Munchausen by internet was identified in 1998 by Dr. Marc Feldman, a clinical professor of psychiatry at the University of Alabama, and an expert on Munchausen syndrome and factitious disorders. Dr. Feldman coined the term “Munchausen by Internet” in an article published in 2000, “Munchausen by Internet: Detecting Factitious Illness and Crisis on the Internet.”

Dr. Feldman’s noted that at the start Munchausen by internet was more common in online medical support groups, but is now showing up anywhere people socialize online from social networking sites and blogs to forums, discussion groups, and chat rooms. The fictitious stories can take months and even years to fully play out. Some are never uncovered as fakes.

Munchausen by internet is usually complex and intricate. The perpetrators have usually joined an online community for a period of time, watching, learning and getting to know people, gaining trust and giving sympathy to others before they disclose their own “illness.” The drama unfolds in various ways but inevitably they share their own illness, one often highly researched ahead of time. They put on a good show of bravely coping with whatever tragic situation they are facing and go on to provide details of their declining health, including hospitalizations, doctor appointments, treatments, surgeries and other personal issues as a result. They will fake that their “illness” leaves them hospitalized or unable in some way to access the computer making it possible for their other fictitious characters to post for them. In some instances, there is a miraculous recovery, followed by relapses, and more drama. Some even end up having shocking or sudden deaths, which are then relayed to the group by one of the fictitious characters.

Almost all Munchausen by internet perpetrators display a remarkable degree of research about their illness and treatment procedures and a high level of endurance to stretch the fiction over many months. The lies escalate slowly, which makes them hard to detect. But most eventually slip up. At first, there might not be any clues to suggest that they are anything other than a normal support group member, but slight details can introduce contradictions and eventually the whole web of lies can unravel.

Those with Munchausen by internet are usually not trying to scam other people for money or physically harm others. It’s generally attention-seeking behavior, although some have accepted money and gifts of support. Victims are emotionally exploited by these stories but they still have little recourse. Because perpetrators lie so frequently and with such ease, there are often few clues as to a person’s real identity. While most perpetrators don’t share real personal details, some do. And in cases where enough information has been known, investigators can string enough clues together to locate the person. Some investigators have even done surveillance only to discover the person appears to be in perfect health and certainly not hospitalized or otherwise disabled by the illness. Some have even been caught at home or out shopping while posting they are in the hospital undergoing extensive treatment.

But for many cases the person’s real identity is never uncovered and because of HIPPA, medical records and conversations with doctors and hospitals are traditionally off limits to most investigators, so detection is close to impossible. Given these factors, Dr. Feldman has listed some methods of detection to weed out the fakes.

  • Posts consistently duplicate material in other posts, books, or health-related websites. The liars became walking medical textbooks at times.
  • Characteristics of the supposed illness emerge more as caricatures than true to life scenarios.
  • There are frequent near-fatal bouts of illness alternating with miraculous recoveries.
  • Fantastical claims are contradicted by subsequent posts or flatly disproved.
  • There are continual dramatic events in the person’s life, especially when other group members have become the focus of attention.
  • They up the ante of their tragic situation to immediately attract attention and regain the center of attention if it has moved to other members.
  • Others apparently posting on behalf of the individual have identical patterns of writing and work hard to prove the illness claims.

For victims and investigators these can be complex and challenging cases that often end with no tangible proof.  More often than not unless the person’s real identity can be established a review of what the victim already knows and suspects is usually the most that can be established. Providing support and validation to the victim even if it’s not in tangible proof can sometimes be the best and only course of action that can come from these investigations.