Psych & the internet

[gotname]

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I recently watched the story of Lacey Spears and when I looked it up, I came across "Munchausen by Internet". A related article about Belle Gibson caught my attention and thought I'd ask...

I may be incorrect but it seems like those that have hypochondria, munchausen's, munchausen by proxy or are malingering typically interact with physicians often (as they are part of the means to their end). Because of that, it seems that there is an opportunity to successfully intervene or offer help sometimes. But in munchausen by internet, not so much?

As a collective, is psychiatric intervention more likely to occur much later (or never) in most MBI cases than pts with those other conditions?

And what were they before the popularity of social media? Just regular munchausen's cases (who now found a new stage) or were they just people with undiagnosed psych issues?

Thanks for your thoughts.

 

[nitemagi]

I'm not familiar with it. Are they seeking validation to their disorder through the internet? Such as on forums like SDN?

 

[gotname]

I'm not familiar with it. Are they seeking validation to their disorder through the internet? Such as on forums like SDN?

Lol c'mon, you know SDN would tear one down faster than an angry mob of teen girl Justin Bieber fans.

Anyway I know it is really boring but...I have no desire to ask veiled questions. I simply found out about MBI and was intrigued.

Edit: link

Here is the article about Gibson

http://www.theguardian.com/society/...ternet-sickness-bloggers-fake-it-whole-pantry

 

[Ceke2002]

I recently watched the story of Lacey Spears and when I looked it up, I came across "Munchausen by Internet". A related article about Belle Gibson caught my attention and thought I'd ask...

I may be incorrect but it seems like those that have hypochondria, munchausen's, munchausen by proxy or are malingering typically interact with physicians often (as they are part of the means to their end). Because of that, it seems that there is an opportunity to successfully intervene or offer help sometimes. But in munchausen by internet, not so much?

As a collective, is psychiatric intervention more likely to occur much later (or never) in most MBI cases than pts with those other conditions?

And what were they before the popularity of social media? Just regular munchausen's cases (who now found a new stage) or were they just people with undiagnosed psych issues?

Thanks for your thoughts.

This is just anecdotal, but I had a now former online friend, who I became very close with over a period of around 12+ years, who turned out to be faking cystic fibrosis and scammed a lot of people out of their time and money. I'm not sure if you'd call it malingering, or munchausen's by internet, or just outright fraud, and I'm not asking anyone to give a diagnosis, but she played it pretty low key for the first 10 years or so, most of the time she seemed to reject or even seem embarrassed by people's concerns or attention, and she wasn't making any outlandish claims so there wasn't really any red flags going up at that time. But then suddenly her 'condition' took a drastic turn for the worse, and then she's at death's door, and she wants a chance to marry her girlfriend in a US state where same sex marriage was legal (prior to the supreme court ruling obviously), so please send money now...oh but wait, now her girlfriend's left her, and her dying wish is to go the beach one last time...nope, hang on, it's to hire out snow white's castle at Disney Land and spend a night there, and oh won't someone please grant a dying girl her final wish -- because she couldn't possibly go through one of those make a wish type foundations because um 'reasons'. 🙄 At this point people started asking questions and suspicions were obviously starting to be raised, but those of us who had been particularly close with her over a period of time and also a lot of people who had just known her through various support forums were still willing to stand by her, as hard as that might be to believe. All we wanted was for her to answer questions honestly (she wouldn't), to return any money she'd taken under false pretences (she did return some of the money, whilst pitching a fit about having to do so, some was returned through the people she'd conned into setting numerous donation accounts up through once they realised what was really happening, the rest she'd already spent), and to admit what she'd done, that she had lied about having a terminal illness/conditon, and get help so she could work through why she felt the need to do something like that in the first place (she refused, maintained she was not lying despite mountains of evidence to the contrary, and was adamant she didn't need help because all of us were just delusional bullies).

