Reader’s Question

I make up illnesses for sympathy. I pretend to have sprained my arm, or to have gotten stitches. I might just go and buy ace bandages or gauze and pretend that something’s wrong. If anybody asks to see my fake wounds, I come up with an excuse.

I have no idea why I do this and hate it.

Our Clinical Psychologist’s Reply

There are several kinds of labels given to behaviors that involve feigning or exaggerating illness. And such behaviors can sometimes rise to a level of intensity and frequency that constitutes a true mental condition or disorder.

Factitious Disorder is a condition that involves a pattern of intentionally fabricating illness or exaggerating the circumstances of a condition to elicit sympathy, nurturing, and attention from others. When such fabricated illnesses are applied to a dependent child or other person, the disorder is termed Factitious Disorder by Proxy. In either case, the motivation is to secure attention and sympathy by assuming the sick role.

An older term for Factitious Disorder is Munchausen’s Syndrome (which can also occur by proxy). This term is still sometimes used to describe factitious circumstances in which a person falsifies medical records, greatly magnifies problems, or even takes some action to cause some degree of injury in order to secure medical attention and the involvement of medical professionals. Factitious Disorder is also distinguished from malingering, which is not considered a psychiatric condition per se but is a deliberate attempt to secure some identifiable gain by feigning illness (such as trying to secure disability payments by falsely claiming a malady or grossly exaggerating symptoms).

There are no definitive or reliably effective treatments for Factitious Disorder, and there are no clearly identifiable causes for it. Indeed, there can be several variables at play in the creation of this disturbance.

The leading treatments for Factitious Disorder involve the use of medications to help stabilize mood and improve impulse control, and psychotherapy to help address personality dynamics and other factors that might be contributing to the behavior. The ultimate goal of treatment is to improve control over symptoms as well as attend to any underlying factors.

Because individuals with Factitious Disorder (or persons exhibiting a pattern of feigning illness not rising to the level of a true disorder) are often not distressed by their behavior pattern, they don’t typically seek or remain invested in treatment. Individuals distressed by their behavior pattern who wish make a change in their manner of coping and are invested in and compliant with treatment efforts are thought to have a better prognosis.