Andrea Dunlop (on Munchausen by proxy)

Welcome, welcome, welcome to Armchair Expert, Experts on Expert. I'm Monica Padman and I'm.

joined by Dax Shepard. Hi. Hi. I'm Dax. I'm Dax.

That wasn't fair to Andrea Dunlop at all. Not really. Andrea Dunlop is a writer and a host of an award-winning podcast, which we talk about a lot in this episode called Nobody Should Believe Me. This was tasty. This is all about Munchausen, and Munchausen by proxy,

one of our favorite topics. This episode is so fascinating. I've just told everyone I've encountered since then about this, so a lot of people are waiting for this episode to.

drop. She's also written several books. Women Are the Fiercest Creatures, Losing the Light, She Regrets Nothing, We Came Here to Forget, and Broken Bay. But please check out Nobody Should Believe Me, the podcast. It's phenomenal and we discuss a lot.

He's an armchair expert.

Hi. I'm so sorry I'm late. Oh, no problem. Dax, nice to meet you. Nice to meet you, too.

delayed. It'd be pretty awkward if you guys clashed. Yeah. It wouldn't work. It just simply wouldn't work.

you know? That's one of the main issues. We hear that a lot. Truth be told, you're mildly responsible for my tardiness. I am?

a really good compliment. I'm going to take that one and carry it with me. Yeah. Yeah,

I was distracted listening. Then I was distracted. Oh, I want to write that down, to bring that up. And then I was like, what are we doing up here? Oh, we're in the middle of exercising.

That's amazing. As long as I didn't cause any injuries, I'm extremely glad to hear it.

They usually surface the next day. So TBD, I was lifting with bad form. Good thing I.

have insurance. I don't know if my liability insurance covers that, but we'll see. That'd be a pretty wild claim to levy. I mean, I deal with very litigious. Oh, yeah.

do we got? They have really cute tote bags with her books in them. And they say Armchair.

Expert on them. Yeah, that's really sweet. ACX. My friend who works for Land's End, is also a huge fan. Shout out.

you live there? I am. I'm from there and I live there. And you grew up where exactly?

I grew up in Woodinville, Washington. It's a little suburb northeast of Seattle. It was very quiet and rural when I was living there. It's gotten a lot busier. Is it north of Bellevue?

It is east. Do you ever go to that janky water park that was just south on the floor? I guess it's the 405 that loops through there. Wild Waves, baby. Yes.

that was a real destination when I was growing up. Maybe it is janky. I haven't been there since I was a kid, but I mean, it was practically Disneyland. Of course. And I shouldn't have.

said.

A, I loved it. B, everyone should go. It's a wonderful place for your family to make memories, but also water parks in general, it's a tremendous amount of people with recycled water. And the thought of being fully nude with your genitals out in the very public water, I think, is why I leapt to janky. It was a janky situation, it sounds like.

the jankiness. We actually took the kids earlier this year to Great Wolf Lodge. Are you familiar with Great Wolf Lodge? Yes, absolutely. Yeah.

which is fantastic. My children have never been happier. Vegas for kids. But there's an added component, which is it's indoors. It's a water park indoors?

You know what I'm saying? That is not for me. It really is. And it gets packed. So there was just a point when we were at the water park, where I was like, there are too many people in this wave pool.

Just all the people and all the variables, of all the germs, and it's all just trapped in a Ziploc bag. But it's a really fun place. No one should miss out on it in their life. Okay. What were mom and dad doing in that area?

which was lovely for us. And my dad, he is an entrepreneur. He has always worked sort of adjacent to aerospace stuff. So when I was younger, he was doing sort of consulting and business turnaround work. And then he eventually bought an aerospace subcontracting firm where they made parts for all those companies.

So you have, actually, let's go through some of those things first before we get to the podcast.

So did you go to University of Washington? No, my husband did. So, you know, go dogs, all that. Yeah. I went to the University of Redlands.

getting off to get in and out on your way to Palm Springs. I think that's the best way to describe

Redlands. It's a very small town, but it's very cute for college towns. I wanted to go to a big school and then I actually loved going to a teeny tiny school. So it was a really good experience.

But did you have a fantasy of LA and Southern California growing up in Seattle? And you get.

to Redlands, you're not really there. You're very close. That is very true. And yes, I was hellbent on going to school in California, partly because of the tennis, the lure of being able to play tennis outside all the time. Like I wanted to change.

Oh, it's so fun. Once I started watching that tennis show, I need to get into this because everyone's been talking to me about it this week. Oh, it's so good. And Challengers. Oh, I was thinking of Challengers.

Yeah, it's by the people who make Drive to Survive, Box to Box. They make all these incredible, compelling sports documentaries. And you can watch them about sports. you would never be interested in. Golf.

