Lisa Blakemore-Brown
Chartered Psychologist and Author
B.Sc.MSc.C.Psychol.A.F.B.Ps.S

MSBP - A PSEUDO-SCIENTIFIC TRAP

A Paper presented at Portcullis House on 2nd December 2004 as part of Conference Proceedings entitled `ABUSE ALLEGATIONS –SYSTEMIC FAILURE’ and organised by the All Party Group for Abuse Investigations (APGAI)

To begin the talk, in order to illustrate the rigid mindset at the core of false allegations, an interview was shown of a Paediatrician who frequently diagnoses MSBP. The interviewer, Genevieve Westcott for New Zealand’s TV3 20/20 in March 1997, asked whether he `ever got it wrong`. The answer was that anyone who said they never got it wrong was suspect. He then went on to admit he had got it wrong, but in not diagnosing it when he should have. He was adamant that he had never falsely accused anyone. When given an example of someone who had her children returned after an Appeal of a Family Court decision, he went on to begin to say ‘Just because a Judge, on a technicality…’ whereupon the interviewer suggested he would only accept what the Judge says, as long as it is what he says.


From this starting point, we can see how no matter what evidence is brought to bear onto this belief system, it will not change. Cognitive Dissonance studies have shown us that if an individual’s belief system is rigid all incoming information will be twisted to keep that belief in place. This happens with the false accusers and appears to still be happening in the system. As more shocking cases are highlighted, the stronger the denial of wrongful allegations of abuse. Whoever doubts and expresses concerns is then regarded as an advocate for child abusers.



At the core of false accusations of MBSP are secrets, falsehoods and omissions – by the system. The Attorney General, Lord Goldsmith, just days before the conference, had stated “ if there are alternative explanations, we need to know. If the Expert only owns up to possible alternatives under cross examination, he risks showing himself as careless, inexpert or worse – a charlatan” London November 27th 2004

MSBP – not devised by Professor Meadow and not a rare medical condition.

The first omission, secret and falsehood to be discussed was that it was not Professor Sir Roy Meadow who thought of the theory of Munchausen Syndrome by Proxy, and it was not a rare medical condition. It was a sex researcher and psycho-endocrinologist, John Money who coined the term MSBP in relation to a case of failure to thrive, blaming the parents. (Money and Werlwas, Bulletin of the American Academy of Psychiatry and the Law, 4: 351-362 1976 ) a year before Roy Meadow used the term without acknowledgement and described it as a rare medical attention seeking condition.

It is important for the public to be made aware of this fact and also to understand the stable from which the thinking originally emerged. John Money is controversial not only for thinking up MSBP but also for his apparently very successful treatment of individuals to change their gender. This apparent success followed the life long `treatment` of a man named David Reimer after a botched document led to the burning off of this twin boy’s penis. John Money was claiming that operations and psychotherapy could change a person’s gender and David was experimented on throughout his childhood. John Money gave the impression professionally that this was a huge success. In truth it was a total disaster and the child was subjected to mental and physical torture throughout his childhood. He committed suicide in 2004. The purpose of relating to this issue was to establish that the thinking behind this theory belonged to someone who has been exposed for claiming success in another area
 in which his thinking was seriously flawed and his actions led to terrible suffering.

He gave a false impression that this first case was a huge success and on the basis of that, many more children underwent the same treatment as tragic David Reimer. The same false impression of a great scientific discovery, with claims of great benefit to children, but in fact a trumped up belief causing huge suffering, has been given in MSBP.

Another error of judgment, in my view, by John Money, and associated with the interwoven themes within MSBP, was that he refers to Kaspar Hauser as an abused child given his odd behaviour and presentation. Nowadays, Kasper would be described as autistic. The purpose of mentioning this issue relates to the interesting parallel between this misinterpretation of behaviour by the man who thought up MSBP, and the misinterpretations of autistic behaviour as child abuse, in the last few years by current MSBP accusers.

