An Irritating Woman

Susan Diamond learned that it doesn't pay to annoy your kids' psychiatrists, even if you're a doctor

In an emergency hearing in September 1999, Pearson testified that Diamond was a liar and manifested MSBP. Asked if it was possible his diagnosis of Daniel was wrong, Pearson replied: "Anything is possible, but I'd give that one 100 percent."

The specter of MSBP--in which mothers have been known to injure or kill their children--was too great to ignore. The judge ordered Diamond to have 24-hour supervision at home when the children were with her. That was in effect until April 2000, when an agreement on shared custody was signed.

Diamond had now been labeled. Her prickly personality and obstreperous attitude would do the rest.

A court-appointed psychiatrist believed that Dr. Susan Diamond was perpetrating a bizarre and controversial kind of deception called Munchausen Syndrome by Proxy.
Mark Graham
A court-appointed psychiatrist believed that Dr. Susan Diamond was perpetrating a bizarre and controversial kind of deception called Munchausen Syndrome by Proxy.
"House manager" Michael Lamberti contended that Diamond encouraged her son to act up. Lamberti is now in prison on an unrelated fraud charge.
"House manager" Michael Lamberti contended that Diamond encouraged her son to act up. Lamberti is now in prison on an unrelated fraud charge.

A person with Munchausen Syndrome--named after Baron Karl von Munchhausen, an 18th-century teller of tall tales--fakes physical illness for psychological gratification.

Munchausen Syndrome by Proxy, first described in 1977 by British pediatrician Dr. Roy Meadow, is a form of child abuse applied to someone who simulates or triggers illness in a child to assume the sick role through a surrogate.

MSBP is included in the DSM-IV, the "bible" of the psychiatric profession, only in an appendix, because not enough empirical studies have been done to warrant inclusion as an official diagnosis. But it has received a lot of attention because of the shock value of "monster moms" willing to hurt their own children for sympathy.

In the American Journal of Forensic Psychology, Dr. Eric G. Mart describes the many problems with the MSBP diagnosis, especially the "vague, general, and possibly false profile data" relied on by doctors.

The typical perpetrator is described as a mother, often with medical or nursing experience, who describes symptoms that are extremely unusual. The victim is usually a young child. Chronic family dysfunction can be present. The mother grows defensive if the information she provides is questioned. If her belief about her child's disorder is not supported by one doctor, she will seek out another one.

More than 100 "red flags" of MSBP were identified by 1996, even though some of these warning signs are contradictory. Despite the imprecision, MSBP has gained wide acceptance. In England, Dr. Meadow testified in thousands of trials. Hundreds of children were removed from their parents, and 250 women were convicted of abusing or murdering their children. "He is so personally powerful, so sincere, so correct, he convinced judges," Oregon psychologist Pankratz says. "An inarticulate mother had no chance against him."

Meadow was discredited in the late 1990s after research showed his knowledge of genetic defects in children deficient and his methodology seriously flawed. Reviews were ordered of 5,000 cases in which he had testified. Next month, Meadow faces a hearing on charges of serious professional misconduct by the General Medical Council for his testimony against three women wrongly convicted.

But Meadow's discrediting hasn't slowed the MSBP diagnosis in America. Pankratz has evaluated 37 MSBP cases for U.S. courts, verifying the diagnosis in only two of the cases. The consequences of a false diagnosis are "devastating, especially as they unfold in courtrooms," Pankratz says. "The exotic label entangled them in a destructive web with no apparent escape. Some of these are simply conviction by profiling."

Dr. Mark Blotcky, appointed by the family court, became Daniel's treating psychiatrist in the fall of 1999. Described by colleagues as brilliant, acerbic and arrogant, Blotcky has been a mainstay of the Dallas psychiatric community since the 1980s heyday of Timberlawn Hospital, before managed care killed the long-term psychiatric inpatient business.

Daniel's condition had deteriorated. While walking from services one Sabbath with friends, he announced he wanted to kill himself and ran into Preston Road. A caregiver described how a "sudden rage" would come over Daniel and he would lash out, kicking, hitting and biting both children and adults. "It is as if he is in his own world when he does this because it is not a playful act, but malicious," the caregiver wrote.

In September, Blotcky saw a boy torn between two parents, angry at his father for leaving and parroting his mother's line that San Soucie was "sick" and didn't really want a divorce. He denied having suicidal thoughts. Asked about previous threats to kill himself, Daniel said "it was when Dad wasn't around."

"Seems coached," Blotcky wrote. "Demanding, bossy, poor S[elf] E[steem], almost a bitter tone to this boy."

After a handful of sessions, Blotcky diagnosed Daniel as suffering from a "mixed bipolar disorder" and prescribed Depakote, Prozac and Risperdal, an antipsychotic. He disagreed with Pearson's evaluation of Diamond for the time being.

Diamond was relieved that her son's disorder had finally been correctly identified. With medication, Daniel seemed calmer.

Handling such a disturbed child is difficult even in the best of circumstances. But the Diamond-San Soucie divorce had devolved into unrelenting animosity. Diamond and her estranged husband fought over everything, including who got to spend Jewish holidays with the children and when the Sabbath began. Diamond refused to drive on the Sabbath or on certain holidays and wanted the children to attend a Jewish school through 12th grade.

San Soucie felt she was retreating further into the world of Orthodox Judaism and taking the children with her. He wanted them to go to a less religious school.

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