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Demystifying Munchausen’s Syndrome By Proxy

VCU CNS | May 2, 2019

Topics: child abuse, elder abuse, Gypsy Rose Blanchard, Mommy Dead and Dearest, Munchausen's Syndrome By Proxy, The Act

After multiple films have drawn attention to the case of Gypsy Rose Blanchard, awareness of Munchausen’s Syndrome By Proxy is growing. But the details are still only vaguely understood by most.

Recent programs such as Hulu’s The Act and the HBO documentary Mommy Dead and Dearest have introduced audiences to a dangerous and often overlooked phenomenon: Munchausen’s syndrome by proxy.

It is a mental health problem in which a caregiver causes an illness or injury to a vulnerable person – often a child. The disorder is difficult to diagnose and treat. Here are key facts about Munchausen syndrome by proxy, or MSBP.

What is it?

The symptoms of MSBP manifest as child or elder abuse, depending on the circumstances. Officials at the National Institutes of Health describe MSBP as “a special form of child abuse in which an adult repeatedly produces symptoms of illness in a person under his/her care.”

Health professionals distinguish MSBP from Munchausen syndrome, a condition in which people intentionally harm themselves or purposely self-induce illness to satisfy a desire to be cared for. With MSBP, the perpetrator (often a mother) will inflict such symptoms on a child or elder as a way to inspire sympathy from others.

The methods used to garner such attention from others can range from simple lies about an illness to actual physical harm — even poisoning — of the victim.

Health officials say the victim may have been initially healthy but face the risk of becoming seriously ill or even dying in the care of someone with MSBP.

Studies cited by the NIH report a mortality rate between 6% and 10% for MSBP victims, making it one of the “most lethal forms of abuse.”

The current medical term for such an illness is Factitious Disorder Imposed on Another, although it is more commonly referred to as MSBP. The phenomenon is relatively rare in the U.S. — making up just 1,000 of the approximately 2.5 million cases of child abuse reported annually.

Health experts said it is notoriously difficult to identify and properly treat Munchausen’s syndrome by proxy. People with the disorder are known to be great liars and master manipulators.

One method they use is to alter medical tests and results to make it seem as if the person in their care is sicker than they truly are. People with MSBP can get away with this, health experts say, because they often are familiar with medical terms and concepts.

This could explain why many cases of abuse caused by people with MSBP can go undetected by medical staff and law enforcement for long periods of time.

Online organizations such as the Munchausen Syndrome by Proxy Survivor Support and Awareness Group on Facebook provide those affected by MSBP with a community to vent and to heal.

Cases in Virginia

Two cases of MSBP involving young mothers in Virginia have been publicized in recent years. In both instances, the perpetrator was arrested on child abuse charges.

One case involved a 23-year-old woman whose 3-year-old son was being treated in 2016 at the Children’s Hospital of the King’s Daughters in Norfolk for “ongoing medical issues.”

The woman was arrested after video surveillance from her son’s room showed the young mother allegedly detaching medical equipment being used to give the boy vital medicine. The judge overseeing her case said there was reason to believe the woman gave doctors false information about her child’s medical records.

Earlier this year, 29-year-old Elizabeth Malone admitted to purposely poisoning her 5-year-old son with syringes of her own blood while he was being treated at Inova Fairfax Hospital last spring. She said she did so because she “liked the way staff responded to him once he was bleeding.” Video footage from a security camera shows Malone injecting blood into her son’s IV line and tracheostomy tube.

Had she not been caught, according to doctors, it is likely that her child would have died from the injections, which resulted in high fevers and infections. Malone, who has two other children, will be sentenced in July.

Gypsy Rose Blanchard: Stranger than Fiction

Such an illness may seem too bizarre to be true, but the disorder can result in major consequences, for both the caregiver and patient. No case may demonstrate this better than the conviction of Gypsy Rose Blanchard for the murder of her mother Dee Dee.

The Blanchards, who lived in Greene County, Missouri, are the subject of The Act and Mommy Dead and Dearest.

