Morgan Triplette is a 20 year old student at the University of California Santa Cruz who filed a false rape claim that left her campus in fear and cost the county more than $20,000 in investigative charges. In reading about her I was struck by her immense psychological pathology.
As I have said before stories of psychiatric patients are often much more interesting and bizarre than what any novelist can turn out. Ms Triplette is certainly a perfect case example!
What first came to my mind was her having Munchausen syndrome, in addition to a personality disorder, most probably borderline. I thought her case would provide an introduction to this very bizarre mental illness.
It was named in 1951, by British physician Richard Asher, after a Baron von Munchausen, who was a German nobleman who wrote of improbable tales that were difficult to believe.
Ms Triplette’s incredibly bizarre story begins with her using Craigslist wanting to hire a man to “shoot her in arm or leg, with smallest caliber bullet possible”. Her second ad stated her wanting “someone to punch, kick and bruise” and then she would compensate with sex , stating that she would not file any charges.
Not surprising, she found a willing candidate, who did as requested. One could additionally presume her to have a deviant sexuality that involves sadomasochistic fantasies, but her case is more complicated than just that.
She then filed a false rape claim, saying she was raped by an unknown intruder, on a campus trail. A composed portrait from her description was circulated around the campus and surrounding area, creating increasing fear on the campus.
Police officials launched an intense investigation into her rape allegations, which within 10 days police considered it to be a false claim. The man she hired told police that after he had hit her, she used a mirror to see if her injuries were” bad enough” and then asked him to “hit her some more”.
When confronted with their suspicions, Ms. Triplette finally confessed. Her explanation and rationale centered around her being very depressed with suicidal thoughts. Obviously she has mutilatory needs, but desired that it be inflicted by another person. It would be interesting to know if she has a past history of self-mutilation.
Let me get back to my first thought about this young woman. Munchausen syndrome is definitely a rather strange way to obtain attention and sympathy. It is classified as one of the factitious disorders. Malingering, is similar, but it has the primary goal of obtaining money, rather emotional needs.
Basically it is a self-inflicted injury, or faking symptoms of a disease, injuries or violent trauma in order to be seen as a victim that would provoke attention, care and concern. Patients can self inflict themselves or that of their child, for example. When they cause injuries or attribute symptoms of disease states to their child, it is called Munchausen syndrome by proxy and it is certainly considered child abuse.
You might ask why would anyone go to such extremes to either injure themselves or their children in order to fake a disease. The major underlying precipitating factor is a very pathological need to be cared for with sympathy and concern.
The sociopathic side of it all, is that it is a complete falsification with a premeditated attempt to fool others in believing either the patient or her child are sick. The sociopathy is even more pronounced in the case of Malingerers who use their feigned illness to seek charitable donations from others who believe they are helping this sick person’s cause.
Some classic examples in the news was the recent case of a Arizona mother who was using poison to intentionally make her infant constantly sick in order to attract the obvious attentions and sympathy one would feel for any mother of a sick child.
Other cases include a mother contaminating their child’s urine samples with blood and bacteria feigning chronic illness and the list goes on. As you can imagine, this results in multiple batteries of tests and examinations that are not only costly, but extremely traumatic for the child.
These very sick and abusive mothers though come across as very caring and attentive to their children. A lot of Munchausen’s patients can be very knowledgeable about medical interventions and disease process.
One of the most seriously injuring case was that of a young woman who intentionally applied acid to her face! Her facial scars are a blatant reminder to the extreme nature some of these patients are willing to go!
Most are women, and all generally have an extremely pathological need to make up getting care, attention, warmth and sympathy, that they were deprived of in their childhood. Also a lot of them have suffered abuse, either psychological, emotional or sexual in the past.
It is said that approximately 1 to 5% of illnesses are exaggerated, self-inflicted and falsified. Since most clinicians view a patient or victim of trauma with utmost attention, focus, care and empathy, it is not surprising they are sought out to provide this deep unmet longing.
The only suspected case of Munchausen that I have been exposed to(fortunately) was a middle aged woman, who repeatedly presented symptoms of Porphyria, which is a hard to diagnose illness, because symptoms come and go. Beside abdominal pain, some psychiatric symptoms, and discolored skin blotches; patients have intermittent reddish-purple urine.
Hospitalised several weeks in a psychiatry,( this was before american insurance companies chased you out), I remember the women being very secretive and manipulative. After multiple lab tests and examinations by multiple physicians, it was concluded that she somehow was simulating symptoms herself.
A lot of Munchausen patients have a tendency to fake these rare conditions, where a diagnosis is difficult to establish. Having a rather exotic disease makes them feel special and gives them an “elite” patient role.
They also take pleasure in being able to fool a multitude of doctors and nurses by their cleverness and fakery, which can covertly boost their sense of self and ego, which generally is very low.
Psychotherapy with these patients focuses on their childhood abuse, neglect and their incessant need for affection, care and attention. Because almost all have concomitant personality disorders, the prognosis is poor and limited at best.
I should add that the diagnosis has expanded due to the net, as Munchausen by Internet means someone using patient forums or blogs to derive needed sympathy from others by making up various medical and psychiatric diagnosis.
Munchausen should not be confused with Hypochondria, which is different in that the patient actually believes they are suffering various illness. Borderline personality disorders patients who self mutilate, do not generally inflict self injury for attention and concern, except in certain situations, where they may feel fear of being abandoned.
I have had a few borderline patients to intentionally inflict injury or feign getting “sick” again, as a way, however manipulative, in order to be hospitalised. I remember a few patients who would self mutilate or decompensate each time I was getting ready to go on vacation.
Drug addicts are also notorious for creating or feigning injuries, but they are just seeking more drugs, so their motivation is totally different from Munchausen.
Munchausen patients may be driven by their unmet emotional cravings as mentioned above, but they practically all include committing fraud by intentional lying and falsification, wasting vast amounts of time and medical expenses.
In Ms. Triplette’s case, despite her obvious psychiatric pathology, her fake rape claim has resulted in criminal charges. Munchausen by proxy mothers often have their children removed for their care, though there are some cases where children have grown up with these mothers who were not caught till many years later.
Since treatment has a poor prognosis; recidivism is high. Some experts state it becomes almost a compulsion, therefore once someone is proven to be a Munchausen case, the motto for the clinician, however caring would be; beware and investigate with doubt till proven otherwise.
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