Oh, fun. It couldn't be better. This is how I feel about football. I do not like watching football, but I love Friday Night Lights. I love a football arc.

but I don't love watching football. Totally. As a metaphor. Okay, what did you major in? at Redlands?

you just write a lot of very bad work, and that is your job when you're that age. I also want to say I have listened to a bunch of episodes of the show. Thank you very much. You don't have to.

listen. It's just shocking. you would have made it through an episode where I didn't say. Maybe you removed it. It definitely could be white noise.

novel when I was in school. that alone is an accomplishment, right? I always tell people when they're trying to get into writing, I'm like, well, you have to write so much. bad, like, don't try and publish the first thing you write. That's a fool's errand.

you're right. Almost every occupation benefits from something well-written. Yeah. So when you graduate, though, finding employment as an author. Right.

book publishing. anyway, it's all electronic now. So you don't have that anymore. This is 95. I'm referencing.

book. I think maybe even my mother got it for me for Christmas. And it was like an encyclopedia of who you could submit to. And, Monica, it's hundreds and hundreds of pages of addresses. Yes.

I did a few of the SASE, but they were moving a little bit to electronic. But I did send some of those out. One of the best pieces of advice I've heard, and I think it still holds true. There are many literary agent databases now online and lots of information you can find there. But I still think one of the better ways is to find books you like and look in the acknowledgements, because people always think they're agents.

interviewed with Anna. Oh, that's terrifying. But that must have been on like a third round of interviews. I don't know what happened. She is not first on the gate.

So it was assistant to the managing editor, but I did not get it, which was great, because then I got a temp job working at Random House. Oh. And then I was like, oh yeah, like I am a book person, really. So I should be here. So I worked at Random House the entire time I was in New York.

it. Can I ask really quick, you said that it was a bananas industry. Could you give me a couple of highlights? We don't know enough. I feel like if I made that comment about Hollywood, I would have.

some specific aspects of it. Oh, I guess it just depends on how much of the interview. what I did. Growing up on the West Coast and then moving to the East Coast, was a huge culture shock. And publishing is the most East Coast, blue blood.

right in that? I don't know where they're at currently, but they certainly suffered an incredible downturn in sales and whatnot, right? It was a shrinking industry. Not really. It just is never growing.

was ever like. Publishing has always been a business of really small numbers. Most books that come from big houses don't sell more than a thousand copies. Wow. I just read there was that big lawsuit, the DOJ versus, you know, there's supposed to be this merger with, I always want to call it Random Penguin, but it's Penguin Random House.

I like learning about that. Very interesting. Okay. So you have published several novels, and how does writing We Came Here to Forget end up filing into Munchausen, Munchausen by.

proxy and your podcast? I started writing. We Came Here to Forget when I was pregnant with my older daughter, Fiona. The reason that timing lined up is because getting pregnant really brought up for me all of the things that had happened with my sister. And so it was something that I always knew that I would write about eventually.

So that was the summer of 2019.

come out. around that same time The Act came out, which was Hulu. And I know you guys interviewed.

Yes, we played. It was a good performance. Also Aaron Lee Carr, who did. Mommy, Dead and Dearest.

The documentary in particular is excellent. And Sharp Objects came out. So it was having this weird little pop culture moment. So I was doing an interview with a journalist. She introduced me to Dr.

experience. Yeah. I got to say, I'm really delighted to have had the personal experience of not directly, but my wife worked with somebody who clearly has Munchausen. So I can relate to the very bizarre position you're in. It feels unapproachable because you're recognizing the person already is caught in a huge yarn of reality.

with my relationship with Megan, and she did have these previous Munchausen behaviors.

Yeah, we should back up a little, I think, because if people are just entering,

can we get what happened? How did we get to the point where I was even writing that book? Yes, yes. My sister and I were close in age. We were close growing up, at least from my perspective.

said, it's not falling out. She's shaving it.

Yeah. So that's one of those things where, obviously, that's alarming, but no one said it could be Munchausen. No one gave us- That's a big leap. It feels like. And teenagers in general, but teenage girls sometimes do really strange things for attention.

I'm so sorry, too. And is it your sister, or is it Hope? Because what would be fun, too, to start paralleling? Because your podcast, as you're investigating this person, Hope, from Texas, all of these insane parallels are becoming obvious to you. Maybe you saw them before, or as you're learning them.

Part of the reason I was so drawn to the Hope Ybarra story is because of all those parallels. It's easy to look at someone who engages in these behaviors as an adult and think, oh, they must have had a traumatic childhood, or they must have just been this really sort of desperate person, because it is a desperate behavior. Yeah, yeah. With Megan, she was so well-liked. She had this huge group of friends, many of whom I was close with, a couple of whom I'm still in touch with.

