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Faking it online: The disturbing trend of Internet cancer hoaxes

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You see it all the time on Facebook – “Jennifer Smith likes ‘Prayers for Baby Christian’” pops up in your newsfeed;  the page detailing the medical struggles of an innocent little child, born prematurely, who has lost his twin sister and undergone countless life-saving surgeries, only to battle a brain tumor.

They’re stories that tug on the heartstrings of the people who come into contact with them. Whether you follow every detail and rally your friends for support, or just peruse the page, you become emotionally invested.

The thought that anyone could suffer so much tragedy seems unbelievable – and in some cases, it is.

A modern version of an old psychiatric disorder is emerging from within social networks and online support groups called Munchausen by Internet, or MBI.

"It started when I was around 11 with small things, and by the time I was 15, I faked my first seizure.”

- "Maria," Munchausen by Internet patient

“It refers to people who go online and either feign, exaggerate, or in the most extreme cases, actually induce illness and present themselves to health-based support groups or special interest groups online in order to mobilize attention and sympathy,” Dr. Marc Feldman, a clinical professor of psychiatry and adjunct professor of psychology at the University of Alabama, who coined the term, told FoxNews.com.

Feldman became interested in studying the disorder in 1998 after giving a talk on Munchausen syndrome, a condition which causes people to make themselves sick or lie about having an illness for attention.

“Somebody came up to me after the talk and told me this involved story about a guy who was going online and claiming to be a monk in the Catholic church, and he told this story about having cancer and how due to his vow of poverty, he couldn’t afford medical care,” said Feldman.

‘If there’s a medical diagnosis, someone has faked it online’

For “Maria,” a 45-year-old bookkeeper currently in recovery, who chose to withhold her real name, a long history of Munchausen syndrome, starting in childhood, paved the way for her online deceptions later in life.

“I have had some themes which I think are common with MBI patients; seizures, cancer, sex abuse. It started when I was around 11 with small things, and by the time I was 15, I faked my first seizure,” she told FoxNews.com in an email.

Maria’s struggle with Munchausen syndrome even forced her to drop out of college. But once she was out of school, there was no one in her life to meet the emotional needs that had been fulfilled by faking illness, so she turned to the Internet, in particular, an online cancer survivors forum.

Maria eventually stopped visiting the forum, but MBI reared its ugly head again with a new deception that involved posing as a child and forming a relationship with an unsuspecting victim.

“It was a very complicated and involved fantasy that became almost real for me,” she wrote. “It involved posing as other people in addition to the main person, serious illness and serious emotional trauma. I don’t think it would be wise to get into the specifics of this, but this was MBI at its worst.”

Social networks and online health forums provide MBI sufferers with a sense of human connection, while affording them the anonymity to choose a fake online identity.  

“They’ll sign onto a cystic fibrosis group where most of the members have cystic fibrosis or are family members of someone who has cystic fibrosis, and then make claims about their extensive illness that don’t ring true,” Feldman said. “The same thing happens on cancer forums, eating disorder forums – you name it – if there’s a medical diagnosis, someone has faked it online.”

Feldman, who refers to MBI patients as “perpetrators,” said these people often have deep-seated personality disorders which prevent them from getting their needs met in healthy ways. But he said it was important to distinguish between MBI and malingering, in which people feign illness for a tangible goal like money.  

“I’ve had some of the perpetrators tell me their stories and it always comes back to this core of un-socially skilled or non-socially skilled, people who are alone and lonely, and find a shortcut to building a supportive community around them,” he said.

Motivated to deceive

For Maria, Feldman’s words rang true. She said her online deceptions were motivated by an extreme emotional neediness.

“I didn’t do it as a trick,” Maria said. “I didn’t do it to see who I could fool. I most certainly didn’t do it to hurt anyone. I didn’t do it to make money. I did it to feel significant, to feel nurtured and loved, and that I am cared about. I didn’t know any other way to get those needs met.”

Maria described the attention she would get when she was lying in online forums like a “feel-good drug” that always left her “wanting another hit,” but said keeping up with the lies was stressful.

In 2010, when members of an online community became suspicious and started asking her questions, she finally decided admit her deception and get help.

Maria was diagnosed and treated for borderline personality disorder, depression and anxiety. But a year later, she found herself in another cancer forum, lying to unsuspecting supporters, and was referred to Feldman by her therapist.

“Once caught up in the game, it’s like I'm leading a double life,” she wrote in a journal entry shortly before she entered recovery. “It takes a lot of energy. Your mind is constantly working to figure out what to say next. And all for what? A virtual hug and a stranger saying they care?”

Feldman noted that a major clue as to whether or not an online community member may be a MBI perpetrator is when new profiles or personas, called “sock puppets,” start to emerge to support the original deception.

“You’ll often see the very same writing styles, grammatical errors, and typographical errors that reveal this is all really stemming from the same one individual,” Feldman said. “They’ll originally claim to be an individual with cancer, but then sign on as their mother who supports the deceptions and say ‘yes indeed, we’re all struggling with John’s cancer.’  And then sign on as a girlfriend who’s pregnant with his child, and so on.”

“I’ve often said that if these MBI perpetrators would take their talent and use them in constructive ways they could accomplish anything because they are motivated, they’re verbally very skilled, they’re often high-energy to be able to juggle all these relationships,” he added.

Accepting a diagnosis

According to Feldman, MBI perpetrators are most commonly young women, but it’s hard to tell how many people are actually living with the disorder because many of them are reluctant admit their deceptions.

“It usually isn’t treated because these individuals are not willing to access help,” said Feldman. “That is, they’re happy to claim a medical diagnosis they don’t really have, but they won’t accept a psychiatric diagnosis which they really do have.”

Treatment for MBI can include medication to treat underlying mental illness, cognitive behavioral therapy and talk therapy.

Maria said medication and therapy have helped her stop the pattern of online deceit for the time being.

“Just like the alcoholic has the urge to drink, I have the urge to engage in MBI behavior,” she explained.

“MBI has caused me a lot of shame and hiding. It has caused me to think I am a horrible person who didn’t deserve anything - even the air to breathe, but the idea of it crumbling meant recovery for me,” Maria said. “It meant growth. It meant new ways to get my needs met. It meant freedom.”

For more information, log onto Dr. Feldman's website Munchausen.com.