Münchhausen Syndrome by Proxy and Harassment in Children and Adolescents able to Lead During the Growth to Personality’s Dysharmony, Even Later to Psychic Disorders Volume 8 - Issue 2

Hugues Scharbach*

• Neuro Psychiatrist, Past head of General, Pedo-psychiatrist Service in CHU Paris’ University, France

Received: June 17, 2024;   Published: June 25, 2024

Corresponding author: Hugues Scharbach, MD PARIS’s University, Neuropsychiatrist, Past Head of Psychiatric Service in C.H.U. and Teacher in PARIS University, Doctor of Psychology LYON’s II’s University; Expert hon.

DOI: 10.32474/SJPBS.2024.08.000283

Abstract PDF

Abstract

Background: MÜNCHHAUSEN ‘s syndrome is described by DIEULAFOY in 1908 but, this factice Troubles by PROXY caused by people in charge of the young, usually mothers are more known only particularly since 2002, after the works of MEADOWS, ROSENBERG and DE BECKER [1] in 2006. We will try to highlight his explicitation/clarification in the changing society.

Introduction: Working during 40 years in the frame of hospitals, in charge of different places of cares :-as Chief of adults then children and adolescents psychiatric Services in C.H.U., and also as counsellor in medico-psychologique institutional ‘s places - we have had to receive mothers, by whom, we discerned, during our clinical approach, the reality of that morbid attitude to create factice deleterious disorders by the young ones inside their family or being close during educational times. That kind of comportment due to their imaginary may drive children or teenagers to psychic organizations or even disorders later. As pedo-psychiatrist, we have to discern such type of troubles and to help and take preventive care and therapeutical means and to meet such cases resulting of false interrelationships. As Psychiatric Expert of Appeal’s and also Cassation’s Courts, we have had the opportunity to make expert examinations.

Results: All was depending on psychogenetic background of the child and more other, the type of disguised malevolence and of the deep intentionality and also, if a medical add had happen. The age where these factice troubles were suicidal and the duration and the resilience’s capacities and of the level of ability of the young victims.

Keywords: Factitious disorders; inadequate modalities of rhythms of life; incoherent behavior and pernicious affective-emotional exchanges; poor loving expression, foolish feelings from the mother-Educator-host family; negative weighing proceeding of morbid factice demands; Objectivization of the Child or of the Teenager falsely located in a state of relative illness by proxy

Preamble: Among animal species, we do not find equivalents to the mistreatment that adults or parents can inflict on children or young adolescents. Worse are the abandonment or the murder of the child, sometimes of the baby or even the new-born after the delivery or the childbirth (neoticide). Relating this acting, we can even cite some unexplicited deaths and the rare case concerning one placed in the freezer in the aim of dissimulation. The unconscious of these parents contains complex hate, which is projected to serve for a substitutive following self. We have also to report the case of the « Wild Man » « Homme sauvage ». A father, who was mayor of the village, had to hide his son from his birth until he was 39, that means until his death, because he did not want that this one would be seen around, which could have tainted his lineage. That one was suffering of genetically dystrophic appearance and was mentally retarded: a Bourneville’s disease. In this reason, he was locked in a cellar, living completely alone and feeding like a dog. The family, embarrassed after the funeral, had to bring him, to our consultation in hospital. His social progresses, due to the implementation of the nursing and the care helped associated at an educational support, a film had to be made, with the help of OFRATEME. That one was taking preference over at the VII Jornadas Internationals de Cine Medico de SAN SEBASTIAN (SPAIN)

Introduction

We have to highlight the usual difficulties to realize the diagnostic of such factice troubles by Proxy, the parents seeming always very devoted to their children, when they meet a caregiver or a M.D. and have to speak about their type of educational attitude. In our study, we have met and realized psychologic evaluation and the follow of 3 mothers and of two possibly caregivers -who cause on children inadequate behaviors or pernicious modes of exchange, more usually by imagining troubles. All could be referenced with those diagnoses. Preceded studies reported that induced bodily or psychological disorders, in the long run, may be likely to arouse in the children or the adolescents, for whom they have the care and the social responsibility. organic illness, sometimes even caused partially, such as temperature rises, different manipulations, stupid diet or crazy nutrition, injections, mustard poulstice, humiliating schedules of life, long stay in bed, deprival of diverse activities in the frame of culture, music, sports I.e., even restriction to go long. They attract, mobilize the attention of the young person about so-called discomfort or malaise to accentuate his dependence. It appears obvious, that he relation of mastering of the mother occupied a central place, especially when the father relieves himself of educational responsibility on her, to devote himself to personal interests or is absent...To much busy or when the couple separates.

