Wednesday, April 29, 2009

Amateur Pshrink III



This one sounds like fun too! I wanna get all of em!

Better than collecting old comic books!


Münchausen syndrome is a psychiatric disorder in which those affected feign disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is in a class of disorders known as factitious disorders which involve "illnesses" whose symptoms are either self-induced or falsified by the patient. It is also sometimes known as hospital addiction syndrome.
In Münchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves or their child/children in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extremes, people suffering from Münchausen's Syndrome are highly knowledgeable about the practice of medicine, and are able to produce symptoms that result in multiple unnecessary operations. For example, they may inject a vein with infected material, causing widespread infection of unknown origin, and as a result cause lengthy and costly medical analysis and prolonged hospital stay. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Münchausen's. It is distinct from hypochondriasis in that patients with Münchausen syndrome are aware that they are exaggerating, whereas sufferers of hypochondriasis believe they actually have a disease.
In 1951, Richard Asher was the first to describe a pattern of self-harm, where individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Münchausen, Asher named this condition Münchausen's Syndrome in his article in The Lancet in February 1951, quoted in his obituary in the British Medical Journal:
"Here is described a common syndrome which most doctors have seen, but about which little has been written. Like the famous Baron von Münchausen, the persons affected have always travelled widely; and their stories, like those attributed to him, are both dramatic and untruthful. Accordingly the syndrome is respectfully dedicated to the Baron, and named after him."
British Medical Journal, R.A.J. Asher, M.D., F.R.C.P.
Originally, this term was used for all factitious disorders. Now, however, there is considered to be a wide range of factitious disorders, and the diagnosis of "Münchausen syndrome" is reserved for the most severe form, where the simulation of disease is the central activity of the affected person's life.

Risk factors for developing Münchausen syndrome include childhood traumas, and growing up with caretakers who, through illness or emotional problems, were unavailable.
Medical professionals suspecting Münchausen's in a patient should first rule out the possibility that the patient does indeed have a disease state, but it is in an early stage and not yet clinically detectable. Providers need to acknowledge that there is uncertainty in treating suspected Münchausen patients, so that real diseases are not under treated. Then they should take a careful patient history, and seek medical records, to look for early deprivation, childhood abuse, mental illness.
Medical professionals should avoid surgical and diagnostic procedures, if they do not seem absolutely warranted – this may well anger the Münchausen patient who seeks out such procedures and attention. At the same time, providers should attempt to form an alliance with the patients, identifying with the emotional pain they may have suffered leading to this behavior.
Medical providers should consider working with mental health specialists to help treat the underlying mood or disorder and well as to avoid countertransference, Therapeutic and medical treatment should center on the underlying psychiatric disorder: a mood disorder, an anxiety disorder or borderline personality disorder. The patient's prognosis depends upon the category under which the underlying disorder falls; depression and anxiety, for example, generally respond well to medication and/or cognitive behavioral therapy, whereas borderline personality disorder, like all personality disorders, is presumed to be pervasive and more stable over time [5], thus offers the worst prognosis.
If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated.

Illnesses and conditions commonly feigned by Münchausen patients

Note that many of these conditions do not have clearly observable or diagnostic symptoms.

See also



10 comments:

Billy Bob Bambino Bombabious Baby the Third said...

I heard about a lady who used to start fires in her house so the fire department would come. The City building inspector went out to look at some wiring in a home and found that the lady had started stuffing the wiring boxes behind electrical sockets with toilet paper in order to provide fuel for a fire. She was diagnosed with this Munchausen disorder and put in a safe place...

Jim Cobabe said...

Bill,

I hope they give her some matches to play with, just occasionally. Gotta keep things lively somehow.

LivingstonClan said...

Wow--this article was amazingly accurate in describing someone I know. Such a hard thing, to feel like a slave to those cravings. I wonder if people suffering from this disorder are ever able to recognize it and come to terms. Hmm...

Jim Cobabe said...

Well, that is the point of the DSM it seems -- to describe everything so it fits anyone. I fit all these categories without too much bending. The fact is, everybody has problems. We need to be asking ourselves, am I so bad off that I need help that I´m not getting right now, or should I be confiding in someone I trust?

I depend a lot on help from Heavenly Father, but He answers my prayers in ways I don´t always expect, like sending someone to help that understands. I am reluctant to burden others with my troubles, but sometimes that has helped me when I am in too deep. When I feel overwhelmed, I ask for help. So far someone or something comes to the rescue. As near as I can judge, that is a good thing. I don´t worry much about which pigeonholes my mental or spiritual problems fall into. Probably they don´t fall into any neat categories like this. I defy classification. The DSM is for insurance billing and paperwork.

Jim Cobabe said...

Remember too, how easily we can identify faults in others, but are so busy covering up our own. If I were completely honest about all YOUR sins, I could just go on and on. But everyone knows I am practically perfect myself.

LivingstonClan said...

Wow--why the back lash? I was not referring to who you think I was. In fact--it was my SISTER IN LAW! I was trying to be polite and not use names or anything. I just found this post interesting as far as thinking about her and her struggles. I was pointing out NO ONES sins. And I am just confused to see you say you could go on and on about MY sins? Well, I suppose I am done commenting on this blog. Sorry for whatever.

Sarah Cobabe Thomas said...

I'm pretty sure "YOUR" was meant as a general statement - meaning that it is always more difficult to see others faults than your own. I don't think this was meant as a personal attack in any way.

Billy Bob Bambino Bombabious Baby the Third said...

I also think Jim gets comments that he chooses not to post because of their negative or defamatory nature but responds to them here... I don't think his remark was directed at you, Lindsey...

Jim Cobabe said...

Bill and Lindsey,

I meant my comment as tongue-in-cheek sarcasm. I´m generally the only one entitled to such subtle humor, because I tend to discard such comments out of hand from others. But then, I never claimed to be fair or consistent. I play by my own set of standards, and you just have to guess what they are most times. It isn´t really so hard -- most have been abiding by the rules with no apparent effort (except maybe me, but don´t worry about me. My pshrink says such psych disorders only take three or four years of therapy to correct, on average).

Bill is right, though. I am rejecting a certain class of comments fairly consistently. If I gave it any more than casual mention, it would defeat the purpose of taking attention away from those who crave it, and are willing to act out to get it. I´m sure you get the point. Please play by the rules, and if something rubs you wrong, just shrug it off, or write to me privately if you must. I consider all gripes carefully, then file them where they belong. ;->

Billy Bob Bambino Bombabious Baby the Third said...

We call that "file 13" or "the circular file" although they're not circular any more. I wonder if you could actually buy a circular waste basket - you know, the ones from the 30s and 40s that were made out of some kind of woven wire mesh... Maybe on ebay. If I was any more interested I might look it up. I don't want one, I just wonder. We seem to have gone to the easy to produce and cheap to stack/sell rectangular ones... Efficient, but not as aesthetically pleasing.