MUNCHAUSEN-BY-PROXY SYNDROME - COUNTERTRANSFERENCE AS A DIAGNOSTIC-TOOL

The authors report on an unusual reaction in clinicians interviewing k nown perpetrators of Munchausen-by-proxy syndrome (MBPS): an uncanny, ego-dystonic, and cognitively dissonant sense that the parent could no t be the perpetrator, despite all clinical/forensic evidence. The auth ors suggest that this reaction can have various sources: One may be '' as-if'' character pathology in the parent, with the capacity to evoke, unconsciously, disbelief in the clinician. Given the poor treatment o utcome reported in MBPS perpetrators, the authors suggest that, if con firmed, this finding will lead to more accurate psychiatric diagnosis of the parent, and more informed treatment of this potentially harmful or lethal syndrome.