Other interwoven factors include the increasing evidence that some form of brain inflammation is linked to autism. A recent report from the Johns Hopkins University found that certain immune system components that promote inflammation are consistently activated in people with autism. (Annals of Neurology November 2004) So not only are the false accusers misinterpreting what they see before them but they are also omitting evidence which would lead them to a different view. The importance of immune system problems being misinterpreted as child abuse is important in the context of False MSBP (see below).

As MSBP became embedded into the system, irrespective of its base in a belief thought up by a sex researcher, as opposed to an eminent paediatrician, and claims of `proof` in an epidemiological study full of flaws with no follow up (Sibert et al), differential diagnoses became heavily skewed toward the idea of child abuse, whilst ignoring and omitting alternative explanations.


Misunderstanding and/or Shaping of Evidence to Fit the Theory and conflicting advice.

Behaviours assumed to be caused by abuse included many autistic behaviours such as “a dislike of close physical contact and cuddling because it recalls episodes of smothering”. Jones and Bools 1999. The errors have been compounded in the underlying belief system by a cause being imagined yet stated as if fact. Recently the public heard how a paediatrician, on the basis of a TV programme, accused a father of smothering his child because he had a nose bleed. The accuser continues to believe this.

Over the years, there have been considerable efforts in Family Court cases to prove that a child’s problems abate once the child is removed from the mother, to meet one of the stated criteria. RCPCH (Royal College of Paediatrics and Child Health) Guidelines state ‘Remove from parents as a diagnostic manoeuvre’ (5.8 Page 46) yet Government Guidelines admit there has been ‘little research done’, and they go on to speculate that outcomes have been poor. (Guidelines re Fabricating and Inducing Illness. 2.35) The interpretation for this is that the continuing problems just show how effects of abuse can be life long, or it could be a pre-existing disorder. However, such disorders were never admitted when the efforts were made to prove the child was `perfectly normal` to remove it from the family. If a child continues to experience the same problems as those blamed on the mother, AFTER removal, it is not considered that it may be that this was a real disorder and the allegation of
 abuse was wrong.

Mother ‘profiles’ stay in the minds of workers, the public and the media, despite Government Guidelines stating there is ‘no evidence to support a unique profile of carers who fabricate or induce illness in their children’ (2.27) The retention of rigid thinking about the profiles is helped by contradictory Guidance. For instance, despite 2.27, a list of behaviours to watch out for is given in another part of the Guidance, for instance, parent very involved with care in hospital. To add to the confusion, parents who are unusually unconcerned are also suspect. The Government is right – there is NO evidence to support the thinking that these behaviours are indicative of a person who will abuse her children. Yet the fearfulness engendered in the system has extended to not only thinking there is evidence to support the idea that such behaviours are linked to people who fabricate illness but that they are also likely to go on to kill them. There is no scientific basis to these
 beliefs. (Blakemore-Brown The Psychologist September 1997)

By embedding the thinking in the minds of workers that mothers of a certain disposition are child abusers and if they present with a sick child they must have caused it, or be exaggerating it, it is easy to understand how Paediatricians can make errors of judgement when this thinking is also bolstered by RCPCH Guidelines which include the following
‘ The first threshold to be crossed is in the mind of the paediatrician’. Professor Golding in the Cannings Appeal 2003 referred to a `hunch that the paediatrician may have…not based on any scientific foundation’.

The Guidelines go on to say ‘Concern may be raised by non-specific feelings that the account does not feel right, or from the attitudes, behaviour and responses of the carer.’ The paediatrician is being asked to be not just a psychologist or psychiatrist but also telepathic given the lack of research to support these ideas.

As the system demands that the medic move very quickly to refer to social workers if there is even a `non specific feeling`, the chance of mistakes being made is significant. ‘Criterion for referral is that the paediatrician has continuing concerns about the child’s welfare and not that fabrication or illness induction or harm has been proved.’ (RCPCH) However, once the social worker takes the referral, its too late (Blakemore-Brown June 1998 The Therapist) Both think the other will do the checks and balances. The medic will be only too pleased to hand a difficult case over and the social worker will accept that the referral is robust and will from that point start from the premise that the person is guilty of MSBP/FII. As any denial is read as guilt there is no way a person can protest their innocence and if real issues are omitted, evidence tampered with or Experts influenced, there is no way they can prove their innocence. The label is never removed as there is no multi
 disciplinary methodology to admit fault.


