ABC Health and Wellbeing
by Joel Werner and Olivia Willis
Dana Dirr, trauma surgeon and mother of 11, was hit by a drunk driver on
the eve of Mother's Day in 2012.
She was pregnant at the time.
Doctors managed to save her baby, but Dana died in hospital.
To make matters worse, one of her children, a 7-year-old boy, had cancer
at the time.
Dana's husband posted an emotional tribute to his wife on Facebook,
which quickly went viral — eliciting an outpouring of grief.
But the story turned out to be entirely fake.
Lies, exaggeration … and even making yourself sick
The tale of Dana Dirr was actually a case of Munchausen by internet, a
syndrome that sees people feign illness online in an attempt to garner the
sympathy and attention of others.
"Munchausen syndrome refers to people who have evolved a severe and
chronic lifestyle in which they lie about illness, actually enact illness or
exaggerate an illness they have, or, in the most extreme cases, make themselves
sick," Professor Marc Feldman said.
Professor Feldman, a clinical professor of psychiatry at the University
of Alabama and the world's foremost authority on Munchausen syndrome, says
Munchausen by internet is the latest iteration a syndrome with a long history.
"It used to be that people had to go from emergency room to
emergency room, they would have to study up on illness and try to appear
authentic when they were faking. Now all you have to do is sit at home in your
pyjamas and click into a support group and make up a story," Professor
Feldman said.
Because of this, Professor Feldman suspects Munchausen syndrome is now
"more common than it's ever been."
"[People] do it not because they are trying to make money from it
or get on disability [benefits], they do it because it's inherently gratifying.
They get attention and sympathy and care that they feel unable to get in any
other way," he said.
There are even cases in which abusive parents have made their own
children sick — an iteration often known as Munchausen syndrome by proxy.
Belle Gibson case 'straightforward malingering, fraud'
According to Professor Feldman, what separates Munchausen syndrome from
fraud is that it isn't about ripping people off; it's about fulfilling a
psychological and emotional need.
"The moment someone goes online and gets money as a result of their
lying about illness, that becomes a criminal activity," Professor Feldman
said.
"In the case of Belle Gibson and others, there was such an avid
search for money and fame that you have to conclude … that's just
straightforward malingering, it's fraud, and it needs to be prosecuted."
But the distinction between Munchausen syndrome and fraudulent,
malevolent deceit isn't always so clear-cut.
"Sometimes there are cases in which someone, say, has gone online
and faked cancer for a long period time, and well-meaning people will provide
them, without their asking, for gifts. That, I have a hard time just dismissing
as malingering," Professor Feldman said.
The psychiatrist explains that turning down support — whether it's an
offer of money or a bunch of flowers — increases the likelihood of being
exposed as a fraud, "because it makes no sense". As a result, Feldman
says people with Munchausen syndrome are therefore compelled to accept the
gifts that come their way.
"The moment that happens, even though the overall picture is
clearly one of Munchausen syndrome … the police tend to step in, and they
ignore the pursuit of sympathy and attention and just declare it's all fraud
from beginning to end," he said.
Munchausen syndrome is recognised in the Diagnostic and Statistical
Manual of Mental Disorders – the 'bible of psychiatry' – under the name
"factitious disorder". But the jury is still out on Munchausen by
internet.
"Munchausen by internet is not classified as a
mental illness. We don't know what it is, frankly," Professor Feldman
said.
The difficulty in understanding the syndrome no doubt stems from the
difficulty in studying those who have it. Professor Feldman and his colleagues
are, after all, only looking at cases where the deception has failed.
"Where it's crafty and skilful, we probably never know that the
person has lied about illness and have no opportunity to count them in
statistics," he said.
Meet 'hoax hunter' Taryn Harper Wright
So how can you tell when someone is faking an illness online?
Taryn Harper Wright, a self-described ‘hoax hunter’, was the first
person to discover the Dana Dirr ruse.
She says there are often inconsistencies in the information someone with
Munchausen by internet gives.
"You'd be surprised at how often a character name will change or
the person will say they have six siblings and suddenly they will have
two," Ms Harper Wright said.
Moreover, she adds that "drama" is nearly always central to
the narrative of a story crafted by someone with Munchausen by internet.
"Every single day something dramatic is happening, and if it's not
to do with the cancer battle or whatever illness they are struggling with, one
of their neighbours will die in a car accident, or somebody will be hurt in a
skydiving accident. There is just tonnes and tonnes and tonnes of drama,"
she said.
Ms Harper Wright's discovery of the complex Dirr family story was almost
by accident, but nonetheless, went viral. Her revelation struck a chord amongst
many childhood cancer support groups, some of which the fake Dirr family had
ingratiated themselves with.
"After I exposed everything and they realised that none of it was
true … they were genuinely grieving for that person and they felt a sense of
loss, that they had lost this friendship with these people that never actually
existed," she said.
According to Professor Feldman, the groups of people who provide support
— whether online or in real life — are "universally devastated" when
an illness is exposed as being fake.
"Sometimes these lies have gone on for months, if not years, and
you get invested in what that other person is telling you and you start to
really care about them … And to have the house of cards go crumbling down is a
devastating experience," he said.
But hoax hunting isn't without its ethical ambiguities. If Ms Harper
Wright gets it wrong, she could end up accusing someone with a serious, often
life-threatening, illness of 'faking it'. And even if she is right, she's still
confronting someone who, in all likelihood, is dealing with some sort of
serious mental health issue.
"Nobody that is having a happy life decides, 'Oh, I'm going to go
online and pretend that my child is dying.' So, I think that they've got
something going on too … And I think that that needs to be understood a lot
better than it is," she said.
So can people with Munchausen syndrome be treated?
"The professional literature is pretty clear on whether or not
treatment works: it's an emphatic no," Professor Feldman said.
"Trainees who are learning about Munchausen syndrome and factitious
disorder are told pretty much: if you encounter a patient with Munchausen
syndrome, run as fast as possible in the opposite direction."