Dee Dee Blanchard’s MSBP was reportedly so severe that she forced her daughter Gypsy to use a wheelchair, despite knowing that the girl could walk without difficulty.

Dee Dee lied to Gypsy about her age, telling her she was 14 when she was actually 18 or 19. She also told doctors Gypsy had the mental capacity of a 7-year-old. This allowed the mother to keep Gypsy under her control for as long as possible.

Dee Dee reportedly used manipulation and medical jargon to keep her daughter powerless. She shaved Gypsy’s head and told her, and others, that she had leukemia. As a young girl, Gypsy’s salivary glands were removed at the insistence of her mother, and the child required a feeding tube.

Dee Dee also made Gypsy use a breathing machine while she slept. This combination of feigned illnesses rendered Gypsy a hostage in her own home.

After conspiring with a man she met online named Nicholas Godejohn, the two came up with a plan to murder Dee Dee. Godejohn stabbed Dee Dee to death before the pair fled to his Wisconsin home and were soon tracked down by the police.

Godejohn was found guilty of first-degree murder in 2018. He will spend the rest of his life in prison.

Gypsy pleaded guilty to second-degree murder in 2016. She was sentenced to 10 years in prison and will be eligible for parole in 2024.

Written by Serena Fischer, Capital News Service. Photo via CNS

Virginia Battles a ‘Crime that Hides in Plain Sight’: Human Trafficking

VCU CNS | May 9, 2018

Topics: attorney general mark herring, backpage, child abuse, Child Protect Team at Children’s Hospital of Richmond at Virginia Commonwealth University, General Assembly, Hampton Roads Human Trafficking Task Force, human Trafficking, human trafficking in Virginia, ImPACT Virginia, International Labor Organization, National Center for Missing and Exploited Children, Polaris Project, sex traffic victims, sex trafficking, sexual assault

RICHMOND – Robin Foster had worked with abused and neglected children for years, but it wasn’t until she came face to face with a trafficking victim that she fully recognized the dimensions of the crisis that brought a 17-year-old to a hospital emergency room early one morning.

The teen came to the hospital complaining of a sore throat but ran off when Foster tried to call her mom for permission to treat her.

“I chased her up the street at 1 in the morning,” Foster recalled.

Foster, who heads the Child Protect Team at Children’s Hospital of Richmond at Virginia Commonwealth University, said she later learned from police the girl had run away from her group home in Northern Virginia and was being trafficked by a man in a hotel in Richmond.

Human trafficking – a $150 billion global criminal enterprise, according to the International Labor Organization – is increasingly on the radars of law enforcement, politicians, and non-profits across the country. Statistics show the problem is worse in Virginia, and in the Richmond area, than in many other states and localities.

In 2017, Virginia ranked 15th in the United States for the most reported cases of human trafficking for sex and cheap or free employment. Last year, the state reported 156 cases, and 70 percent of those were sex trafficking, according to the National Human Trafficking Hotline.

Richmond ranked ninth nationwide in the number of calls per capita to the hotline, according to the organization’s 2017 report on the 100 most populous U.S. cities. Virginia Beach ranked 71st for calls per capita and Norfolk was 77th.

The Richmond region’s location at the junction of Interstates 64 and 95 makes the area an attractive place for traffickers, as does its large tourism and hospitality industry, says the Richmond Justice Initiative, a faith-based, anti-trafficking group.

While there is not an official estimate on the number of trafficking victims in the United States, the Polaris Project, a non-profit nongovernmental organization that runs the hotline, estimates the number to be in the hundreds of thousands.

Last month, President Donald Trump signed a bill giving federal and state prosecutors greater power to pursue websites that host sex-trafficking ads and enabling victims and state attorneys general to file lawsuits against those sites.

Trump’s action came a few days after several executives from the website Backpage.com were arrested on 93 indictments including knowingly facilitating trafficking through their website and allegedly laundering millions of dollars. The deaths of some trafficking victims have allegedly been linked to the website.

However, critics of the bill say it conflates legitimate and willing sex work with forced trafficking.

