When we think of narcissistic abuse, we often think of manipulation, control, and emotional torment. But for some parents, dealing with a narcissistic ex takes an even darker turn when the ex begins fabricating or exaggerating a child’s illness—a behavior rooted in what’s known as

Munchausen Syndrome by Proxy (MSBP). This is a rare and severe form of abuse where the caregiver creates the illusion of illness in a child for attention, sympathy, or control.

In the context of shared custody, the dynamic becomes even more complicated. A narcissistic parent may use MSBP-like behavior to maintain control over their ex-spouse, claiming that their children are sick or in constant need of medical attention. This situation can be challenging and emotionally exhausting for the non-narcissistic parent who is trying to co-parent effectively and protect their children.

What is Munchausen Syndrome by Proxy?

Munchausen Syndrome by Proxy (MSBP), also known as factitious disorder imposed on another, is a mental health disorder where a caregiver falsifies or induces illness in someone under their care, typically a child. The abuser often seeks validation, attention, or sympathy from medical professionals, family, or the community by presenting themselves as a devoted and selfless caregiver.

Narcissists, who thrive on controlling others and gaining attention, may engage in behaviors similar to MSBP. They may repeatedly bring their children to doctors, fabricate medical issues, or exaggerate minor illnesses to exert control over their ex-spouse and create a narrative where they are the “good” parent while the other parent is dismissive or neglectful.

Signs and Red Flags

If you suspect that your narcissistic ex may be fabricating or exaggerating your child’s health issues, here are some red flags to look out for:

1. Frequent and Unnecessary Doctor Visits: The narcissistic parent may continually take the child to the doctor for vague symptoms or minor issues, pushing for more tests and treatments than necessary.
2. Conflicting Stories: The parent may offer different stories to different people about the child’s health, making it difficult to discern what’s true.
3. Medical Procedures: The child may be subjected to unnecessary medical tests, treatments, or hospital stays. The narcissist may pressure medical professionals for procedures that aren’t needed.
4. Manipulating the Child: The child might be coached to believe they are sicker than they really are. The child could start parroting symptoms or medical terms they don’t fully understand.
5. Over-exaggeration of Minor Illnesses: Every small cough, sneeze, or sniffle may be portrayed as a major health issue by the narcissistic parent, heightening the child’s sense of fear and fragility.

Impact on the Child

The emotional toll on a child caught in this web of lies can be profound. The child may grow up confused about their own health and body, mistrusting both themselves and medical professionals. Children subjected to MSBP-like behaviors are often scared and anxious, constantly feeling that something is wrong with them when it isn't. This can lead to long-term psychological harm, including anxiety, depression, and trust issues, especially with authority figures.

Challenges in Co-Parenting

For the non-narcissistic parent, co-parenting with someone who exhibits MSBP tendencies is an uphill battle. Not only are you trying to protect your child, but you’re also being painted as a neglectful or uninvolved parent if you challenge the narrative of the child’s illness. The narcissist may accuse you of not caring about your child's health or even use this false narrative in court to undermine your custody arrangements.

Legal and Protective Measures

While it’s a difficult situation, there are steps that you can take to protect your child and yourself:

1. Document Everything: Keep detailed records of all medical appointments, tests, and treatments your child has undergone. Include dates, doctors’ notes, and your observations about the child’s actual health. This documentation will be crucial if you need to present evidence in court.
2. Seek Medical Verification: When possible, ask for second opinions from unbiased doctors. If you have a shared custody agreement, consider pushing for a stipulation that all major medical decisions require joint approval. In most states this is already presumed in Joint Legal Custody (not legal advice - ask an attorney for clarification)
3. Involve a Guardian ad Litem: Request that the court appoint a guardian ad litem (GAL) or child advocate to act as an independent voice for the child’s best interests. A GAL can help mitigate the influence of a narcissistic parent and ensure the child’s needs are truly prioritized.
4. Therapeutic Interventions: Engage a therapist who is trained in dealing with children in high-conflict custody situations. This therapist can work with the child and provide professional insight into whether the child is being subjected to unnecessary medical procedures or manipulation.
5. Court Intervention: If the narcissistic parent’s behavior becomes dangerous or crosses into clear abuse, you may need to pursue legal action. This could include requesting changes to custody arrangements or even seeking full custody if the child’s well-being is in jeopardy.

Long-Term Solutions

Dealing with a narcissistic ex who exhibits MSBP behaviors is draining, but taking proactive steps can make a difference. Encourage therapy for your child to help them separate the truth from the manipulation they’ve experienced. You may also want to include specific medical decision-making provisions in any future custody agreements, ensuring that no medical decisions can be made without joint approval or oversight.

Supporting the Child’s Healing

Ultimately, the goal is to protect your child from unnecessary harm. By taking legal, therapeutic, and medical steps, you can counteract the narcissist’s manipulation and keep your child’s well-being front and center. While the journey can be difficult, consistent efforts and proper support can help shield your child from the lasting effects of this damaging behavior.

By raising awareness of these issues, particularly in the context of narcissistic co-parenting, you can empower others to take action before the situation escalates.

About the Author

Will Grey is a co-founder, author and Grey Rock Specialist. He offers and insight through 1-on-1 coaching and as a communications expert for members.