Munchausen by Internet

Overview
Munchausen by Internet is a type of factitious disorder which utilizes the Internet's easy access to a broad audience. The term was coined by Marc D Feldman, M.D., in 2000. It specifically relates to Munchausen Syndrome - where a sufferer fakes or induces illness to gain attention and sympathy - and Munchausen Syndrome by Proxy (MSBP), where the sufferer creates fake illnesses in others, or physically harms others. Sufferers of MSBP are often parents who inflict fake illnesses on their children, or children.

Munchausen by Internet provides a twist on MSBP in that the sufferer not only invents the illness but sometimes also invents the people involved. Munchausen By Internet has also been described as virtual factitious disorder and cyberMunch.

Notable cases of Munchausen by Internet
Two well known cases in the USA and the UK highlight the different behaviours of Munchausen by Internet. Kaycee Nicole was supposedly a 19-year-old Kansas girl, sharing her ongoing battle against cancer with members of an internet forum. Only after she died, to the heartbreak of thousands, was she exposed as 40-year-old Debbie Swenson. In the UK, Emma Bowyer is notorious among members of many parenting forums after she not only created fake children, reporting on their deaths and her subsequent miscarriages, but Emma Bowyer turned out to not exist at all. She was the creation of Rachel Hale, who was childless at the time and who later confessed that she was seeking psychological counselling.

For two years, the young American girl who called herself "Kaycee Nicole" recounted her brave struggle against leukaemia in a daily online diary until she died. Thousands of web-users sent condolences. But the 19-year-old from Kansas was discovered to be the invention of 40-year-old Debbie Swenson. As reported in Wired, bereavement counselor Pam Cohen was spurred by the Swenson hoax to investigate Munchausen's by Internet and expose it to a wider audience.

"Emma Bowyer" is a fake persona created by a user of the Hunnybeez parenting forum. She was "pregnant" with twins, one of which died in utero, the other of which died after birth. Her tales of woe were exposed as a fake. Emma Bowyer is one of many fake personas created to garner attention and sympathy relating to pregnancy and illness.

Emma reveled in the sympathy of other mothers, despite the person who invented her not having any children of her own at the time. Emma Bowyer claimed to have a ten month old daughter while imminently expecting twins, which had been conceived shortly after the daughter was born. As the twins came to term, Emma claimed to have complications and one of the twins died. She later gave birth to the other twin. Later, her second twin died, and soon afterwards, Emma was pregnant again, with yet more twins. This caused people to become extremely suspicious and ask questions, and soon the story started unraveling. By this time, a "friend" had posted in her own name, on Emma's behalf, and a Robert Bowyer, supposedly Emma's airline pilot husband, posted to update members on her progress. Robert Bowyer, as was later discovered, didn't exist either. Emma's inventor also signed up to the site under other names - Jo74 and Kerrytwinkle.

She was also spotted on other sites such as UK Parents Lounge, SANDS, Bliss and Babyworld, although some dispute the validity of these claims. LouDearden on Bliss reportedly admitted to having the same name as the person who was, months later on yet another website, proven to be the inventor of Emma Bowyer.

In another case, a woman who called herself "Anna" claimed her husband had been killed in a plane crash to garner sympathy. Her claims, made between 1998 and 2000, were to a private email group rather than the Internet at large.

Detection and identification
The most successful way to detect a fake is by cross-referencing statements for inconsistencies, and checking the validity of their medical claims.

Photographs: Emma Bowyer was detected as a fraud after she posted photographs of her twin, and the owner of the photographs, a mother in the USA, spotted them. The photos had been copied.

Wild claims: The deception can go to extremes. In the case of Emma Bowyer she claimed to have become pregnant with twins within two months of giving birth, then lost both twins and, shortly afterwards, was pregnant again before having a miscarriage. The succession of multiple pregnancies and losses in such a short time span seemed unlikely.

Inconsistencies: Kaycee Nicole was exposed after suspicious members cross-checked claims on the websites of Kaycee and Debbie Swenson (Kaycee's creator). Inconsistent "facts" then encouraged investigators to make their claims public.