Well, you do some light paralleling with addiction, and I think there is something in that, that they're in a dopamine deficit cycle where it works, but it's short-lived,

and we need it all the time, and more extreme. And it makes it that very compulsive behavior, right? Yeah, yeah. And that's why you sort of see it escalate over time.

Okay, so how do you begin investigating hope? And let's talk about hope for a minute, because the childhoods are similar, and then even more interesting, them as adults and parents becomes really similar.

Say her last name. Yeah, Hopiabara.

It sounded every time like you were saying Capybara, the large rodent from South America.

Yeah, actually, our transcription sometimes put Capybara in there, and it was very funny. Yeah, I was like, I don't think that's what I said. So when I first met with the APSAC committee that I had mentioned, I met Detective Mike Weber, who's a frequent guest on the podcast, he's my collaborator on the book. And here was this guy who'd investigated all of these cases and just knew so much. So I started just talking to him about his cases, and I think that was really around the time that I thought I was just a big podcast listener and just love the podcast.

And were you initially not intending to even involve your own story into it?

No, I wasn't. The experience around publishing the novel was not great. I didn't enjoy getting those letters from the lawyers. And it's never been something I've been super comfortable sharing at that point in my life. It felt extremely vulnerable to be sharing that.

A betrayal of your sister?

Yeah, I spent a lot of years trying to think, how can I talk about this in such a way that will hurt her the least?

Yes, of course.

But still be true to my experience and still get across to people that what I'm saying is from a lived experience, right? I'm not just a novelist who's writing about this because I thought it was interesting. So I was still very much in that stage. So the story was covered a little bit in the media. When I read about it, I just was so stunned by the parallels, the things we've talked about, that they were both seemingly just very charming, very smart, very close families, parents still married, no obvious signs of why this person became this person.

They both lost their twin pregnancies.

At like the same six months in, which, you know, is a devastating time to lose a pregnancy because it's past even, I think, the viability line. So it just was so similar. Hope had back stuff. My sister had back stuff, even sort of at the same ages. I mean, it was just stunning.

OK, so let's talk about Hope's early childhood, because there there's all these insane similarities between your sister and Hope.

They were both in the band and they even sort of look a little bit of like. she had a back injury in high school, same timing, very mysterious. And then she was in a wheelchair. My sister was not in a wheelchair, but she did wear a very visible back brace for a long time.

But your sister had surgeries, you said?

She had a couple of surgeries. And then there was an issue with one of the surgeries.

I know people listening are having all these questions, which is something had to have been wrong if a doctor performed a surgery, right? Or no?

I'm going to defend the doctors a little bit for one second. So A, Lane Norton, guess we had on, talked about this very large scale study where they gave MRIs to people without back pain. 10,000 people, huge study. 40% of people have a herniated disc, but it doesn't hurt. So the problem is, if your back hurts, they give you an MRI.

defense of it. That's a really interesting piece of data. Back injuries are one of those things that can be really tricky to get to the bottom of. I mean, I had a back injury when I was in college from tennis. It was a bulge disc or something.

And I'm watching my father-in-law go through it right now, which he has been suffering insane back pain. And I've seen it's affected his walking. And he's with the best person in LA. He flies here and they're trying their hardest. But there's a lot of guesses.

Yeah. And if you tried this intervention and then that intervention and you're saying nothing's working. PT's not helping.

Medication's not helping. Eventually,

they may escalate to a surgery. And that is what happened.

The conviction to go get the surgery knowing, God, okay, here's-. Do they know? Well, great. It's hard to know if they at all end up believing their own story, or do we know for sure they don't actually ever believe their story?

So that was one of my first questions for Dr. Mark Feldman. And I've subsequently talked to another wonderful colleague, Dr. Mary Sanders at Stanford, who's done a lot of research into perpetrators. And they do know.

You can't outmaneuver her.

You can't. In the moment, you're like, oh, and then later you're like, wait.

You're getting gaslit.

Exactly. And people use that term real willy-nilly these days, but it is true. gaslighting. Right, exactly. It's like you can't use it anytime.

Can I argue too, there is an added layer where the stakes are inordinately high, because, if you're wrong, it's so cruel to be shaming someone who's actually suffering. I think that's the component that's baked in. that makes it really hard to confront.

Let alone someone who has a sick child.

Yes. Or having lost, like, if you want to go, I don't think you were really pregnant. Oh my God. But you have 10% and you're like, what if she was? And not only has she lost children, I'm now accusing her of being a liar.

It's very hard, as it turns out, to prove that someone was never pregnant. How can that be hard?

Well, it's like non-falsifiable. How are you going to?

