After defining and describing the Munchausen, syndrome by proxy (MSBP) in a
review of the international literature, the authors summarize the parental
characteristics which organize this form of abuse which involves medical s
taff members. Their descriptions and phenomenological analysis of mother/ch
ild interactions give a certain orientation to the investigation as concern
s underlying psychodynamic stakes.
In four detailed and annotated observations, they try to identify and elabo
rate narcissistic and perverse parental problem configurations. The importa
nce of the denied or foreclosed losses, the splitting processes and the sym
bolization limitations involved are evidenced in transgenerational repetiti
ons. Precocious intervention for this abnormality in the very first moments
of parenting enables simultaneous treatment of morbid parental projections
on the child and of projections to which the parents have themselves been
exposed during childhood.