Australian blogger Belle Gibson has been exposed for fabricating a tragic cancer story that brought her fame and riches: various publishing contracts and large donations to a ‘charity’ which she plundered. But Gibson’s strange behaviour is not that unusual – faking disease in return for online fame is now a recognised medical condition.
Following Gibson’s recent admission that she lied, questions have been raised about the media's lack of due diligence. There has also been concern over the damage done among the gullible by Gibson’s promotion of fruits and vegetables’, craniosacral therapy, colonic irrigations, and the consumption of non-pasteurised raw milk as cures of cancer, as well her widely publicised anti-vaccination stance.
The story of Belle Gibson is a masterclass on faking cancer, reports The Guardian. She fooled Apple, Cosmopolitan, Elle and Penguin. She fooled the hundreds of thousands who bought her app, read her blog and believed that her story could be their story.
Diagnosed with a brain tumour aged 20, Gibson had four months to live. She blogged her journey of radiotherapy and chemotherapy, treatments she shunned after eight weeks. Instead, she cut gluten and dairy and turned to oxygen therapy, craniosacral treatments and colonic irrigation. Against all odds, she made it.
The report says Gibson launched The Whole Pantry app in 2013, filled with healthy living tips and recipes. She promised a third of proceeds from the 300,000 downloads to charity. Then cancer re-emerged, and Gibson announced on Instagram: "It hurts me to find space tonight to let you all know with love and strength that I’ve been diagnosed with a third and forth (sic) cancer. One is secondary and the other is primary. I have cancer in my blood, spleen, brain, uterus, and liver. I am hurting."
But, the report notes, Gibson recently admitted it was all a lie. She is now being investigated over the disappearance of $300,000 of promised charity donations.
The report says the diagnosis of Münchausen syndrome has dominated analysis of Gibson's case. It comes under the rubric of a wider term, factitious disorder: the intentional production (feigning) of disease in order to assume the role of a sick person. Münchausen is the most severe form of factitious disorder, accounting for about 10% of cases. The behaviour of this group is dramatic: visiting different hospitals with various aliases, injecting faeces into the veins to induce sepsis, eating rotting food to perforate the bowels.
Then, the report says, there is malingering, which is a distinct diagnosis from factitious disorder. Rather than solely seeking to inhabit the sick role (an internal incentive), malingerers are driven by external incentives: money, drugs, evading criminal responsibility or work.
Factitious disorders and malingering can overlap. External incentives might not drive the initial behaviour but can follow thereafter. Gibson might have initially enjoyed playing the sick role. But she didn't turn away the money that flowed afterwards.
The report says Doctor Mark Feldman, clinical professor of psychiatry at the University of Alabama, coined the term Münchausen’s by Internet (MBI) in 2000. In some cases the deception begins online, in others the Internet propels the deception to new levels.
Various psychological theories have been proposed including unconscious motivation (childhood deprivation or trauma) creating a positive experience of the sick role: emotional upset was kissed better, emotional wounds were bandaged. However, early trauma is often impossible to verify. IQ is normal or high in most patients and personality disorders are common: borderline personality disorder in up to a half and narcissistic personality disorder in up to a third. The most severe cases are linked with another personality disorder: sociopathy (formally known as anti-social personality disorder) characterised by a pervasive pattern of disregard for and violation of the rights of others. Its hallmarks include deceitfulness, manipulation, disregard for the safety of others and lack of remorse. This deceit entails repeated lying, use of aliases or conning others for personal profit or pleasure.
The report says Internet sites crush physical barriers but abolish physical cues that help us to assess trust and reliability. But even when unmasked and facing opprobrium, the fraudster frequently just moves on. Policing every member of a largely empathic, trusting forum seems unrealistic and unfair. Mumsnet co-founder Justine Roberts has stated: "It's part of our philosophy to take people at face value. We'd rather be taken in than deny support and advice to someone who's real. None of this abdicates our responsibility as doctors to treat these patients either. They are sick, albeit it in a very different way than claimed."
Münchausen can be impossible to treat if patients refuse to acknowledge the deception, let alone see a psychiatrist. There is also the tricky question of whether those who engage in MBI are patients or perpetrators. Feldman says: "Sometimes they are both, but in the Gibson case, the audacity of her ruses and the (alleged) misappropriation of monies may make the word 'perpetrator' more appropriate."
[link url="http://www.theguardian.com/society/2015/apr/29/jules-gibson-munchausen-by-internet-sickness-bloggers-fake-it-whole-pantry"]Full report in The Guardian[/link]