Exactly. Because you don't have that person's medical records. Well, true. I mean, with my sister, it ended up unraveling because she had told different stories of how she lost the pregnancy to a bunch of people. As soon as we started talking to each other, we realized, okay, this is not adding up.

Was she wearing like a fake belly?

A belly button.

It's not funny at all, but the idea that she's getting dressed in the morning and putting on.

a costume, it is a little funny because it's so absurd. I think it's okay to find those moments and you need to when you're looking at these stories. I don't know. I mean, she looked pregnant, but bodies are bodies. One can look pregnant and not be pregnant.

She probably ate more during that period. It's possible. Was it your story, or is it Hope's, that one of the sisters was feeling the stomach and was certain she felt a kick?

That was me.

So you felt your sister's stomach.

It was at my aunt's house and I was home for the holidays because this is when I was living in New York. And she said, Oh, put your hand on my stomach and feel the baby kick. And I felt something. That is the level that I believed it. And I don't know what that was.

Also how confident in her story. That's cocky. Feel it kick.

Another friend of hers, when we were catching up about the whole saga, told me that at one point she had one of those like Dopplers, because she was working at an OBGYN office. She was a nurse at an OBGYN office. So she had one, so you can listen to the baby's heartbeat. And she told her friend here, listen to the baby's heartbeat. And she said that she didn't hear anything, but she was like, Oh, well, I just must be using it wrong.

And she had fake ultrasounds that she was showing people.

Oh, yes. Obviously, I mean, she works at an OBGYN clinic. She has plenty of access to that kind of stuff. No one would ever go to an ultrasound with her. She would bring us pictures.

Stay tuned for more armchair expert, if you dare.

I feel so stressed out. This is like, really...

Can I ask really quick, what is the overlap with sociopathy? Because I gotta say there's so much of this is like where everyone else is kind of a pawn there for your approval and adoration or sympathy, the line and no fear of consequences. All this stuff also feels like it would give you that diagnosis on the DSM. This total inability to own, fault and apologize seems also very sociopathic.

Yeah, absolutely. I've researched a little bit here and there, but I don't know a ton about what the criteria exactly is for being a sociopath. It is tricky or being a psychopath, or what the difference is. But either Munchausen behavior, and certainly Munchausen by proxy behavior, especially at the extreme end, entails a profound lack of empathy. If you are capable of that, what are you not capable of?

That'd be a great name for a punk band. just real quick. It's such a fuck you. It's so antisocial. Okay.

Yes.

But she lied and said she had a PhD. Tell us about that.

She just had a fake PhD. So she said she had one. And when she was being investigated for the abuse of her younger daughter, that was one of the things that then Detective Mike Weber dug into. And it turned out that I believe she had been actually fired from her job because they discovered that she was not in fact a PhD and it was a PhD level job. She was the lead chemist.

And she was ordering pathogens from a clinic that they no longer used as a supplier, which raised this flag and interest in who had ordered them. And then they went through some surveillance tape and they discovered that it was Hope that had ordered them. She had these Petri dishes of pathogens. And then allegedly she contaminated some water for one of the coworkers who got sick and then rubbed a pathogen on the phone. The guy who had called out all this got this crazy rash on his face.

Yeah. This feels psychotic. Isn't there something in vague like the caring piece?

That's the biggest part of it. But I mean, there is a very, very strong vindictive quality, because it's that behavior of like splitting people. You are either with them or you are against them. And if you are against them, then they can be extremely vindictive. The elements of mental illness or personality disorder are interesting to look at, but it's the behaviors and the harm to other people that we should be focused on.

No. Yeah.

And it is mostly focused on that dynamic of being able to then be the heroic caretaker. And that's the intrinsic emotional reward. But this is not a person who's playing by the normal rules of society. That's so far outside what most people would do, that you have to sort of assume the worst.

So she exhibited all this Munchausen disorder on her own. And then she has real pregnancy. She has fake pregnancy. She has three different kinds of cancer.

Eight-year-long cancer journey.

And so these two things can be happening simultaneously, right? The Munchausen disorder and the Munchausen by proxy. How soon does it begin with her children?

For her oldest child, her son, when she was in college, and that's when she met her husband, and that's part of the reason they stayed together, according to Fabian, who we interviewed, there was no evidence of abuse with him. And that happens sometimes, that there's one child that doesn't get any, or that it sort of escalates as they have younger children. There was evidence of abuse with her middle child, her older daughter.

I wonder if there's a gender thing because the boy's not her gender. It's not as clean of a, oh, what do they call that?

Projection.

Yeah. And that is a clear extension of your own ego.

Yeah. It's your proxy, right?

Yeah. And it's a little, not your story, because it's a boy.

