Julie Miller's Mental Health Blog

Factitious Disorder #2

Posted on: March 21, 2010

An individual suffering from factitious disorder is utilizing the sick role to gain benefits such as nurturance, sympathy and/or attention.  This is not the same as malingering, in which an individual feigns illness of some kind to benefit financially or to avoid military service.

Ever called in sick to work because you didn’t want to get that unpleasant assignment from your boss?  Or what about telling the professor that you have the H1N1 flu, and could you take the test at a later date?  Of course, on the phone, you sniffle or cough just to improve the effect.  Anyone ever get out of an important work obligation by reporting that your mother is sick or died or that her father died, or her mother?  This would be malingering, not a factitious disorder, as the benefit is not simply to gain sympathy or nurturance, but indeed to escape a responsibility.

You may recall the TV series M*A*S*H, and Corporal Max Klinger feigning various psychological symptoms or bereavement issues in an effort to get out of the army (transvestitism, frequent deaths of mother, grandmother, aunt, father, brother, etc.).  Malingering.

The cost to the sufferer of a factitious disorder and their family and friends may be steep, including fear, resentment, anger, hurt and sadness.  Treatment includes psychotherapy for the individual with the factitious disorder, and family therapy to address the impact of the illness on the family.  The disorder tends to be chronic and difficult to treat, requiring acquisition of painful insight and family involvement.


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