Having been through the ringer in terms of therapeutic exposure, that exposure being both to therapies and to fellow patients, I feel that it’s important for me to share some of the darker sides of what I’ve seen with you all. What feels perfectly normal to you is like floating on cloud nine to myself and others in the “mental illness world.” There is a realm underneath the clouds that gets darker and darker as you go down it. Almost all mental illnesses hurt those around the sufferer less than the sufferer itself. There are a select few that are deemed dangerous and nearly impossible to treat, by almost every doctor. I’ve encountered a fascinating one in my lifetime, and I’m here to share it with you all.
If you’ve seen Sharp Objects, or have been reading the news on a regular basis, you’ll know part of what this is. Have you ever seen a news story about a mom who pretends their child has cancer? Maybe she’s drugging the kid and has kept them in a wheelchair. That condition is called Munchausen’s By Proxy, and it’s despicable, but of course rooted in mental illness all the same.
There’s another version of Munchausen’s, and I want to say it’s worse because I fell for it, but in reality it’s likely the same level of harmful.
Munchausen’s is an illness wherein you intentionally make yourself sick and intentionally hurt yourself in order to garner sympathy. It’s not well understood and is historically very untreatable. I’ve known someone with this disorder and, as a practice in exposing the more unusual, shocking side of mental illness, I want to share some of the absurdity.
The boy I knew was not the boy I knew, at all. I knew a boy who wrote paragraphs upon paragraphs, went on rant upon rant, about how he had the “worst case of insomnia in the country.” I don’t know, today, if I suspected anything when he first said it. I do know that the first thing I felt was overwhelming sympathy. Which is, of course, the goal of the disorder. The sufferer needs sympathy like we need to breathe.
He used to keep me up all night Facetiming. We were close for a time. During this one month period, his parents had taken him to a doctor to once and for all solve this insomnia problem! He was to wear a bracelet monitoring his heart rate and other sleep indicators for four weeks, if I remember correctly. In theory, it would prove that he wasn’t sleeping.
The only problem was, he naturally slept just fine.
So he had to fabricate the data. He kept me up all night playing games, talking about odd subjects. I’d be up until 5am with him, then off to school the next hour. One day, we Facetimed for 18 hours straight.
Then, the bracelet came off, and the Facetimes faded.
He had intentionally altered his sleep pattern down to next to nothing in order to maintain the illusion that his insomnia even existed. Forget the worst in the US; he was desperate to keep convincing his parents that there was something wrong with him. The bracelet data was fabricated.
I remember after the bracelet came off, his mother sat down with me at his kitchen table and said, in a low voice for he was upstairs, “I know he doesn’t sleep normally, but it is not what he says it is.”
But what were they to do? There’s no treating it. They’re in denial. Wouldn’t you be?
He’d pretend to fall and trip and pass out frequently- I’d never seen him do it, for all the time I spent with him, but it was apparently common when I wasn’t there- and he would moan and groan constantly that his head was hurting, or his muscles were hurting, or everything was hurting. When everything is hurting, everyone is asking after the one in pain, doting on them with love and sympathy. It’s by design.
We once went into the city together. It could have been fun if most of it hadn’t been spent by me running my hand over his back, chasing down a pharmacy to find muscle relaxant cream that he didn’t need, Tylenol that wasn’t necessary. I remember looking him in the eye as he took his Tylenol, at a little sandwich shop in Manhattan. I remember thinking that he knew I didn’t believe him, right then. Something about his gaze told me he knew the jig was up. I normally was able to shove aside suspicions, but if he wasn’t able to set aside the fraud for one NYC afternoon, just so we could be carefree together, I wasn’t sure about our future. As we listened to Harry Potter on tape in a park in the center of the city, I knew something was very wrong.
If you’re wondering why he didn’t just take sleep medication, he’s got you there, too! He’s apparently had terrible side effects to every sleep medication and therefore refuses to take any. Another common Munchausen’s technique. Once, I thought I’d managed to convince him to take some. It’s the obvious solution to his supposed problem, yeah? We were Facetiming and, through sleight of hand and a convenient dropped phone, he tried to say that he took the medication.
There was a pause. I said, gently and nervously, “did you actually take it?” Big mistake. He went off on me, yelling and hollering about how I didn’t believe him, patting himself down and emptying his pockets as if that proved anything. I was scared. He’d never shown this side of himself to me, before. I’d see it again several times. It would lead to a terrible mess and a whole nest of lies unearthed, subsequently. I discovered his diagnosis. He’s still lying up a storm, today. God bless him.
To switch gears to the clinical side of things, Munchausen’s is a very serious illness that is treatment resistant. One of the more common manifestations of it is pretending to have cancer. Like the kid I knew, people falsify medical records and results in order to appear sick. When they’re proven healthy, they’ll switch treatment. The boy I knew has bounced around treatment providers, calling them “abusive” when they discover what he does.
It’s very difficult to collect data on the disorder because not only is it rare, but those who have it are so good at manipulation that it can take years to finally see the light of day. Symptoms include “dramatic” and inconsistent medical history, extensive knowledge of medical terminology (a rare medical term my Munchausen’s boy used was convincing until I Googled it), relapses following improvement, and unclear, shifting symptoms.
All of which I saw right before my eyes. It was terrifying. The more terrifying thing was that I believed it.
As I’ve written before, honesty is crucial to recovery. There are some people who are incapable of being honest. They have lying disorders, and the best thing you can do for them is to not enable them and to leave them to get help with professionals. This particular disorder may be treatment resistant, but all kinds of disorders that rely on deception are treatable.
Why do you lie? That usually unlocks the source and neutralizes the behavior. In Munchausen’s, the problem is that the sufferer will go to dangerous and sometimes fatal lengths to deny having the disorder. With someone like that, there’s often little to do but steer clear.
That’s been today’s update of weird psychiatric illnesses you’ve never heard of! I have a few others up my sleeve. Stay tuned for a bit more on my therapeutic school, from my most popular writer by far… my mother!