Munchausen’s
syndrome by proxy and Lyme disease:
medical
misogyny or diagnostic mystery?
Virginia
T. Sherr, M.D.
ABSTRACT
Reprinted
with permission from Medical Hypotheses. 2005;65(5):440–447
May
27, 2005
|
Preface
to the article
By
Eric G. Mart, Ph.D., ABPP (Forensic)
Munchausen’s
syndrome by proxy (also known as Factitious disorder
by proxy) is a diagnosis that lacks scientific validity.
Unfortunately, it still occurs for any number of reasons,
among which are its uses of psychological profile data
with untested reliability and validity, confirmatory
bias, and over-inclusiveness of the diagnosis, just
to name a few. However, the starting point for making
the putative diagnosis rests on a physician’s decision
that a possible MSBP victim does not suffer from the
disease in question. All discussion about motives, underlying
psychopathology and other issues follows from this judgment.
The
paper, Munchausen’s Syndrome by Proxy and Lyme
Disease: Medical Misogyny or Diagnostic Mystery?
makes it clear that there are significant differences
of opinion among physicians with regard to the signs,
symptoms and medical course of diseases, most notably
Lyme disease. Such disagreement assures an inevitability
that parents, especially mothers, whose children suffer
from this or similar conditions will be placed at risk
for allegations of child abuse, particularly in the
present atmosphere in which MSBP is the “disease
du jour.”
In
promulgating a hypothesis that the MSBP label may be
mostly about misplacement of responsibility for lack
of medically significant diagnoses onto innocent mothers,
this article performs an important service for children
and their parents who suffer from these conditions
—
Eric G. Mart, Ph.D., ABPP (Forensic)
Eric
G. Mart, Ph.D., ABPP is a licensed psychologist in private
practice treating patients in Manchester, New Hampshire,
USA. He is board certified in forensic psychology, is
an internationally known expert on Munchausen’s
syndrome by proxy, and the author of Munchausen’s
Syndrome By Proxy Reconsidered, In his forensic work,
Dr. Mart emphasizes investigative techniques based on
empirical research and established protocols.
|
Chronic,
tertiary Lyme disease, a vector-borne infection most accurately
designated neuroborreliosis, is often misdiagnosed. Infectors
of the human brain, Lyme borrelial spirochetes are neurotropic,
similar to the spirochetes of syphilis. Symptoms of either disease
may be stable and persistent, transient and inconsistent or
severe yet fleeting. Characteristics may be incompatible with
established knowledge of neurological dermatomes, appearing
to conventional medical eyes as anatomically impossible, thus
creating confusion for doctors, parents and child patients.
Physicians
unfamiliar with Lyme patients’ shifting, seemingly vague,
emotional, and/or bizarre-sounding complaints, frequently know
little about late-stage spirochetal disease. Consequently, they
may accuse mothers of fabricating their children’s symptoms-the
so-called Munchausen’s by proxy (MBP) diagnoses.”
Women,
following ancient losses of feminine authority in provinces
of religion, ethics, and healing-disciplines comprising known
fields of early medicine, have been scapegoated throughout history.
In the Middle Ages, women considered potentially weak-minded
devil’s apprentices became victims of witch-hunts throughout
Europe and America. Millions of women were burned alive at the
stake.
Modern
Medicine’s tendency to trivialize women’s “offbeat”
concerns and the fact that today’s hurried physicians of
both genders tend to seek easy panaceas, frequently result in
the misogyny of mother-devaluation, especially by doctors who
are spirochetally naïve. These factors, when involving cases
of cryptic neuroborreliosis, may lead to accusations of MBP.
Thousands
of children, sick from complex diseases, have been forcibly
removed from mothers who insist, contrary to customary evaluations,
that their children are ill. The charges against these mothers
relate to the idea they believe their children sick to satisfy
warped internal agendas of their own. “MBP mothers”
are then vilified, frequently jailed and publicly shamed for
the “sins” of advocating for their children. In actuality,
many such cases involve an unrecognized Lyme borreliosis causation
that mothers may insist is valid despite negative tests.
Doctors
who have utilized MBP tactics against mothers are likely to
be unaware that in advanced borreliosis, seronegativity is often
the rule, a principle disagreed upon by its two extant, published,
peer-reviewed, Standards of Care. These are guidelines for Lyme
disease management--the older system questioning the existence
of persistent Lyme and the newer system relying on established
clinical criteria.
Mothers
must be free to obtain the family’s preferred medical care
by choosing between physicians practicing within either system
without fear of reprisal. Doctors and mothers together may then
explore medical options with renewed mutual respect toward the
best interest of children’s health.
DOI information:
10.1016/j.mehy.2005.04.009
Private
Practice of Psychiatry,
47 Crescent Drive, Holland, PA 18966–2105, USA
vtsherr@comcast.net
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