Stbxh- is this Munchausen S by proxy

[Tangled mangled]

My ex only has the children during school breaks and no matter how much information I provide about the care of my younger son’s condition, no matter how well the child is doing, the ex will find a reason to take our son to ER.

Their last visit it got so bad that he was intending to take the child to ER for no reason, trying to use the visit to delay dropping off the kids.

I called the ER in advance to alert them, I’m a medical professional and know the ER staff.

I was reading up about Muchausen S, and it fits the picture so well. It even mentions that PWBPD are known to have this syndrome and will do so by proxy for their children.
My son is unhappy about these visits to the ER but is afraid of refusing to do as dad demands.
Does anyone here have any experience with this kind of behaviour?
It’s annoying to say the least. The problem is, if I challenge his rights to make medical decisions, it can put my son in harms way if there’s an emergency and dad refuses to take him to the ER.

[Notwendy]

If this is a frequent occurrence and the ER staff suspects Muchausen by proxy- isn't this a form of child abuse? They'd be obligated to report it to child protective services.

[Tangled mangled]

If this is a frequent occurrence and the ER staff suspects Muchausen by proxy- isn't this a form of child abuse? They'd be obligated to report it to child protective services.

I’m seriously considering that it is a form of abuse, but it’s difficult to prove. Her in the UK even medical professionals pretend they don’t see/understand the damage caused by pwbpd- and I’m careful not to be seen as hiding my sons illness.

His condition is very easy to tamper with and my ex can pretend he didn’t know x,y,z can make our son worse even after spelling it out on paper.

[kells76]

Have you shared with your son's primary care doctor (regular pediatrician) that Dad takes Son to the ER frequently?

If we are "assuming the best", that Dad has genuine concern about Son's condition, then having Son's doctor make the call about if/when to go to ER ought to satisfy all the parents. "As a doctor, I'd say take Son to ER only if you notice symptoms A, B, and/or C. Anything else, call me first". Can you get this statement from the doc to both parents, and can you get it on record that the doctor told both parents what to do (and what not to do)?

Can you get the ER and your son's doctor connected -- give permission for ER to notify son's doc whenever son shows up, give son's doc permission to communicate with ER?

I'd hope that your son's doc could not only maintain "average visit" records but could also get in the record when son has been taken to ER between "average visits", and which parent took him.

Some parents wBPD do get weird about medical stuff with the kids in various ways that aren't necessarily MBP. My H's kids' mom tends to "hoard" medical visits and block H from knowing or participating. She feels "above" when she is the only one with knowledge/info, and it is very hard for her to feel "equal to" H (i.e. for both of them to be equal parents). Being "equal to" H in terms of involvement/information, for her, means she is "less than" and that is intolerable.

It doesn't have to be MBP necessarily. The ER visits could be meeting some other deep emotional need for your H. That doesn't mean it's good for your son -- but to my eyes, this is less about trying to prove that it's a certain label or syndrome, and more about: "whatever this is called, what are the most effective moves I can make to care about the kids". It certainly may end up being called MBP by some professional involved, and I think that'll be more powerful than coming from a parent, unfortunately.

Getting you, your son's primary doctor, and the ER staff all on the same page could be effective, especially if the ER staff can be strategic about it: "Oh, hello Mr. Tangled mangled, thank you for bringing Son in and caring about him. The best thing for you to do right now is call Son's Doctor and we will follow Son's Doctor's advice as part of Son's care team."

Might be a reach, but it'd be great if the medical professionals could neutralize these ER moves that way.

[ForeverDad]

My ex took our son to the Children's ER multiple times.  I don't recall the number exactly, but I usually went to the medical records office just before a hearing to determine if there were any more visits.

Once and only ONCE the ER doc called me and I said, "Thank you for being the first doctor to notify father that son was there."  The reply was, "No, I'm only calling to ask what drugs you gave your son."  They were just homeopathic pills to aid concentration, an issue with him in his early school years.  I had explained it to my ex earlier in the day but she thought it was basis for another ER visit downtown.  Anything to make me look worse than her.  Doc was fine with my answer.  The ER is for emergencies or sudden incidents, they only deal with the medical issues and only make referrals is necessary.  Maybe they'd call the pediatrician, depends.

[Gerda]

Is your ex harming your child in some way to make it necessary to take him to the ER, or is your ex taking your son to the ER unnecessarily?

