Munchausen's Syndrome by Proxy Reconsidered

Eric G. Mart, Ph.D., ABPP Paperback, 128 pages. U.S. $34.95 To order from Amazon.com, click here

A critical examination of the rare diagnosis "Munchausen's Syndrome by Proxy" (MSBP) and the way in which it has been employed by medical, mental health and child protective professionals.

The macabre nature of this syndrome, in which parents or other caretakers fabricate, exaggerate or induce symptoms of illness in their children in order to obtain unnecessary medical treatment, has attracted attention in the scientific literature and popular news media. The number of cases of MSBP reported and prosecuted has steadily increased in recent years, and allegations of MSBP have been appearing in contexts other than child protective actions, such as medical malpractice lawsuits, in which MSBP has been offered as a defense, and child custody disputes. While a number of books and scholarly articles have proposed protocols for the careful evaluation of these complex cases, a review of the collected case materials reveals that serious methodological errors, as well as problems with the conceptualization of the disorder and the steps needed to diagnose it, are more the rule than the exception. Further, the doctors and mental health experts who pursue these cases are often haphazard and sloppy in their methods, despite the appalling harm inflicted on families when these professionals are mistaken in their conclusions.

Eric G. Mart, a forensic psychologist and internationally-known expert on Munchausen's Syndrome by Proxy, examines prevalent investigative and diagnostic techniques, as well as the literature and research on the disorder, according to the standards of empirical science. Munchausen's Syndrome by Proxy Reconsidered explores the difference between empiricism and the clinical method and discusses concepts such as confirmatory bias and logical errors, which contribute to the misdiagnosis of MSBP and other conditions. These concepts are illustrated with case narratives and material from alleged MSBP cases in which Dr. Mart has been involved. Dr. Mart concludes with a revealing account of the real-world legal process in child protective cases, and the lack of protections afforded to parents accused of MSBP and in danger of having their children seized by the state. Munchausen's Syndrome by Proxy Reconsidered provides an unsettling look at the harm and injustice that misguided professionals can inflict by means of a "benevolent" process.

The Author

Eric G. Mart, Ph.D., ABPP, is a licensed psychologist in private practice in Manchester, New Hampshire. He is board certified in forensic psychology and is also certified as a school psychologist by the New Hampshire State Board of Education. Dr. Mart specializes in forensic psychology and his work in this area includes assessments of civil and criminal competencies, risk assessments, custody evaluations, special education cases and offender treatment. He also sees children, adolescents, adults and couples for psychotherapy and testing. Dr. Mart is an internationally known expert on Munchausen's Syndrome by Proxy, and has testified on the subject in court cases throughout the United States and Canada.

Reviews

"Mart's book is essential reading for any psychologist or other mental health worker involved in a suspected MSBP case, and is highly recommended for physicians, attorneys, judges, child protection workers, and others involved in such cases."

Gregory DeClue, Ph.D., ABPP, Forensic Psychologist
Sarasota, Florida

"Dr. Eric Mart clarifies much of the confusion surrounding this condition. He exposes ways in which both the therapeutic and legal communities may misunderstand and misuse currently available information about this condition. Dr. Mart's work is concise, clear and direct. I recommend it as essential reading for anyone involved with a case of this nature."

Denise Lamothe, Psy.D., H.H.D., Author & Clinical Psychologist
Epping, New Hampshire

"In days past, any woman who complained too much to her doctor was at risk of being labeled a hysteric. Now, any mother who complains too much to her child's pediatrician is a candidate for Munchausen's Syndrome by Proxy. In this book, Eric Mart takes this diagnosis apart with skillful precision."

Loren Pankratz, Ph.D., Consultation Psychologist & Clinical Professor
Department of Psychiatry, Oregon Health Sciences University

"One of the finest, most erudite pieces of scholarship and clear thinking I have yet to read, Dr. Mart's treatise explodes the myths of faulty reasoning and pseudoscience underlying the MSBP construct. His masterful and elevating exposé fully embraces the scientific heart of advanced differential diagnosis and shines a lasered beacon for directing competent investigations of purported abuse phenomena. 'Unenlightened expertise' will topple in the wake of this masterful work."

Kirk Witherspoon, Ph.D., Forensic & Clinical Psychologist
Moline, Illinois

"This book will be of great value to any clinician or researcher who is interested in Munchausen's Syndrome by Proxy (also known as Factitious Disorder by Proxy). Eric Mart reminds us that scientific information about the disorder is scant, that many common assertions about it are either wrong or lacking in support, and that the risk of false diagnoses is very high. The take-home message is simple and important: Professionals should be wary of diagnosing this disorder unless there is very solid evidence that a child has been physically abused."

James M. Wood, Ph.D., Associate Professor
Department of Psychology, University of Texas at El Paso