How It Starts

Gossamer breath of rumour (Blakemore-Brown The Therapist 1998) based on speculation, false theory and omission of alternative explanations can rapidly lead to a `referral` from which there is no turning back. Secret phone calls, secret files, secret courts, one day seminars and the ‘use of unsubstantiated but sickening details to make the mind reel’ (Blakemore-Brown The Therapist page 2 shock us and help to convince us of the horror before us. Our natural desire to protect children and revulsion at the demonising descriptions of mothers lead to real fears that children will be harmed if we do not believe the opinions and accept the belief.

Dogma and Shock Tactics

Lord Justice Judge referred to the use of dogma as the first erroneous approach, in his Judgment in the Cannings case (19th January 2004) A sound bite used by a Detective Inspector to whom I went with enormous concerns, was ‘Three dead children, no evidence, so its MSBP’. This dogmatic statement can stand alongside ’73 million to 1’ and other well known MSBP phrases. If there is no evidence because the evidence has been omitted, the appalling assumption is likely to be entirely wrong.

Elements of truth are bound up with shock tactics, suggestibility, omission, rumour and delusion leading to very serious errors of judgment, false allegations and terminal damage to innocent families.

We have been led to believe that `these women` are so dangerous and plausible that any and every intervention is justified – even with no evidence. This maps onto the thinking about `terrorists` and the secret courts which try them.

The example of Patricia Stallings was given to show how we have been invited to believe that mothers can do the most astonishing things right before our eyes without us spotting it, to the extent that they must have their babies removed from them the instant they are born. In the Stallings case, in the US, a mother was accused of feeding copious amounts of anti freeze to her baby when he was found to be ill and to have high levels of ethanol glycol in his blood. In visits to her child she came with nothing but her arms to hold him, yet as the levels remained high she was blamed. In prison she found she was expecting another child. She was continuously watched and frequently shackled. A team of people stood around as she gave birth. The infant was removed from her care instantly. Some months later it was discovered- despite many attempts to prevent her finding out, that this fostered out child also had high levels of ethanol glycol in his blood. At the Appeal Court, her
 defence filled a room with canisters to show how much this woman would have had to have been pumping into the baby - in full view of everyone - to lead to the levels found in his blood, if indeed it was anti freeze. Of course it was not. As the second child had spent no time at all with her, the very idea that she could have done the same to him was even more preposterous. It was found that the children had a rare genetic disorder which was treatable.


Moveable Feast

As many questions have been raised about MSBP, including a lack of consensus amongst professionals, there have been shifts and changes to encompass the criticism but leave the theory in tact, as in Cognitive Dissonance Theory. Recently, the Royal College of Paediatrics and Child Health has said `as there is no single psychological profile in MSBP and the label makes unwarranted assumptions about the parent’s mental state and motivation, many UK paediatricians feel that the term should be abandoned. The preferred term is now fabricated and induced illness. Fabricated and induced illness is seen as part of a spectrum of child abuse and death caused by suffocation is at the severe end of that spectrum. The term keeps the focus on the presenting features of the child who needs to be protected, rather than on the supposed psychopathology of the parent’.

Factitious Disorder by Proxy is described as:: the intentional production or feigning of physical or psychological signs or symptoms in another person who is under the individual’s care for the purpose of indirectly assuming the sick role (DSM-IV 300-19) However, we also read ‘Factitious Disorder by Proxy must be distinguished from a general medical condition or a mental disorder in the individual being brought for treatment.’

So, the issue of omission is once again raised. If evidence of real disorders and conditions is OMITTED the presenting features of the child will not be interpreted correctly.


Examples of Omitted Information

The most current example of the pathologist Dr Green leaving out evidence of an infection in the Clark infant is just one of many.