I ask because I thought MSBP was when a parent actually harms a child in some way to create an excuse to take the kid to the doctor to get attention. However, I'm not a mental health expert, so I might have a television/movies understanding of it and that's not necessarily how it works in real life.

My daughter has been to the ER way too many times (in my opinion), but that's because her dad often overreacts whenever she's sick or hurt. Basically, I think he's a hypochondriac when it comes to her and blows minor aliments totally out of proportion. I lost count of how many times he's insisted we take her to the ER only to be told she has a cold, told to give her some Tylenol, and then sent home.

So now after reading this thread I wonder if it's a common BPD thing, and not just a thing with my stbxH. My therapist has speculated that my stbxH views our daughter as an extension of himself and that's why he overreacts this way. He also always gets really angry at me and blames me whenever she gets sick or hurt, like it's all my fault and proves I'm a terrible parent. And of course him taking her to the ER so much just proves he's a wonderful, caring parent. My stbxH also doesn't like to listen to the doctors when they tell him the "diagnosis" he came up with by consulting Dr. Google was incorrect.

[ForeverDad]

Some states allow for one parent to have Decision Making or Tie Breaker status.  (Perhaps not in the temp order but possibly in the final decree.)  With that, you'd at least be able to proceed with your decision if the other parent disagrees.  Doesn't mean that the other parent can't take the issue to officialdom but at least a joint custody status won't require you to wait on action while waiting for a mediator, court or parenting coordinator to step in and decide the matter.

If you face ending up with joint custody, ask your lawyer whether you can have something like the above-mentioned status - for example, for medical, mental health and school matters - so ex's obstructions could be relegated to background chaos.  Are there any legal custody aspects that you'd be okay with him taking the lead on so you can get the aspects important to you?

All our ideas and suggestions may be a bit much for you to remember as the divorce winds on, so feel free to review our comments periodically to refresh your memory.  After all, we're only human and there's a lot of new chaos you're dealing with that must be overwhelming.

[Tangled mangled]

Have you shared with your son's primary care doctor (regular pediatrician) that Dad takes Son to the ER frequently?

If we are "assuming the best", that Dad has genuine concern about Son's condition, then having Son's doctor make the call about if/when to go to ER ought to satisfy all the parents. "As a doctor, I'd say take Son to ER only if you notice symptoms A, B, and/or C. Anything else, call me first". Can you get this statement from the doc to both parents, and can you get it on record that the doctor told both parents what to do (and what not to do)?

Can you get the ER and your son's doctor connected -- give permission for ER to notify son's doc whenever son shows up, give son's doc permission to communicate with ER?

I'd hope that your son's doc could not only maintain "average visit" records but could also get in the record when son has been taken to ER between "average visits", and which parent took him.

Some parents wBPD do get weird about medical stuff with the kids in various ways that aren't necessarily MBP. My H's kids' mom tends to "hoard" medical visits and block H from knowing or participating. She feels "above" when she is the only one with knowledge/info, and it is very hard for her to feel "equal to" H (i.e. for both of them to be equal parents). Being "equal to" H in terms of involvement/information, for her, means she is "less than" and that is intolerable.

It doesn't have to be MBP necessarily. The ER visits could be meeting some other deep emotional need for your H. That doesn't mean it's good for your son -- but to my eyes, this is less about trying to prove that it's a certain label or syndrome, and more about: "whatever this is called, what are the most effective moves I can make to care about the kids". It certainly may end up being called MBP by some professional involved, and I think that'll be more powerful than coming from a parent, unfortunately.

Getting you, your son's primary doctor, and the ER staff all on the same page could be effective, especially if the ER staff can be strategic about it: "Oh, hello Mr. Tangled mangled, thank you for bringing Son in and caring about him. The best thing for you to do right now is call Son's Doctor and we will follow Son's Doctor's advice as part of Son's care team."

Might be a reach, but it'd be great if the medical professionals could neutralize these ER moves that way.

Thanks Kells,
The main issue is that I still live over 5 hours away from my ex and he has no access to the family doctor (GP) , so he uses the ER close to the family home( different parts of the country)for minor things. In any case it’s reached the stage where I have to place limits to access to son’s healthcare and decision making.

I’ll raise concerns with the family doctor who can possibly help place limitations eg giving mum a call whenever son shows up in hospital- we have a national health service here so access to his records can be restricted- I hope.

