Karl Friedrich Hieronymus Freiherr von Münchhausen (1720–1797) was a German nobleman known in his time as a weaver of tall tales and humorous anecdotes. Over the years many anonymous authors republished Münchausen’s stories; then in 1785 Rudolf Erich Raspe published “The Surprising Adventures of Baron Munchausen”, an unflattering collection of Munchausen tales which forever labeled the German story teller as a liar.
Fast-forward to 1951; Dr. Richard Alan John Asher published a paper in the medical journal, "Lancet" describing a particular psychosis whereby patients were intentionally making themselves ill in order to gain attention and sympathy. Dr. Asher named the disorder: Munchausen’s syndrome after the old baron.
At the Skeptic’s Toolbox, forensic psychologist and clinical professor, Loren Pankratz, gave a talk about Dr. Asher and the ramifications of the discovery of this interesting psychosis. Munchausen’s syndrome, and in particular its derivation, Munchausen’s by Proxy (whereby parents cause their children to become ill in order to gain attention and sympathy) has become a controversial topic in recent years. As physicians and social workers became educated about this syndrome, it began popping up with increasing frequency in their practices. So much so that soon child protective services workers were removing children from their parents amid accusations of causing their children’s illnesses.
So were physicians and social workers truly witnessing a monumental increase in child abuse through Munchausen’s by Proxy? As a forensic psychologist, Loren Pankratz has been called as an expert witness in the defense of parents accused of causing their child’s illness. Over the years of treating patients for the Department of Veterans Affairs, Pankratz had encountered significant numbers of patients who lied about their own illnesses. During this time the VA was investing significant mental health resources in treating Vietnam War veterans who claimed they suffered from PTSD resulting from horrific war experiences – only to find, upon reviewing their service records, some had never even served overseas.
Pankratz found that medical professionals were now suddenly diagnosing Munchausen’s by Proxy precisely because they had become aware of it in lectures and journals. However the problem was that the physicians were not adequately trained to conclude such a diagnosis; it was not their field of expertise. The result was that mothers genuinely concerned about the health of their children, and often aggressively advocating for their child sometimes to the point of irritating the doctor, were having charges of Munchausen’s by Proxy leveled at them.
This is yet another way in which intelligent people can go wrong; assuming that if they are competent in their chosen field of study, they will be equally competent in another. It is not uncommon for even scientists to check their rationality at the door when venturing into fields where they lack expertise.
Occasionally possessing a little knowledge, incorrectly applied, can be outright dangerous. Or as the old saying goes: “Sometimes when one has a hammer, every problem begins to look like a nail”.