Guest Author Sam Vaknin, PhD: Munchausen and Munchausen by Proxy Syndromes: Forms of Pathological Narcissism?

"Forlorn Heart" by Mimi Stuart ©  Live the Life you Desire

“Forlorn Heart” by Mimi Stuart ©
Live the Life you Desire

Guest Author Sam Vaknin writes:

Patients afflicted with the Factitious Disorder colloquially known as “Munchausen Syndrome” seek to attract the attention of medical personnel by feigning or by self-inflicting serious illness or injury. “Munchausen by Proxy Syndrome” (Factitious Illness or Disorder by Proxy, or Imposed by Another, or FII – Fabricated or Induced Illness by Carers) involves the patient inducing illness in or causing injury to a dependent (child, old parent) in order to gain, in her capacity as a caretaker, the attention, praise, and sympathy of medical care providers. Both syndromes are forms of shared psychosis (folie a deux or a plusieurs) and “crazy-making” with hospital staff as unwilling and unwitting participants in the drama.

Superficially, this overwhelming need for consideration by figures of authority and role models (doctors, nurses, clergy, social workers) resembles the narcissist’s relentless and compulsive pursuit of narcissistic supply (which consists of attention, adulation, admiration, being feared or noted, etc.) But, there are some important differences.

To start with, the narcissist – especially the somatic variety – worships his body and cherishes his health. If anything, narcissists tend to be hypochondriacs. They are loath to self-harm and self-mutilate, let alone fake laboratory tests and consume potentially deleterious substances and medications. They are also unlikely to seriously “damage” their sources of supply (e.g., children) as long as they are compliant and adulating.

As opposed to narcissists, people with both Munchausen Syndromes desire acceptance, love, caring, relationships, and nurturing, not merely attention: theirs is an emotional need that amounts to more than the mere regulation of their sense of self-worth. They have no full-fledged False Self, only a clinging, insecure, traumatized, deceitful, and needy True Self. Munchausen Syndrome may be comorbid (can be diagnosed with) personality disorders, though and the patients are pathological liars, schizoid, paranoid, hypervigilant, and aggressive (especially when confronted.)

While narcissists are indiscriminate and “promiscuous” when it comes to their sources of narcissistic supply – anyone would do – patients with the Munchausen Syndromes derive emotional nurturance and sustenance mainly from healthcare practitioners.

by Guest Author Sam Vaknin, the author of Malignant Self-love: Narcissism Revisited and After the Rain – How the West Lost the East, as well as many other books and ebooks about topics in psychology, relationships, philosophy, economics, and international affairs.

He is the Editor-in-Chief of Global Politician and served as a columnist for Central Europe Review, PopMatters, eBookWeb , and Bellaonline, and as a United Press International (UPI) Senior Business Correspondent. He was the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Visit Sam’s Web site at

Read Sam Vaknin’s “I can’t seem to be able to protect my child from the other parent’s narcissistic bad influence.”

Read Alison Poulsen’s “Emotionally Volatile People: ‘He can be so charming and then so defiant.’”

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One thought on “Guest Author Sam Vaknin, PhD: Munchausen and Munchausen by Proxy Syndromes: Forms of Pathological Narcissism?

  1. Vanessa

    I am not a clinical psychologist, however I have dealt with many people professionally and a Lay Minister. I have a great interest in people and value the personal relationships I have harvested.

    The article you provided is great on Narcissism.

    I do think the perception and reality of dealing with PD is the key to maintaining your own sense of self and healthy well-being. We do know that ‘relationships’ so shift whether it is ‘families’, ‘friends’, ‘siblings’ ‘colleagues’. If our ‘radar’ and ‘natural’ instincts are working properly we will be able to adjust them accordingly taking the necessary actions into place. The problem, as I see it is that with narcissism is that ‘the light has to constantly be shinning on them’ (reward, what am I going to get). It is often complex as we have read. The delusion is that ‘the old self’ will return, when we realize that the illness is greater. [It is not until people have that ‘watershed moment’ or the need to self preserve goes logic prevail] Which often requires intervention or medical help to restore the balance of the relationship. I know others will have their own options, naturally.

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