It’s my phone records on the childrens records so whenever he attends ER I get an alert about it.
Thanks

[Tangled mangled]

My ex took our son to the Children's ER multiple times.  I don't recall the number exactly, but I usually went to the medical records office just before a hearing to determine if there were any more visits.

Once and only ONCE the ER doc called me and I said, "Thank you for being the first doctor to notify father that son was there."  The reply was, "No, I'm only calling to ask what drugs you gave your son."  They were just homeopathic pills to aid concentration, an issue with him in his early school years.  I had explained it to my ex earlier in the day but she thought it was basis for another ER visit downtown.  Anything to make me look worse than her.  Doc was fine with my answer.  The ER is for emergencies or sudden incidents, they only deal with the medical issues and only make referrals is necessary.  Maybe they'd call the pediatrician, depends.

I see this as the agender here as well. Anything to make me look bad or worse than him. He doesn’t care that it affects our son’s wellbeing.

Thankfully I have track record of taking son to see his GP / family doctor whenever he’s condition flares up. It feels like a competition for who’s the better parent.

Even when we were together it always felt as if he was jealous of my position as mum- like he wished he had a uterus. For our older son, once I returned from work to find he had been shopping for over the counter medicines that we already had, cleaning the house immediately after I had cleaned etc.

[Notwendy]

5 hours is too far to go to the GP so this leaves only the ER. It seems a possible solution is for the kids to have a GP near their father. It would also be better for them as they'd be known to the GP, have their records there. My guess is that many families do this- since divorced parents don't always live in the same area.

You could be a part of this decision, meet the GP too if you wish.

[CC43]

Hi Tangled,

You ask if anyone has seen this type of behavior before, and I can say I certainly have seen it.

My brother-in-law is an undiagnosed NPD, and like your ex, he is not the primary caregiver of his school-age children, but he does have visitation.  He has taken the children to urgent care literally dozens of times in the last three years.  A difference is that his children do not have any unusual medical conditions, and they do not take any medications, either.  None of the manufactured crises would qualify for urgent care in my opinion.

Here's my read of the situation.  I think my brother-in-law LIKES urgent care.  He gets attention, which pwBPD and pwNPD desperately crave.  It's something for him to do, because I suspect he finds filling up time during visitation is very difficult and taxing, whenever he has the kids to himself.  In contrast, when he takes the kids to grandma's, they never visit urgent care.  I think it's no coincidence that they don't visit urgent care during those visits, because she handles the bulk of the caretaking, and she's giving him the attention he craves!

In addition, I think that general parental incompetence feeds into the urgent care situation as well.  You see, my brother-in-law doesn't adequately prepare for visitation.  He won't keep any food the kids like at home, and he doesn't respect normal hours when it comes to routines.  Thus the kids will skip breakfast and/or lunch, and they'll stay up all night with screens.  It's no wonder that they are basically catatonic by the end of the day.  Then the whining and complaints about aches and pains will emerge--headaches, and for my poor niece, vomiting episodes.  They are so tired, hungry and stressed out during visitation that they literally feel a little sick.  Moreover, they might not want to do whatever activity is proposed, so they use sickness as an excuse to get out of it--which, not coincidentally, mimics their father's behavior exactly.  (He often bails on parenting time because of sore knees, a painful foot, eye trouble or all sorts of physical ailments, basically because he doesn't want to face parental responsibilities!  Maybe seeing his kids sick is basically "projection" of his own ailments onto them!)  And maybe the kids don't want to go to soccer practice, so a headache is a perfect excuse.  As a parent, he just doesn't diagnose the situation properly or have an appropriate response along the lines of, "Don't worry honey, you're just hungry, here, let me make you a sandwich and get you some juice."  In addition, he has no interest driving the kids to soccer practice anyway.  Instead, he invents a health crisis.  And in his twisted NPD mind that is prone to projection, a health event is always a crisis.  Their suffering is special, and they deserve urgent care.  So they're off to the doctor, and he's insisting on all sorts of unnecessary tests.  In addition, he probably feels he deserves a gold star, for handling such a crisis during his parenting time.  Does that sort of scenario seem explicable or make sense to you?

Just my two cents.

[Tangled mangled]

Is your ex harming your child in some way to make it necessary to take him to the ER, or is your ex taking your son to the ER unnecessarily?

I ask because I thought MSBP was when a parent actually harms a child in some way to create an excuse to take the kid to the doctor to get attention. However, I'm not a mental health expert, so I might have a television/movies understanding of it and that's not necessarily how it works in real life.