“I think it’s ridiculous that the two are being compared because the key difference is that trafficking victims cannot choose to stop working, they are not being empowered by what they do like sex workers are, and it (the bill) doesn’t address the reasons why people are being trafficked,” said Fay Chelmow, founder and director of ImPACT Virginia.

Chelmow founded ImPACT, a nonprofit fighting to prevent and end the sex trafficking of children, in May 2015 after reading the U.S. Department of Education report, “Human Trafficking in America’s Schools.” Chelmow said she was alarmed to learn how vulnerable youth are lured into the commercial sex industry by traffickers who scout middle and high schools.

“There still needs to be more advocating work around simply educating people that this is an issue in the first place because trafficking is very profitable,” said Chelmow, a registered nurse since 1984 and a former hospice and palliative care nurse in Boston, Massachusetts, before moving to Richmond in 2010. One of the reasons trafficking is so lucrative for criminal perpetrators, she said, is that they can sell the same person “over and over and over again.”

Human trafficking “is a crime that hides in plain sight,” said Charlotte Gomer, press secretary for Attorney General Mark Herring. “It is very difficult to identify victims and prosecute traffickers. Trafficking is about supply and demand and, unfortunately, as long as there is a demand for commercial sex and cheap or free labor, human trafficking will continue to exist.”

She said the attorney general’s office works with the city of Richmond and Henrico and Chesterfield counties to provide training, resources, victim services and operational assistance to combat trafficking.

During this year’s General Assembly session, Herring won passage of legislation that will make it harder for people who are charged with trafficking-related crimes to post bail – essentially placing a presumption of no bond for such offenses.

Del. Michael Mullin, D-Newport News, cosponsored the legislation with Del. Dawn Adams, D-Richmond. Mullin, who works as an assistant commonwealth’s attorney in Suffolk focusing on sexual assault and gang-related cases, said that fighting human trafficking transcends partisan politics. The bill passed the House and Senate unanimously and has been signed by Gov. Ralph Northam.

“This is a bipartisan issue and something everyone seems to agree we need to work on,” Mullin said in a statement earlier this year.

Gomer said Herring has been working to combat human trafficking since he took office in 2014. In early 2017, Herring signed a memorandum of understanding creating the Hampton Roads Human Trafficking Task Force, a partnership involving his office, the U.S. Department of Homeland Security, the U.S. Attorney’s Office, Virginia State Police and Hampton Roads law enforcement agencies, and Samaritan House, a Virginia Beach nonprofit that provides emergency shelters for domestic violence victims and homeless families.

Advocates Press for Prevention and Solutions

At Children Hospital, Foster said the biggest medical roadblock when helping child human trafficking victims is finding them a secure place, away from their exploiters.

“Where do you place these kids? So what if you recognize that they’re victims? You can’t discharge them home, so where are we putting them? A lot of the time they have drug dependency so they might have to stay in the hospital to make sure they don’t have to go through drug withdrawal,” Foster said.

Foster said helping victims is even more difficult in the case of family-controlled trafficking.

Elisabeth Corey, a survivor of family-controlled child sex trafficking and abuse, recounts those experiences in her advocacy and book, “One Voice.” She said that her encounters with domestic violence and incest began when she was 2 years old and that after years of familial sexual abuse, her father began selling her.

Corey said her parents were highly involved in medical appointments, but answered the doctors’ questions with lies. For example, Corey said she was seen frequently at a young age for urinary tract infections, but her mother told nurses it was a result of bed-wetting. Corey said that should have raised alarms because bed-wetting is a symptom, not a cause of urinary tract infections. Likewise, she said the frequency she was being seen by doctors should have raised concerns.

“It was mind-blowing they would just trust what my parents said,” Corey said. “When I was being trafficked, they (medical professionals) weren’t even addressing domestic violence – so no one even had a word for trafficking, no one was even looking for it.”

It wasn’t until Corey had severe pelvic pain during a sleepover that red flags were raised. A neighbor took Corey to the emergency room after being unable to contact her parents.

