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As the Government attempts to bring the pandemic to a state of control by ramping up the vaccine rollout, for those already under medical supervision there has been a significant disruption, and in my opinion with worrying consequences… 

Mental Health Transference

An area that is often a secondary consideration, as the focus naturally is targeted towards the patient, are the children of those under medical care. We are fortunate here in the U.K to have specific safeguarding measures, to protect children, but with a system overwhelmed, I think the transference and real struggle for mental health professionals is on the horizon.

Within this article I want to explore going beyond the ‘my’ struggles, looking at the ‘me-to-them’ transference, from parent to child, specifically Munchausen Syndrome. 

Munchausen Syndrome By Proxy.

            by proxy - if you do something by proxy, you arrange for someone else to do it for you.

Munchausen syndrome by proxy is a mental health issue where the ‘parental / guardian’ figure (not always the case but for the sake for this article we’ll use this description), creates a false illness or injury in a vulnerable person, under their care.

Hannah Turtle was convicted of murdering her seven-week-old son James in June 2016, in her sentencing hearing heard that she was suffering with the condition. Up to 500 cases of it a year in the U.K may be going undetected, according to research. 

Because vulnerable people are the victims, it is a form of abuse and in many situations missed by health care professionals (vastly not due to competence but due to workload or the manipulation from the patient). Since the majority of cases are usually linked between mother and child, I will describe that relationship within the context of this article.

Examples, Munchausen Syndrome by proxy

  • The parent will lie about the child's symptoms often exaggerating an innocent comment, to mean something requiring medically care or attention
  • Manipulating test results or medical records to make a child appear to be ill or a victim, using those items to gain significance or attention from a third party
  • Physically harm the child to produce symptoms, both mentally and physically, forcing a situation requiring medical care
  • Subjecting the child to unnecessary tests, inoculations or treatments

Children who are victims of Munchausen syndrome by proxy can have lifelong physical and emotional problems and may have Munchausen syndrome as adults, the victim becoming the abuser.

What causes Munchausen syndrome by proxy? 

There is little evidence that defines one reason for the adoption of this negative trait, but it could be linked to problems during the abuser's childhood. Abusers feel like their life is out of control, randomly looking for purpose, often have poor self-esteem and can't deal with stress or anxiety.

The attention, significance and purpose they receive from having a sick child may encourage their behaviour, ultimately receiving the attention from persons who wouldn’t normally be within their community or social network.

How does someone with Munchausen syndrome by proxy act?

Some people with Munchausen's syndrome may spend years travelling from hospital to hospital, clinic to clinic, therapist to therapist faking a wide range of illnesses, often at great cost and resource. When little evidence is found regarding the specific illness they will source other medical opinion or establish new issues, ultimately starting the referral cycle again, exhausting all avenues at the frustration to many.

Without limitation they will; 

  • Heavily research medical illness, attempting to link manifested feelings to symptoms, and self diagnose
  • Project elevated parental kindness via social media and their community
  • Looks for sympathy and attention, often victimising themselves to strangers in an attempt to gain emotional credit
  • Looks to build relationships with medical staff in the attempt to manipulate the outcomes or diagnosis
  • Fail to identify destructive behaviours within relationships, often using people until no longer of value to their current projections

What are the behaviours?

They will promote that their child has a repeated or unusual illness, and no reason can be found

Their child doesn't get better, even with treatments that should help

Verbal or physical symptoms get better or go away when the parent not present. These can be identified via the language that they use, usually by ownership; I have, I am, for example 

The other parent (usually the father) is not involved in the child's treatment, and alienated from medical treatment or contact in the attempt to control the outcome

There is a sudden change in medical treatment, fearing that they will be found out unless continually moving the goalposts and symptoms

How is it treated?

Child safeguarding is triggered automatically in a number of situations in the U.K, with a number of treatments available with continued monitoring in parallel with long-term counselling, ensuring the protection and welfare of the child.

What now…

Within this article I wanted to explore going beyond the ‘my’ struggles, looking at the ‘me-to-them’ within mental health, I have used Munchausen syndrome as the reference point for the article as an extreme… 

…but the transference between the current Covid-19 issues, the mental health fallout and the impact on adults doesn’t just stop there … it filters down, from the words we use and the behaviours towards our children, something that all parents should pause, take note and consider.

If you know a child at risk then avoid any delay, report them to the appropriate authorities, many offer an anonymous reporting procedures and will only take action if the child is at risk.

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