Description authentically demonstrative of the pathological development of an adult in his early forties. That Observation relates to a type of pathological evolution comprising factice aspects during which the construction of his personality was affected and inflected by and inappropriate education, due to pernicious in the affective-emotional exchanges with a mother, which seems to represent a model of a typically perfidiously mother.

Clinical Observations of Victims in this Context, as becoming Adult

1. An A patient, who suffered from Factitious disorders between the Ages of 5-7 years particular Charles, aged 43 years, single, in a way with sentimental ineptitude, not having be able to form a relationship with young woman during his previous years, not having been able, no longer, integrating into a stable socioprofessional activity and having found himself, as a result, placed on mental invalidity for phobic-obsessive neurotic disorders against a background of depressive mood, of inhibitions depending more from living with shame rather than real overwhelming guilt. The aim of his determination to consult a psychiatrist r must have resulted from his way of never finding himself in phase in a group, of not sensing the necessities of the atmosphere and often committing blunders leading to his social rejection, even error of empathy or clumsy posture driving to self-punitive effect, which he later regretted. Certainly to try to overcome a hidden feeling of inferiority, he was, during the time of the examination, tending always to promote himself by narrating, to fill out his speech, his remarks, highlighting his critical sense, regarding errors in the editing of films or screaming, which he would have discerned better than any other, by looking to occupy his long days full of boring troubles, had to explain to us how his mother established bad modes of relationships marked by duplicity, slyly denigrating him, belittling him, treating him as a sickly child, always ill, inferior to his peers of the same age, not letting him have fun with other young people, confining him at home.

He could only dress in the clothes she chose, according to her own test and, also, considering, that CHARLES was fundamentally unwell and prone to colds, she obliged him, to constantly wear a beret outside. This gave other young people the opportunity to steal from him by making fun of him. The worst was when she became concerned about his phimosis as he was twelve years old, saying that he was risking to get a difficult sexual realization causing by a phimosis, as the last BOURBON’s King, she decides to be removed herself, pulling on the foreskin of his penis. The fact that that young teenager was bodily and mentally immature in reason of the conditions in which he was educated mistreated the edification of his Self-Being and the building of his identity. The object child – that he was become -obscured the real living one. That one escaped her in reason of the strength of her imagination. She conceives regarding the natural modifications of body maturating evolution, but she had the power to intervene instead the hormonal effects with a great emotion, he remembers during the twentieth session of psychotherapy treatment an event, of which he was a victim in a context of dramatic humiliation. There had happened, when he was a 15th year-old adolescent, a group outing of all the neighbours together. Charles and his mother were taking part for the first time. At a moment, he escapes from the bench, where his mother was sitting, and had let himself be inspired to participate fully in the lively games of the other adolescents, to run at full speed. After a while, his mother called him back to him and found him sweating, notably because he was wearing a woolen sweater, which him to wear. Angrily declaring to him that he was going to get lung problems, she gave him aa strong slap in front of the group of young people and their parents. Everyone was dismayed and the return to the homes took place to a context of coldness; while he, sulking, walked forward sullenly. Later, his mother declared to his father - which was a bus’s driver, who paid little attention to his education- but who, had inevitably been challenged by the words of some spectators of the scene: I don’t know what came over me! ... And that was all she said, without to try to explain her violent reaction. Without allowing a restorative explanation or expression of corrective or lovely words, such as a bandage must be applied to a wound.

The plan to run away crossed CHARLES’s mind but, in fact, only touched on it, as he was caught in the context of domination and he locked himself away in a moment in his room...Without allowing a restorative explanation or expression of corrective or lovely words, such as a bandage must be applied to a wound. This attack on his already slim prestige could only be devastating and allows us to understand his weak existential dynamism, punctuated by social slips in the social field. This emotional avatar was to be correlated, during his growth, with the imprint of the malicious imagination of a mother partly overwhelmed by an abusive imagination. After his father’s death, his mother, 75 years old expected him to welcome her into his home but he placed her in a retirement home. It was somehow his revenge on destiny.

During the following therapeutic session he reported restless nights, marked by painful dreams and nightmares and mentioned other aspects of the imagery of his mother: She believed, that he had frequent flu symptoms, even though they lived in a sunny area and, being interested in both his intestines as his lungs, lefts him in a bed with high sides for young people during a long part of the day. Fast each day, she applied mustards poultices to his chest, causing a painful effect. His passivity milked to useless care could only be reinforced. The authorities would nowadays demand explanations. This mother, who had little education, set about taking over teaching activity of the normal teacher, but showed herself to be impulsive, impatient, and getting upset and angry, when CHARLES didn’t understand his requests in writing or calculi. It was then that presented us a painting illustrating his CRIES/SCHIRTS, as he was being in that awful state, which evokes the famous Scream painted by Edward MÜNCH, of which he did not however know the existence. Later, he adds that, I believe that her mother was also drinking to much alcohol since the morning and, some years later, she stops this habit. She had a rosacea on the face, which would disappear during the later years of sobriety. Finally, his father often outside, never intervened and even acquiesced.

