THE BLOG OF
DR. JOSH C. SIMMONS.

I AM A MUNCHAUSEN BY PROXY SURVIVOR

16 MIN READ

If the Dutch angle was ever appropriate for one of my essay photos, it's this one. Photo is from a solo trip I did up California's Highway 1 sometime around 2015 or 2016

It's summer, I'm driving northbound on I-15 through Northern Arizona and it hits me hard. The phrase “Munchausen by Proxy” is uttered and explained on the Dr. Drew After Dark podcast. My wife is sitting next to me, I jokingly say, “huh, that explains my childhood” and laugh. Maintain composure — behave normally and the mind will fall in line — this is a mantra I've been living out for my entire adult life. Fate has ordained this moment for the phrase to be spoken on this podcast at this exact moment in my life. Multiple chemical reactions begin inside of my brain as the cascading effects of this trigger word spiral out through all of my body's systems. Intellectualization, my preferred defense mechanism, is insufficient, I feel the words in my body despite my best efforts not to.

I keep my head facing forward and I keep driving as I get that weird feeling like I'm floating outside of my body. I feel the need to pull off to the side of the road and take a moment. I silence it aggressively as the world around me starts to take on a surreal, druglike quality. I keep my head facing forward and I keep driving just like I always have. Some sick part of me, the part that pushes it back down says I can't stop now and that I need to keep going. Stopping is death. Taking your foot off the gas means all of those things left scattered behind on the road are going to catch up with you. You can't face them or else you already would have, you're good at running, running works, stick to that. I can't remember the last time I took a moment. That muscle is so atrophied I don't even know if it works anymore. The healing of my body began at this moment. The San Francisco Peaks come into view over the highway, but they're real far away.

I've rewritten this essay six seven eight times now mostly from scratch. The essay is not perfect yet but part of me still thinks it can be. I am nervous to post it. Criticism buzzes around my head as I structure the thoughts for another attempt at willing it into existence — what if people don't believe me, what if my parents read this, what will current and future coworkers think of me, is it bad for my career to be open about these things, will friends that didn't know look at me differently, as a weak or f••••• up person?

This time This time will be different. I am able to articulate the following reasons that make me brave enough to publish this essay (despite the doubts I'm having) after this this rewrite.

  1. I have dropped enough of the shame around being an abuse survivor that, although I feel a bit shy publishing this essay, I feel overall positive about sharing the experience. If you were to tell me it's not masculine, not professional, or “a bad idea” to share my experience as many have - I would traditionally question myself and feel a lot of shame about it. Nowadays, I would just feel bad for you that you have to put people in such neat and tidy boxes. At first I let go of thinking I have anything to be ashamed about, recently my body let go of feeling like I have anything to be ashamed about.

  2. There are virtually no resources for Munchausen by Proxy (a term I'll define later) survivors. It is an extremely lonely path. We don't have support groups. It's my hope that somehow this article becomes somewhat Google-able so that other survivors know that they're not the only ones. An essay like this would have made me feel much less isolated during the early stages of my healing.

  3. Being honest in my life seems to guide me to exactly where I need to be. Sometimes, not always, that means talking about difficult and otherwise private matters. These topics can often be divisive so I only broach them when I feel like there's adequate reason to. The imperativeness of speaking on these topics overrides the potential risk of divisiveness and the fallout that this may cause. Being public about this feels like something I'm being guided to do by a benevolent part of myself. It feels like a part of the healing. This doesn't absolve the professional concerns I've had surrounding publishing this, but it puts them properly in perspective.

  4. There are few resources that deal authentically with mens' mental health — society casts it aside in general despite it being a massive issue by-the-numbers.1 Culture has normalized women-only groups and spaces but has progressively vilified mens mental health and traditionally male spaces.2 3 4 5 I posted my last essay on a few forums and was actually flamed the most for suggesting it was positive that a politician spoke briefly about mens' issues (misogynist, toxic, etc., the usual). It often seems like a societal inconvenience to be a man and to do things that are traditionally masculine.

  5. Jennette McCurdy gave me the last push I needed. Somewhere between rewrites two and three I read her new book titled I'm Glad My Mom Died. It was brave of her to share her story as a victim of abuse at such great personal risk. Although my maladaptive coping mechanisms were never disordered eating as McCurdy's were, I strongly identified with a lot of the patterns in the book, and felt like many of the scenes of abuse from her childhood could have had the names changed and been a pretty good account of my own. I felt less alone after I read it. I'm hoping I can pay that forward, especially for MBP survivors.

Munchausen by Proxy

Munchausen by Proxy (also known as Factitious Disorder Imposed on Another, or FDIA) is a form of abuse and/or neglect in which a caregiver (usually the mother of a young child) fabricates, exaggerates, or induces illness in their victim for the purposes of attention and sympathy from medical professionals and/or those in their community. It may be the deadliest form of child abuse, with a fatality rate estimated to be between six and nine percent in published reports. Munchausen by Proxy, or MBP, is underreported, so it is difficult to know how many children are victimized by this type of abuse each year.6

I am an abuse survivor. I was abused medically, physically, and emotionally.