Another serious omission which is not fully recognised is the evidence of side effects of medications and vaccines given to children. Professor Meadow wrote a review about the side effects of anti convulsants on the unborn child when given to the pregnant mother. It was noted that anti convulsants may depress the vitamin K dependent clotting factors, with coagulation deficiencies leading to reports of massive haemorrhages occurring in late pregnancy or shortly before birth. He stated ‘they tended to occur suddenly in unusual sites’ i.e. intrathoracically. Perinatal mortality rate is twice as high among babies of epileptic mothers who have been taking anticonvulsants regularly. Anticonvulsants cross the placenta freely. Newborns may suffer harmful effects from the anticonvulsant level and as a group; tend to be less efficient at feeding and will gain weight more slowly (My insertion - maybe regarded as failure to thrive) A minority will suffer withdrawal symptoms such as
 tremor, excitability and seizures. There are consistent reports of significant developmental delay in a proportion of children, minor facial and skeletal abnormalities are common and there is a 6% chance of a major congenital abnormality. (Meadow 1991; Anti Convulsants in Pregnancy. Archives of Disease in Childhood 66; 62 – 65)

It is curious that this well written paper by Professor Meadow is never referred to in Court when MSBP and Shaken Baby Syndrome is mentioned. Indeed it is very difficult to access at all.

Other evidence of the omission of vaccine reactions - for instance occurring in both the Clark and Cannings cases – is also curious.

Another study of the effect of anti convulsants on the unborn fetus was undertaken by Moore et al (Journal of Medical Genetics. 2000 July; 37 (7): 489-97) They found a range of conditions including autism, autistic features, ADHD and behaviour problems, speech delay, gross motor delay and fine motor delay, glue ear and joint laxity.

The range of conditions on the increase in the last few years include: Apnea, Reflux, Allergies and food intolerances, gastro-intestinal problems, autistic spectrum disorders, ADHD, ME/CFS etc. It is the mothers whose children have these conditions who are likely to be accused of causing them or exaggerating them. All of these have been implicated in iatrogenic abuse, which is NEVER considered as part of the differential diagnosis, for some curious reason. Auto immune disorders, congenital abnormalities, birth trauma and the greater likelihood of problems given prematurity, are simply not considered as the suspicion of the demonised mother in the MSBP theory swamps reasoning.

In a Survey of families undertaken in 2003 and presented at Portcullis House, mainly from the Isle of Wight but including others experiencing the same problems of feeling blamed for their children’s difficulties and being totally unable to access appropriate services for them, over 80% felt blamed and targeted, over 70% felt the process was highly stressful and over 90% felt frightened. Amongst this group, 28% of the babies were in Special Care Baby Units and 13% were prescribed essential medication during pregnancy. The range of their children’s problems echoed those listed above as having increased dramatically over the last few years, with over 70% displaying obsessional behaviour and literacy difficulties, over 65% suffering from anxieties, attentional problems, social exclusion and learning difficulties, 50% suffering from motor impairments and bowel problems, over 30% suffering from allergies and 30% suffering from depression.

The effects of Vitamin K and C deficiencies following vaccines in vulnerable children have been misinterpreted as fractures or cigarette burns. (Kalokerinos 1981, Innis 2002. Clemetson 2002) and Professor Meadow’s own paper makes interesting reading in this regard. Mercury effects from thimerosal in vaccines (Simpsonwood meeting 2000) are never introduced as part of the differential diagnosis. Neither are the side effects of drugs such as Cisapride given for gastro-intestinal problems, now taken off the market due to serious side effects and sudden death.

The misinterpretation of vitamin deficiencies and signs of Rickets occurring through iatrogenic abuse must also be placed in this category of omitted information.

The `tapestry’ of Autism, ADHD and related conditions (Blakemore-Brown Reweaving the Autistic Tapestry Jessica Kingsley Publishers 2001) irrespective of causality, are increasingly misinterpreted as behaviour problems caused or exaggerated by mothers, with no interest in the real disorders or the effective interventions. The epidemic of these disorders maps onto the epidemic in false allegations of MSBP type abuse.

Leaving out information which may not support MSBP is common place in my experience in false cases.

As long ago as 1991, Mr Justice Cazalet said that ‘Experts should be objective and not omit factors which do not support their opinion’.




