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 no one could figure this out in their hometown, so they came to Boston for evaluation. And he had these hypoglycemic low blood sugar episodes, which were life threatening, in the hospital. And the doctor would immediately take blood. And this is the chief of endocrinology. And he looked at the findings and he said, this can't be. the lab is wrong. Then there was a second episode.
Then there was a third episode. And he finally said, this has gotta be right. And what he was doing is he could identify that this child was being injected with insulin because the breakdown products for insulin were not present in the child's blood. if it had been insulin that had been created from the child's pancreas. So there was in some sense a smoking gun.
And he went in and faced the mother and said, this is what's going on with you. She came back to me and she said, I don't know why. He came in and he told me I did this. The syringes were in my purse. I don't know why he didn't come find them. I don't know why no one looked at me or examined me.
you know, or looked for some evidence that I did this because I really wanted to stop and I couldn't stop and I really needed to stop. And as ashamed as she was, and I helped her walk through telling her husband, which was the hardest thing for her, she was desperate to stop. And the women that I've worked with, at least in treatment, and maybe this is just random,
but are women who are almost compulsive about doing this. They started to do it, they continue to do it, and then they can't stop. And so I think that's one group of mothers. And those were often the mothers that were actually able to interact with their children fairly normally in other ways.
Yeah.
It's like kids are here.
I think that they really came from different backgrounds and that they had different genetic predispositions. In each of these cases, what I discovered fairly quickly was that these women had experienced significant and severe trauma of their own. Many of them have been sexually abused within their families. They had been physically ignored and really mistreated.
although they were designated as the caregivers in their families and they actually took care of their own parents who oftentimes were abusive to them. Now, I don't think that's the case with all Munchausen perpetrators, but with this subgroup, I wonder if there is an extended family trauma that along with a very strong push to be the caregiver in the family
And then the third piece is that I believe that there is often a trigger. for these perpetrators. Some of them really had triggers in adolescence and began with some issues in adolescence, but they're offering often some triggers or some trigger that really pushes them into this. Now, there are two other groups.
And I think the biggest one are the mothers who really don't do a lot with their children unless they're on stage. And I think that's a different Because the bond between the child and the parent is really not there from the parent's perspective. And those are the individuals who have recreated themselves. As my colleague, Herb Schreier, says, they are impostering as nurturing parents.
And that takes up their whole time, their whole being. And those are the folks who... I think are very, very difficult. I mean, that's where you're really not, you're not going to get admissions and treatment isn't effective without some kind of an admission. Well, without a genuine sustained admission.
Yes, absolutely. And that you've got it, that those tend to be the people who oftentimes have factitious disorder as well as they're involved in factitious disorder, you know, imposed on another. They make themselves sick. And those people, we may often see some of that develop in adolescence. And they start the behavior of, you know, distorting situations.
And some of them in the extreme, I think, then go over into the third group where they tend to really make all kinds of people ill. Their spouses, their friends, you know, they may, if they're upset with a partner, they may fabricate domestic violence is something that we see. You know, it's only limited by the perpetrator's imagination, just like the forms of illness are.
Right. And it's more than that. What we found in our study was that about 60% of the, and these were all women in our study, 60% of them were also fabricating, exaggerating, reducing illness in themselves. We did find that a very large number of the women that we evaluated had mixed character disorders or personality disorders.
In other words, they had long-term dysfunctional ways of being and of acting that they had really kind of supported for a number of years. Again, on the extreme where we had women that were really chronically violent with their children in a number of different ways. And then they tended to be with other people as well, oftentimes in a very indirect or subtle way.
But, you know, I'm going to put Ipecac, which makes you vomit in your applesauce and you're not going to know what's there kind of thing.
Let me start with the current information because I'd love to talk about fathers. We evaluated mothers and fathers or partners in both cases. And in terms of thinking about, again, I always did this from thinking about, so how can the child be safe? How can they be cared for? And how can they have some permanent placement?
there were really two groups of fathers, were really two family constellations. There was the two-parent family. And in those situations, almost always the father was enabling the perpetrator. And there often times were additional maternal family members in particular that were also supporting the perpetrator. mom.
In some cases, there were other maternal family members who were really, really trying to get into the system, grandparents, aunts and uncles, and they couldn't kind of break this couple because dad really supported mom. That was really quite typical. Those father's totally stayed out of the healthcare for their kids. That's mom's job.
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