Munchausen Syndrome by Proxy Can Lead to False Child Abuse Allegations

When it comes to allegations of child abuse, the situation is often fraught with complexities and requires the most delicate of handling.

Establishing a process becomes even more challenging when the accuser is afflicted with Munchausen by proxy (MSbP). Today, MSbP is more commonly known as Factitious disorder imposed on another (FDIA).

Munchausen Syndrome by Proxy is a condition where the parent or caregiver to a child will fabricate, or induce, symptoms of physical or mental ill-health in a child. The parent will often obsessively pursue repeated contact with doctors, psychologists, specialists, and medical professionals.

According to The Cleveland Clinic, around 1 percent of people have Munchausen syndrome, and an estimated one in 50, 000 children are victims of MSbP. Yet, based on the fact that caregivers will often go to extraordinary lengths to manipulate anyone in their orbit, it's likely that this number may be higher.

In the late 1980s, a unique form of MSbP was described for the first time: Contemporary-type Munchausen by proxy. Contemporary-type MSbP shares many similarities with classical MSbP but has a specific focus on alleging that a child has been sexually abused.

These cases are rare, when considering the general population, but they're not unheard of, and with the increased focus on protecting children from sexual abuse, this has created new opportunities for an adult with MSbP.

In an article by Deirdre Rand, Ph.D., a leading expert in the field of contemporary MSbP, cases of MSbP typically involve the mother as the perpetrator and the father as the accused. Quite often, this is the basis for the parent (mother) seeking sole custody of a child in divorce proceedings.

What must not be taken lightly is the trauma that can occur for both the child and the falsely accused in these cases.

As with classical Munchausen Syndrome by Proxy, the caregiver will turn to authority figures such as the courts, Child Protective Services, and mental health workers to "prove" the assault abuse by the accused parent.

In one case, covered in detail in the book "Dark Moon Rising: A True Story," a divorced, MSbP mother induced her children to allege that sexual abuse had occurred. She subjected the children to exorcism rituals and extensive brainwashing sessions to present a false history to mental health professionals.

Due to the professionals who have to assess in a child sexual abuse allegation, but who don’t catch the MSbP, it is possible that people just trying to do their jobs exacerbate MSbP.

In a divorce or other high conflict child custody dispute, a powerful motivation for developing the idea that a child has been abused is to gain custody and to sever the child's emotional relationship with the other parent.

In a 1988 case reported by Wakefield and Underwager, a divorced mother confessed to examining her children after they had stayed with their father, including taking them for medical examinations. She was also suspected of abusing her youngest child to produce "physical evidence" of the non-existent abuse.

Typically, the primary caregiver with MSbP will be described as "histrionic, obsessed, angry, fanatical, self-righteous, aggressive, emotionally labile, manipulative, dramatic, unpredictable, and unable to distinguish fact from fantasy." However, this can often be perceived by trusting professionals as devoted parenting until the deception is discovered.

A typical scenario we see within contemporary-type MSbP is the primary caregiver will take the child to multiple therapists until they find one who will corroborate the accusation of sexual assault. These “validators,” presumably in good faith, act on the assumption that all sexual abuse allegations are legitimate.

Unfortunately, this can lead to persistent questioning, leading the child, and unwittingly reinforce to the child that abuse occurred.

In "Management of Munchausen by proxy," Richard Meadow provides a helpful set of guidelines for evaluating MSbP, which can also be applied to contemporary-type cases.

1. Compile an in-depth study of the history of the child, accuser, and accused.
2. Look for a temporal relationship between the events and the presence of the mother.
3. Verify the details the accuser has given, as in many cases, they will have lied about personal, family, or social history.
4. Speak with other family members to compile a broader picture.
5. Look for a motive for potential MSbP behavior.

In cases where one parent is found by authorities to have committed the alleged abuse, there is often a heavier weight placed on statements made by the child.

However, where possible, videotaped interviews with the child can highlight where a story has been rehearsed or learned by rote.

An adult with MSbP will go to extraordinary lengths to convince the child, and any authority figures, of the validity of their sexual abuse claims.

It is imperative in all cases that the accused parent understands the pressure the child has been placed under, and to understand that they are victims too. And then fight like mad to correct the situation, not just to save one’s own reputation, but to save the child.