Munchausen by Internet
Munchausen by Internet is a pattern of behavior akin to Munchausen syndrome (renamed factitious disorder imposed on self), a psychiatric disorder, wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. In Munchausen by Internet, users seek attention by feigning illnesses in online venues such as chat rooms, message boards, and Internet Relay Chat (IRC). It is different from catfishing, where the person feigns an identity to seek attention by online dating. It has been described in medical literature as a manifestation of factitious disorder imposed on self, or if claiming illness of a child or other family member, factitious disorder imposed on another. Chronic manifestation of factitious disorder is often called Munchausen syndrome, after a book about the exaggerated accounts of the adventures of Baron Munchausen, a German cavalry officer in the Russian Army, that was written by Rudolf Erich Raspe. When the symptoms of another person, such as a child or an elderly parent, are purposely induced by the caregiver, it is called factitious disorder imposed on another, or Munchausen syndrome by proxy.
Feldman noted that the advent of online support groups, combined with access to vast stores of medical information, enabled individuals seeking to gain sympathy by relating a series of harrowing medical or psychological problems that defy comprehension to misuse the groups. Communication forums specializing in medical or psychological recovery were established to give lay users support in navigating often confusing and frustrating medical processes and bureaucracy. Communities often formed on those forums, with the goal of sharing information to help other members. Medical websites also became common, giving lay users access to literature in a way that was accessible to those without specific medical training. As Internet communication grew in popularity, users began to forgo the doctors and hospitals often consulted for medical advice. Frequenting virtual communities that have experience with a medical problem, Feldman notes, is easier than going through the physical pain or illness that would be necessary before visiting a doctor to get the attention sought. By pretending to be gravely ill, Internet users can gain sympathy from a group whose sole reason for existence is support. Health care professionals, with their limited time, greater medical knowledge, and tendency to be more skeptical in their diagnoses, may be less likely to provide that support.
Behavior patterns
People who demonstrate factitious disorders often claim to have physical ailments or be recovering from the consequences of stalking, victimization, harassment, and sexual abuse. Several behaviors present themselves to suggest factors beyond genuine problems. After studying 21 cases of deception, Feldman listed the following common behavior patterns in people who exhibited Munchausen by Internet:
* Medical literature from websites or textbooks is often duplicated or discussed in great detail.
* The length and severity of purported physical ailments conflicts with user behavior. Feldman uses the example of someone posting in considerable detail about being in septic shock, when such a possibility is extremely unlikely.
* Symptoms of ailments may be exaggerated as they correspond to a user's misunderstanding of the nature of an illness.
* Grave situations and increasingly critical prognoses are interspersed with "miraculous" recoveries.
* A user's posts eventually reveal contradictory information or claims that are implausible: for example, other users of a forum may find that a user has been divulging contradictory information about occurrence or length of hospital visits.
* When attention and sympathy decreases to focus on other members of the group, a user may announce that other dire events have transpired, including the illness or death of a close family member.
* When faced with insufficient expressions of attention or sympathy, a forum member claims this as a cause that symptoms worsen or do not improve.
* A user resists contact beyond the Internet, such as by telephone or personal visit, often claiming bizarre reasons for not being able to accept such contact.
* Further emergencies are described with inappropriate happiness, designed to garner immediate reactions.
* The posts of other forum members exhibit identical writing styles, spelling errors, and language idiosyncrasies, suggesting that the user has created fictitious identities to move the conversation in their direction. Online interaction has only been possible since the 1980s, steadily growing over the years. After analyzing several cases of online deception and interaction, social theorists Adam Joinson and Beth Dietz-Uhler write in a 2002 Social Science Computer Review article that deception on the Internet is a paradox: the faceless nature of online communications not only gives opportunity to the unscrupulous and attention-seekers, but also allows earnest users to express themselves more freely, representing a truer version of themselves. Typically, Internet deception takes the form of changing one's sex or presenting one's own idealized image of oneself. Joinson and Dietz-Uhler cite a chapter in Network and Netplay, in which researchers note the purpose of some forums is to allow their members to participate in a kind of online party, affording chances to pretend and perform: "the type of play on the Internet is usually allowed only in children or adults during masked balls or carnivals". More practical issues such as age, location, marital status, and occupation are also frequently changed online, or left ambiguous to preserve users' privacy or continue identity play.
Notable cases
Feldman's article in the Western Journal of Medicine was picked up by The New York Times in a story by Denise Grady, who described three cases of Internet forum members who were "incorrigible fakers". These include a woman with a professed eating disorder who posted to a support group saying she was reporting from an intensive care unit via her laptop computer, and claimed to have had a stroke while online, to be followed by her mother's posts declaring that she too had to be hospitalized; the original poster's father purportedly continued to update the online group. In another example, a teenager frequenting a forum for mothers with premature infants - some of whom had endured lengthy, expensive, and painful medical procedures, or had died - claimed to have given birth to a premature baby and expressed her fears for her own child, after which she received support and sympathy from the 400-member group. The teenager confided to the group that her baby had also died, and soon after returned to the forum to announce she was again pregnant and feared her baby would be premature, which it turned out to be; more frail this time than the first. Forum members eventually became unsympathetic with her vivid descriptions of surgeries and confronted her. Grady also addresses a similar confrontation that occurred when a man who claimed to be a monk with end-stage cancer posted long descriptions of his trials and struggles with facing death alone, eventually arousing the suspicions of other forum members who were not convinced someone so sick could correspond with so much vitality.
