Factitious disorder - Treating Munchausen's syndrome

Treating Munchausen's syndrome can be difficult because most people refuse to admit they have a problem and will not co-operate with suggested treatment plans.

Some experts suggest healthcare professionals adopt a gentle non-confrontational approach, suggesting the person has complex health needs and may benefit from a referral to a psychiatrist.

Other experts argue that a person with Munchausen's syndrome should be confronted directly with a question about why they have lied and whether they suffer from stress and anxiety.

One of the biggest ironies surrounding Munchausen's syndrome is that people with the condition are genuinely mentally ill, but will often only admit to having a physical illness.

If a person admits to their behaviour, they can be referred to specialist psychiatric services for further treatment.

If the person does not admit to lying, most experts agree the doctor in charge of their care should minimise medical contact with them.

This is because the doctor-patient relationship is based on trust and if there is evidence the patient can no longer be trusted, the doctor is unable to continue treating them.

Psychiatric treatment

It may be possible to help someone control the symptoms of Munchausen's syndrome if they admit they have a problem and co-operate with treatment.

There is no standard treatment for the condition, but a combination of psychoanalysis and cognitive behavioural therapy (CBT) has shown some success in helping people control their symptoms.

Psychoanalysis

Psychoanalysis is a type of psychotherapy based on the theories of Sigmund Freud. Freud suggested unconscious beliefs or motivations, often formed during early childhood, can be the cause of many psychological conditions.

Psychoanalysis attempts to uncover and resolve these unconscious beliefs and motivations.

Read more about psychotherapy. 

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) works by helping a person identify unhelpful and unrealistic beliefs and behavioural patterns.

A specially trained therapist teaches the person ways of replacing unrealistic beliefs with more realistic and balanced ones.

Read more about CBT.

Family therapy

People with Munchausen's syndrome still in close contact with their family may also benefit from having family therapy. 

The person with Munchausen's syndrome and their close family members discuss how the condition has affected the family and the positive changes that can be made.

It can also teach family members ways to avoid reinforcing the person's abnormal behaviour. For example, this could involve recognising when the person is playing the "sick role" and avoiding showing them concern or offering support.