People are nicer to you when you’re ill; they pay you more attention. Most of us appreciate this special treatment, but what if you begin to crave it? What if you craved it so much that you started to embellish a little, making your symptoms seem worse than they really were? What if you went further, and pretended you had an illness when in fact you didn’t?
Munchausen’s Syndrome, or as it’s referred to in the medical literature, “factitious disorder”, is one of those conditions that’s rare enough that we don’t know how rare it is. It usually goes unnoticed for years or decades. Patients often visit many different doctors and hospitals, sometimes abruptly disappearing if anyone questions the reality of their illnesses, means it’s difficult to diagnose, let alone study. But there’s plenty of evidence of these fake illnesses ruining real lives.
At the end of last year, Helen Naylor published a memoir, My Mother, Munchausen’s, and Me. The final word in the title could be referring not only to the author, but also to ME — Myalgic Encephalomyelitis, or Chronic Fatigue Syndrome — which Naylor’s mother Elinor claimed to have all the way through Naylor’s childhood. She required, she said, long bed rest every day, meaning she was rarely around to look after Naylor. Years later, Naylor discovered that her mother had regularly gone out shopping and on day trips while she was at school.
Over time, Naylor’s mother seemed to forget the ME, instead seizing on a diagnosis of “mild Parkinsonism” — a set of minor symptoms that are related to the vastly more serious Parkinson’s Disease, but are absolutely not the same thing. Doctors told her that it would be decades, if at all, before the symptoms had an impact on her life, and yet she obsessed over it, blowing it out of all proportion, mentioning it at every opportunity and becoming terribly offended when anyone tried to change the subject.
Her diary, which she’d diligently kept for decades, was focused on her never-ending sicknesses. Her daughter’s life, her husband’s death, the birth of her grandchildren: these were side issues, in which she showed little interest — her focus was always on herself, her fragilities, and her visits to the doctor. But her diary entries didn’t display anything like the normal reaction to being ill, which might involve anxiety, stress, or some form of coping mechanism like denial. This was glee: Naylor’s mother delighted in every potential disease she might have caught and symptom she might be showing, regularly researching conditions to find out more of the grisly details.
There is no known treatment for Munchausen’s. It presents all sorts of challenging questions — for instance, whether doctors should confront a patient about their fake illnesses, or whether that would make things worse. Since symptoms vary so much, medical researchers have to rely on small amounts of case experience — doctors describing their experiences with individual patients — rather than any larger-scale samples.
Those case studies often make for grim reading. For instance, one report from 2019 describes a man in his 20s who went from hospital to hospital across the whole of Italy — and sometimes abroad — complaining of a wide variety of symptoms and pains that required investigation. He had a total of 41 known hospitalisations in a four-year period, and managed to convince enough doctors to perform invasive surgical tests that his torso was covered in scars. He was taking a variety of drugs, including testosterone — which was necessary since he’d had both of his testicles removed in one of his numerous unnecessary operations. When asked by aghast doctors the reasons behind this “mutilating operation”, he could only give a vague, noncommittal reply.
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
Subscribe