Munchausen By Internet: Faking Illness Online

  1. Anyone experienced Munchausen's online? I am pretty sure that I have, at least a couple of times!

    I would think that Allnurses would be a perfect site for that -- whether actual nurses or not they could use, or should I say abuse, this site in that way.

    I know that for myself, when I get reeled into that situation, it is very uncomforable. I get SO ANGRY - and frustrated. Of course, my over-involvement in the FIRST place is due to my own poor boundaries! See:

    http://www.selfhelpmagazine.com/arti...ic/faking.html


    MUNCHAUSEN BY INTERNET: FAKING ILLNESS ONLINE
    by Marc D. Feldman

    Online Support for People with Illness

    The Internet is a medium of choice for millions of people who need health-related information. Medical websites have multiplied exponentially over the past several years. Thousands of virtual support groups have sprung up for those suffering from particular illnesses. Whether formatted as chat rooms, as newsgroups, or in other ways, they offer patients and families the chance to share their hopes, fears, and knowledge with others experiencing life as they are. These online groups can counter isolation and serve as bastions of understanding, deep concern, and even affection.

    Unfortunately, cyberspace resources are sometimes deliberately misused by people intent on deceiving others. False product claims in spam are perhaps the best-known example. But even in the relative intimacy of health support groups, individuals may choose to mislead others by pretending to have illnesses they do not. They divert the attention of the group toward their feigned battles with cancer, multiple sclerosis, anorexia nervosa, or other ailments. The eventual discovery of the deceptions can be devastating. One group member called it "emotional rape" to have cared so deeply about a person who lied to her and others from his first post on.


    Munchausen by Internet

    For decades, physicians have known about so-called factitious disorder, better known in its severe form as Munchausen syndrome (Feldman & Ford, 1995). Here, people willfully fake or produce illness to command attention, obtain lenience, act out anger, or control others... I coined the terms "virtual factitious disorder" (Feldman, Bibby, & Crites, 1998) and "Munchausen by Internet" (Feldman, 2000) to refer to people who simplify this "real-life" process by carrying out their deceptions online. Instead of seeking care at numerous hospitals, they gain new audiences merely by clicking from one support group to another. Under the guise of illness, they can also join multiple groups simultaneously. Using different names and accounts, they can even sign on to one group as a stricken patient, his frantic mother, and his distraught son all to make the ruse utterly convincing.



    Clues to Detection of False Claims

    Based on experience with two dozen cases of Munchausen by Internet, I have arrived at a list of clues to the detection of factititous Internet claims. The most important follow:

    the posts consistently duplicate material in other posts, in books, or on health-related websites;

    the characteristics of the supposed illness emerge as caricatures;

    near-fatal bouts of illness alternate with miraculous recoveries;

    claims are fantastic, contradicted by subsequent posts, or flatly disproved;

    there are continual dramatic events in the person's life, especially when other group members have become the focus of attention;

    there is feigned blitheness about crises (e.g., going into septic shock) that will predictably attract immediate attention;

    others apparently posting on behalf of the individual (e.g., family members, friends) have identical patterns of writing.


    Lessons

    Perhaps the most important lesson is that, while most people visiting support groups are honest, all members must balance empathy with circumspection. Group members should be especially careful about basing their own health care decisions on uncorroborated information supplied in groups. When Munchausen by Internet seems likely, it is best to have a small number of established members gently, empathically, and privately question the author of the dubious posts. Even though the typical response is vehement denial regardless of the strength of the evidence, the author typically will eventually disappear from the group....
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  2. 50 Comments

  3. by   UM Review RN
    Of course, my over-involvement in the FIRST place is due to my own poor boundaries
    Could you elaborate,please?

    Are you saying that you're offering advice, a sympathetic ear (virtually speaking), and that is a boundary issue? Or is there a deeper level of involvement going on here?

    I'm not trying to judge you, Zoey, I'm just curious as to what the appropriate boundaries should be here at allnurses. I thought the mods sorted out the ones who wanted medical advice pretty well, so we didn't have that level of personal involvement.
  4. by   NRSKarenRN
    Yes we have seen this in the past 5 years and have terminated accounts. Long term members are pretty good at pointing out discrepancy of info in statements by members. Any concerns regarding members posting behaviour should be reported for Admin Team review.
  5. by   cardiacRN2006
    Interesting. I frequent another board, and just last month, another member and I realized that a member had lied about being pregnant, then lied about a miscarriage, and then lied about being pregnant again (a fertility message board). She was doing if for the sympathy. Here this board is filled with women who can't get pregnant or stay pregnant, and she was lying about these things.