I think that's a really good insight. There is no long-term data on survivors available. I do have a colleague at Harvard who's working on a study, but certainly anecdotally, and in the nonprofit that I founded, I have seen far more female identifying survivors. And so I do think that it's possible that there's a gendered aspect, not just to the perpetrator, but to the victim as well. Her middle child was born five weeks premature, or something.

Because she allegedly fell down the stairs.

And then she lost the alleged twin pregnancy. that was not real because of alleged treatment for her, alleged cancer.

Right. She said that the chemo had caused...

Was she on chemo? No. None of that was real at all.

No. She never got any treatment.

She was in support groups. She had a blog. She had a following. There were people donating money to her.

She said she lost her hearing because of the treatment. So she had a cochlear implant.

There's so many aspects to this, but one of them is just how fucking busy the person has to be. It's so much convincing someone to implant the cochlear implant and remembering where you're at in your lie and where you're at in your treatment schedule. Talk about a lot of balls in the air. It must be exhausting to be perpetrating this many lies.

Takes a lot of research. Takes a lot of time. We always kind of joke about. there's always these binders of health information that they have about themselves. People who are suffering from actual chronic illnesses may need to have this kind of thing to keep track of while they don't want to, but it's a little bit of a red flag.

My favorite Abraham Lincoln quote is, no man's memory is so good that he can afford to lie. And that's so true. Lies are very hard to remember. At this point, when she's on her second child, the amount of lies she's been telling, this is 10,000 lies. So what did she start doing to the daughter?

With her daughter, she said that she had a diagnosis of cerebral palsy.

Was it that or cystic fibrosis?

Cystic fibrosis was her youngest.

Oh, sorry, sorry, sorry. Okay.

So with her middle daughter, she started this whole thing and she had, I think, some leg braces. and then this child was a gymnast. She did not have that diagnosis. And then the most extreme abuse was with her youngest daughter. And so she had just this absolute, ubiquitous trajectory in these cases, where she was born early and then had failure to thrive, and then had the nasal gastric, which is the nose feeding tube, and then escalated to the surgically implanted feeding tube through her stomach.

Before we move on from the feeding tubes. So some of this stuff does require medical professionals. Some of it, she can just be telling people she got results. But certainly the feeding tube, was it that she was restricting the calories of the baby so much that they were like, well, fuck it, we got to give this kid food?

Well, so, Dex, you have two kids and I know you're a few years away from the baby stage, but when you go to those early appointments, I have two very young kids, this is very fresh for me, weigh the baby and how are they eating? And there can be plenty of issues, especially if you have a premature baby. All these babies are always premature. You know, they can often have some issues around feeding. And so you monitor that.

Do you think she was getting her hands on pitocin and self-inducing labor?

I do. Yeah. And of course, I can't confirm that in either case. I think it's the same with my sister, because it's too much of a coincidence that every one of these cases involves premature and increasingly premature babies. Yeah, because having a preemie.

She survived. And we know for sure the one she lost at 24 weeks, that really happened.

That really happened. We found a death record. And my sister posted pictures on social media of her in the hospital holding the baby.

Oh, my God. I mean, again, if you post on social media in that moment, I don't want to be judgmental of anyone, that's coping that way, but again, that's just a very.

interesting choice, minimally. There are so many of these things. where there's a context, people could be doing them where there's a genuine need for support, and people do get support that way.

And people have the right to do that. But showing the baby on social media.

seems uniquely.

of it in that context. You're participating in the process, that they're going to get their hit.

Oh, hugely. I think those people are responsible for a big piece of the harm, right? Especially when you have these stories, you're playing into that person's narrative. When you're presenting the parent as a victim of the system, you are part of the problem. Yeah.

palsy for the middle, for the youngest, cystic fibrosis. There's also a moment where she knows that anemia would be good in this situation. Yeah. One of the complicated things about these.

cases is that medical child abuse itself, either than in a couple of states, is not a crime. So it's not a crime to lie to doctors, even if you're harming your child by lying to them. So you have to find a way to fit it into an injury to a child charge or child endangerment. when you're on the criminal side. You know, the family court situation is different, but when we're talking about a criminal investigation.

Draining blood so she would be anemic. Draining the blood of her child so she would be anemic, so she could get a treatment that would make her sicker, so she could get more. And have anaphylactic shock. So she could get more sympathy and attention.

Oh my God. This is so disturbing. I mean it is.

The only thing I'll say, though, is the part I can relate to is when you're an addict and either you can't get the thing you want, or you can get the thing you want, but you're going to need such an extreme reason. In the amount of computations you make and the weird story or process you can come up, you're the most creative you've ever been in your life. This is just so detailed and thought out. You really get a sense of how much time the person's putting into. I'm going to do this and then I'll do that and I'll drain the blood, and then I mean it's just so complicated.