Index of suspicion raised in the minds of other Experts

If the Expert in MSBP has given false information i.e.: 73 million to 1 when patently wrong, this would lead to misunderstanding amongst other Experts and may lead to omission of evidence which, it might be thought, would pale into insignificance given the odds. This may have happened in the Sally Clark case to the pathologist who left out the pathology report. (Watkins 2001)

If we ignore or miss crucial information and misconstrue behaviour the chances of making a Type 1 error is greatly increased. This error occurs when we say, for instance, someone is guilty when they are innocent. The decision to say a person is guilty will have been made on the basis of dubious evidence and wrong opinions and make the risk of Type 1 errors unacceptably high. This is happening in our Courts.

Furthermore, the professional attitudes in the lead up to the Court case will be affected by such a raised index of suspicion which could create professional hysteria, whispered phone calls spreading the influence across the world rapidly, file tampering and omission of evidence. In a discussion with a Detective Inspector many years ago he mentioned ‘Noble Cause Corruption’. This occurs when we become so convinced we are right about a person’s guilt, even when based on rumour and no evidence at all, that it allows us to justify all the actions we put in place to make sure the person is ‘caught’.


Ways Forward

I called for an Inquiry into this back in 1997 (The Psychologist September 1997) and have since publicly backed the voices of others to ask for a public inquiry, to no avail.

Various checks and balances can easily be put into place with correct advice and training to ensure conditions are not omitted and indeed, to prevent many difficulties which parents are being blamed for. Dr Innis, Haematologist in Australia, an Expert in False Shaken Baby Syndrome, in a personal communication on November 17th 2004 advises a protocol in which the history of illness needs to be checked, prior to any acute symptoms, that any adverse event within 28 days of vaccination should be reported, that a full haematological screen should be undertaken. He went on to say that certain tests should be undertaken if a fracture is diagnosed as the test will be abnormal if the problem is actually Rickets.

Recognition of Autism and the range of conditions and side effects as described above is also essential to avoid the trap John Money fell in with Kaspar Hauser and the failure to thrive child.

Detailed histories in correct order help to understand how events occur.

Falsely accusing innocent parents of MSBP and the rigid punitive methods applied, leading to draconian outcomes, removes all trust in the system, crushes and destroys individuals including children wrongly taken, turns basic principles of justice on their head with its circular arguments which prevent anyone from proving their innocence.

Removal of our children and our liberty must demand the highest standard of proof and MSBP/FII and SBS theories and methodologies provide the least.

If we truly care about children as we claim, we must base our thinking on facts, not rumour, fanciful speculation and warped opinions based on incomplete evidence and suppositions. All the potential differential diagnoses must be viewed in context based on thorough and appropriate training. (Personal communication with Charles Pragnell November 2004)

This talk was augmented by the tragic example of the Turner family whose daughter when, at age 19, in the Army away from home, would not see a Doctor when she began to get headaches as her mother had been falsely accused of MSBP and the nightmare of their lives which followed and has not abated, made her terrified that she would not be believed, or, worse, accused of making it up.

She died on Good Friday 2004 of a massive brain haemorrhage. Her older twin brother and sister’s problems were blamed on her mother and despite a Judge severely condemning the entire system, the family emerging with `not a blemish` on their character, the mother’s health needs have not been met and she is now wheelchair bound and reliant on oxygen at home. She attended Portcullis House with her husband, Reverend Turner, having just been in intensive care following a blood clot to her lung. The deterioration to her health is a result of the illogical thinking and the influence on the system despite parents being exonerated in Court. Her children’s needs are not met in school as the gossamer whisper of MSBP never leaves them.

The talk is dedicated to their beautiful daughter Victoria.


Papers written by: This author, Helen Hayward-Brown and Michael Nott in Australia were available at the talk.

A sculpture created by Melanie Swan, artist from the Isle of Wight, `A Whole New Standard’, was displayed in the hope that we are heading toward such a state. Melanie created the head as part of an exhibition by autistic children and their parents `Inside Outside’ to celebrate their differences and fight back against a system which has failed them.