    Karen is right. After being on a board for a while, you get really good at picking things up like that. (as a result, that crazy girl was banned...)
  6. by   UM Review RN
    Very sad. To think of all the beautiful, constructive, and worthwhile things that there are to do in this world....
  7. by   Liddle Noodnik
    Quote from Angie O'Plasty, RN
    Could you elaborate,please?

    Are you saying that you're offering advice, a sympathetic ear (virtually speaking), and that is a boundary issue? Or is there a deeper level of involvement going on here?

    I'm not trying to judge you, Zoey, I'm just curious as to what the appropriate boundaries should be here at allnurses. I thought the mods sorted out the ones who wanted medical advice pretty well, so we didn't have that level of personal involvement.
    Hi

    Actually the people I'm referring to aren't on this forum. And yes the mods do weed out the medical advice seekers. Can't always catch them in time but they are not allowed to linger from what I can tell!

    What I'm referring to are a few experiences I have had online. I was very empathetic with a couple of women who related to the "stuff" I was going through a couple years ago, and vice versa. But after a year's time their crises, in number and in bizarr-ity (if that is a word) added up to more than what a DOZEN people might experience. With one, I had to cut off the relationship entirely. She did not understand "no".

    I am at the same point with this other one, who was more subtle or perhaps more pitiful (?). I'm on the verge of sending her a copy of the above article. I feel really taken advantage of. Yes I can understand being stuck emotionally, or being lonely, but this person seems very sick emotionally. One fire gets put out and another one starts, whether it's with her, her family, physical, mental, financial, whatever. You would not believe (literally) some of the stuff she's gone through.

    I just was curious if others had had the same or similar experiences online.


    As to medical advice, I didn't offer any other than to STRONNNNGLY suggest they seek professional help (medical and mental health). I also referred them to sites that helped me ie self-help and spirituality.

    Thanks for asking Angie
  8. by   Liddle Noodnik
    Quote from NRSKarenRN
    Yes we have seen this in the past 5 years and have terminated accounts. Long term members are pretty good at pointing out discrepancy of info in statements by members. Any concerns regarding members posting behaviour should be reported for Admin Team review.
    {{{{{{{Karen}}}}}}}} You guys do GREAT!
  9. by   Liddle Noodnik
    Quote from Angie O'Plasty, RN
    Very sad. To think of all the beautiful, constructive, and worthwhile things that there are to do in this world....
    I do have to say tho that this board, and another one (that will remain nameless) really helped me so much when I was in a very dark time. I'm probably VERY FORTUNATE I didn't get booted because I was whining a lot, often about the same things over and over - I want to thank the people who put up with me for so long

    I think tho that my being so vulnerable online kinda got me in this kind of trouble with the "imposters" --

    -- who are actually people with real needs, just don't know how to express it in a healthy way. But not fostering it is the best way to help them I imagine!
  10. by   UM Review RN
    I guess that's all you can do then, Zoe. Sad.
  11. by   muffie
    my zoe is back

    yeah !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    i have never encountered this myself and prolly wouldn't put up with [too long]someone sucking the life out of me emotionally

    allnurses is my first and only interactive web adventure

    and yes it is so well moderated
  12. by   TazziRN
    I was on another board where a member claimed to be pregnant, then said she was carrying twins, then said she delivered them at 25 weeks, but *gasp* the twins were healthy enough to go home two whole weeks later!!! She got lots of sympathy until that last bit, even the least medically knowledgable knew that.
  13. by   Liddle Noodnik
    Quote from muffie
    my zoe is back

    yeah !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    i have never encountered this myself and prolly wouldn't put up with [too long]someone sucking the life out of me emotionally

    allnurses is my first and only interactive web adventure

    and yes it is so well moderated


    Hey woman

    Wanny hear about my crises?

    ar ar ar


    {{{{{{Muffie}}}}}}


    That's what it feels like, "sucking the life out of me" - not going to do it ennnny-more...
  14. by   Liddle Noodnik
    Quote from TazziRN
    I was on another board where a member claimed to be pregnant, then said she was carrying twins, then said she delivered them at 25 weeks, but *gasp* the twins were healthy enough to go home two whole weeks later!!! She got lots of sympathy until that last bit, even the least medically knowledgable knew that.
    Not too bright, was she?

    I think life is tough enough (sometimes) without having to make stuff up!!! And it's also not fair to those who really DO need the support

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