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Munchausen-by-proxy syndrome: countertransference as a diagnostic tool
N M Szajnberg1, I Moilanen, A Kanerva
1Langley Porter Psychiatric Institute, University of California, San Francisco 94143, USA.
Bulletin of the Menninger Clinic
|January 1, 1996
Summary
Clinicians interviewing parents suspected of Munchausen-by-proxy syndrome (MBPS) may experience disbelief, even with evidence. This reaction might stem from the parent's "as-if" personality traits, impacting diagnosis and treatment.
Area of Science:
- Psychiatry
- Psychology
- Forensic Psychology
Background:
- Munchausen-by-proxy syndrome (MBPS) is a form of abuse where a caregiver fabricates or induces illness in a child.
- Diagnosing and treating MBPS perpetrators presents significant challenges for clinicians.
Observation:
- Clinicians interviewing individuals suspected of MBPS report an unusual reaction: a strong, often subconscious, disbelief that the parent could be the perpetrator, despite compelling evidence.
- This phenomenon is described as uncanny, ego-dystonic, and cognitively dissonant.
Findings:
- The authors propose that "as-if" character pathology in the suspected perpetrator may unconsciously elicit this disbelief in clinicians.
- This psychological defense mechanism in the parent could hinder accurate assessment and intervention.
Implications:
- Confirming this clinician reaction could lead to improved diagnostic accuracy for MBPS perpetrators.
- Enhanced understanding may facilitate more effective and informed treatment strategies for this dangerous syndrome, potentially improving outcomes for affected children.