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Alienation Through Munchhausen by Proxy

In the mid-nineties there were many cases involving “chronic fatigue syndrome” and Lyme disease.  Lately, it seems that one in 5 divorces involve a child who is suffering from A.D.D. and/or A.D.H.D. or another “not otherwise specified” (N.O.S.) cognitive problem.

Attention Deficit Disorder (“A.D.D.”) and Attention Deficit Hyperactive Disorder (“A.D.H.D.”) are being aggressively diagnosed and therefore it seems there is a windfall of diagnoses.1  Practitioners that remember the Lyme disease and the Epstein Barr/chronic fatigue syndrome cases of the nineties, take a more generational view of these disorders.2  Indeed, there may have been significant “undocumented or undiagnosed” cases of A.D.D. or A.D.H.D. in the decades past.  Or, as many suggest, there may be other reasons for A.D.H.D. such as: environmental causes, medication, allergies, or child rearing styles.  Many school districts and/or counties are proactive and provide early intervention.  This is a fantastic way to address problems early on before they become pervasive and/or “learned”.   However, in contrast to the above, we are seeing many cases where one parent believes the child is suffering from A.D.D or A.D.H.D. and the other parent does not believe it and/or thinks the condition is being exaggerated.   

There are many cases nowadays where that is the key to the custody problem.  We have cases where one parent believes in medication and the other parent does not, and where one parent believes in labeling the child and the other is adamantly against it.

It must be frustrating to believe in your heart that your child is suffering from a condition or a syndrome and have the other parent believe in their heart that it is not true.  These cases prove to be some of the most complex and conflicted battles. 

To make things worse, there is a form of alienation whereby a parent will exaggerate a child’s condition, whether it is asthma, a learning disability, allergies and/or behavioral problems.  The parent then, to the exclusion of the other parent, ensconce himself/herself as the savior for the child and makes sure that everyone knows the child will certainly be harmed if that parent isn’t there to save the child.3

In the wide spectrum of parenting, only a very few parents go against nurture, love and basic instinct to harm their child.  However, there are documented cases of divorcing parents where we see one parent forcing a diagnosis upon a child, or exaggerating a condition so that this parent can label themselves as the child’s savior, or otherwise exaggerate their role as parent. Occasionally, a parent exaggerates a condition, or label, or a malady to the point where the parents can elevate themselves as the child’s “champion” and convince both the child and others that without them the child’s health, education and well-being would be destroyed.  This is a very insidious form of alienation; it is alienation by Munchhausen. 

Often referred to as “medical child abuse”, Munchausen by Proxy Syndrome is birthed from the desire of a parent or caregiver to obtain sympathy from doctors, nurses, and other professionals. In the context of litigation where children are involved, one parent will seek to establish themselves as the only hope for the child to receive “necessary” care.  Often, the child suffers greatly as the parent or caregiver goes to great lengths to ensure the child is symptomatic of the desired illness. Care must be exercised in confronting suspected cases of Munchausen by Proxy Syndrome as, often, when the parent or caregiver is accused of this behavior they will attempt to increase the child’s symptoms to “prove” the presence of the illness.

Here at Bryan L. Salamone & Associates, P.C., we have special experience on both sides of this phenomenon. We have the unique skills and necessary experience to recognize the signs of this condition. We offer free consultation on selective cases and we practice only in the area of Matrimonial and Family Law.    




1 The Centers for Disease Control and Prevention indicate that there has been a steady increase in the diagnosis of cases of ADHD in the United States since 2003. The percentage of children diagnoses with the disorder increased from 7.8% in 2003 to 9.5% in 2007. This number continued to rise to an astonishing 11% of children (6.4 million) age 4-17 were diagnosed with the disorder in 2011. The rate of increase of diagnosis from 1997 to 2006 was 3% per year while in years 2003 to 2011 the rate of increase in diagnosis was approximately 5% per year.

2 According to information obtained from the Centers for Disease Control and Prevention, for a span of 18 years, approximately 442,000 cases of Lyme Disease were diagnosed in the United States.

3 Munchausen Syndrome, named after Baron von Munchausen, an 18th century German dignitary known for exaggerating stories of his travels and experiences, is a factitious disease in which an individual either fabricates or intentionally causes symptoms of a medical condition. This results in the individual seeking otherwise unnecessary care for the feigned condition. Similarly, Munchausen by Proxy results when a parent or caregiver fabricates or causes symptoms of a medical condition in a child under their care in an attempt to mislead medical professionals to obtain a desired diagnosis for the child. In some documented cases the parent or caregiver has actually caused the symptoms in the child by poisoning, medicating, or even suffocating the child.

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