Analysis: The abusive J'lem mother: Personality disorder or child abuse?
By SARAH RAMLER
The Jerusalem mother alleged to have starved her toddler son is suspected to be suffering from Munchausen-by-proxy syndrome (MBPS), which is difficult to assess in a one-off evaluation.
According to Dr. Shoshana Arbelle, a pediatric psychiatrist at Beersheba's Soroka Hospital, "to assess the patient [of MBPS], supplied evidence is crucial to show that actions are taken against medical advice."
Arbelle said she believes that "achieving an accurate diagnosis is very difficult, as the symptoms of the disorder are concealed during conversation."
Those afflicted with MBPS don't have a psychiatric disorder, but rather a severe personality disorder. Sufferers "do not display any psychotic episodes, manic patterns or have any depressive features," Arbelle explained to The Jerusalem Post.
Parents with Munchausen-by-proxy syndrome "use their child as an extension of themselves. Through their children, [the victims] are fulfilling their need to be in the center of the scene, and receive the attention and gratification" they seek.
In treating those with MBPS, "sometimes it's enough for them to know that they're being observed all the time," Arbelle said. "[Confrontation] in itself can stop the behavior."
Ongoing psychotherapy is also needed to protect both parent and child, she added.
American psychiatrist Dr. Marc Feldman, clinical professor of psychiatry at the University of Alabama and an expert on MBPS says that those with Munchausen-by-proxy syndrome are often guilty of both physical abuse and medical neglect, as well as psychological maltreatment of their child, and warns against leaving the child at home.
His Web site provides links with information for physicians regarding when to report a case to their state's child protective service agency.
Some professionals argue that the fabrication of a pediatric illness is a form of child abuse and not merely a mental health disorder. Pediatricians need to be highly suspicious when faced with seemingly inexplicable findings or treatment failures.
According to an unnamed Hadassah source, sufferers of MBPS are conscious of their actions; "they know that they're doing it."
However, this source believes that "this case of the haredi woman is not rare - the media storm surrounding her arrest is pushed by a political agenda."
The source claimed that the uproar was not appropriate to the case, but rather a response to the way it was handled, the manner of the woman's arrest and the behavior of the police.
"Another case of the haredi versus the secular community," the source explained.
After violent protests last week against the arrest of this mother, the haredi community is calling for a boycott on all Hadassah medical facilities.
Hadassah personnel would not comment when asked about the video recorded by the police that the police claim proves the woman suffers from MBPS.
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The Jerusalem Post - July 20, 2009
Haredim of all sects unite against perceived vilification
By MATTHEW WAGNER
Out of a deep feeling that the secular public is out to vilify and persecute them, the entire haredi public - from the most extreme and insular hassidic sects to the most mainstream elements - formed a united front over the weekend to support the Jerusalem mother who allegedly starved her three-year-old boy.
A police officer and a haredi man argue during a protest against the arrest of a woman accused of child abuse in Jerusalem.
Photo: AP
Although many mainstream haredim may still believe police, doctors and social workers that there is reason to suspect that the mother severely harmed her child, they believe the secular news media were too ready to blame and that authorities were insensitive to haredi cultural norms.
"When a secular newscaster on Army Radio starts calling our demographic growth 'haredi cancer,' it becomes clear to anyone with a little sense that the secular media have blown things totally out of proportion in an attempt to disparage the entire haredi public," a senior editor of a large haredi daily, who preferred to remain anonymous, said Sunday.
The senior editor said that in a meeting with President Shimon Peres last week, he had warned that the mother had to be released from prison to house arrest.
"Otherwise thousands of haredim would file complaints with the United Nations and the International Court in The Hague against the State of Israel for persecuting the haredi population. Peres understood what we were saying," he said.
Last week reactions among haredi representatives were subdued when police, doctors and social workers publicized the horrific, incriminatory details of how a mother - a member of the Toldot Aharon hassidic sect, perhaps the most tightly knit, socially cohesive and parochial of the groups that make up haredi society - had, according to the charges, systematically starved her little boy.
At first most haredi media outlets ignored the story, uncertain how to react. Even haredi reporters had difficulty obtaining information from the closed sect. A few reported on the angry, violent demonstrations staged by Toldot Aharon and the Eda Haredit, which were criticized by haredi rabbinic figures such as Rabbi Natan Tzvi Finkel, head of the Mir Yeshiva.
Papers have refrained from printing details about the alleged starving or the claims that the mother suffered from Munchausen's-by-proxy, a psychiatric condition that can turn a mother against her child.
But last Friday, as more details began to materialize - first on haredi Internet news forums such as "B'hadarei Haredim" (In Haredi Rooms) and later in the written haredi press - more mainstream haredi figures and the wider haredi public threw their support behind the mother and her family.
The larger haredi public was notified that the baby boy had been hospitalized for a year at Hadassah-University Hospital on Mount Scopus and had been transferred at the request of the family to Hadassah Ein Kerem for the past seven months. During this time, the baby was under observation, which raised the question of why the mother was suddenly being accused of intentionally starving her son.
Although the police said they had video footage of the mother removing the baby's feeding tube, this evidence has not been shown. It was also unclear how the mother had been able to remove the tube, which is surgically installed, over 20 times, as claimed by the police.
Most importantly, the haredi public did not understand why a woman who purportedly suffered from a serious psychiatric disease had been arrested and placed in a prison cell for criminals, together with an Arab woman accused of killing her husband, as reported by the haredi press.
"The haredi public sees this fight as a battle against discrimination," said Mordechai Lavi, popular haredi newscaster for Radio Kol Hai, in an interview with The Jerusalem Post. "I believe this episode will go down in history as a prime example of how the haredi public in all its diversity sticks together when it senses an injustice."
Lavi denied that the incident would dampen secular Israel's relationship with haredim.
"I think secular Israelis will appreciate our ability to unite and stand up for our rights," said Lavi.
The sudden unification of all streams of haredi Judaism also represents a unique, rare situation. It's rare for Toldot Aharon, which totally rejects any cooperation with the Zionist entity, to turn for help to more moderate elements of haredi Jewry.
But in the current crisis, haredi figures such as Deputy Health Minister Ya'acov Litzman of the Gerer hassidic sect and public relations agent Dudi Zilbershlag of the Seret-Viznitz Hassidic sect, who are ideologically at odds with more insular sects like Toldot Aharon, were enlisted to help negotiate with the authorities.
"Just as I need to go to the grocer to buy food even though I may not agree with his opinions," said a spokesman for the Eda Haredit, "I also recruit the aid of people who know how to deal with the media and the state officials when I need to."
This article was found at:
http://www.jpost.com/servlet/Satellite?cid=1246443853506&pagename=JPost%2FJPArticle%2FShowFull
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