Analysis: The abusive J'lem mother: Personality disorder or child abuse?

According to an unnamed Hadassah source, sufferers of MBPS are conscious of their actions; "they know that they're doing it.

Jerusalem child starver 248.88 (photo credit: Channel 2)
Jerusalem child starver 248.88
(photo credit: Channel 2)
The Jerusalem mother alleged to have starved her toddler son is suspected to be suffering from Munchausen-by-proxy syndrome (MBPS), which is difficult to assess in a one-off evaluation. According to Dr. Shoshana Arbelle, a pediatric psychiatrist at Beersheba's Soroka Hospital, "to assess the patient [of MBPS], supplied evidence is crucial to show that actions are taken against medical advice." Arbelle said she believes that "achieving an accurate diagnosis is very difficult, as the symptoms of the disorder are concealed during conversation." Those afflicted with MBPS don't have a psychiatric disorder, but rather a severe personality disorder. Sufferers "do not display any psychotic episodes, manic patterns or have any depressive features," Arbelle explained to The Jerusalem Post. Parents with Munchausen-by-proxy syndrome "use their child as an extension of themselves. Through their children, [the victims] are fulfilling their need to be in the center of the scene, and receive the attention and gratification" they seek. In treating those with MBPS, "sometimes it's enough for them to know that they're being observed all the time," Arbelle said. "[Confrontation] in itself can stop the behavior." Ongoing psychotherapy is also needed to protect both parent and child, she added. American psychiatrist Dr. Marc Feldman, clinical professor of psychiatry at the University of Alabama and an expert on MBPS says that those with Munchausen-by-proxy syndrome are often guilty of both physical abuse and medical neglect, as well as psychological maltreatment of their child, and warns against leaving the child at home. His Web site provides links with information for physicians regarding when to report a case to their state's child protective service agency. Some professionals argue that the fabrication of a pediatric illness is a form of child abuse and not merely a mental health disorder. Pediatricians need to be highly suspicious when faced with seemingly inexplicable findings or treatment failures. According to an unnamed Hadassah source, sufferers of MBPS are conscious of their actions; "they know that they're doing it." However, this source believes that "this case of the haredi woman is not rare - the media storm surrounding her arrest is pushed by a political agenda." The source claimed that the uproar was not appropriate to the case, but rather a response to the way it was handled, the manner of the woman's arrest and the behavior of the police. "Another case of the haredi versus the secular community," the source explained. After violent protests last week against the arrest of this mother, the haredi community is calling for a boycott on all Hadassah medical facilities. Hadassah personnel would not comment when asked about the video recorded by the police that the police claim proves the woman suffers from MBPS.