10.2 The counterfeit victim
A not altogether rare presence in the doctor's office is the person who has a serious complaint, be it of repeated vomiting, or unexplained fever, a wound that never heals, blood in the urine or in the stools. After numerous consultations and laboratory tests, one of the specialists or nurses brings forward the question whether the patient her/himself plays an active part in self-administering the disorder and obstructing the healing process. If this happens in a non-incriminating and understanding way the counterfeit victim may be ready to disclose what has driven her/him to this sort of attention-getting behaviour. If it is done in a tactless or offensive way, the patient will likely move on to the next hospital, to repeat the procedures. It is also called the Münchhausen syndrome. A related form, called Münchhausen by proxy (MBP) is cited next.
A child is presented, seriously ill, and much to the concern of the hospital staff no explanation can be found and nothing seems to alleviate the illness. The mother, equally concerned, is around to look after and "protect" her child. In this case the mother has infected the child by injecting faecal matter or by nearly suffocating it, or by damaging it in another way that is life-threatening but hard to discover and hard to prove. The child is stripped of its identity by the mother, is refused any existence of its own, is wholly part of her maladjusted personality. The persons using this vicious coping style are usually intelligent and resourceful and victims of a personality disorder due to maltreatment in their own childhood. The fact that relatively often they have attempted some form of medical training in which they have failed, may facilitate as well as provoke their deceitful behaviour.