Most of us who knew her had met her through a couple of online support forums for people with psychiatric diagnosis, so we knew she had a long history of anorexia, bulimia, self harm, and a diagnosis of BPD, hence our first thought wasn't 'let's burn her at the stake', it was more along the lines of 'what made her do a thing like this, why did she feel like this was a good idea, how can we encourage her to get the help she needs', and all of it was to absolutely no avail so at that point we wiped our hands of her, and when she moved to other platforms and started trying to set up more scams for money and gift packages to be sent we put together a detailed document outlining all of her lies, inconsistencies, faked hospital visits, faked operations, exaggerated medical claims, etc etc to try and warn people not to get taken in by her. The point where she started targeting minors for money was when a group of us started looking into bringing possible criminal or at least civil liability charges against her, but being in Australia there wasn't much I could do and this might sound a tad selfish but after a certain point I was just sick of having old wounds re-opened and constantly being reminded of how many people she'd betrayed, so I stepped away. Last I heard she had at least admitted that she had exaggerated some aspects of her illness (she never outright admitted lying about the cystic fibrosis), and she had apologised, but she still insisted she didn't need any help and then 6 months or so later she was back asking for money again so I don't think there are too many people who put much stock in her so called 'coming clean' and 'apologising'.

But anyway, yeah she conned a lot of people, including members of these forums who were med students and nurses. And I think she would have gotten away with it, or still be getting away with it now if it hadn't been for the fact that she suddenly started money grubbing and set off alarm bells.

 

[smalltownpsych]

People who function by assuming the sick role come in a variety of flavors. The method of communicating that to others and learning about new illnesses is typically not that relevant. They used to have to go to this building that held these things called books that was called a library and they would talk to people in the same room as them or on devices that were connected to each other by long wires.

 

[deleted343839]

I've read several recent cases of parents who collected donations for a "sick" child via Facebook, etc. In one especially disturbing case the mother shaved her young daughter's head to make her appear bald from chemotherapy and posted her photo on Facebook seeking monetary donations. This happened in the context of other, far more severe abuse and neglect, the details of which still make my stomach turn.

I don't think most of these cases would meet criteria for factitious disorder, though. They seem to be straight-up fraud and exploitation.

 

[Ceke2002]

I've read several recent cases of parents who collected donations for a "sick" child via Facebook, etc. In one especially disturbing case the mother shaved her young daughter's head to make her appear bald from chemotherapy and posted her photo on Facebook seeking monetary donations. This happened in the context of other, far more severe abuse and neglect, the details of which still make my stomach turn.

I don't think most of these cases would meet criteria for factitious disorder, though. They seem to be straight-up fraud and exploitation.

Cases like these are why I have to unfortunately vet people who ask for assistance in raising awareness of their friend/loved ones plight/need for a transplant through an organ donation charity group/page I kind of run. We have a blanket rule that any donations are directed to registered charities only, so no 'go fund me' stuff or similar, but we sometimes get people asking if we could just post about their son/daughter/brother/sister/father/mother's (etc) story and it always sucks when the person is genuine and I have to tell them I'll be running background checks and asking for verification or the answer is no. Makes me even more disgusted at the scammers than I already am.

 

[gotname]

People who function by assuming the sick role come in a variety of flavors. The method of communicating that to others and learning about new illnesses is typically not that relevant. They used to have to go to this building that held these things called books that was called a library and they would talk to people in the same room as them or on devices that were connected to each other by long wires.

I think you misunderstood me. Since "munchausen by internet" is the sick role acted out online, I meant where did they do it prior to the rise of social media...hence wondering if they were "regular" cases of munchausen's or other psych issues that simply found another way to escalate their behavior.

In one especially disturbing case the mother shaved her young daughter's head to make her appear bald from chemotherapy and posted her photo on Facebook seeking monetary donations. This happened in the context of other, far more severe abuse and neglect, the details of which still make my stomach turn.

Yes. It really is disturbing what people will do for attention...and especially from strangers. The Lacey Spears story I watched was heartbreaking. She did it all for online attention, constantly fabricating her son's illness (made him so, if need be) to get more likes etc. She eventually killed him at age 4 or 5 whilst riding the "you're so brave" high.

