Parents who systematically fabricate illnesses in their children or intentionally make their children gravely ill are said to suffer from Munchausen by Proxy syndrome (MBPS). It is a form of child abuse that can lead to death or serious physical or psychological damage to the child, either through outright harm or as a result of painful tests and procedures performed by doctors trying to diagnose the child's "illness." Unlike other types of child abuse - where signs of disruption in the parent-child relationship are apparent, and in which men are more likely the perpetrators - the vast majority of Munchausen by Proxy abusers are mothers who appear to all the world to be wonderful, concerned parents. This book offers the first comprehensive, detailed examination of Munchausen by Proxy syndrome. Written by leading authorities, it covers all known clinical, medical, psychological, social, and legal aspects of the disorder, including detection, dynamics, treatment, and clinical management. Based on their own experiences evaluating and treating these patients, the authors present an innovative theory of the disorder as a form of imposturing. By posing as a good mother, the MBPS patient establishes a perverse relationship with the child's doctors. The apparently loved infant serves as an object to regulate this relationship. Detailed psychological test data on a group of MBPS mothers are presented to enhance our understanding of the cognitive and psychological makeup of parents who fabricate illness in their children. Importantly, the text contains a thoughtful discussion of the larger social context of women in our society and in our medical institutions - a discussion crucial to our understanding of why MBPS is predominantly a disorder of women. The authors demonstrate that the very nature of this disorder reveals a great deal about the difficulties women face in our society. Case histories clearly illustrate that MBPS patients' underlying desire to be recognized and admired expresses itself through a grossly distorted rendition of mothering. Doctors - blinded by the mothers' seemingly devoted behavior, by traditional assumptions about mothering, and by their own need to be viewed as experts - often contribute to a vicious cycle that inflicts deep psychological wounds and that, in the worst cases, ends with the death of a child. Detailing all that is known about Munchausen by Proxy syndrome, Hurting for Love is required reading for mental health professionals, physicians, nurses, child protection professionals, and all who may come in contact with abused children. Written in a straightforward manner and full of fascinating case studies, the book offers a valuable contribution to anyone interested in women's issues, child abuse, and medical and social history.
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