Disordered Mother or Disordered Diagnosis? Munchausen by Proxy Syndrome

Rating:
Summary: A much-needed, but over-reaching, critique
Review: I approach Munchausen by Proxy from a somewhat novel perspective: I have been trained as a developmental and philosophical psychologist, and I currently am the CEO of a child welfare agency. This cross-breeding makes me both sympathetic to the authors' aims and argument (the book reminds me of Ian Hacking's book on multiple personality disorder), *and* sympathetic with those practitioners who have diagnosed MBPS in their work.

One of the premises of this book is that MBPS is rampantly over-identified, and is in fact used as a tool for the continued subjugation of women. I am surprised at this claim, since in my experience social workers, physicians, psychologists, child protection workers, judges, and other professionals display either complete ignorance of the disorder or, if they know what it is, a high degree of denial and reluctance to acknowledge it. This is far from the picture painted by the authors of a Salem-witch-trial frenzy.

The simple fact is that there are people out there who, for various reasons, either invent or exaggerate their children's symptoms OR induce those symptoms. The question is WHY this happens. Sometimes it happens because the parent is seeking material gain. And sometimes it happens because of more complex motives, because in some way the parent is seeking the less tangible rewards of the sick role -- BY PROXY. This latter type of motive is what is involved in MBPS. Notice that there is a wealth of philosophical and sociological questions one could pose here that would also accord with the authors' basic assumptions: What features of modern society might be exerting pressure on mothers to fabricate illness in their children? What does this say about the availability of social supports for women in societies like the US? What pathologies of relationships might be involved here?

I greatly value the kind of analysis presented in this book. There is no question that, especially in the area of psychological disorder, societal forces play a huge role in the construction and identification of pathology. (I highly recommend, in this connection, Arthur Kleinman's book _Social Origins of Distress and Disease_. Nevertheless, I think that it is important to remember that when MBPS is alleged, it is USUALLY alleged by mental health or child welfare professionals who are highly well-intentioned and, above all, careful in their assessments. It is not a matter of judgmental social workers going of half-cocked blaming mothers for their childrens' illnesses. MBPS is a diagnosis that is made only after a lot of hand-wringing and searching for other possibilities.

In my opinion, there is at least as much philosophical interest in the question of what makes so many women fabricate illness in their children as there is in the question of society's interest in creating such a disorder. But this book is a valuable entry in what I hope will be a continuing conversation among philosophers, sociologists, social workers, physicians, and other thinkers.

I would very much like to sign my name to this review, but because of the work that I do and where I do it, I can't. But I'll keep watching these reviews to see if anyone has a comment on what I've said!

Rating:
Summary: Poorly substantied tripe
Review: I bought this book hoping that is would be a well researched and supported overview of the development of the diagnosis for Munchausen By Proxy Syndrome. Unfortunately, it did not deliver. I wanted backround and research to support it, but none was forthcoming. The authors write mainly from the philsophical point of view and do not bother to examine whether MBPS is a valid diagnosis based on case study or clinical research. Many MBPS mothers endorse this book because they believe that it vidicates them, however, the mere overdiagnosis of a disorder does not prove it's nonexistance. A reader interested in this subject would do better to read Marc Feldman's book "Patient or Pretender" and/or review the joural articles on Medline. Buy a book about Factitious Disorders that has a more substantial foundation than this book does that is founded on research not supposition. This book is a waste for serious MSBP researchers. Pass.

Rating:
Summary: A One-of-a-Kind Effort
Review: It is a real shame that Amazon.com has not really rallied behind this book, or at least has not offered a better discount. Munchausen-By-Proxy-Syndrome is yet another of those awful tools that prosecuters have to indict and convict people (women, in this case) without any real justification or evidence. The 'science' behind this "syndrome" is -- not unlike false memory syndrome, et al. -- a throwback to the days of witch hunts and the like. This text is the only one out there to counter the rampant conviction factory of shameless prosecutors and the FBI.