Munchausen’s syndrome - Causes 

Causes of Munchausen's syndrome 

There is little available evidence about possible causes of Munchausen's syndrome because many people with the condition refuse to co-operate with psychiatric treatment or psychological profiling.

Theories

There are two main theories about the root cause of Munchausen's syndrome. The condition may be the result of:

  • emotional trauma (deeply upsetting experiences) that occurred during a person’s childhood
  • a personality disorder: a mental health condition that causes patterns of abnormal thinking and behaviour

It could be the case that both theories are interrelated to some extent. A person with a traumatic childhood can often go on to develop a personality disorder in later life.

The two theories are discussed in more detail below.

Childhood trauma

Some experts have suggested that many cases of Munchausen's syndrome may be the result of parental neglect and abandonment, resulting in feelings of childhood trauma.

As a result of this trauma, a person may have unresolved issues with their parents that cause them to fake illness. They may do this for a number of reasons, for example because they have:

  • a compulsion to punish themselves (masochism) by making themselves ill because they feel unworthy
  • a need to feel important and be the centre of attention
  • a need to pass responsibility for their wellbeing and care onto other people

There is also some evidence to suggest that people who have had extensive medical procedures, or received prolonged medical attention during childhood or adolescence, are more likely to develop Munchausen's syndrome when they are older.

This may be because they associate their childhood memories with a sense of being cared for. As they get older they try to obtain the same feelings of reassurance by pretending to be ill.

Personality disorders

There is some evidence that many people with Munchausen's syndrome have a personality disorder.

Personality disorders are a type of mental health condition where an individual has a distorted pattern of thoughts and beliefs about themselves and others. This leads them to behave in ways most people would regard as disturbed and abnormal.

One theory is that there may be people with Munchausen's syndrome who have an antisocial personality disorder that causes them to take pleasure in manipulating and deceiving doctors. They may see doctors as authority figures and by tricking them it may give them a sense of power and control.

Another theory is that some people with Munchausen's syndrome have an extreme form of what are known as cluster B personality disorders. A person with a cluster B personality disorder struggles to regulate their feelings and often swings between positive and negative views of others. (The most common type of cluster B personality disorders is borderline personality disorder).

It could be that the person has an unstable sense of their own identity and also has difficulties establishing meaningful relationships with others. So playing the 'sick role' allows them to adopt an identity that brings with it unconditional support and acceptance from others. And admission to hospital gives that person a clearly defined place in a social network.

Page last reviewed: 29/06/2012

Next review due: 29/06/2014

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