Münchausen by internet — The little known but not uncommon illness

We all know that one person. One who is either terminally ill, has some or other rare disease or that one who has tried to commit suicide numerous times, sometimes even giving us a blow-by-blow account of how they were doing it.

We know these people, perhaps not personally, but we know their Twitter handles, their forum names, their blogs. What many of us don’t know is that while these people might indeed be ill, it might not be in the way they claim.

Münchausen by internet (MBI) is nothing new. Reports of users pretending to be gravely ill, victims of violence or suicidal go as far back as 1990 and in 1998, psychiatrist Marc Feldman identified the pattern and coined the term “Münchausen by Internet” in 2000.

Medical literature describes it as “a manifestation of factitious disorder or factitious disorder by proxy” and it’s not something that’s at all uncommon.

The most famous instance of Münchausen by internet dates back to the strange case of Mandy Wilson.

Wilson was going through a terrible time. She was 37 and had been diagnosed with Leukaemia, her husband had left her and she had to look after her five-year old daughter and her baby son all by herself. The chemo had damaged her immune system to such an extent that that she had a stroke and slipped into a coma. Weeks were spent in hospital where she was recovering, but nurses treated her horrifically and she was covered in bruises.

Lucky for Mandy she had a support system online.

Through a paid community called Connected moms, she shared her story with other members. When she was ill and in hospital friends called Gemma, Sophie, Pete and Janet would update other members of the community. Women from all over the world became engrossed in it all until one of them made the discovery that Mandy was not sick. Her friends didn’t exist and everything was a lie.

This is just one case out of the many thousands of people feigning illness online to get support and attention. A quick search in Google will show that this is not uncommon at all. People who feign illness aren’t people who have a twisted sense of humour, not at all. Faking a life threatening illness online takes time to research and some psychologists reckon that such behaviour is pathological. Ironically, people like Mandy are, in fact ill — just not in the way they claim to be.

Sarah Jones* was living a similar lie, but unlike other fakers who tend to disappear after their lies unravelled, she decided to own up:

“Someone confronted me, and I decided it was about bloody time I dealt with this properly. At other times in my life people have confronted me and I’ve just excised those people from my life, rather than dealing with the real issues. Partly because enough was enough, itt was just so damn exhausting living this life, constantly wondering if someone would find out, trying to get through my real life,” Jones confesses.

Every day was just about making it to that night. I needed to feel I’d made a clean slate. And I also felt that telling people would prevent me from going down this road again — this feels like an addiction I need to kick, so it feels like something the people around me need to be aware of. I think in the end I wanted to stop lying, and realised all I could do was apologise, and stop making those decisions. That there was no easy way, I just had to rip the plaster off.

It’s not uncommon for MBI sufferers to go to extreme lengths to make their stories seem real and Jones’ situation was no different.

“Normally there’s an element of truth, and I think about it late at night, and imagine scenarios in my head, and start obsessing over them until they start to seem completely real. I sent myself mails and smses from imaginary people, bought myself presents. I bought the medical equipment. I didn’t eat solid food. I shaved my head. I created numerous online identities.”

Spotting a fake isn’t easy, but when your gut tells you that something is up, it might be worth investigating further, however, things to look out for are:

• The posts from the person and their symptoms seem text book — like they were copied from websites or other medical-related resources.
• The characteristics of the claimed illness generally shows up as caricatures.
• Fatal bounds or near-death experiences are generally followed my miraculous recoveries.
• When attention shifts from the person, new dramatic events emerge

Of course, it’s difficult to judge by just a few signs or hunches and the only way to really ever know the truth is to confront the suspect. You might want to ring up the hospital where the person claims to be at first to find out whether they are in fact there to back up your claims as MBI sufferers will often claim that your accusations might be making them feel worse.

The tragic side is that fakers will generally just disappear instead of facing up like Jones did. They’ll probably emerge elsewhere, under an alternative fake identity, looking for more info.

It’s vital to remember, though, that these people are ill — and should be treated as such.

If you are confronting somebody whom you suspect might suffer from MBI, make sure you do so carefully. Admit that while you are disappointed, you are still their friend and you’d like to help them get over what they are dealing with. While it might not be the life-threatening illness they claimed to suffer from, depression, especially of the severe kind can be just as dangerous. Be positive and supportive, don’t act out of anger.

The downside to all this is, of course, that it almost pushes us back to square one when it comes to trusting people from the big, dark internet machine.

Remember pre-2000 and how “weird” it was to meet people from IRC and other internet chat-rooms? We were all warned that only bad people hang out there. Now, it’s almost become “the norm” to meet people from online. You talk to these people every day, you know their pets’ names, you know their families names, heck, you even know how their day was every day.

Meeting up for a lunch or coffee or a night out on the town with a Twitter buddy is no big deal. But when your trust is broken, we’re given a stark reminder of just how much the internet should or can be trusted.

*Not her real name

Image: World News Photo