several conditions, was confined to a wheelchair, and had, according to her mother, the mental capacity of a child. They were often the beneficiaries of fundraisers for Gypsy’s medical care and had even received a wheelchair-accessible home from Habitat for Humanity.
A Gruesome Discovery
As concerned friends contacted the police after reading the disturbing Facebook posts, the police arrived to the Blanchard’s home and entered, finding the body of Dee Dee Blanchard. Immediately, the community grew concerned for the vulnerable Gypsy Rose, suspecting that she’d been kidnapped. Gypsy was small in stature, needed a variety of medications daily (according to her mother), and spoke in a high, child-like voice. They were shocked the next day when Gypsy was eventually found by police in a hotel room, perfectly fine, with her boyfriend Nicholas Godejohn. The pair were arrested for their involvement in Dee Dee’s murder. The concern and sympathy in the community quickly turned to shock and outrage when the police made clear that not only was Gypsy an adult, not the stunted teen her mother had made her out to be, but that she wasn’t actually sick, as Dee Dee had claimed she’d been. While there had been suspicion that Dee Dee was fabricating some of Gypsy’s problems, the pair had never stayed in one place enough for it to pan out. By the time Gypsy reached adulthood, she had begun to yearn for more independence from her mother, and had reached out to a number of men online before entering a relationship with Godejohn. Godejohn visited the Blanchard home in June 2015, where Gypsy gave him duct tape and a knife, to be used to murder her mother. They then took $4,000 of Dee Dee’s money and left.
The Question of Victimhood
After the initial outrage over the revelation that Gypsy was neither sick nor wheelchair bound, there was soon an outpouring of sympathy as people realized that Gypsy had been the victim of a mother who was very likely affected with Munchausen by proxy. While Godejohn’s trial is forthcoming, Gypsy Rose Blanchard accepted a plea deal for her charges in the murder of her mother. She’ll serve ten years in prison. Subsequent portrayals of her in the media, including Mommy Dead & Dearest, are somewhat sympathetic despite the more gory details of the crime she’s been found guilty of. After all, isn’t she a victim as well? Perhaps that’s what made the case of Gypsy and Dee Dee Blanchard such a phenomenon. It finally turned the trope of Munchausen by proxy on its head—instead of the conclusion being the death of a child at the hands of a parent, Gypsy was the one helpless “child” who actually devised a way to defend herself from the mother who had spent years harming her.