I teach the psychology of family murder. Here’s what we can learn from Gypsy Rose.

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In 2015, Gypsy Rose Blanchard shot to infamy when her then-secret boyfriend, Nicholas Godejohn, killed her mother, Clauddine “Dee Dee” Blanchard. Gypsy Rose was briefly feared dead herself — an unprotected wheelchair-bound teenager with grave medical issues. The truth, retold over and over in articles, a documentary, a fictionalized drama series and now a new Lifetime special, was even more shocking. Gypsy Rose was neither sick nor a teenager. Her mother had lied to her about her diagnoses, treatments and even her age. Dee Dee Blanchard was the victim of a brutal stabbing. But as prosecutors noted, Gypsy Rose was also a victim, of a lifetime of medical child abuse.

The stunning murder and its related fallout shined a very bright spotlight on Munchausen syndrome by proxy.

Gypsy Rose who had pleaded guilty to second-degree murder for her role in Dee Dee Blanchard’s killing was granted parole Dec. 28 and released three years early. (Godejohn was convicted of first-degree murder and sentenced to life in prison.) Gypsy Rose married behind bars and has quickly amassed more than six million TikTok followers, in addition to penning a memoir.

The stunning murder and its related fallout shined a very bright spotlight on Factitious disorder imposed on another, more widely known by its former name, Munchausen syndrome by proxy (MbP), a rare psychological condition in which a person — almost always the mother of the victim — induces injury or disease in another person, falsifies symptoms, or presents the victim as ill, typically forcing them to have unneeded medical treatments.

Children can be harmed by their abusers through countless medical mechanisms. When speaking of child abuse, we often only think of physical, sexual or emotional abuse, ignoring medical child abuse. While MbP is a psychological condition, the victim suffers the most as a result, not the person with the condition. We cannot allow the salacious, made-for-Hollywood details of the case distract us from the complex and tragic abuse at its core.

As any parent of a sick child would do, Dee Dee Blanchard appeared preoccupied with her daughter’s medical care, claiming she suffered from epilepsy, muscular dystrophy, leukemia and brain damage. The mother-daughter pair received an outpouring of community support and governmental aid — including a house and a vacation to Disney. But all of this was based on a lie. Dee Dee Blanchard was forcing her child to use a wheelchair, undergo unnecessary surgeries, endure feeding tubes and take unhelpful medications.

I use the Blanchard case when teaching because of its clear connections to both medical child abuse and matricide. Matricide (when a child murders the mother) occurs roughly 100 times per year in the United States. The two most common subgroups of people who murder their parents are those who are severely mentally ill and those who have been victims of abuse.

We need to recognize potential abuse occurring and protect vulnerable victims, instead of merely focusing on the psychological reasoning of offenders. Various motives exist for their actions — receiving attention or sympathy in doting or even significant financial rewards. While Dee Dee Blanchard ultimately became a victim herself, she had abused her daughter for many years, and in return received attention and financial rewards from her trusting community.

These are diagnoses which need not only a level of clinical suspicion, but also a careful and proper evaluation.

Julie Gregory’s memoir “Sickened” tells a similar story of survival of medical child abuse. Her mother-abuser even attempted to force a doctor to perform open-heart surgery. Such horrific cases are not common but they should serve as important reminders. It can be hard to fight preconceptions about mothers as inherently loving caregivers. Doctors have blind spots, just like everyone.

There is a careful line that doctors must tread, however. These are diagnoses which need not only a level of clinical suspicion, but also a careful and proper evaluation. The recent “Take Care of Maya” $261 million verdict against Johns Hopkins in November highlights the fraught nature of medical child abuse, and the far-reaching consequences of making such a diagnosis.

The science of child abuse is a relatively new field. Only in the mid-20th century was child abuse taken up in earnest by the medical community. Thankfully, child abuse ending in a parent’s murder is rare. Gypsy Rose’s case needs to fuel more than tabloid headlines. It should serve as a reminder of this covert crime of child abuse and the hidden horrors it involves.

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