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TODAY contributor
updated 3/4/2009 6:57:28 PM ET 2009-03-04T23:57:28

Q. Are there mild forms of Munchausen Syndrome by proxy? My mother is mentally ill and has ruined almost every relationship in her life. I had six operations before the age of 15 and she was always telling people, “I can't figure out what’s wrong with my daughter.” She is what’s wrong.

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Now, my dad has to have permission from my mother if he wants to spend time with me or call me. She sounds like me on the phone, and I’ve caught her calling my doctor impersonating me. I should have confronted her behavior right then, but now it’s too late. I prefer that she not be in my life.

A. Yes, there are mild forms of the mental diagnosis known as Munchausen Syndrome by proxy.

In this disorder, a parent (usually a mother) either feigns or manufactures illness in her child for the purpose of gaining the attention of medical professionals for herself through her child. Like any other mental health issue, it exists in varying degrees.

Anybody who has an ongoing health problem that cannot be explained — like a child who repeatedly has vomiting, diarrhea or muscle weakness that improves in the hospital unless the parent visits, and worsens upon a return home — might get unnecessary medical procedures as a result. Munchausen takes a lot of detective work to figure out. One would hope the doctors would identify it before they actually perform any operations.

The more recent behavior of your mother sounds disturbed. It is not normal for anyone to call your physician and impersonate you. And there is no reason your father needs her permission before contacting you. She sounds extraordinarily controlling. The reason for her attempt to control you is unclear and could range from more-severe mental illness to a disturbance in her personality that makes her extremely insecure and self-involved.

I don’t agree that it is too late for you to say something to your mother. You should tell her that her behavior is not acceptable or permissible, and ask what information she is trying to get from your physician. Maybe this will help you understand where she is coming from.

You should also tell your physician what has happened, so you do not put your doctor in a position of inadvertently giving your mother information that is not appropriate, and so the doctor’s office is not given erroneous information that purportedly comes from you.

You say you have no relationship with your mother, but it sounds as though you do have some contact with her. Is she trying to find out what is going on with you because you have cut her out of your life, or is she so upset you feel you cannot have a real relationship with her? Is there a way to approach her so you can find out what is really going on with her?

As for your preference that she be out of your life, it is unfortunate when one cannot have any sort of decent relationship with a parent. In general, I advocate trying to understand what the impediment is and work on it.

But sometimes a very disturbed or attacking parent refuses to get professional help to rectify the situation, in which case you are better off living your life independently rather than suffering at your parent’s hand.

Dr. Gail’s Bottom Line: Like all mental illnesses, Munchausen Syndrome by proxy can exist in varying degrees of severity.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her latest book is “Anatomy of a Secret Life: The Psychology of Living a Lie.” She is also the author of “Amazing You! Getting Smart About Your Private Parts,” which helps parents deal with preschoolers’ questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, www.drgailsaltz.com.

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