@Ceke2002 Over the years, I have heard a few stories of people faking illnesses and taking money from others but until now, I did not realize it happened that frequently. It is difficult to understand but I guess people will do anything for money. However, the ones who do it just to do it...that's a bit harder to to comprehend.

Either way, I agree, it would be good to vet people but with all the different social media platforms to move around to and with so many different types of people (personalities, from cynics, sympathizers & everything in between) to interact with, it seems almost impossible effectively and consistently police these behaviors.

Check this out...the pattern of ups and downs sounds like the story you shared. A med student was behind it...

http://gawker.com/5914621/the-long-fake-life-of-js-dirr-a-decade-long-internet-cancer-hoax-unravels

 

[WisNeuro]

Over the years, I have heard a few stories of people faking illnesses and taking money from others but until now, I did not realize it happened that frequently.

Just start working with mild TBI, you'll see it fairly frequently.

 

[smalltownpsych]

I think you misunderstood me. Since "munchausen by internet" is the sick role acted out online, I meant where did they do it prior to the rise of social media...hence wondering if they were "regular" cases of munchausen's or other psych issues that simply found another way to escalate their behavior.

I guess what I was saying is that a new means of expressing it does not mean that the underlying dynamics are that much different. So before they would have found other ways to communicate their "illness" and had that need met in that way. The evolving culture and language does changes the expression and flavor of psychiatric disturbances substantially though. In some ways, this whole field is a moving target or endless cycle as we try to define and categorize mental illness and that process itself changes how people experience it which leads to redefining and re-categorizing and so on.

 

[gotname]

I guess what I was saying is that a new means of expressing it does not mean that the underlying dynamics are that much different.

Makes sense. Thanks for explaining.

 

[Ceke2002]

I guess what I was saying is that a new means of expressing it does not mean that the underlying dynamics are that much different. So before they would have found other ways to communicate their "illness" and had that need met in that way. The evolving culture and language does changes the expression and flavor of psychiatric disturbances substantially though. In some ways, this whole field is a moving target or endless cycle as we try to define and categorize mental illness and that process itself changes how people experience it which leads to redefining and re-categorizing and so on.

I knew there was something I was forgetting to respond to... @gotname, what smalltownpsych wrote here definitely makes a lot of sense and is also in line with my own experience as well. Take, for example, the communities of eating disorder patients that have developed online over the years -- none of those communities actually needed the internet in order to come into existence. Instead, a decade or more prior to the internet first starting to become popular for home use, we walked around clutching dog eared copies of Hilde Bruch's "The Golden Cage", gave meaningful looks to people in grocery stores we thought might be making tell tale purchases in hopes of striking up a conversation, turned up for coffee and chat afternoons, went to guest speaker nights, and attended support groups run by local eating disorder help and awareness networks. In other words the internet didn't suddenly invent these communities, they'd already existed in one form or another for years prior, all it really did was just make it easier for us to meet and communicate (we hopped online and clicked through bookmarked URLs, rather than hopping on a bus and travelling across town).

 

[Ceke2002]

@Ceke2002 Over the years, I have heard a few stories of people faking illnesses and taking money from others but until now, I did not realize it happened that frequently. It is difficult to understand but I guess people will do anything for money. However, the ones who do it just to do it...that's a bit harder to to comprehend.

Either way, I agree, it would be good to vet people but with all the different social media platforms to move around to and with so many different types of people (personalities, from cynics, sympathizers & everything in between) to interact with, it seems almost impossible effectively and consistently police these behaviors.

Check this out...the pattern of ups and downs sounds like the story you shared. A med student was behind it...

http://gawker.com/5914621/the-long-fake-life-of-js-dirr-a-decade-long-internet-cancer-hoax-unravels

Sorry it's taken me a while to respond to this. You're right it can be difficult to consistently police this type of behaviour online if it's being done across multiple platforms, so when it comes to something like my charity work all I can really do is worry about what's in my own backyard, so to speak (and I've built up a nice little network of contacts over the years that can help me with that). I was aware of the story behind that link you shared, and the group that developed out of that event to help track down and alert people to internet scammers, 'Warrior Eli is a Hoax', is one that I do follow. The big difference between the 'Warrior Eli' story, and what my former friend did though is that it sounds like there were at least a few red flags earlier on with the Warrior Eli thing, probably because the person behind the Warrior Eli hoax seems as if they were putting themselves out there a lot more right from the start.

