Gender bias in the conceptualisation and operationalisation of the diagnosis of Munchausen syndrome by proxy. Clive Baldwin Senior Lecturer Social Sciences and Humanities University of Bradford. Gender and Child Welfare Conference 22 nd April 2009.
Social Sciences and Humanities
University of Bradford
Gender and Child Welfare Conference 22nd April 2009
Munchausen syndrome by proxy (MSbP) is an alleged form of child abuse in which the perpetrator (usually the mother) fabricates or induces illness in another (usually a child).
Term used by Meadow 1977 to describe cases of two children being presented for medical investigation and treatment who failed to respond to treatment and in which it was thought that the mothers were harming their children in order to seek medical attention.
According to Meadow (1995): being presented for medical investigation and treatment who failed to respond to treatment and in which it was thought that the mothers were harming their children in order to seek medical attention.
90% of cases involve the mother
5% a female caregiver
Indications of MSbP
Deviancy from idealised motherhood
Theories of motivation
In research and the literature
Absence of analysis
Absence of research
Indicators of MSbP
Symptoms start in the presence of the mother
One parent (usually the father) absent from hospital
A parent constantly at the child’s bedside
Norms of motherhood as benchmark against which to identify deviancy
Seen in language: e.g ‘the perversion of mothering’
Concern for child’s health
Appears as the ‘perfect parent’: nurturing, loving, caring
Theories of causation ‘identify’ women
Attention of (male) paediatricians (Schreier and Libow 1993)
Links to other ‘mental illnesses’ (e.g. depression, generalised anxiety, ‘hysterical illnesses’ etc) in which women predominate
Nurturance cast in an evil light (Bergeron 1996)
MSbP mothers are over-socialised into caretaking and traditionally female roles and such behaviour is a means of gaining recognition through the exaggeration of these, often undervalued, competencies (Leeder 1990).
A-symmetry: treating/interpreting the same behaviour on the part of father/mother differently
In treatment: even if social factors are acknowledged (e.g. Yorker, Leeder) the response is individual therapy
Profiling – of mother, no corresponding profile of father
Meadow (1995) was sceptical about the masculinity of the first few male perpetrators he came across to the extent of taking steps to find out if they had male chromosomes and glands
Randall (1997) in answering a question about why he and his co-author did not address gender issues in their article about social work and MSBP replied: “we didn't want to distract the intended SW [social work] audience from the core issues “
In literature and research
Gender-power issues as marginal or irrelevant to the development, diagnosis, treatment and management of MSbP as evidenced by absence of discussion, contextualisation and research