I’ve been enjoying BBC Three’s Clique – a drama mostly involving a gaggle of ridiculously good-looking Edinburgh students sharing dark glances across champagne glasses in grandiose, poorly-lit entrance halls – for its bizarre mix of the political and the personal. Each series makes a valiant attempt to mix social commentary about feminism with absurd, melodramatic twists.
In Sunday night’s episode, I gleefully watched as the lead character Holly was sent the medical records of a feminist MSP named Agnes, who is up for re-election. Holly suspects Agnes is framing her own son, Jack, for the rape of another student, as a tactic to gain support for her new feminist party. (I did tell you it was absurd and melodramatic.)
As Holly desperately scours these records for evidence of her conspiracy theory, words flash across her computer screen: “Administering of unnecessary medication”. Then, finally, the big reveal: “Munchausen syndrome by proxy indicated”. “It’s a disorder,” Holly explains to Jack. “They make other people ill on purpose to get attention or keep control.”
Munchausen syndrome by proxy: if you’ve been engaged with pop culture this year, you’ve probably heard the words before. Over the past twelve months, at least three prestige dramas have used the condition – in which carers deliberately weaken or disable those in their care in order to enable themselves to fulfil a nursing role, present themselves as the perfect, self-sacrificing maternal figure, and gain sympathy or attention as a result – as their twist. Also known as fabricated or induced illness by carers (FII), Munchausen syndrome by proxy (MSbP) is a rare – or, as some suspect, underdiagnosed – form of abuse, usually involving mothers and their children.
Sharp Objects, the HBO miniseries based on Gone Girl writer Gillian Flynn’s novel, took the same turn in August, when the lead character Camille (Amy Adams) realised her mother abused her three daughters, including Camille’s mysteriously sick late sister, by deliberately poisoning them until they were infantilised and helpless. As one nurse says, “Nothing more laudable than a woman who puts all her energy into her sick child.”
In June’s final ever episode of the critically acclaimed Scandi-crime drama The Bridge, the lead character Saga (Sofia Helin) dug through diaries, medical records and her memories to prove that her mother also abused her daughters, including Saga’s mysteriously sick late sister, by deliberately poisoning them until they were infantilised and helpless.
In the UK, February saw the release of Phantom Thread: a portrait of a strange marriage in which Alma (Vicky Krieps) deliberately poisons her difficult husband Woodcock (Daniel Day-Lewis), leaving him infantilised and helpless – this time with the added twist that Woodcock is an adult who seems to understand and enthusiastically consent to this arrangement. “I want you flat on your back,” Alma tells him. “Helpless, tender, open – with only me to help. And then I want you strong again. You’re not going to die. You might wish you’re going to die, but you’re not going to. You need to settle down a little.” While Alma and Woodcock’s relationship is deliberately ambiguous, and can’t be straightforwardly diagnosed as Munchausen by proxy, director Paul Thomas Anderson has mentioned the condition by name in interviews about the film.
In 2004, Margaret Talbot wrote in the New Yorker that Munchausen by proxy had “seeped into popular culture with a rapidity and a fervency that recall the fascination with child sexual abuse in the 1980s”. As Talbot demonstrates, in the Nineties and early Noughties, a number of films, TV shows, and even songs had ropelled the condition into the limelight. Over a decade before Gillian Flynn wrote Sharp Objects, Jonathan Kellerman’s Devil’s Waltz and Patricia Cornwell’s The Body Farm centred on villainous mothers with MSbP. In film, 1999’s The Sixth Sense immortalised the condition in popular culture. In his 2002 hit song “Cleanin’ Out My Closet”, Eminem declared himself the victim of a Munchausen mother: “Victim of Munchausen syndrome / My whole life I was made to believe I was sick when I wasn’t”. TV procedurals from Law and Order to The X Files had episodes plotted around MSbP. The condition was even mocked on an episode of Scrubs.
