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Book Review - Sickened: The Memoir of a Munchausen by Proxy Childhood by Julie Gregory
Munchausen by Proxy Syndrome is a relatively rare and misunderstood form of child abuse and possibly mental illness although it is not listed in the DSM-IV as such. It involves a pattern of behavior in which a care-giver fabricates physical or mental illnesses in others, mostly children. The care-giver is usually the mother of the child who is the object of the abusive fabrication of illness. The term proxy is used because the care-giver assumes the sick role by proxy through her child. The motivation for this abuse and neglect of the child is to seek attention from authority figures which physicians and nurses represent and the sense of control and power the care-giver derives from deceiving authority figures who she perceives to be powerful. Some key symptoms of this behavior include: the care-giver's lack of distress over the hospitalization of her child, a child who has medical problems that do not respond to treatment or cannot be diagnosed, a parent who requires constant attention from the physician and other medical professionals and the absence of symptoms of a child's illness outside the parent's presence. The syndrome is named after the German nobleman Baron Munchausen who was famous for supposedly fabricating or embellishing tall tales about his adventures in the military.
The author, Julie Gregory, recounts in her memoir the abuse she endured as a child due to her mother suffering from Munchausen by Proxy Syndrome. Ms. Gregory details her frustration when no one believes her account of this abuse on the part of her mother. She poignantly writes about her discovery of the syndrome as an adult during a psychology class and understands the purposeful danger and abuse she endured at the hands of her mother.
Ms. Gregory's abuse was particularly cruel as her mother chose to fabricate a heart condition for her daughter and continuously encouraged the cardiologist to perform open heart surgery. Fortunately, the physician refused to do so, angering the mother and styming her efforts for further dangerous redress on this end. However, Julie was prescribed a plethora of medication for a possible irregular heart arrythmia and blood pressure issues. To make her child look as sickly as possible, the mother denied her solid food, only allowing the child to drink as many Ensures as she wanted. When the mother gets her wish to have her child undergo specialized testing of the heart, the child is elated with the hospital food due to her lack of nutrition at home. She never wants to go home until she finds out that she is scheduled for an invasive heart procedure. She fights the nurse who is trying to shave her and yells that her mother is making up the symptoms. The nurse does nothing but medicate Julie to calm her. The procedure is very traumatic for Julie but she endures it in a half dreamy, drugged haze.
When she returns to school from the procedure, she tells a friend about her traumatic experience at the hospital and the fabrication of illnesses by her mother to medical personnel. She is about 14 at this time. The friend reacts in violent disbelief, gathering the signatures of t0 other classmates, all declaring in a letter that no mother would ever do the things Julie was claiming and that none of them will be her friend any longer. She tries telling her school counselor about her mother but is again disbelieved and accused of being too imaginative.
Ms. Gregory does a wonderful job of portraying the nasty family dysfunction and the games played by her parents. Her mother encourages Julie's father to physically abuse the child by taunting his lack of manhood and masculinity. She taunts her husband by language such as, "What kind of man are you that allows his child to leave her snot rags all over the place? Are you a man or a fairy faggot?" The husband, Dan, worked into a frenzy of anger, likely at his wife, takes it out on Julie, banging her head repeatedly on the coffee table and forcing her to eat one of the used Kleenex that she left on the floor. This is just one instance of the family dynamics. Although never verbally acknowledged by Dan, he knows perfectly well that his wife fabricates illnesses for Julie so when she tries to do the same to the son, his favorite, he asserts himself and demands that she leave him alone, that there is nothing wrong with him and that he is healthy. He is fortunately spared as a result. This is the only acknowledgment in Julie's childhood of her mother's dangerous abuse.
The parents lack character, honesty and a moral compass. They take in foster children and elderly veterans just for the income, keeping them locked in their rooms all day and physically abusing the children. They also commit arson, setting fire to their trailer home to obtain the insurance proceeds. When Julie initiates emancipation procedures in court, her parents frighten her out of it by threatening to lie to the court about her supposed delinquent behavior. Her mother is a histrionic, abusive mess of a woman and the father is not much better. Neither work and seem to live off the income proceeds for their "care" of the foster children and veterans which they ignore.
Julie questions her sanity and state of health throughout her childhood and her young adulthood years. She can not decide whether, in fact, she is prone to illness and frailty or if her mother has created a fantasy vision of the sickly, inept child to serve her own evil purposes. Julie senses that her mother is ill in some way but, as she is not believed and genuinely often feels tired as a result of all the medications she if forced to ingest, she comes to believe that there is also something wrong with her.
She discovers in a psychology class that her mother's condition does have a name and that it is Manchausen by Proxy Syndrome. She undergoes a brief nervous breakdown at this new awareness that she is not the ill, fragile girl of her childhood but a strong, healthy woman whose strength was denied by a mother who sought to destroy her child due to her own emotional hunger. She comes alive then and decides to confront her parents and to help save the adoptive children currently under their care from enduring the horrific childhood of her past.
I highly recommend this book. It provides a wealth of information, anecdotal and factual, about this little understood syndrome and Julie's story is a riveting one which the reader won't forget. As in any memoir, the reader should be aware that they are reading only one side of the story and to keep an open mind that the author's perspective may not be the only correct one. However, I do believe her story about her mother's mental aberration and that alone would create an abusive environment for a child.