With my former friend it was the opposite, at first she seemed almost reluctant to tell people about her 'diagnosis', and when she did talk about it then more often than not it was to downplay the situation. The way she first presented things was more like 'Look, I've lived with this all my life and I've learnt to just get on with it and try not let it interfere too much with how I live my life, so please don't worry about me', which of course then made it far easier for people to step forward and offer to send her gift cards, or a gift basket etc, when she did put up the occasional 'woe is me, I just need to vent' type post. Even when she did start to become more open about her 'condition' a few years later, and began talking/posting more about the 'progression' of her 'cystic fibrosis', she still kept her story well within the range of what you'd expect for someone who legitimately had the condition (unbeknownst to myself, and many of her other close(r) friends at the time, this was also roughly the point where she started selectively targeting people privately for small to moderate amounts of cash). Right up until the last couple of years of her scam -- when her requests/campaigning for money escalated dramatically and the sheer exaggeration of her story sent any last shreds of believability flying straight out the window -- the whole of the rest of the time it was like she was engaging in some sort of slow burn type of manipulative process, and of course once everything had finally come out that's when we were all hit with the full realisation of just how manipulative she had been.

As for your question in the original post, "is psychiatric intervention more likely to occur much later (or never) in most MBI cases than pts with those other conditions", obviously without knowing whether the situation I've described was of someone with MBI, or something else entirely, I can only give an opinion based on what I've directly observed, but how soon or how likely it is that psychiatric intervention will occur in a case like this (if psychiatric intervention is what is called for) I think probably depends on how long the person can get away with what they're doing, who it is their behaviour/manipulation is aimed at, and whether or not people offline become aware of what is going on -- although none of those things, either alone or as a whole, is still any guarantee than any sort of psychiatric intervention will take place, or if it does that the person in question will be open to the idea of treatment (just my completely non professional, untrained opinion of course).

 

[gotname]

@Ceke2002 I certainly understand what you (and smalltownpsych) mean.

I had asked the question because from what I read, there seemed to have been an emphasis on the role of the internet (perhaps even as the catalyst?) and the person's behavior.

Take, for example, the communities of eating disorder patients that have developed online over the years -- none of those communities actually needed the internet in order to come into existence.

I guess the distinction may be that a person with an eating disorder (pre-internet) is still a person with an eating disorder...the internet has no bearing on the condition's existence. It (internet) may perhaps aid in networking with similar people (which can help or worsen behavior).

On the other hand, from the description of "MBI", it is the vast reach of the internet (and sometimes the anonyminity) that allows for a person to feign illness in their "online life" (typically seeking attention from sympathetic strangers) that they don't/may not in their "real life" unlike garden variety munchausen's wherein they seek attention from everyone including the medical community and those who know them.

A person without an eating disorder but has one online kinda thing.

In other words the internet didn't suddenly invent these communities, they'd already existed in one form or another for years prior, all it really did was just make it easier for us to meet and communicate

The pre-internet question came from that - adapting the sick role in "one life" just to prey on strangers whilst living as an assumably healthy individual in "another life". I suppose people could and still do it in (real world) support group settings etc. but the internet just made it a lot easier to create or assume identities.

I think probably depends on how long the person can get away with what they're doing, who it is their behaviour/manipulation is aimed at, and whether or not people offline become aware of what is going on -- although none of those things, either alone or as a whole, is still any guarantee than any sort of psychiatric intervention will take place, or if it does that the person in question will be open to the idea of treatment

It was a thought from reading the stories (still shocked at the #), these people hit bottom or came very close before alarm bells went off whereas in the case of those who frequent hospitals for attention, it seems that the destructive behavior may be caught sooner than later. Just the dynamics, I guess. You are absolutely right though. Intervention is not synonymous with treatment!