Internet venues unrelated to medical issues have also been the audience for such cases. A member of an online fan club for the musical Rent divulged numerous illnesses that caused her to slip in and out of comas, prompting some cast members to send sympathy cards. When other fan club members expressed their concern, even purchasing airline tickets to visit the sick woman, she reported that she had immediately improved. On May 16, 2001, Kaycee Nicole's death of an aneurysm was announced, shocking her readers and causing them intense grief. Soon however, Swenson caused skepticism in online communities. Although many cards and gifts had been previously sent, she refused to accept more. People began to learn that no one named Kaycee Nicole lived in Kansas, had been enrolled in schools, or admitted to local hospitals, and no obituary had been printed. After repeated questioning, Swenson posted that she had woven the stories of three cancer patients to create the character of Kaycee Nicole, who had never existed. Others disappear and simply stop posting, such as the monk who claimed to have cancer.
When confronted with inaccuracies or inconsistencies, those who are suspected of perpetrating fabrications may compound the deceit by accusing forum members of imposing greater stresses upon them, exacerbating their conditions, or worsening their depression. Users may employ sockpuppets—separate online identities controlled by the same person—to accuse other forum members of disloyalty and persecution, or support the user who is under suspicion.
Because no money is exchanged and laws are rarely broken, there is little legal recourse to take upon discovery of someone faking illness. However, a participant in a 7,000-member online support group brought a lawsuit against a website for defamatory language in 2005. The lawsuit followed heated discussion on the website about his dire predicaments and related crises, which seemed to contradict medical knowledge and his own accounts. The lawsuit was withdrawn after the presiding judge intended to allow cross-examination of the plaintiff's medical history.
Such dramatic situations often polarize online communities. Many members feel ashamed for believing elaborate lies, while others remain staunch supporters. Members who admit to feigning their conditions often respond by implicating the gullibility of forum members, suggesting that it is their own fault for being deceived. Feldman admits that an element of sadism may be evident in some of the more egregious abuses of trust. Pam Cohen, a grief counselor who witnessed the outpouring of emotion for Kaycee Nicole, likened the personal devastation resulting from genuine concern, sympathy, and support that forum members gave to the 19-year-old and her mother, only to discover that none of it was true, to "emotional rape". Adam Joinson and Beth Dietz-Uhler, in Social Science Computer Review, address deception perpetrated on some forums—specifically IRC and multi-user dungeons—and state that masquerading is so common that hoaxes are expected, and their perpetrators are sometimes even praised for creating realistic ones. In 2007 The LiveJournal forum reported that, of the deaths reported to them, about 10% were real.
Feldman noted that the advent of online support groups, combined with access to vast stores of medical information, enabled individuals seeking to gain sympathy by relating a series of harrowing medical or psychological problems that defy comprehension to misuse the groups. Communication forums specializing in medical or psychological recovery were established to give lay users support in navigating often confusing and frustrating medical processes and bureaucracy. Communities often formed on those forums, with the goal of sharing information to help other members. Medical websites also became common, giving lay users access to literature in a way that was accessible to those without specific medical training. As Internet communication grew in popularity, users began to forgo the doctors and hospitals often consulted for medical advice. Frequenting virtual communities that have experience with a medical problem, Feldman notes, is easier than going through the physical pain or illness that would be necessary before visiting a doctor to get the attention sought. By pretending to be gravely ill, Internet users can gain sympathy from a group whose sole reason for existence is support. Health care professionals, with their limited time, greater medical knowledge, and tendency to be more skeptical in their diagnoses, may be less likely to provide that support.
Behavior patterns
People who demonstrate factitious disorders often claim to have physical ailments or be recovering from the consequences of stalking, victimization, harassment, and sexual abuse. Several behaviors present themselves to suggest factors beyond genuine problems. After studying 21 cases of deception, Feldman listed the following common behavior patterns in people who exhibited Munchausen by Internet:
* Medical literature from websites or textbooks is often duplicated or discussed in great detail.
* The length and severity of purported physical ailments conflicts with user behavior. Feldman uses the example of someone posting in considerable detail about being in septic shock, when such a possibility is extremely unlikely.
* Symptoms of ailments may be exaggerated as they correspond to a user's misunderstanding of the nature of an illness.
* Grave situations and increasingly critical prognoses are interspersed with "miraculous" recoveries.
* A user's posts eventually reveal contradictory information or claims that are implausible: for example, other users of a forum may find that a user has been divulging contradictory information about occurrence or length of hospital visits.
* When attention and sympathy decreases to focus on other members of the group, a user may announce that other dire events have transpired, including the illness or death of a close family member.
