In this series of posts, I review the scientific work in the field of Munchausen Syndrome by Proxy (MSbP) published by authors Libow & Schreier. In my recent posts, I discussed my reaction to their book on the topic, “Hurting for Love”, and also began to discuss a book review published by Dr. Dierdre Conway Rand. Here, I list what I consider weaknesses of the book, backed up by quotes from Conway Rand’s review.
Highlights of Conway Rand’s Review
It is impossible to do justice to Conway Rand’s awesome review, so I will just put a few quotes here. She opens her discussion by rightfully complimenting the authors on their book that will provide “practical guidance”, but then says that the book:
…presents MBPS abuse in a neat, comprehensive, total package which is both its strength and its weakness.
And here are more weaknesses of the book, which I will label with my own words and support with quotes from Conway Rand.
Weakness #1: Lack of Scientific Objectivity and Rigor
Schreier and Libow’s over-commitment to their hypothesis that the mother’s primary motivation is to maintain a special relationship with the child’s doctor has the effect of dogma. While the hypothesis is well developed and intrinsically interesting, it fails to integrate conflicting material and thereby stultifies further scientific inquiry.
Schreier and Libow mention my [Conway Rand’s] work in passing but consistent with their tendency to downplay data that does not fit in with their view, they fail to explain or integrate it.
Weakness #2: Lack of Public Health Perspective
Another of the book’s overvalued ideas is that MBPS is so unique that it is qualitatively different from adult Munchausen syndrome… The importance of these differences is not that MBPS is special and unique but that it can teach us things about the two major classes to which it belongs: factitious disorders and child abuse.
Weakness #3: Lack of Awareness of How Authorities are “Played” by the Perpetrator
Note: The bolded area below is my emphasis, not the emphasis of the original author.
The authors are clearly aware that MBPS parents, once discovered, can transfer their attention-seeking efforts from the medical establishment to therapists, social workers, and the child protective establishment. What they fail to comprehend is that some parents do more than transfer the MBPS behavior to this arena… In my work, I define this as a contemporary manifestation of MBPS because it has developed in tandem with the proliferation of social services directed at managing the problem of child abuse… Meadow recently reported on 14 cases of dual factitious disorder by proxy in which mothers were simultaneously presenting their children to the child abuse establishment in the victim role and to the medical establishment in the patient role. For 11 of these children, it was the discovery that the abuse allegations were false that led to the discovery that the children were also incurring factitious illnesses.
I bolded those phrases because I thought they did a great job of describing Libow & Schreier’s naiveté in this area.
Next Up – 1994
In 1994, Libow & Schreier publish two more co-authored articles – again, not without criticism. I’ll cover those in my next post.
Have you read a book on MSbP?
If so, which one? And what is your review? Please comment on our blog and let us know what you thought of it!