Doctors alerted child protective services officials, who placed Corey in foster care in Northern Virginia.

“Foster care was so bad – I was getting raped in foster care – that I rescinded my story so that I could go back home,” Corey said. “I literally preferred my home to the foster care environment.”

In 2016, the National Center for Missing and Exploited Children estimated that one out of six runaways might be children sex traffic victims and that the vast majority of those runaways had been in foster care or social services care.

Foster credited the work of Chelmow and others in drawing attention to the victimization of children by traffickers. Ten years ago, she said, the problem and strategies to fight it were “totally off the radar.” There is more awareness overall, she said, with information being placed in “schools, hospitals, airports, at bus stations – critical points people are being trafficked.”

The role of the federal government, at the same time, has helped reshape the fight against trafficking, Foster said, as has the view that “the trafficked person is a victim and not part of the problem.”

Still, many problems remain, especially among higher-risk populations – minors in the foster care or social services systems; the homeless, young people with a history of running away; and LGBTQ youth.

LGBTQ youth “are already so marginalized, and it’s all about exploiting vulnerability,” Chelmow said. “Being marginalized makes you even more vulnerable.”

Despite the wide variety of backgrounds from which young people can be trafficked, Corey said, there are common elements in identifying the abused.

“I work as a life coach all over the world, and it’s almost scary how everybody, regardless of how similar experiences are, reacts to trauma the same way,” Corey said. “We really have to get away from the idea that trafficking is in a silo because it’s not.”

Authorities investigating human trafficking should be ready to consider issues ranging from emotional abuse to financial problems, she said.

According to Foster, among the signs that medical professionals can look for is the presence of someone who is not related to the person seeking help but who acts as if they are – for example, “someone who is like an uncle but won’t really act or look like an uncle.”

Other signs include anxious behavior from a patient, the inability to speak for themselves, sexually transmitted diseases and pregnancy. Foster said practitioners should also be aware of excuses used to justify physical trauma and the possibility that any overdoses were done with the intent to commit suicide.

Some of these problems may also be seen by teachers, Corey said.

“I know, we already ask our teachers to do a lot, but they are the first responders to spotting this because they see the children every day,” Corey said. “Another solution is asking survivors what they need and what other survivors need, because we know our experience and solutions need to be trauma-informed.”

However, Corey is aware that finding survivors who are willing to speak out can be difficult due to threats to their safety from their abusers.

“Another reason they don’t come forward is that people who are trafficked have been manipulated into thinking this is their choice and it’s their fault, and they don’t know what trafficking is or what its definition is,” Corey said. “Another side of it, and this is true for me, is that they disassociate and repress the memories.”

A major part of Corey’s work as a life coach and running her website beatingtrauma.com revolves around addressing how trauma manifests through memory loss. She left home at 18, but it was not until the birth of her children in her 30s that she remembered the trafficking and other forms of physical and sexual abuse she experienced.

“There were years of me going to Christmases and events with my family before I remembered the abuse,” Corey said. “I remember always feeling angry around them and like something was not right and I couldn’t name exactly what it was, but my children reminded me of what had happened. A lot of times, children will remind survivors of their own trauma.”

Corey is no longer in contact with her family. She said avoiding the generational cycle of abuse is difficult, but possible.

“I believe that anyone who abuses their children was also abused as a child, but that does not mean every person who was abused will then go on to abuse their own children,” Corey said. “There is a process to deal with the trauma and to address it.”’

Story By: Sophia Belletti and Siona Peterous via VCU Capital News Service

Bill would add those who ‘maliciously wound’ children to Virginia Sex Offender Registry

Amy David | February 9, 2016

Topics: child abuse, GA 2016, Sex Offender and Crimes against Minors Registry

RICHMOND – A Hanover County mother, whose son suffered brain damage and other injuries when he was abused by a man in 2010, urged state lawmakers Monday to expand who must be listed on Virginia’s Sex
[Read more…] about Bill would add those who ‘maliciously wound’ children to Virginia Sex Offender Registry

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