Dr. Cathy Ayoub
speaker
148 appearances
1 recordings
1 series
first heard Dec 2024
last heard Dec 2024
Dr. Cathy Ayoub’s voice in public audio — every appearance, attributed to the second.
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And he worked with Walter Mondale when he was in the Senate and actually got them to pass legislation that provided federal funds for states that would develop child protection laws. And what year was that? That was in the 1960s, because by the time we got to the 1970s, all 50 states had passed child protection laws.
And most states had child protection systems that were developed within their states. However, there were a few states that didn't, and Massachusetts was actually the last state to
to integrate into their state system child protection services because those services had been provided since the late 1880s by the Centers for Prevention of Child Abuse, the Massachusetts Society for the Prevention of Child Abuse.
So, you know, we're really in a very different place now than people were in the 1960s as this was really developing and even in the 70s. But we're still struggling with some of the same issues and some of the real backlash to protecting children today.
There are some very distinct differences, but oftentimes healthcare professionals get so wrapped up with, and I'm going to say mothers because 97% are moms or are women who are caretakers. But there are some real distinctions. Having worked with a lot of families with chronically ill children, it's incredibly anxiety producing.
I mean, there's nothing worse than having your child be ill, particularly chronically ill. And so parents are anxious. But what you see by and large is that
parents want action, and then they're so relieved when the child gets better, or they're very anxious when the child is not getting better, or when they have a chronic life course that the parent often can't control, particularly if the child's quite ill. What you see in much husband by proxy is that there's always what I call a yes, but. It's like there's a procedure, the child has a procedure.
Sometimes the parent will often push for a procedure that the doctor may not think is totally necessary. And the parent comes back and says, yes, but my child is still ill or my child has another problem. If their GI problem was taken care of, now they have seizures. If they're also having seizures, then they have an immunological problem.
So almost every body system gets tagged and it just gets worse. The other thing you see is if providers have time to go back and look at the records, you can almost track where different disorders appeared. So you also see doctor shopping, not to try to find a way to have the child get better, but to have somebody validate that the child is ill.
So you have to really look at all those patterns very carefully. I think I could say almost every parent that I've interviewed with factitious disorder has convinced me at some point in time. I get taken in to the point where I often have a colleague when I'm doing these forensic interviews where I can do six interviews, 10 interviews, you know, I can spend much more time.
I may have a colleague sit behind me to watch me be taken in oftentimes because these are very, very convincing people. Now, And some of these women present as victims and really want everybody to feel sorry for them. Some of them are more assertive and are more intellectual. You know, I know more about this disease than the doctor. And that's also kind of another sign.
It doesn't mean that parents of chronically ill kids aren't going to know a lot about their child's disease, but it almost comes across in a different way. They don't spend all their waking hours on the internet looking at rare diseases. So I hope that's given you a few characteristics that are really different, but you can see that it's not something that you might know
instantaneously and you have to dig. And that's one of the things I think that's always interested me is that it's very important to really start out thinking this is a chronically ill child and really peeling back the onion.
And then watching and spending some time with the child, really understanding who is this child, what are they doing, you know, how do they appear when they're, you know, relaxed or will sit and, you know, be with you, play with you, those kinds of things.
Yes, exactly. And it's what a lot of times we talk about it as there are lots of what we call cognitive distortions. with the parents, it's that you think you're following a logical train of thought, but it gets distorted. And what you see is that the events that,
most people would see one way are often described by these mothers in a way that actually moves to make them look like they're more nurturing, more competent, and that they're right about what they're saying. They also will take a piece of truth and distort it.
So even when I have the opportunity to do psychological testing, which I think is interested in understanding people's personalities, it certainly doesn't define or identify Munchausen.
But to look at how oftentimes these women will actually start with the detail and build information, like circle that detail to make it something that it isn't, or they'll take an overall statement and add the details that then change the situation. So even looking, and I also believe that these women are not all made in the same cloth.
that there are at least three or more different pretty clear groups of women with different ways of being and that their prognosis for really being able to change their behavior has something to do with that as well.
There are a number of different ways of talking about perpetrators. And we actually did what I think is still the largest prospective study, which is only 45 families of Munchausen by proxy cases. And they all were verified through one court. In other words, the judge found that this was true. Several cases were criminal courts. Most often it was juvenile court or family court.
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