My daughter has been to the ER way too many times (in my opinion), but that's because her dad often overreacts whenever she's sick or hurt. Basically, I think he's a hypochondriac when it comes to her and blows minor aliments totally out of proportion. I lost count of how many times he's insisted we take her to the ER only to be told she has a cold, told to give her some Tylenol, and then sent home.

So now after reading this thread I wonder if it's a common BPD thing, and not just a thing with my stbxH. My therapist has speculated that my stbxH views our daughter as an extension of himself and that's why he overreacts this way. He also always gets really angry at me and blames me whenever she gets sick or hurt, like it's all my fault and proves I'm a terrible parent. And of course him taking her to the ER so much just proves he's a wonderful, caring parent. My stbxH also doesn't like to listen to the doctors when they tell him the "diagnosis" he came up with by consulting Dr. Google was incorrect.

My ex overreacts as well as, and will oppose any attempt at reasoning or problem solving. Children are allowed to have a temperature every now and again but for pwbpd, a minor ailment will result in an exaggerated response. My worry is the impact on our son, the fact that the 7 year old realises that is not doing the right things.
Oh my ex has sent me lengthy emails of severe diagnosis that he worked out with google. I’ve continued to ignore this as it feels weird seeing him attempt problem solving or it even seems like another competition with me, a medical doctor.

It’s possible that going to the ER gives pwbpd something to do- since their internal chaos has to match the external environment.

[Tangled mangled]

5 hours is too far to go to the GP so this leaves only the ER. It seems a possible solution is for the kids to have a GP near their father. It would also be better for them as they'd be known to the GP, have their records there. My guess is that many families do this- since divorced parents don't always live in the same area.

You could be a part of this decision, meet the GP too if you wish.

Over here you are only allowed to have one GP, and if my ex had any concerns he could request to have a conversation with the GP.
The things be has accessed the ER for are so minor eg requesting medication, taking son to see a doctor when there’s been no changes to the condition or deciding that the condition has gotten worse or he making the condition worse by not following instructions then seeking help.
A reasonable way to go about things would have been sending me an email with his concerns or asking for medications order that can be picked up where he lives,
The children spend less than 58 days per year with dad as I have full custody.

[Notwendy]

I didn't realize you couldn't each have a GP that could see the kids- in two locations if parents live a distance from each other. But it makes sense that only one GP would see the kids for check ups and management. You are correct that your ex could contact the kids' GP himself for advice, rather than go straight to emergency but he's going to do what he chooses.

I think for your kids- seeing "Dad do the wrong thing" is a part of their maturity process. As they become more mature- they will learn what is appropriate behavior.

Unless he's doing actual harm to the kids, I don't know of a way to intervene. The ER staff is probably familiar with him at this point. CC43 has a point too- my BPD mother uses the ER frequently. My BPD mother has NPD traits. The ER situation serves a purpose- the urgency of the situation, the attention. For her, if she wants something - she  wants it immediately. While it is more logical to have your ex contact you or your GP- going to the ER with the kids is more immediate for him. You think about this logically while your ex may be thinking emotionally.

The good aspect of this is that you do know the ER staff and have access to them. I don't know if it's possible to stop your ex from doing this- unless there's evidence of actual harm to the kids. I understand it's concerning.

[Tangled mangled]

@CC43,

Your description fits too. I have noticed the visits to ER coincide with the day after he’s been shopping for stuff for the kids or with times when he may not have enough money to spoil them as much. He likes to be SEEN as caring and responsible.

Everything is a show, mine once requested I send him £20 for groceries- so I’m thinking he’s not stocking up on food before the children arrive, I didn’t send  him the money as I see him abusing my kindness. He’s not paying the mortgage so should have more than half his income available to himself.
Like your BIL , he doesn’t respect bed times and the parental incompetence fits the bill. On this last visit he sent me an email at 3AM saying the younger child could not sleep because of the symptoms of his illness, so he was going to take him to the ER. I replied stating that I disagreed with the decision to take the child to the hospital and also called the hospital to make them aware. It would have been just 5 days after he had already been to ER and was given unnecessary antibiotics for our son. Thankfully my email to him prevented another visit.
After drop off, I found out the children stayed up until after midnight after trick or treating and were tired but this had nothing to do with any symptoms .
Thinking about this now, it looks like the ER visits also serve as cover up for the incompetence.
Thank you