Münchausen and Münchausen by Proxy: Harming Self and Others to Play the Sick Role Artwork

Good Enough Shrink

We are child psychiatrists practicing in the Los Angeles area on a mission to demystify psychiatry and mental health. The title of this podcast is a tribute to the psychoanalyst, Donald Winnicott, and his concept of the "Good Enough Parent.” This is the idea that the imperfect but sufficient provisions of a parent will build a resilient child in an imperfect world. We want to empower children and parents to embrace their strengths and flaws, and know that you are good enough.

We want to emphasize the power of holding difficult emotions from the lens of attachment theory. Attachment theory is based on the idea that humans need a social bond with another to survive. This bond, when it is “good enough”, serves as a secure base from which a child can explore the world. When this attachment is disrupted, it can lead to emotional issues, and sometimes full-blown psychiatric disorders. This is where therapists and psychiatrists come in.

This podcast is for the curious adults, parents, family members, mental health professionals and trainees. So we hope you join us in this adventure to explore science and mental health from a developmental perspective.

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Good Enough Shrink

Münchausen and Münchausen by Proxy: Harming Self and Others to Play the Sick Role

November 25, 2025 • Dr. Jenna Cheng, Dr. Patrick Kelly • Season 2 • Episode 6

Hello listeners! Münchausen Syndrome or factitious disorder is a fascinating yet devastating topic that we’ve taken a few recordings to discuss, especially in light of the recent Florida appeals court ruling on the famous case of Maya Kowalski. As child psychiatrists, we hope to share with you that we are relentlessly searching for answers in conditions like this, and not giving up on the pursuit despite our own vulnerabilities.

Topics Discussed:

History of Münchausen Syndrome
Diagnosis of Exclusion
Differential Diagnoses: malingering, somatic symptoms disorder, functional neurological symptom disorder
Clues to Diagnosis
Theories Behind Münchausen Syndrome & Münchausen by Proxy
Statistics on Münchausen Syndrome & Münchausen by Proxy
Case 1: Gypsy-Rose Blanchard
Case 2: Maya Kowalski
How families can cope with someone with possible Münchausen Syndrome
Treatment Approaches: Team Effort
Countertransference
Vulnerability as Physicians

**Disclaimer: Any discussion or commentary regarding the mentioned public cases is only intended for educational or illustrative purposes. No confidential or privileged information is being disclosed, and any statements made do not constitute a clinical, psychiatric nor medical evaluation or diagnosis.

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