Over the last four years, that fervour seems to have reached a renewed peak. In 2014, Vice published a personal essay titled My Grandma the Poisoner, a personal reflection from the writer John Reed that asks whether his grandmother was deliberately poisoning her entire family. Then, in 2016, Buzzfeed published reporting of the murder of Dee Dee Blanchard, a harrowing look at the circumstances that led 23-year-old Gypsy Blanchard to kill her MSbP mother. Hulu is currently working on an adaptation of the article, starring Patricia Arquette and Chloe Sevigny, called The Act, and a documentary was made last year about the case: HBO’s Mommy Dead and Dearest. Aside from Blanchard, recent cases of convicted mothers who seemingly had Munchausen by proxy that garnered international attention include Rachel Kinsella and Lacey Spears.
Aside from Clique, Sharp Objects, The Bridge and Phantom Thread, it’s also suggested in 2017 horror film It that Eddie’s mother’s may have Munchausen by proxy, as her obsessive concerns about her son’s health are faked and manipulative. Also in 2017, the young adult film Everything, Everything starred Amandla Stenberg as an 18-year-old girl whose mother prevents her from ever going outside by convincing her she has severe combined immunodeficiency, while 2016’s The 9th Life of Louis Drax explored the life of a 9-year-old boy whose mother engineered a series of near-fatal accidents in order to repeatedly save his life. The condition has reappeared in TV procedurals from a 2014 episode of True Detective to a 2017 episode of Elementary.
It’s clear why it’s an intoxicating story for crime fiction: as the British Medical Journal first reported in 1998, Munchausen by proxy is associated with an extraordinary gender disparity not found in other forms of child abuse. Though all children equally fall victim to those with Munchausen by proxy, the perpetrator is nearly always female, and the child’s mother – in more than 90 per cent of reported cases, in fact. Crime and horror seek to surprise and disturb – the mother is always the last person you’d expect, and the most horrifying disruption of traditional family dynamics.
MSbP mothers in popular culture present as stereotypically perfect mothers: domestic, self-sacrificing, caring. (This understanding of how we expect mothers with the condition to behave goes far beyond TV and film: the UK government’s training resource for professionals dealing with MSbP is actually called Incredibly Caring.) Part of the difficulty of detecting the condition is that abusers often exhibit behaviours that are usually evidence in support of a loving relationship, not of the opposite. As crime, horror and psychological dramas often rely on subverting images of innocence, femininity, family and the domestic, it’s no wonder that the idealised mother – bringing warm milk to a bedside whilst smelling faintly of lavender, yet guarding a dark, violent secret – holds such a grim fascination for writers and audiences.
Western culture, with its similtanteous sancitfication and villification of the feminine, has always relished portraits of terrible mothers and evil, sly female poisoners. Anxiety surrounding this specific image of the perfect mother poisoning her children seems to rise along with more general anxieties about motherhood. One of the greatest obstacles facing mothers today is “the pernicious weight of the ideal,” Jacqueline Rose writes in her book Mothers: An Essay on Love and Cruelty.
Over the last few years, anxieties about feminism and motherhood seem to have peaked (a flurry of books by feminist thinkers on motherhood, including Rose’s, were published this year). An unrelenting pay gap, unstable economies, rising inequalities, and the increasing average age of first-time parents all make it a particularly difficult time to be a mother.
“It is one of the most striking characteristics of discourse on mothering that the idealisation does not let up as the reality of the world makes the ideal harder for mothers to meet,” Rose writes. “If anything, it seems to intensify.” The more difficult it becomes to be a perfect mother in society, the more images of flawless motherhood persist.
“When we give birth, we give birth to a child but also to a new version of ourselves, a parent,” Willa Paskin writes in Slate. Munchausen by proxy presents us with the horror of what it might be to prioritise preserving this ideal version of the mother over the needs of the child itself. Sharp Object’s Isadora needs the town of Wind Gap to revere her as a maternal icon more than she needs her children to be safe and happy. We suspect Clique’s Agnes Reid MSP of being more invested in her public image as a pseudo-maternal champion of young women and a feminist politician than in her son’s innocence. Phantom Thread’s Alma leverages her incapacitation and infantilisation of Woodcock into a marriage, child, and position of power in a prestigious household. Being cruel and violent guardians is precisely what enables them to be admired as model ones.
The gulf between society’s standards for motherhood and the reality of what’s possible for a parent is getting wider and wider. It’s no surprise we’ve become intoxicated by Munchausen by proxy, the most disturbing attempt to bridge the abyss.
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