Munchausen by Internet


Munchausen by Internet is a pattern of behavior akin to Munchausen syndrome, a psychiatric disorder, wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. In Munchausen by Internet, users seek attention by feigning illnesses in online venues. It has been described in medical literature as a manifestation of factitious disorder imposed on self, or if claiming illness of a child or other family member, factitious disorder imposed on another.

Characteristics

Background

Reports of users who deceive Internet forum participants by portraying themselves as gravely ill or as victims of violence first appeared in the 1990s due to the relative newness of Internet communications. The pattern was identified in 1998 by psychiatrist Marc Feldman, who created the term "Münchausen by Internet" in 2000.
Factitious disorders are described in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR as psychological disorders involving the production of non-existent physical or psychological ailments to earn sympathy. These illnesses are feigned not for monetary gain or to avoid inconvenient situations, but to attract compassion or to control others.
When the symptoms of another person, such as a child or an elderly parent, are purposely induced by the caregiver, it is called factitious disorder imposed on another, or Munchausen syndrome by proxy.
In Munchausen by Internet, a person pretends to be gravely ill, to gain sympathy from a group whose sole reason for existence is support. Health care professionals, with their limited time, greater medical knowledge, and tendency to be more skeptical in their diagnoses, may be less likely to provide that support.

Causes

Feldman has admitted in several interviews that he has been the victim of people who email him to explain psychiatric symptoms, only to divulge eventually that they created it all to fool a doctor. For prolonged cases, he states the impetus for such behavior is the "longing for nurturing, sympathy, care and concern that they feel unable to get in appropriate ways," and that the admiration of forum members is a strong motivator to continue. As manipulation is integral to most cases, the need to control others to feel as if the perpetrator is in control of his or her own life is apparent, as is the pre-existence of underlying personality disorders. Many people who present factitious disorders crave sympathy and support because it was notably absent in childhood.
In an article published in The Guardian, Steve Jones, credited the anonymity of the Internet for impeding people's abilities to realize when someone is lying. Online interaction has only been possible since the 1980s, steadily growing over the years.

Notable cases

  1. The New York Times listed three cases of Internet forum members who were "incorrigible fakers". A woman with an eating disorder who posted to a support group saying she was reporting from an intensive care unit and claimed to have had a stroke while online. In another example, a teenager frequenting a forum for mothers with premature infants – some of whom had endured lengthy, expensive, and painful medical procedures, or had died - after which she received support and sympathy from the 400-member group. The teenager confided to the group that her baby had also died. Another man who claimed to be a monk with end-stage cancer posted long descriptions of his trials and struggles with facing death alone, eventually arousing the suspicions of other forum members who were not convinced someone so sick could correspond with so much vitality.
  2. A case that lasted over a year involving a 15-year-old boy participating in an online support group for people enduring debilitating migraine headaches. Some of the group's members had been on disability pension or gone through drug regimens for years to no avail. The boy represented his mother as deaf and his father as an alcoholic, and he reported seizures and hemophilia. Resources of the forum became constantly directed at the boy, especially when some members expressed doubt about his story.
  3. Internet venues unrelated to medical issues have also been the audience for such cases. A member of an online fan club for the musical Rent divulged numerous illnesses that caused her to slip in and out of comas, prompting some cast members to send sympathy cards. When other fan club members expressed their concern, even purchasing airline tickets to visit the sick woman, she reported that she had immediately improved.
  4. From 1999 to 2001 a 40-year-old homemaker named Debbie Swenson perpetrated a ruse under the identity Kaycee Nicole, a 19-year-old woman in Kansas who shared the details of her battles with leukemia online. The Guardian newspaper reported that millions of Internet users read the fictional blog, as well as Swenson's own blog, in which she posed as Kaycee Nicole's mother, describing the trials of living with an intelligent and optimistic daughter who was dying. On May 16, 2001, Kaycee Nicole's death of an aneurysm was announced, shocking her readers and causing them intense grief. Soon however, Swenson caused skepticism in online communities. People began to learn that no one named Kaycee Nicole lived in Kansas, had been enrolled in schools, or admitted to local hospitals, and no obituary had been printed. After repeated questioning, Swenson posted that she had woven the stories of three cancer patients to create the character of Kaycee Nicole, who had never existed.

    Discovery and impact on online communities

Forum members are frequently banned from some online forums. Denise Grady noted in The New York Times that a woman with the eating disorder moved to a group for sexual abuse survivors, then to another where she claimed to be dying of AIDS.
An article in The Weekend Australian highlighted an example of this in 2003: a woman in London admitted to belonging to online support forums dedicated to helping members cope with migraines, grieving over dead children, and breast cancer, all at the same time. She told a psychiatrist that she would study a specific malady and subsequently present herself with its symptoms; her time at each forum followed a daily schedule. Others disappear and simply stop posting, such as the monk who claimed to have cancer.
Some victims of the syndrome will claim that those questioning their illness causes their condition to worsen. These victims will also creates sock puppet accounts to continue their ruse. Feldman's 1998 article in the Western Journal of Medicine notes a case in which a member of a support group for people with chronic fatigue syndrome created a husband, sister-in-law, and family friend who simultaneously engaged in arguments with and about the original member; when the amount of attention directed toward the original member became inadequate, she claimed the sister-in-law committed suicide in response to the lack of support. Because no money is exchanged and laws are rarely broken, there is little legal recourse to take upon discovery of someone faking illness.
Such dramatic situations often polarize online communities. Many members feel ashamed for believing elaborate lies, while others remain staunch supporters. Feldman admits that an element of sadism may be evident in some of the more egregious abuses of trust.,
Other perpetrators react by issuing general accusations of dishonesty to everyone, following the exposure of such fabrications. The support groups themselves often bar discussion about the fraudulent perpetrator, in order to avoid further argument and negativity. Many forums do not recover, often splintering or shutting down. In 2004, members of the blog hosting service LiveJournal established a forum dedicated to investigating cases of members of online communities dying—sometimes while online. Writer Howard Swains referred to the online deaths as "pseuicides" in Wired.com. New Zealand PC World Magazine called Munchausen by Internet "cybermunch", and those who posed online "cybermunchers". In 2007 The LiveJournal forum reported that, of the deaths reported to them, about 10% were real.