2. We could also present the case of a women, 35 years old, secretaire, but it should be two long. he result, the quintessence could be formulated as follows;

« My Self is Another ».

About this Disharmonic Troubles of Personality, which could be subtly Reified. The modalities of behavior and affective-emotional exchanges may be negatively weighing in reason of morbid demands affecting the young, falsely located in a state of illness by proxy. The young person is hampered in his playful activities, emotional, educational and even pedagogical with unreasonably lack of school attendance for example. The mother or the caregiver report with insistence various factice health troubles. In this field, the mother, of whom her unconscious is imprint of aggressive affects, can harass or punish her son or girl, impose sport as well as cultural curiosity’s prohibitions. They sometimes recourses of punishments, or even be beating. She practices overly accentuated body care. Worse, these often-depressive mother’s, with mood fluctuations, incoherent character’s expression or suffering of polymorphic bodily psychosomatic troubles could be projective. A paranoiac component is sometimes present. Moreover, they may be, unexpectedly, at certain moment, adopting a lovely attitude during a moment, that is able to confound deeply the young, creating a certain concern’s culpability, making him or her to obey more easily or a contrary, training rebel attitude, which could become extended to other people.

3. The recourse to medical adviser is usual and the presentation of the child’s bodily or affective-emotional troubles are described with conviction to try to be in an authentic way. The research is to get an official confirmation in the reality of factice conception of bizarre symptoms in that imaginary field, these odd parents being afraid of a possible disfunction leading to a disclosure [2-7].

Results and Discussion

For these reasons, such young people confronted on variable life’s experiences, imprint during a time of fluctuating factice solicitations and credibility, will often develop mental immaturity, attentional disorders, hyperactivity or withdrawal attitudes or attraction to virtual games to be far of any critical reflection, inducing factice disorders, able to reenforce particularly features of borderline register.

1. It’s difficult to precise the moving setting concerning the sharpness of many symptoms due later of the pernicious time of their morbid dependence having implement a disharmonic organization of the psyche, arousing weak self-esteem, uncertain self-confidence linked to narcissistic failures, emptiness of feelings, little emotional regulation, bad pulsional control with easy angry or impulsive reactions.

2. Grievances can be committed, resulting of relative lack of Knowledge/Cultural sensibilization and a weak ability in the social ‘s rules. Often, an Incapacity to face the mentalized conflicts.

3. Also, Disarray, when they discover the dazzling reality of the world, they can express in reckless taking of risks. The Spectrum of entangled Borderline with possible dissocial comportment leading to transgressive acting is to take in consideration, so much the cognitive impact, even for some until-feeble-minded.

4. Other instinctual difficulties may be associated as enuresis until early adolescence... In oral expression, sometimes including enough little verbal resources and dyslexia, even stuttering may be associated and reinforced negative identity.

5. In fact, a great insecure feeling is existing, which could determine the necessity to commit often gratuitous violences to stay being instead to make self-injury [8] or experiment depressive states or of psychotic solutions.

6. Nevertheless, they have to be confronted with ethical and deontological standards and benchmarks, attractive requests, while they are at age of experiences, even adventures, in case of failures of symbolic and poverty of the imaginary. So, in this way, they can be brought to inappropriately rushing into real thought actions.

7. Maturative development is affected in self-confidence, in terms of narcissism’s support by nocive demands, while the child would be rather waiting for gesture of love and for empathic tight exchanges.

Conclusion

The progress in pedo-psychiatric practice recognize, detect now more this type of suffering of youngs. Certainly, they have already been since described since 4 decades but, they appear more frequent in the context of new ethical and deontological standards and benchmarks, which highlight the interrelation between the underpinned factitious troubles, simulated symptoms and psychopathological disorders of parents, notably of inadequate mothers or caregivers. The effects can be discovered in the emotional or compartmental states by young persons. They happen caused by a bad /inappropriate education in the familial environment, in case of failures of the symbolic and poverty of the imaginary. These conditions of growing are inducing, for instance, emptiness feelings, weak ideational development, reckless taking risks leading to transgressive acting or addiction to virtual games, even to drugs or sexual experiences. Moreover, it seems that, in our changing society, both in socio-familial, economic and technological fields, this type of intra-familial perverse/factice relationships could appear more in disadvantaged urban areas. This study is not superposed on that [5,9,10] but complete it.

Conflict of Interest

No conflict of interest.

Acknowledgement

None.

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