* When faced with insufficient expressions of attention or sympathy, a forum member claims this as a cause that symptoms worsen or do not improve.
* A user resists contact beyond the Internet, such as by telephone or personal visit, often claiming bizarre reasons for not being able to accept such contact.
* Further emergencies are described with inappropriate happiness, designed to garner immediate reactions.
* The posts of other forum members exhibit identical writing styles, spelling errors, and language idiosyncrasies, suggesting that the user has created fictitious identities to move the conversation in their direction. Online interaction has only been possible since the 1980s, steadily growing over the years. After analyzing several cases of online deception and interaction, social theorists Adam Joinson and Beth Dietz-Uhler write in a 2002 Social Science Computer Review article that deception on the Internet is a paradox: the faceless nature of online communications not only gives opportunity to the unscrupulous and attention-seekers, but also allows earnest users to express themselves more freely, representing a truer version of themselves. Typically, Internet deception takes the form of changing one's sex or presenting one's own idealized image of oneself. Joinson and Dietz-Uhler cite a chapter in Network and Netplay, in which researchers note the purpose of some forums is to allow their members to participate in a kind of online party, affording chances to pretend and perform: "the type of play on the Internet is usually allowed only in children or adults during masked balls or carnivals". More practical issues such as age, location, marital status, and occupation are also frequently changed online, or left ambiguous to preserve users' privacy or continue identity play.
Notable cases
Feldman's article in the Western Journal of Medicine was picked up by The New York Times in a story by Denise Grady, who described three cases of Internet forum members who were "incorrigible fakers". These include a woman with a professed eating disorder who posted to a support group saying she was reporting from an intensive care unit via her laptop computer, and claimed to have had a stroke while online, to be followed by her mother's posts declaring that she too had to be hospitalized; the original poster's father purportedly continued to update the online group. In another example, a teenager frequenting a forum for mothers with premature infants - some of whom had endured lengthy, expensive, and painful medical procedures, or had died - claimed to have given birth to a premature baby and expressed her fears for her own child, after which she received support and sympathy from the 400-member group. The teenager confided to the group that her baby had also died, and soon after returned to the forum to announce she was again pregnant and feared her baby would be premature, which it turned out to be; more frail this time than the first. Forum members eventually became unsympathetic with her vivid descriptions of surgeries and confronted her. Grady also addresses a similar confrontation that occurred when a man who claimed to be a monk with end-stage cancer posted long descriptions of his trials and struggles with facing death alone, eventually arousing the suspicions of other forum members who were not convinced someone so sick could correspond with so much vitality.
Internet venues unrelated to medical issues have also been the audience for such cases. A member of an online fan club for the musical Rent divulged numerous illnesses that caused her to slip in and out of comas, prompting some cast members to send sympathy cards. When other fan club members expressed their concern, even purchasing airline tickets to visit the sick woman, she reported that she had immediately improved. On May 16, 2001, Kaycee Nicole's death of an aneurysm was announced, shocking her readers and causing them intense grief. Soon however, Swenson caused skepticism in online communities. Although many cards and gifts had been previously sent, she refused to accept more. People began to learn that no one named Kaycee Nicole lived in Kansas, had been enrolled in schools, or admitted to local hospitals, and no obituary had been printed. After repeated questioning, Swenson posted that she had woven the stories of three cancer patients to create the character of Kaycee Nicole, who had never existed. Others disappear and simply stop posting, such as the monk who claimed to have cancer.
When confronted with inaccuracies or inconsistencies, those who are suspected of perpetrating fabrications may compound the deceit by accusing forum members of imposing greater stresses upon them, exacerbating their conditions, or worsening their depression. Users may employ sockpuppets—separate online identities controlled by the same person—to accuse other forum members of disloyalty and persecution, or support the user who is under suspicion.
Because no money is exchanged and laws are rarely broken, there is little legal recourse to take upon discovery of someone faking illness. However, a participant in a 7,000-member online support group brought a lawsuit against a website for defamatory language in 2005. The lawsuit followed heated discussion on the website about his dire predicaments and related crises, which seemed to contradict medical knowledge and his own accounts. The lawsuit was withdrawn after the presiding judge intended to allow cross-examination of the plaintiff's medical history.
Such dramatic situations often polarize online communities. Many members feel ashamed for believing elaborate lies, while others remain staunch supporters. Members who admit to feigning their conditions often respond by implicating the gullibility of forum members, suggesting that it is their own fault for being deceived. Feldman admits that an element of sadism may be evident in some of the more egregious abuses of trust. Pam Cohen, a grief counselor who witnessed the outpouring of emotion for Kaycee Nicole, likened the personal devastation resulting from genuine concern, sympathy, and support that forum members gave to the 19-year-old and her mother, only to discover that none of it was true, to "emotional rape". Adam Joinson and Beth Dietz-Uhler, in Social Science Computer Review, address deception perpetrated on some forums—specifically IRC and multi-user dungeons—and state that masquerading is so common that hoaxes are expected, and their perpetrators are sometimes even praised for creating realistic ones. In 2007 The LiveJournal forum reported that, of the deaths reported to them, about 10% were real.
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