Munchausen Syndrome by Proxy and BPD

[maxsterling]

Today my T suggested my W may also have Munchausen Syndrome by Proxy.  This based upon my revelation that W is insistent our kids have autism and anger towards anyone that does not bend over backwards to provide services to our kids.  She had them tested twice.  Once when they were 2-3, and again when they were 5.  The test at 2-3 did not find any indication of autism.  The test at 5 did - but this diagnosis was almost entirely based upon my W's questionnaire and only a short visit with each of the kids.  They didn't ask me - only W about the kids' behaviors.  When I looked over the questions, it was pretty clear W was either seeing something I wasn't or seeing problems much more severe than I did. 

Later, the school district found no indication that autism was affecting the kids' schooling.  To that, W was furious.

That's not to say they don't have some autism traits such as sensitivity to loud sounds.  There could be other explanations for that.  But they don't show any problems with classic autism issues such as socialization. 

W also claims I have autism - to which my last 3 Ts pretty much laughed at and said I was welcome to get tested but felt I would be wasting my money.  Nobody else in my life has ever even suggested this. 

Today T suggested W may have Munchausen Syndrome by Proxy and wants others in her life to have illnesses in order to validate her mental disorder as truly a problem with others.  Is this common with pwBPD?  Given pwBPD's tendency to blame others, I feel it would be common. 

How do I deal with this?  I'm okay with the kids having that diagnosis (for now) because they aren't being treated any differently, and if they do have issues we may get services for cheap or free.  As for me, I was tempted to go pay for an evaluation in order to prove W wrong, but what would that do?  That would likely make the issue worse as she would claim I faked the test or the doctor was incompetent.  Should I use my agreement for an evaluation as a bargaining chip?  "Ok, I will go get a test and find out if I have something that may cause relationship challenges if you will agree to intensive DBT therapy for a diagnosis that you already have that definitely causes relationship challenges."  My guess is that would backfire, too, but it may get her to drop the subject. 

[Notwendy]

I'd be careful about adding another "label" to your wife's behavior. It's a part of the disorder to project on and blame others. So, for instance, if your child is acting out because he's anxious or reacting to her behavior- he's the problem, you're the problem. Not her.

MBP is more involved than an assumption the child has a disorder. There's a history of multiple doctor/hospital visits for mysterious "illness" that is actually caused by the parent (usually the mother). It's a form of child abuse as sometimes the mother will give the child medicine or drugs to make them look sick. The baby would get an evaluation and there'd be no reason for it found. There is no specific "test" for MBP. It is usually suspected by the medical providers who see that the child has a history of many visits for mysterious ailments and no reason, and the behavior of the parent.

The typical parent is often a mother who has a medical background and seeks the attention to her and her child for these "ailments". It's not apparent at first but then there's a series of these doctor visits, no real reason is found, and MBP is suspected. Other reasons to suspect it is that if the child is in the hospital, the child is fine, but has an "issue" when the mother visits. Some have put cameras in the room and found the mother doing things to or giving her own medicine to the child.

This is not the same as the projections and blame from a BPD parent. In your situation, your wife isn't only focusing on the child having an issue but also blaming you and others.

We had a similar pattern in my family. BPD mother would blame an issue on one of us, or my father- and the proposed solution would be to "fix" the other person. But you know that didn't work- because the issue was her feelings that she was projecting on to the other person.

Unless your kids are having issues learning in school, paying for an evaluation to "prove your wife wrong" is a waste of your money.

I can't say for sure whether or not your wife has MBP but if she did, it would be your children's medical providers who would consider it by looking at their medical records and seeing the pattern of medical visits.

[maxsterling]

Thanks, Wendy.

I agree - this fits in more with the BPD projection rather than the attention seeking that is characteristic of MBP.  Seems more like W is wanting the autism diagnosis to get the finger pointed away from her.

[zachira]

For the person with BPD to avoid having to deal with their overwhelming emotions, they have to blame others for their problems. How they go about shifting the blame to others, can be quite different for each individual with BPD. I have worked in the school system, and dealt with parents who wanted to find things wrong with their children for different reasons: including wanting more services, not having to be accountable for their disordered parenting, liking the attention they get when their child has a problem that will allow the parent to get more attention for themselves.

[Gerda]

I think you're onto something here. I've been in a similar situation with my 5yo daughter's dad. She was having behavioral problems in preschool (she was 4 at the time), and he "diagnosed" her with ADHD.

However, when I suggested we have her tested for it, he had almost the opposite reaction that your W had. He said he is absolutely against having her tested for anything, because then she'll be "labeled" and put in a separate class for special needs kids (though that wasn't the wording he used, he used the much more offensive r-word). I told him I don't think they do that anymore, but he thought I was wrong, and his mom told him that was what they would do (she was a teacher for such a class, but also she's retired and 88 years old now, so her knowledge is a bit out of date).

When I talked to my therapist about it, she thought the much more likely explanation was that my daughter's behavioral problems were due to stress from the abuse she was witnessing at home. I started to keep track and noticed she had the worst incidents at school a day or two after she had witnessed her dad losing his temper at me over something.

It's been almost exactly a year since we separated, and after an initial few months of adjustment, she seems to be doing much better.

So yes, even though my therapist also brought up Munchausen Syndrome by Proxy, I'm thinking the much more likely explanation is the BPD parent "diagnosing" the kid with some kind of disorder to avoid taking any responsibility themselves for any effect they might be having on the kid.

Oh yes, and he also "diagnosed" me with autism. That's supposed to explain my lack of empathy towards him. And that was him being generous. He said if it's not that, then I must be a sociopath. When I first left him, he sent me a barrage of texts and emails begging me to go into therapy to get help with my mental issues before throwing my marriage away. I just replied to remind him that I've already been in therapy for over a year.

[maxsterling]

Thanks, Gerda.  That was really helpful.