Münchausen's by Internet

It is inevitable that, in a society which is supposed to be compassionate towards its ill and invalids, someone will come up with the idea that being sick means getting attention. In psychiatric terms, this is called a factitious disorder, formerly known as Münchausen Syndrome, after a fictional Baron von Münchausen who was known far and wide for his tall tales -- a mental illness which prompts a person to feign, fake, or otherwise mimic the symptoms of a real illness in order to get someone else to pity and care for them. Note that this is not the same thing as malingering; malingering is faking illness in order to avoid something you don't want to do, like pretending to have the flu to get out of going to school. A malingerer generally doesn't want anyone to scrutinize them too closely. The 'faking sick' part isn't the important one for them, it's the 'not having to do something unpleasant'.

People with factitious disorders, on the other hand, live to discuss their illness. Some of them make it a point to fake a load of disconnected symptoms, specifically in order to baffle doctors and prolong the time it takes to handle their case. Others will let doctors 'cure' them only to 'relapse' later. The worst cases cross the line from fakery into the ultimate in method acting, purposely injuring, contaminating, or infecting themselves so that all of the required tests will come up consistent with whatever illness they're trying to mimic. Some sufferers have been known to shave their heads and pluck their eyelashes and eyebrows to feign going through chemotherapy, or bruise themselves over and over to mimic a clotting disorder. Some even go through multiple unnecessary surgeries in aid of their deception.

Almost invariably, these are people who feel they don't get enough attention from the world, for whatever reason, and many of them feel that they're too-harshly punished by the people around them. They all learned at some point in their lives that when they were ill, the pressure suddenly stopped, and everyone was devoted to their care. They felt loved and appreciated. Nothing was required of them, except to lie there and convalesce.

Ironically enough, keeping up a good Münchausen façade takes at least as much work as being a functional human being, and comes with substantially more risk. There's always the chance that an infected cut will turn into sepsis, and then you'll be deathly ill for real.

Not all Münchausen patients fake their own illnesses. A variation called Münchausen syndrome by proxy is when the person who suffers the factitious disorder draws attention and compassion from people by making someone else in their life sick. Chillingly, one of the comparatively common forms of this exceedingly rare disorder involves a mother harming her child, whom she then carts from doctor to doctor claiming to be in search of a cure. The child typically doesn't know what's going on, although they may know that their mother is giving them "secret medicine" of some sort, and have been sworn to secrecy about it. There have also been cases of patients sickening their spouses, or an elderly relative for whom they are supposed to be caring. Getting the victim hospitalized serves the dual function of forcing someone else to take over their care, and garnering sympathy for the person suffering the factitious disorder.

The rise of support groups for various illnesses online has now created a new category of factitious disorders, first called virtual factitious disorder, but now known as Münchausen by internet. Sufferers of this variation of the disorder choose a support board or chatroom online, and build for themselves a persona who can participate in this outpouring of tele-sympathy. After all, on the internet, no one knows you're a dog -- or in this case, no one knows you're a middle-aged woman pretending to be a teenager with cancer, as was the case in one of the more widely-known incidents.

Although not (yet) formally named, there is also an infamous sub-genre of memoirs presented as fact which turned out to be fiction. These narratives read very much like a case of Münchausen by internet, save for the fact that they were published as physical books, and in some cases the desire for sympathy and support co-existed with the desire to make boatloads of cash. James Frey's A Million Little Pieces was revealed to be almost complete BS, drawing the ire even of Oprah Winfrey; decades before that, Go Ask Alice was presented as a sympathetic and cautionary tale about drugs and self-destruction, until a series of small but embarrassing reveals and the fact that the "editor" began giving lectures on the book led many catalogs to quietly re-list it as fiction.


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