6 Ways Munchhausen Syndrome Hides Itself From Others


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Photo Credit: ChristianaBella

Do you know what Munchhausen Syndrome is? Have you ever hear it before? If you are like me you probably have heard it only 1-2 times in your life and have no idea how to even spell it without a spell checker. In fact, it is a rare condition only affecting about (2 out of 100,000 children, according to the Cleveland Clinic. But that doesn’t mean we should not learn about it. Sadly, many children, more often babies, are subjected to their caregiver’s or parent’s emotional and psychological needs and problems. A case of Munchhausen Syndrome can be reported and documented as a form of child abuse or child neglect, depending on your state laws. But most people would agree that the syndrome poses not only physical problems to the victim, but also emotional and psychological problems that can be ultimately traumatizing.Because Munchhausen Syndrome is quite controversial, perplexing, and difficult to identify and understand, this article will highlight and discuss some 8 reasons why Munchhausen Syndrome is difficult to identify. I will also add comments on what to do if action is required. 

As a therapist specializing in child and adolescent trauma, I have seen my fair share of cases of Munchhausen Syndrome by proxy (or by a caregiver). Did I know right away that my case(s) included Munchhausen Syndrome? No. It took me a few months, to get to know the child and family, before I could correctly identify what was going on. Once I recognized the foundation of the child’s multiple health challenges, I was not only afraid but shocked. As a therapist with both legal and ethical responsibilities, I had to act. Sadly, Child Protective Services could not find or prove any of the things that were very obvious to me. This resulted in the child remaining in the home and continuing to be abused. It wasn’t until the second call to CPS, after the mother had intentionally burned her child on the face, that the child finally received help.

A loving and doting parent is one of the most wonderful privileges anyone could have. It is a blessing indeed. A parent that would do anything for you, protect you, love you, support you, etc. is hard to find. Unfortunately, not every parent, just because they have the ability to have children, are truly parents. Some people simply should not be parents. But this, of course, is controversial as many individuals believe that parenthood is for everyone who can have (or even adopt/foster) children. Despite this point of view, parental emotional and psychological instability (including narcissism) can affect the child (biological, adopted, or fostered) in many ways.

It is important that most people discuss their concerns with a psychologist or mental health professional who can not only provide you with education, but also clarify any confusion you may have. It can be extremely difficult for a trained mental health professional to identify Munchhausen Syndrome much less a laymen. A psychology student or someone who has taken a psychology class here and there should also seek out a trained professional. You certainly do not want to label a person with Munchhausen Syndrome until it has been “proven” this may be a true possibility.

After working with 3 adults, 2 who were adolescent girls who did not want to be parents, I found that there were barriers to diagnosing these individuals. Some of the barriers included prestige, race, education, and money in addition to multiple other things such as ancestry or socio-economic status.

But there are some things we all can consider if we suspect Munchhausen Syndrome by proxy which is that:

  1. The parent is intelligent or successful: Who would ever believe that a successful and highly intelligent person would intentionally harm their child? No one. Intelligence, social prestige, and social charm often keeps many of us blinded to the truth and off-guard when we should not be. Individuals like this are often found out only after multiple trips to the emergency room or a mental health facility result in the child’s records being pulled by a healthcare provider for background information.
  2. The parent is open-minded or asks for help: It doesn’t seem to make sense that a parent would ask others (neighbors, co-workers, family members, etc) for help while intentionally harming their child. Although it doesn’t make sense, it happens. Back in 2012 while working at a hospital serving children and adolescents who were suicidal, I learned of a case in which the parent would use her child’s suicidal threats and gestures obtain attention for herself from neighbors, co-workers, strangers, and even mental health providers. Her “favorite” activity was to “assist” her 14 year old daughter in communicating with crisis workers. It seemed as if this mother not only enjoyed the sounds and sights of drama, but the company of a healthcare provider. What appeared to be a doting mother, soon became an overbearing mother who needed the emotional support and attention provided by a healthcare provider.
  3. The parent is regretful (admittedly or not) that the child is born: I previously had a client who was not entirely happy that she had had a child. She always wanted to be a mother, but did not want to be a mother as soon as she had become. Her “dream” was to complete school, marry rich, and then have a child. She was often regarded by her family to be negligent or emotionally unavailable. The difficult part about her becoming a mother so soon was that she did not have time for herself including her own emotional and psychological needs. The only way she got these needs met was by speaking with a healthcare provider, taking her child to the doctor, or being viewed by others as doting. Once behind closed doors or in the office, it became apparent that she was not emotionally close to her child. She liked the attention.
  4. The parent appears overly doting, caring, and loving to the point of suffocation: We must be care with this idea as many parents, including my own, were doting parents who truly loved their children. There was (and still is) nothing that my parent wouldn’t do for me. So this idea must truly be considered with forethought. You want to be open to the possibility that the parent is intentionally harming their child, especially if the child is frequently in the hospital, the parent has always been slightly emotionally and psychologically immature and needy, or if multiple doctors cannot find a cause of a child’s medical conditions. You want to also consider the parent’s history if there are signs of malingering or intentional self-harm.
  5. The parent is a healthcare provider or is connected to someone who is a health professional: Not all parents who are in the healthcare profession or is connected to someone who is, is going to have Munchhausen syndrome. But it is likely in some cases. During the beginning of my internship with a residential treatment facility (a place where kids live and attend school on a mental health “campus”) while completing my graduate program, I had a client who had a mother who was a social worker. She had worked with very sick clients over the course of her career. She was meticulous, observant, and intelligent. I liked her. But she also made doing therapy with her child extremely painful. Why? Because she not on critiqued everything the facility did, but she also requested, on multiple occasions, that the staff call her at the end of every shift to update her on her child. She later began threatening staff stating that she would call Child Protective Services on them for “mishandling my child and giving her a virus.” While many of this woman’s family members viewed her as a “helicopter mommy,” she was well known to the facility as a parent who
    “created” problems to get attention. Sadly, her teenage daughter agreed.


It is important that I mention we must be careful not to label ALL caring parents and questionable cases as Munchhausen Syndrome by Proxy. The so-called disorder is rare and seems to only be used in cases involving Child Protective Services or law enforcement. Most mental health professionals rarely use the term unless there is clear evidence to suspect Munchhausen syndrome. Munchhausen Syndrome is often investigated as a child abuse case and only recognized by the mental health community if there is evidence of true symptoms.


Can you identify Munchhausen Syndrome if you had to? Do you think you may have experienced this yourself or know someone who has? Have you ever had a suspicion that someone may be intentionally harming someone else for attention?

As always, I look forward to your thoughts.

All the best



For further information on Dr. Marc Feldman, the national expert on Munchhausen Syndrome By Proxy, visit here: http://munchausen.com/