TV aficionados who caught Patricia Arquette's Emmy-winning turn in The Act earlier this year, and then streamed The Politician recently, may have noticed something similar: both Arquette, as Dee Dee Blanchard, and Jessica Lange, as cussin' grandma Dusty Jackson, went through considerable lengths to convince people their kid was sick, not least the kid.
In The Act, based on the true story, Dee Dee convinced Gypsy Rose (Joey King) she had a host of ailments that don't exist. In The Politician, Dusty made the people of Santa Barbara believe her granddaughter, Infinity (Zoey Deutch), had cancer so she could cut the line at restaurants and get free stuff. And viewers whose pop culture radar went off at similarities between these shows and last year's Sharp Objects, which had Adora (Patricia Clarkson) poisoning her daughter, would very likely notice that television is suddenly obsessed with Munchausen by proxy.
TV's sudden Munchausen madness didn't get past Dr. Marc Feldman, a professor of psychiatry and adjunct professor of psychology at the University of Alabama, and the author of Dying to Be Ill: True Stories of Medical Deception. Having studied Munchausen by proxy — a mental illness that has a person, usually a caregiver, assign non-existent medical maladies onto someone else, usually a child — for 30 years, Feldman says he's never seen so much attention paid to the mysterious diagnosis. "It's been stunning," he told TV Guide. "I'm at a bit of a loss to understand why it's having such a moment." Feldman is also, as professionals often are when seeing history or science portrayed on-screen, attuned to the ways Hollywood has gotten Munchausen by proxy wrong.
First, some facts: The name Munchausen itself comes via a reference to Baron Munchausen, a fictional character from 18th century German literature who was a comically, blatant liar. In 1951, British endocrinologist Richard Asher used the term "Munchausen syndrome" for patients who were faking sickness for attention, and by 1977 "by proxy" had been added to describe people pretending someone else was sick for attention. The American Psychiatric Association recognized it only in 2013, albeit not under the name Munchausen by proxy, but as "factitious disorder imposed on self."
Not a lot is known about what causes it — hence Feldman's bewilderment at how it's suddenly the plot line du jour — but it's a real mental illness and a form of abuse that causes untold destruction and despair for people affected, as well as their families. Research is slim, but he estimates about 600-1200 cases annually, although that's hard to know for sure since it's such secretive, hard-to-pin-down situation. Victims, some of whom contact Feldman through his site, report being unable to trust medical professionals, even shunning medical help when they really do need it.
While Feldman thought The Act got it right, TV's sudden fascination with Munchausen by proxy (or as Feldman prefers, medical child abuse) means shows are inevitably going to get it wrong too. He can't even bring himself to watch The Politician, he says, since Dusty's actions look more like malingering — when people fake sick to get tangible goods — versus Munchausen by proxy, which is driven by a need for attention and sympathy.
"I do think [shows] conflate the two a little bit," says Andrea Dunlop, who experienced Munchausen by proxy in her family, and includes a Munchausen by proxy storyline in her book We Came Here to Forget. "It makes me furious." She calls her family's experience, which she can't go into specifics about for legal reasons, "absolutely devastating; the worst thing that happened in my life," which is part of the reason inaccurate portrayals of Munchausen by proxy anger her all the more.
The Act, she says, is a particularly egregious example. Dee Dee is portrayed as motivated by money, and as a kooky Southerner whose abnormal social functions send up big red flags. In reality, perpetrators are mostly driven by attention (although they accept money and goods) and are usually such masterful manipulators their abuse goes unnoticed.
"They're able to convince doctors, so they have to be normal-presenting; in the case in my family, this person had an encyclopedic knowledge of medical information. If someone seems crazy from the get-go they wouldn't be able to convince [doctors]." TV's portrayals of Munchausen by proxy are almost caricature, she says.
Dusty's unrepentant confession in The Politician, for example, isn't right: Munchausen by proxy perpetrators usually never confess to what they've done, even when confronted with irrefutable evidence, in turn forcing family members to make the painful choice to cut off contact and hope the victim lives long enough to figure it out and escape.
So why's it so popular on TV now? Dunlop has been thinking about it a lot, and has some very good theories. For one, our culture is in the midst of a scammer celebration that keeps going and going; from the two Fyre Festival documentaries out this year, the Theranos story, Anna Delvey, and the college admissions scandal, stories about people who invent and maintain their own realities have invaded the culture.
Munchausen by proxy stories have roots in true crime, another ever-present fascination, and Dunlop points out that true crime stories seem exponentially juicier when the perpetrator is a woman. Add in television's increasing willingness to talk about mental illness, and Munchausen by proxy was almost destined to become TV's favorite new big dramatic storyline, like the "long lost sibling" or "came back from the dead" tropes made popular decades ago.
Experts like Feldman and Dunlop welcome the exposure, but they hope Hollywood doesn't glamorize or trivialize a situation that's one of the deadliest forms of child abuse, in part because victims are too young to understand or verbalize what's happening, and professionals haven't been trained to spot signs.
"Usually people [dealing with child abuse issues] end up in family court because of poverty," Dunlop explained. "They don't recognize someone like the person in my family, who's white, middle class, educated. That's why the depictions matter. It would be so much easier to spot."