Abstract
Munchausen's Syndrome, which has been described by numerous writers, is the syndrome of the imposter. Generally characterized by multiple complaints, Pseudologia fantastica, wandering and stubbornness; patients thus afflicted cause the medical community much concern and annoyance.
Emergency medical or surgical treatment proves valueless in dealing with fraudulent symptoms. In addition, the patient's identity and past history usually turns out false. Confrontation leads to quick departure and repetition of the play-acting in another locality.
The authors believe that these curious patterns of behaviour can be understood as schizoid mechanisms. To illustrate this view, they present detailed psychiatric and psychological investigation of such a case.
In reviewing the patient's early life and present situation, the authors demonstrate schizoid attitudes of omnipotence, detachment, identity diffusion and dependency. When the significant figures in the patient's life died, his marginal adjustment collapsed and the onset of the syndrome was noted. Virtually all his time was spent between hospital admissions and jail sentences.
The authors interpret these wanderings as a search for a depersonalized-all-healing mother. The ‘symptoms’ (usually centering around the genito-urinary system) reflect confusion of sexual identity. Their fabrications (pseudologia fantastica) may be mistaken for malingering but correspond more to schizoid role-playing and exhibitionism. Through victimizing people by false pretences, such patients assume omnipotence in so far as they prove that nobody can help them.