That's a really good insight. with the mental gymnastics that go on, and certainly when perpetrators are caught out in a criminal context and when they're trying to justify their behavior. A thing that comes up so much is my child was really sick and I knew that if I didn't do this thing to get the doctor's attention that they wouldn't treat her the way they needed to be treated. They weren't taking it seriously enough. Or they'll have these other justifications of something you see all the time.

Do the kids know?

What we are finding, talking to survivors, is that most survivors do not understand that they've been abused until much later in their life. and there's a very strong parallel to child sex abuse survivors here, because there is a very high instance of dissociation and even DID. It is usually when they have gotten some distance from the perpetrator. you know, the psychological manipulation in these cases is so profound.

But the kid did know that her blood was being drained?

No, she was very young, so she was not really able to report and of course she wouldn't know that her mother was doing that. They tell them a story, so what we know from survivors who've been able to tell us about their experiences is that their mother and I say mother because it's 96 percent mother gives them a whole sort of justification.

Listen, this is all you guys got. It's all us white dudes shooting up everything. It's like thank god you guys use something. that's fucking gnarly.

No, but you're more on target than you know with that. I think that the reason that women perpetrate in this way is because people abuse power where they find power. One of the only place we give women unchecked control is over their children. Wow, that's so true. What survivors report is that their mother will give them this explanation.

Well also, if the perpetrator is clever enough to be fooling medical professionals, all of their adult relatives, yeah, a six-year-old's probably going to be something they can manage.

And think how much influence you have over your children. You create their entire world.

Yeah, I was gonna say you're telling them a lot of stuff that makes no sense intuitively. Like if you get an actual cold and they come in, they're like you gotta drink electrolytes and I'm gonna put this washcloth in you and you gotta sit here. It's like you don't know that any of that is real. They present it to you and that's the program to recovery.

You don't question most things your parents tell you and you sort of are, I think, about sort of the cult-like elements of this relationship and you're like well, what could be a more perfect cult leader than a parent? Like you? talk about the bite model, behavior, information. You already control all of those things. as a parent.

Yeah.

That's horrific.

So now let's talk about one of the big problems, and why Nobody Should Believe Me is a very worthwhile endeavor. is that flagging this to authorities, helping shine a light on this, or getting an investigation going, or confronting this is really really hard and it's not been very successful. So what's kind of the history of this? and then how'd the process start in Hope's case?

Luckily for Hope's children, they live in Tarrant County, Texas, which is one of the only places that they are adept at finding this abuse, investigating it, and actually prosecuting and taking action on it. They have a little system that works really well. Number one they have Cook Children's is the big children's hospital there and they have a child abuse pediatrician. There's only about, I think, 250 child abuse pediatricians. This is a very rigorous subspecialty.

remissions. Monica, with remission parties where she skydived into the backyard of her parents' house. Yes. So just like this, ping-ponging back and forth from like apex wellness to apex fragility.

Yeah, that's a great way to say it. They're living for the victory lap. It's all that praise of,

oh, you're such a fighter and you're so strong, and let's celebrate you. But like how greedy to.

want both ends of that spectrum. Like I want to be the most pitied and vulnerable and then the most.

admired and celebrated. Yeah, so she had these two remissions and remission parties and then she called her family together and I talked to both of her siblings. I was close with their siblings, they're lovely. Her sister was pregnant at the time and she like flew into town and you know, maximum dramatic effect. And she told them that the cancer was back and this time she wasn't going to survive.

even going to fight it this time. So this is a declaration that I'm dying. Right. They did a.

local news piece on her where she was saying, oh, I just want to die at home and we might be losing our house. and people donated money. and so it's this very extreme thing. So then Hope goes to the hospital and she is in palliative care, and the doctor who is treating her there calls her mother, Susan, and says, I can't find any information about the doctors treating Hope. Can you tell me what her main doctor, who's been treating her cancer's name is?

what else isn't real? Yeah, you're interviewing the family and I imagine you have the similar thing, which is like once you start entertaining the idea that this is what's going on, you're now going through your entire history with the person. And now, all these things, I imagine too. it's like when you find out you've been cheated on, you're like, oh that trip, oh that phone call. The.

betrayal trauma. that's part of it is just so disorienting. They obviously become very concerned about her daughter, who is also allegedly terminal and has been having lots of ER visits, health crises. So I believe Susan flagged to one of the children's doctors, listen, we've had this whole about Hope's cancer, and that's when they started looking. And then they contact presumably the detective in Child Protective Services.

is engaged in this behavior. You have to, by the way, my wife and I argue about this all the time. She's like, what if you found out one of our daughters was a serial killer? Would you call the police? I'm like, never.

enforcement. Horrific. And I have not entertained in my own head the serial killer. You and your.

husband should have that debate. I'm going to guess right now your husband's going to go,

no, never turn them in for anything. I love the private island idea. that seems maybe not economically feasible. Well, exactly. Great idea.

