Gypsy Rose Blanchard murdered her mother in 2015.
The 23-year-old Missouri woman had spent most of her life in a wheelchair, told by her mother, Dee Dee, that she had muscular dystrophy and was unable to walk. Gypsy was also led to believe that she had a long list of other illnesses and ailments — cancer, brain damage, epilepsy, sleep apnea, eye problems — and subsequently underwent various surgeries and invasive treatments.
But, it turns out Gypsy was not, in fact, sick.
After she secretly started dating a man named Nicholas Godejohn she met online, the couple plotted to kill Dee Dee so Gypsy could be free from her control. Dee Dee’s murder garnered much media attention due to the nature of the crime, but also because it raised awareness of a lesser-known condition called factitious disorder imposed on another, or Munchausen by proxy.
The story of Dee Dee and Gypsy is the subject of a new television series called The Act.
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What is factitious disorder imposed on another?
Factitious disorder imposed on another is when a person fakes or lies about a loved one’s health. It’s related to factitious disorder, which is when someone falsifies symptoms or lies about their own health.
“Factitious disorder imposed on another is a type of mental illness in which a caregiver intentionally creates, causes, or exaggerates illness or injury in another person,” Karen Salerno, a social worker at the Cleveland Clinic who works with people affected by factitious disorder, told Global News.
“They change test results to make someone appear ill, they can physically induce symptoms, such as poisoning, suffocation and inducing infection. They may also try to falsify medical records.”
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While factitious disorder imposed on another is often discussed in terms of parents (usually a mother) lying about their children’s health, Salerno says it can happen to anyone at any age. She’s seen cases where an adult child has intentionally lied about their elderly parent’s health and caused them harm.
When it comes to parents inflicting this abuse onto their child, the kids are most often under the age of six, Salerno said. The Cleveland Clinic says factitious disorder imposed on another is rare and affects an estimated two out of 100,000 children.
In one U.S. case, a mother claimed her young daughter had cystic fibrosis, but medical experts found she faked her child’s disease. Investigators found the mom infected her daughter with harmful bacteria, and also suspected she removed blood from the child so that she would become anemic, CNN reports.
Dr. Marc Feldman, a psychiatrist at the University of Alabama and an internationally-recognized expert in forms of medical deception, previously told the Canadian Press that parents behind this kind of abuse are typically seeking emotional gratification, but at the cost of the child’s well-being.
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“Usually that comes in the form of seeking attention and sympathy,” he told the outlet. “So they present themselves as the caregivers of terribly ill children, whose illnesses are defying diagnosis. And predictably, they get a lot of care and concern from immediate family as well as the community.”
Feldman said many of these parents are dissatisfied with how their own lives have turned out and feel out of control. Successfully manipulating the beliefs of “high-status professionals like doctors allows them to feel once again in control.”
While Salerno says factitious disorder imposed on another is a mental illness, the person on the receiving end is experiencing abuse. Experts estimate that about six to nine per cent of kids die from this abuse, and another six to nine per cent end up with long-term disability or permanent injury.
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“It’s typically a repeated pattern of repeated behaviour,” she said. “In my clinical experience it’s intentional … and they know what they’re doing.”
How do caregivers get away with factitious disorder imposed on another?
New show The Act, starring Patricia Arquette and Joey King, shows the depth of Dee Dee’s deception.
Dee Dee took her daughter around from doctor to doctor, lying about her health in various healthcare settings. This resulted in unnecessary medical testing, operations and treatments.
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Salerno said this behaviour is common in people who carry out factitious disorder. When a caregiver moves a patient from hospital to hospital or across the country, it makes it difficult for healthcare professionals to know a patient’s true medical history.
This is why doctors need to be educated about the condition, researchers say.
The most obvious hint of factitious disorder imposed on another is if children return to hospital with recurrent illness — they’re injured, or bleeding, or they’re fighting infection. Kids should also be interviewed individually when they’re being assessed.
What causes factitious disorder and is it treatable?
Salerno said there’s not a clear cause of factitious disorder, or factitious disorder imposed on another. What is common in a perpetrator, however, is a history of trauma.
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“There is some thought it may be linked to certain biological and psychological factors, such as experiencing — in the case of the caregiver — some sort of trauma in their childhood, either abuse or neglect, divorce of their parents, a death of a parent or interpersonal family dynamic issues,” she said.
“The caregiver is doing it for some kind of attention, and that can be different for the individual person.”
When a child is being abused, Salerno says it’s important social services intervene, and the kid receives medical treatment. For perpetrators, they need to seek psychotherapy and cognitive behaviour therapy.
Do other parents or family members know what’s going on?
In the television show Sharp Objects, based on the book of the same name, one of the main characters, Adora (Patricia Clarkson), lands in jail after police discover she is deliberately poisoning her daughters, played by Amy Adams and Eliza Scanlen. (It turns out Adora is also behind her deceased daughter’s death.)
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Adora’s husband is quiet about his wife’s behaviour and does not intervene. While it is unclear how much he knows, Salerno says it’s common for family members to be unaware of factitious disorder imposed on another.
“In my clinical experience, when I’ve told family members, they’re usually very surprised and shocked, because it’s counter-intuitive,” she said.
“Because on the outside, it looks like the caregiver is doing everything possible to help the sick person, so they’re going to a lot of appointments and really advocating for the person to get better.”
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As in the case of Gypsy, her parents separated when she was a young child. Gypsy’s father, Rod, also believed his daughter was sick and was unaware of Dee Dee’s abuse.
“I think Dee Dee’s problem was she started a web of lies, and there was no escaping after,” Rod told BuzzFeed.
“She got so wound up in it, it was like a tornado got started, and then once she was in so deep that there was no escaping. One lie had to cover another lie, had to cover another lie, and that was her way of life.”
With files from the Canadian Press