The primary abuser was my mother. As with most MBP abusers, she likely also suffered from Munchausen Syndrome - a mental disorder in which the afflicted fabricates their own various imaginary illnesses to gain sympathy from those around them. This is distinct from hypochondriasis in that the afflicted knows that they are not sick, whereas a hypochondriac erroneously believes they are sick. To date my mother has been "unable to work" for nearly a decade due to various illnesses, each one more rare and esoteric than the last.

I've decided to not go into a lot of detail about the abuse. If you're a survivor and want to talk about it I am open to that — please reach out, it can be very isolating. Explaining too much here would only foster one of these outcomes.

  1. Adds some depth to the essay. I can sacrifice this to avoid the other outcomes.

  2. Readers enjoy it as “abuse porn”, or it cheapens the essay by adding a shock factor. There's plenty of that in almost every Hollywood movie right now and it's not what I want to contribute to the world.

  3. Readers who are skeptical of my claim use the details of the account to invalidate the fact that I was abused. I don't need anyone else to believe what happened because I was there for all of it, but it feels bad to have people try to logic away your abuse. If this seems like an out-of-left-field possibility then you don't understand how uncomfortable most people are talking about abuse — many would rather substitute any fiction than believe that “ordinary people” are capable of such horrors. Learning how prevalent this viewpoint is has truly been one of the darkest things I've learned about humans.

  4. I divulge personal health information that can be used to harm me.

Here is the most detailed rundown I'll give. I was physically abused by being hit, locked in closets, and many other means in that vein. My mother coached me to fake symptoms and say certain things to doctors to get specific kinds of treatment. I underwent multiple major unnecessary surgeries each with months-long recovery periods afterwards. They were excruciatingly painful. I was put on very strong medications constantly including those usually prescribed to elderly and terminal patients. Apart from the mental and emotional fallout of the abuses I sustained, I currently, and will perpetually deal with two permanent health conditions that were directly caused by the medications I was forced to take as a child. It was known by the medical professionals that prescribed these medications that there was a nontrivial probability that the drugs would cause these two permanent health issues. I assume this was discussed with my parents before prescribing the medications. Enough details.

Starting

The concept in McCurdy's book that resonated with me the most was that she never thought anything was “wrong” or “off” about her childhood until much later in life. I knew my childhood was strange but I had built up so many years of rationalization around why things were the way they were. It's a common misconception that this falls into the category of a “repressed memory” and actually I had a close friend accuse me of this when first coming to terms with what happened. In my case, as with most abuse survivors, the memories never went anywhere. I never forgot anything. There was only a part of me that was always acting to rationalize these memories as “a normal part of childhood”.

Recognizing abuse isn't like it is in the movies. Everything doesn't just snap back to normal. Even the process of recognizing what happened takes time — it took years to rationalize what happened as “normal”, it logically follows that it might take more than an instant to unfuck that amount of rationalization.

Before that revelatory drive up I-15, I was no stranger to therapy. Even though now I know I have C-PTSD7 I had been diagnosed and tried various treatments for numerous conditions including Generalized Anxiety Disorder and Panic Disorder. I don't fault any of the psychologists for diagnosing me with those issues — whenever they asked me about my childhood I'd smile and say, “It was pretty normal”. These treatments — mostly CBT and talk therapy, provided me relief from some symptoms but I had an intuition that they never got at the root of the issue, they were reactionary methods — it felt more like a hotfix than an authentic rewriting of the errant code in my brain. Hearing someone else talk about Munchausen by Proxy was what I needed to start untangling the mess.

Stagnation

I started to get angry at things so easily that fall. Never at others, always at myself, and always intensely. I would become furious when the slightest thing went wrong while assembling IKEA furniture alone — everyone knows that when couples fight over furniture-building, it's never about the furniture building. When you begin to intensely hate yourself while assembling a PINNIG coat rack with shoe storage bench, you realize that it's not about the PINNIG, the PINNIG was just a Swedish mirror that showed you a reflection of yourself.

The stakes increased. My wife and I had been trying for a baby, and God blessed us with one at the exact moment we were meant to have one — we found out one evening after a dinner out that same fall. I was excited, mission accomplished, we had been trying for a while, not long enough to be concerned, but long enough that it felt like an earned achievement.

I worked diligently with a talk therapist. I had some realizations about myself and got a clearer picture of what happened and how it affected me but I wasn't getting angry or anxious any less. I also wasn't getting angry or anxious any more. I didn't care enough to go deeper. I wasn't ready to drop my armor and get at the root of the problem yet.

Having a Daughter Saved My Life

We moved to a new town. Somewhere around the beginning of the second trimester I could tell my body was realizing that it had helped make a child and that the child was growing. I knew this because I was having a lot of emotions, up until then, I never had very many emotions, certainly not any new ones. The ultrasound pictures looked much more like a human. A massive shift occurred in me — I started to feel a new kind of love towards my daughter. I don't have words to explain it still. It is a transcendent kind of love. I started to feel that I would do anything for my daughter.