I think I'm just going to find an island we can get marooned on. There's probably going to be.

people there and she's probably going to kill them. Or you might, you might be next. and then who's going to keep her there? It's a lot of logistical questions. Yeah.

miss the other daughter. You have to. When they are hurting so many people, it's easier when we do think about them hurting kids. Like in general, the idea of kids being hurt, I think we can all get sort of quickly on the page that that's unacceptable. You would think, but what I have.

found in the way that people, either within that person's community or the way the media, treats these cases is. the idea of, specifically, a mother harming their own children is so aberrant to people that they will reach for any other explanation, no matter how conspiratorial they have to get, they will find some other explanation for what they are seeing than that person is.

harming their child. It's in the top tier of taboos, for sure. 100%. Yeah. It's up there with the ones we discovered yesterday.

get a conviction? In Hope's case, she took a plea deal. In part, that may have been because she didn't have a lot of access to hire an attorney and her family was not going to pay for an attorney for her, but impossible to know why she made that choice, but she got 10 years.

It would also save her the embarrassment of having to hear all of it out loud in front of a jury.

I also wonder how much these people also get off on a big, dramatic court battle. I think that can also be part of it, right? It's another chance to possibly be the victim. That's not the path.

Hope took in this case. That's curious. I would love to ask one of them, because the other ways they're getting attention, either by being a victor over an illness or pitied for having an illness, those are all very positive. Whereas to be the perpetrator of a crime would be very negative.

attention. You would think, except that, unfortunately, the media climate right now, where you have the big story that's been in New York Magazine and NBC News with Mike Hicks and Boggs, do no harm series, is this medical kidnapping narrative. Heavy scare. So medical kidnapping is a conspiracy theory. And it is the idea that you, as an innocent parent, could just take your child to the doctor with an illness or an injury, and that they're accusing all of these parents of abuse and snatching their children away, kidnapping their children.

appealing, because I've had that fear. It crosses your mind. I go through a whole weird spiral.

every time I have to take my kids to the doctor for something because I'm like, what if they think I'm faking it? What if I am exaggerating? You know, there is a visceral fear. Now, the thing is, you know, has no parent in the history of the world ever been falsely accused of this? Of course not.

Mike Hicks and Boggs covered my sister. Oh, and she was seen as one of these innocent parents.

And they absolutely excoriated the doctor who turned her in, who I very strongly believe saved my niece's life. It's just so unethical. And they make the doctors the villains. So they're de-incentivized to flag this stuff. To report it.

Yeah. So you can't have a slander case brought against you, basically.

Right. And you can't, you know, and so now doctors are in a position, particularly child abuse pediatricians, who've gotten so much flack, where, if they do their job, they are then subject to not only legal action, but absolute reputational ruin, which is what happened to the doctor in the Maya Kowalski case, Dr. Sally Smith, who we.

had on the show. This reminds me of Dr. Death. Did you listen to Dr. Death?

case, but in many cases, I mean, hospitals can be complicit in this. They do cover up sometimes for things or they bury things and they don't report things when they should. There's a case in Colorado, the Olivia Gantt case was another Munchausen case, six-year-old girl, I believe, and the hospital released her to her mother, taking her to home hospice care when they suspected that she wasn't really sick and she died. And the grandparents eventually sued the hospital and settled out of court because they didn't report. I don't know what doctors are supposed to do now.

because they can get sued for both. Again, what sucks for them is like the whole problem's on their plate. They're not perpetuating any of this and somehow they're getting sued on both sides of it. Fuck, I don't know the Kowalski thing. Should I watch that doc?

And the medical kidnapping panic that we're in the midst of right now, and sometimes people will say that to me, right? You're trying to start, you, Andrea, are trying to start a moral panic about Munchausen by proxy. And they're like, this is just like the satanic panic. People will say that. Okay.

panic. And I think people took the wrong lesson. That also files nicely into the elite narrative that the elite is trying to, and doctors are implicitly elite. And the state, it's about.

parents' rights and the state have the right to intervene in the situation.

Make your kid trans.

Exactly. And it's the same people. That is where it's getting its political momentum.

It's traction. There's this insane interest right now on the right with child trafficking, which is complete bullshit. The amount that they think it's happening and who's doing it, no.

The data does not bear out that it is happening to the degree that it's happening. But I think, with the satanic panic, the way I interpret that series of events, this is when we were accusing childcare workers of taking children into underground tunnels and abusing them as part of a satanic ritual. Wild, right? But this was also the time, culturally, where we were grappling with the fact that child sex abuse is way more common than what we believed. It just is fathers, uncles, baseball coaches, people who are close to those children.

