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The Exhausted Woman
with Christine Hammond, MS, LMHC

What is Munchausen Syndrome by Proxy?

Kelly Gant, a Colorado mother, was charged with 13 criminal counts for the 2017 death of her 7-year-old daughter, Olivia. Olivia was a Make-a-Wish recipient in which she was dressed up as a “Bat Princess” so she could rescue Disney princesses from their villains. Her mother claimed that Olivia had a terminal illness that attacked her body’s vital organs.

After several treatments, Olivia was placed in hospice and died. It is now suspected that Kelly has the symptoms of Munchausen Syndrome by Proxy after Olivia’s body was exhumed and found to not have any of the physical illnesses. Kelly is now facing first-degree murder charges, child abuse, theft, and charitable fraud accounts.

What is this? Munchausen Syndrome by Proxy (MSP) is an attention-seeking psychological disorder done by the caregiver of a person under their care. It is usually seen in cases where the caregiver is the mother and the person in need of care is the child (for purposes of explanation going forward, this example will be used). The mother exaggerates symptoms of the child to gain attention from medical professionals. In extreme cases, the mother may take deliberate actions against the child to verify their claims of the fictitious disorder.

Is MSP a factitious disorder? Yes, it is listed in the DSM-5 under factitious disorders. This is a mental condition and not a physical one even though physical symptoms are more apparent before the mental ones. A person with Munchausen will believe and then act as if they are sick when they are not. In the case of MSP, the mother believes and then acts as if the child is sick when they are not. The mother might tell the child of the illness and even encourage them to exaggerate the symptoms as well. In extreme cases, the mother might harm the child as a way to prove that there is something wrong and then deny that it happened.

What are the clinical symptoms? There are four components according to the DSM-5 of a factitious disorder that can occur as a single event or reoccurring. For MSP, this same is applicable.

  • Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.
  • The individual presents himself or herself to others as ill, impaired, or injured.
  • The deceptive behavior is evident even in the absence of obvious external rewards.
  • The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

How does this look to others? Those outside a professional counseling profession may see the warning signs of Munchausen as follows:

  • Dramatic physical symptoms with an inconsistent medical diagnosis,
  • The child has a strange set of symptoms,
  • Unclear and uncontrollable symptoms that become more severe or morph with treatment,
  • Mother reports worsening symptoms that are not witnessed by other health-care professionals,
  • Predictable relapses occurring just after an improvement,
  • Extensive knowledge of hospital procedures, policies, and/or medical terminology,
  • Multiple surgical scars,
  • Secretly injuring child to fake test results,
  • New or additional symptoms that appear following negative test results,
  • The child’s symptoms don’t agree with test results,
  • Symptoms occur only when the child is with others or being watched,
  • Unusual eagerness for the mother to have numerous medical tests, operations, or procedures,
  • History of seeking treatment in different cities at hospitals, clinics, and doctor’s offices,
  • More comfortable being in a hospital than at home,
  • The child improves in the hospital but gets worse at home,
  • Reluctance for the mother to allow doctors to talk with family, friends, or prior doctors,
  • Mother’s self-esteem seems to be based on being sick,
  • Blood samples in the lab may not match the child’s blood,
  • Signs of chemicals in the child’s blood, stool, or urine,
  • Family history of unusual illnesses or deaths of children in the family.

What symptoms does the mother have? The mother might be a health-care provider who is already familiar with the health-care system. They are usually friendly and cooperative with nurses, doctors, and suggested tests and treatments. They appear to be overly concerned for their child and at times greatly distraught. The mother might even have Munchausen syndrome herself.

Why would a person do this? Usually, there is some type of gain to the mother for faking the illness, it might be a conscious intention or unconscious. For instance, by having her child be the victim of an illness, a person might gain attention, financial support, gifts, or sympathy. Although in most cases, this is not financially motivated, rather is attention-seeking behavior. The mother often appears to be very loving and concerned for the child and their treatment. Unfortunately, as in the case mentioned above, in order to continue receiving support, the mother might harm the child through poisoning, suffocating, and starving resulting in death.

What is the cause? While there is no known cause for MSP, it is seen predominantly in mothers with an underlying personality disorder. The need for attention is met when others (friends and family members) express sympathy for the child’s physical illness. This reinforces the idea that by having a severe illness, the mother and child can gain even more attention. Other causes in the mother might be found in a traumatic experience in childhood, extensive hospitalization as a child, neglectful parenting, or helicopter parenting.

What is the treatment? The most important factor is to rule out any and all physical disorders, conditions, or diseases. A medical doctor is usually the one to refer the person to therapy after it is determined that there is no underlying illness. Talk therapy is highly effective in the treatment of Munchausen and MSP. A trained therapist can identify the causes of the disorder, suggest more appropriate coping mechanisms, and teach the management of expectations, thoughts, and emotions. In some cases, the child might have to be removed from the mother’s home before they can get better. Often child services are involved due to the abusive nature of MSP.

The case of Olivia and her mother is on-going so the exact determination of what happened might take years to uncover. If you suspect that a child is the victim of MSP, it is critical that the state’s child services be informed to get them help.

What is Munchausen Syndrome by Proxy?

Christine Hammond, MS, LMHC

Christine Hammond is a leading mental health influencer, author, and guest speaker. As an author of the award-winning “The Exhausted Woman’s Handbook,” and more than 500 articles, Christine has more than one million people downloading her podcast “Understanding Today’s Narcissist,” and more than 400,000 views on YouTube. Her practice specializes in treating families of abuse, and trauma, with personality disorders involved which are based on her own personal experience. Her new book, Abuse Exposed: Identifying Family Secrets that Breed Dysfunction will be published in 2020. Christine is a Licensed Mental Health Counselor and Qualified Supervisor by the State of Florida, a National Certified Counselor, Certified Family Trauma Professional, with extensive training in crisis intervention and peaceful resolution. Based in Orlando, you may connect with Christine at Grow with Christine (


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APA Reference
Hammond, C. (2019). What is Munchausen Syndrome by Proxy?. Psych Central. Retrieved on July 6, 2020, from