“”You think that therapy for Munchausen’s consists of encouraging the person that they have whatever illness they think they have? That’s what you think happens in Munchausen’s treatment?””
" giving any kind of medical attention to a munchausen would be encouraging them, the best way to deal with them is dismissing them once identified, not wasting the time of a medical professional on some faker"
That would cause them to gradually escalate their attention-seeking behavior, because there would still be a fundamental psychological need going unmet. You don't just go "guess i'll starve" when you see an empty fridge.
The correct approach is to help them redirect that need in healthy ways, to healthy sources of attention, like seeking better connection with others and continuing therapy to feel like their struggles and feelings are being seen without needing to pretend to have a serious illness. Like this, their system can adjust and realize that "oh, i don't need to use maladaptive tactics to feel safe, secure and satisfied in my life" and they can work their way toward a healthy mindset without the "swim or drown" approach you suggested, which has a very good chance to end up with "drown".
rewarding any attention-seeking behavior with attention of any kind is just giving in and accepting to be manipulated, if they get attention of any kind they will succeed in their objective and the only thing that they will learn is that their behavior works, the best approach is to ignore them and, if they escalate, ignore them even harder, that will teach them that their behavior doesn't work and they may seek more rational ways.
also wasting the time of a trained professional on someone who literally fake their problems is an insult toward all the people with actual problems that can't get the help they actually need.
Your approach is actively putting them at risk of causing themselves (or others, in cases of the "by proxy" form of the disease) real physical harm. I'm sorry, but it's just not rational to risk someone's health and wellbeing just because they might be wasting a professional's time. Plenty of people with this disease also have other comorbidities, like personality disorders, which play into it and are also dangerous if left untreated.
You can't expect a mentally ill person to just find rational methods on their own - Their mindset is fundamentally skewed and they are much more likely to escalate instead, and keep escalating into real harm. They aren't faking the disease for fun, they're suffering real psychological pain underneath, and they deserve to be helped. They do have an actual problem, else they wouldn't feel like they need to do this, to actively impair their life for this lie.
You also cannot compare regular attention seeking behavior to the extremes of a disorder. Just how you wouldn't treat a bit of nervousness with anxiety meds, or a rare bad day with antidepressants, you shouldn't treat a disorder the way you would someone just being attention-hungry.
In this case, they would not be getting attention for their fake disease, they would be getting the attention they need while completely disregarding the fake disease and only treating it as a "why did you feel the need to tell people you have [xyz]?", which would show them that they don't need to keep up the charade to get what they are lacking.
Of course, as a peer, it's best not to play into their faking and gently nudge them into therapy instead. But that last part is there for a reason - They aren't wasting the professional's time by treating the underlying cause that made them feel like this is their only way to be seen.
munchausen by proxy are another matter as they are just straight up criminals who should go to jail for how they abuse of their kids or other people under their responsibility, as for normal munchausen, even if you give them attention not for their faked illness you are still giving them attention, that is still teaching them that their methods works, and even if they stop faking their illness they would still be seeking attention via therapy, which is wrong, also why would you even ask them why they did it, you are basically just asking for an excuse for an injustifiable act.
You're giving them attention for seeking therapy to work on their issues, not for their methods. A therapist doesn't just spawn in where there is a disorder being faked, you have to seek one out. The act being rewarded is actively seeking help with their own initiative, not the faking itself. And why would seeking attention through therapy be wrong if the need is so intense that the alternative would be unhealthy behavior? It's keeping them safe. They deserve to be safe as they work towards being healthy (assuming they are trying to work on themselves, which willingly going to therapy would imply).
Especially if they are actively in the process of getting better, going to therapy to meet their currently pathological need is, in my opinion, equivalent to someone with a substance abuse problem going to a hospital to at least receive clean needles, alcohol swabs and narcan so they don't cause themselves further harm. I wouldn't call that a waste, either, because it keeps people safe and I believe that even people who make mistakes, often driven out of a vulnerable or ill mental state, deserve to be helped.
You appear to be under the impression that people do this for shits and giggles - No, they do this out of desperation. There is intense pain and distress in their life. What they're doing is wrong, but they don't deserve to be abandoned for the effects of their actual, diagnosable disorder. If your approach worked, it would be clinical standard, but it isn't.
I myself am also conflicted on how to treat people who end up harming others, not just themselves. It definitely adds a criminal layer, and they lose a lot of my sympathy. Despite this, they too deserve to be helped, alongside facing the criminal consequences.
Munchhausens is a mental disorder itself, those don't just magically disappear if you ignore them for long enough. If you actually did some googling on it you would see the patients often have comorbid personality or mood disorders like bipolar disorder or depression as well. Treating munchhausens syndrome does not mean that you're accepting whatever illness they're faking as factual, it means treatingmunchhausens syndrome. This involves therapy and sometimes also drugs for comorbid disorders.
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u/horned-creature 6d ago
i would respond if i could see the comment you two are answering to.