My mind wandered during the idle times of the day and images emerged of a future life with my daughter and my wife — my family. Naturally my brain started to compare and contrast these feelings to my own upbringing. I felt panic creep up my chest whenever my mind would try to hold the two images in parallel — there was too much cognitive dissonance. Thinking about treating my daughter how I was treated as a child — subjecting her to the intense pain of surgery when unnecessary, locking her in closets, made me physically ill.

I knew I would do anything to protect my daughter from harm. It would be my responsibility, my duty. How could I protect my daughter if I couldn't even protect myself? If I am compromised, my daughter is more vulnerable. I thought it was a demon living inside of my head but it was a part of me that thought it was protecting me. This part of me thought that I was still a child. It thought that if it just made me be perfect and quiet, mom wouldn't kick me out of the house again. I was grateful to that part of me, it helped me survive the worst years, it got me far away from Ohio, but it wasn't helping me anymore. Paradoxically, I needed to drop this armor to better protect my daughter, to better protect myself.

The gift that my daughter gave me was the experience of pure love. I hadn't even seen her with my own unaided eyes yet and she had transformed me. She allowed me to see what was wrong in a way that I could not look away - I had been too scared to look my trauma in the eyes before but Caroline gave me the strength I needed to do it. I was living a lie. I was driving for decades without stopping, terrified that looking in the rearview mirror would put me back in That Place. I was “recalled to life”.

Healing

I'm not healed but I'm a lot more healed. I take care of myself because I've done a lot of work on repairing my relationship with my self. I rarely get angry now. I'm getting pretty good at recognizing when I'm having a flashback and giving myself what I need instead of forcing myself to keep working. I've been able to make a lot of new friends because I'm less scared to open up. I've lost some friends that didn't like how much I've changed in the past year. I picked up some old hobbies that I had to suppress because my parents didn't like them. I bought a big red pickup truck because I always wanted one as a child (I can feel my inner child beaming every time I get in it). Sometimes I buy myself M&M minis at the gas station because I liked them as a child (I'm at the gas station a lot on account of the aforementioned truck).

I have been doing EMDR with a trauma therapist to reprocess the emotions around my traumatic memories. I thought it was a bit woo-y but there's plenty of clinical evidence for its efficacy, I saw it rapidly heal a close friend before, and I had tried most other approaches to not-much-avail. The progress and emotional intensity of those sessions has been one of the most spiritual phenomena I've ever experienced. The first time I recall a traumatic memory in-session it brings up tension. The tension gives way to grieving. There are sometimes tears, usually a lot of them. Sometimes unrelated sensations come up like giggling. By the end of the session when I recall the memory it's like watching a movie. I wish it didn't happen but I acknowledge that it did. I no longer feel overwhelming sensations in my body when I recall the memory. Each time I process a different memory I feel safer. As I feel incrementally more safe, I feel like I don't need to keep driving so fast.

Yoga has been an important part of my healing process. I was only able to identify the way a few emotions felt in my body up until this spring — now I can feel a lot more. I was fortunate enough to have done enough of this work that I happy-cried a lot when Caroline was finally born. I'm proud of myself that I was able to be there emotionally instead of shutting down, as is my usual M.O. for highly emotional situations.

I'm not "cured". I don't think that's where this road is headed and honestly that's not where I want to go. Cured is a bullshit destination that the perfectionistic part of me wants to go to. For the first time in my life, the GPS isn't set - at least not in the usual way. I have goals, places I want to go, but I'm going there now because I want to, not just because it's the furthest point on the map from what's chasing me. This approach leaves ample time for detours and curiosities, which often end up being better than the destination anyways. Maybe I'll be less of a good programmer, less of a good artist, I don't know how this all shakes out. The one thing I do know for certain is that I'll be less scared and more present for the people that need me.

Footnotes

  1. Men are more likely to be homicide victims, incarcerated, have chronic disease, become addicted to drugs and alcohol, and die deaths of despair. I'll reiterate as I stated in the last essay - I am not saying that womens-specific issues are not important, only that we don't give enough (equal) attention to mens's issues. Criticize away, I will never back down from this point. ↩

  2. Opinion: Hate football? Or maybe the real problem is maleness - Los Angeles Times ↩

  3. Are man caves sexist? | The Independent | The Independent ↩

  4. Girls can now join Boy Scouts — but not everyone is prepared to like it | CNN ↩

  5. Veterans Affairs says worker ‘inappropriately' discussed medically assisted death with veteran ↩

  6. Munchausen by Proxy | Dr. Marc Feldman ↩

  7. I often use this interchangeably in my writing with “PTSD” even though they're slightly different disorders. I do this because nobody knows what C-PTSD is. The bottom line is that it's similar to PTSD but it's generally caused by a shitload of traumatic experiences as opposed to just a one-off, situational event like surviving a car crash. ↩

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