Premium
The Inpatient Psychotherapy of a Mother and Child at the Cassel Hospital: A Case of Munchausen's Syndrome by Proxy
Author(s) -
Coombe Paul
Publication year - 1995
Publication title -
british journal of psychotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 17
eISSN - 1752-0118
pISSN - 0265-9883
DOI - 10.1111/j.1752-0118.1995.tb00806.x
Subject(s) - munchausen syndrome , psychoanalytic theory , psychology , psychiatry , child abuse , projective identification , psychotherapist , suicide prevention , poison control , medical emergency , medicine
This account of the inpatient psychoanalytic psychotherapy of a mother and child at the Cassel Hospital, London is of a serious case of so‐called ‘Munchausen's syndrome by proxy’. The mother presented two of her children to medical staff with complaints which were later found to be due to her chronic poisoning of them, by salt administration, which narrowly missed causing their death. It is an account of a treatment using both individual and group analytic methods in a psychoanalytic therapeutic community. Attention is drawn to the mother's use of projective identification defensively and malignantly in a concrete fashion and its gradual conversion into a more benign agent. The function of the institution as a container is described, and comment is made on the experience of working with severe cases of child abuse.