The Act” portrays the fictionalized account of the true story of Gypsy Rose Blanchard, a lifelong victim of her mother’s mental illness. Dee Dee Blanchard raises Gypsy to believe that she has multiple illnesses requiring near constant care and sometimes painful medical interventions. Gypsy visits countless doctors and emergency rooms, uses a wheelchair despite no clear evidence that she can’t walk, ingests unknown medications that often result in overwhelming drowsiness, and learns to let her mother do the talking for her.

Dee Dee convinces Gypsy and many other people that Gypsy functions at the developmental level of a seven-year-old due to brain damage from traumatic birth, that she requires a feeding tube because she can’t swallow properly due to removal of glands from another illness, and that she has food allergies, seizures, asthma, leukemia, and muscular dystrophy. In essence, Dee Dee creates a condition where Gypsy is forced to live in a perpetual state of fear for her own survival.

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The story unfolds as Gyspy reaches her teen years (though due to falsified birth date records it’s difficult to ascertain her true age) and begins to realize what happened to her. She walks around the house during the night when she discovers that her legs do function properly. Upon overhearing an emergency room doctor dispel Dee Dee’s belief that Gypsy is allergic to sugar, Gypsy binge-eats high sugar snacks while her mother sleeps. Largely kept confined to her home by Dee Dee to “protect” her, Gypsy takes to the Internet to connect with other people, seek information, and ultimately meet her boyfriend, Nick Godejohn, who ultimately helps Gypsy plot and carry out the murder of her mother.

What Is Factitious Disorder Imposed on Another?

Factitious Disorder Imposed on Another (FDIA), commonly referred to as Munchausen by proxy (MSP), occurs when an individual (generally an adult parent/caregiver) acts as if an individual (usually a child under the age of six) he or she is caring for has a physical or mental illness when the person being cared is not ill at all. The caregiver has a profound need for the individual to appear ill or injured, even to the point of having the child endure painful and risky medical procedures, tests, and/or surgeries based on lies, falsified medical records, exaggerated symptoms, altered diagnostic tests (contaminating a urine sample, for example), and/or inducing symptoms.

It is difficult to assess how common FDIA is given unreliable statistics on the disorder and the fact that many cases go undetected. However, estimates suggest that about 1,000 of the 2.5 million cases of child abuse reported annually are related to FDIA.

How FDIA Impacts the Psychological Health of Kids?

In addition to the fact that child victims of FDIA are forced to endure physically painful and unnecessary tests and medical procedures to assess for and treat feigned illnesses, FDIA can also have a devastating psychological impact.

In “The Act,” viewers see Gypsy’s emotions range from fear to indifference to anger to sadness as she is shuffled from appointment to appointment but otherwise kept isolated from age-appropriate peers. She begins to develop a friendship with one neighbor, only to have her mother pull back when that neighbor shares stories and tips about teen interests with Gypsy. The longer she is kept isolated and the more Gypsy grows (despite her mother’s efforts to keep her young), the more intense Gypsy’s emotional reactions appear.

Kids living with a parent or caregiver with FDIA are at risk for social isolation and loneliness, anxiety, and depression. Not only are these kids conditioned to fear for their physical safety, but the isolation they experience makes it difficult for them to establish trusting relationships with peers or other adults.

Children of Parents with Mental Illness Need Support

“The Act” acknowledges in every episode that some events have been “dramatized or fictionalized,” making it difficult to determine fact from fiction within the story, but the series does highlight the importance of understanding how parental mental illness affects children. While FDIA is rare, many children live with parents struggling with a wide variety of mood, anxiety, and other disorders.

Just as parents need support when raising kids with anxiety, depression, and other disorders, kids living with parents coping with mental health issues also need resources. From group therapy to individual therapy to additional supports in place at school, children benefit from building relationships with trusted adults and increasing their network of support.

Kids need to hear the message that there’s no shame in seeking help when life feels overwhelming and that reaching out to an adult for assistance won’t result in some kind of punishment for the parent.

Gypsy Rose is taught that she can’t trust other adults and that she must keep her family secrets for her survival, but the message we want children to understand is that help is available and they never have to go it alone.

*FDIA is a form of child abuse. If you suspect someone you know has this illness or if you think you know a child who is suffering as a result of FDIA, notify a health care professional, the police or child protective services. Call 911 if you know a child who is in immediate danger because of abuse or neglect. Or, contact the Childhelp National Child Abuse Hotline at 1-800-422-4453 (1-800-4-A-CHILD). All calls are anonymous and confidential. Crisis counselors are available to guide you through next steps.


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Last Updated: Jul 11, 2019