Disordered Mother or Disordered Diagnosis by Allison, David B.; Roberts, Mark S.;

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The diagnosis of Munchausen By Proxy Syndrome (MBPS) conjures up an eerie spectacle.  This putative "syndrome," which horrifically combines the elusiveness of the classic Munchausen Syndrome patient seeking care for nonexistent illness with the evil

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Disordered Mother or Disordered Diagnosis? begins with a thorough review of the original literature on Munchausen patients, from which authors David Allison and Mark Roberts demonstrate in detail how, psychiatric descriptions of this alleged condition have been thoroughly circular.  The label "Munchausen Syndrome" never denoted a coherent Syndrome: from its "discovery" it has served as a catchphrase for chronically and disagreeably ill patients who share nothing beyond an ability to confuse and eventually antagonize their physicians. With the new MBPS variant, the unity of a "Syndrome" again follows entirely from medical suspicion about a heterogeneous population of disadvantaged mothers and chronically ill children.

Yet, if the diagnosis is an artifact, it is not without serious social implications.  Their final chapter reviews the celebrated case of Yvonne Eldridge to show how the application of this specious diagnostic category may lead to the forcible removal of children from the home over the protests of already disempowered mothers. Seeking to regain custody of their children, mothers accused of MBPS face long, uphill legal battles in which they are confronted by "expert witnesses" who rely on a wholly circular and self-justifying literature.  This extraordinary situation invites comparison with the grievous institutional follies of other eras, to wit, the accuser's power of attribution in the prosecution of witches in early modern history and the physician's authority to diagnose and treat hysteria in the 19th century.

Passionately written and possessed of rare historical breadth and intellectual clarity, Disordered Mother or Disordered Diagnosis? is a powerful wake-up call for the medical, psychiatric, and legal professions. It is essential reading for clinicians and feminist scholars, for social historians, sociologists, and jurists, indeed for all who care about the plight of disadvantaged mothers and the rights of medical patients in our society.

"Drawing on a rich array of philosophy, history, politics, psychology, and sociology, Allison and Roberts write in lucid prose that makes reading and learning about their important and appalling subject a pleasure. With an enlightened sensibility, they expose the way that mothers have been blamed and pathologized by the unscientific and damaging creation of an allegedly rampant ?mental disorder.' This book is essential reading both for its own sake and because it beautifully illustrates the dangerous workings of a largely unchallenged, hegemonic mental ?health' system."

- Paula J. Caplan, Ph.D., Author, They Say You're Crazy

"David Allison and Mark Roberts's book opens a fundamental problematic whose stakes go far beyond the caricatured applications of so-called psychoanalysis in contemporary American society. Beyond the technocratic abuse of such an abstract model as MBPS, which ignores clinical detail and perpetuates social exclusion, a great question arises here that will hold the reader's attention and will certainly prompt new research: What is the mother's role in the mental development of the individual? What are her strengths, her weaknesses, her limits -- her rights?"

- Julia Kristeva, Ph.D., Author, Black Sun: Depression and Melancholia

Disordered Mother or Disordered Diagnosis? begins with a thorough review of the original literature on Munchausen patients, from which authors David Allison and Mark Roberts demonstrate in detail how, psychiatric descriptions of this alleged condition have been thoroughly circular.  The label "Munchausen Syndrome" never denoted a coherent Syndrome: from its "discovery" it has served as a catchphrase for chronically and disagreeably ill patients who share nothing beyond an ability to confuse and eventually antagonize their physicians. With the new MBPS variant, the unity of a "Syndrome" again follows entirely from medical suspicion about a heterogeneous population of disadvantaged mothers and chronically ill children.

Yet, if the diagnosis is an artifact, it is not without serious social implications.  Their final chapter reviews the celebrated case of Yvonne Eldridge to show how the application of this specious diagnostic category may lead to the forcible removal of children from the home over the protests of already disempowered mothers. Seeking to regain custody of their children, mothers accused of MBPS face long, uphill legal battles in which they are confronted by "expert witnesses" who rely on a wholly circular and self-justifying literature.  This extraordinary situation invites comparison with the grievous institutional follies of other eras, to wit, the accuser's power of attribution in the prosecution of witches in early modern history and the physician's authority to diagnose and treat hysteria in the 19th century.

Passionately written and possessed of rare historical breadth and intellectual clarity, Disordered Mother or Disordered Diagnosis? is a powerful wake-up call for the medical, psychiatric, and legal professions. It is essential reading for clinicians and feminist scholars, for social historians, sociologists, and jurists, indeed for all who care about the plight of disadvantaged mothers and the rights of medical patients in our society.

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