Yeah. Here's where the males are back on the scene. Thank God. Yelled disproportionately.

And I think that people believed the satanic thing because it was easier to believe that, and that's an easier problem to solve. Then, if you get rid of satanic childcare workers, the problem is solved. Whereas if you have to recognize that this is fathers and uncles, it's not so easily solved. So I think right now we may be in a moment of reckoning with Munchausen by proxy, where it's much easier to say, oh, this is bad doctors.

This is an institutional problem.

Institutional problem. And the solution is to fire all these child abuse pediatricians rather than reckon with the fact that it's mothers who are doing it.

Well, also, if I'm to believe the data in Body Keeps the Score, which I'm inclined to do, I'm going to mess these numbers up, but these are vaguely what it was. It was like 50% of all kids will experience physical abuse in a house that requires a trip to the hospital. 40% or 30% of all couples have physical violence in the relationship. I think what's scarier and crazier is that it's a very violent fucking world we live in and a lot of us experience violence, and that's almost too much to acknowledge.

Yeah. And sure enough, the medical kidnapping panic, there have been some Munchausen by proxy cases in there. There's also a lot of abusive head trauma cases and non-accidental injuries. And when you read the police reports of how these went down, you think, this is not a false accusation. This is a person who wasn't held accountable for what they did.

that. Yeah. I think for those people, they were really just trying to find the line between, like a good old fashioned character building, ass whooping, and then like child abuse. Too much. What's too much?

Physical discipline used to just be the norm, right?

Yes. And then when does it transfer into abuse is very arbitrary and nebulous. Yeah. What do you think? This is impossible to know.

The best and most recent study I can point to is one out of Children's Hospital in Seattle, actually. And I'm going to be paraphrasing this, go dogs. And one of the authors of this study was Dr. Carol Jenny, who is a legendary child abuse pediatrician. She's the author of the book on medical child abuse.

everyone that is working in this space, the option isn't great. So the incentive to keep them with their family is quite high because the alternative is foster care. So it's like we have a suspicion of some abuse, but we also know foster care, we're going to quadruple your incident rate of going to prison. We know what the product of foster care is. So it's like the option is so fucking terrible that you're heavily incentivized to keep them with their parents.

You're right. I never want people to think that I don't take removing a child from their parents seriously. With these cases, when you've reached the point where it's being investigated, it is.

often a life or death situation. I guess I point that out because often we want solutions to a specific avenue of the problem. But really, you have to like keep zooming out and go like, what piece of what system is this, and why is it so hard? Well, one of the reasons would be this, like I've been saying on here forever, foster care should be like going to Hogwarts. It should be like the golden ticket for Charlie and the Chocolate Factory, right?

rest of the people. You're so right. There are many of these cases I look at. There are cases where there are family members who would willingly take that child in and then, okay, you have a good option. That seems like a much easier choice.

Yeah, you need to fix all four of these domains and they've been pretty impervious to change thus far. Yeah, it's really complicated. So were you able to talk to, are Hopes, children, adults now?

They are. They did not want to be interviewed, and I am very respectful of that. I interviewed their dad and I interviewed a bunch of other family members.

And so your sister, she cut off ties with you and the whole family 14 years ago.

After your mom confronted her, after my nephew was born and we had a lot of experience already with some of these behaviors, we were very concerned when he was born early and then very ill and having all these escalating interventions. And my parents went to speak to our family doctor, who'd known all of us for a long time. And she was the one who gave them that terminology, Munchausen by proxy. And I was living with my parents at the time. I'd just moved back from New York to my late twenties.

though, that her being investigated would be a big enough of a warning for her to stop.

doing it in the future? I was so naive going into that. I really thought, okay, they're going to do something. And then I felt that way the second time too, because the police were involved and I knew there was video evidence and there was all of this stuff. And I was like, okay, they've got her.

You must feel some obligation to like kidnap your niece as a nephew.

It's a strong compulsion. I'm not recommending it. I'm not going to. Nobody call the authorities. You know, when I went into the project, I didn't think I would talk about my story at all.

Well, again, it's counter evidence to this earth shattering worldview, which is, I can't trust anyone. It is helpful to have some data to say, no, no, actually, there were people I could trust. It just wasn't this person. Right. Are we allowed to talk about Gypsy Rose?

Well, Gypsy Rose went to jail. She did, yes. She was in prison for seven years.

And then she got out and she married a very old man.

No.

I mean, there's a lot of tabloid behavior around Gypsy Rose. So I am always a little careful to talk about her.

I think it was you that told me not to talk about her in the past.

I'm happy to share my thoughts. So obviously, Gypsy's story has been covered more than any other survivor's story.

I watched both things and now I'm forgetting, did she kill her mother?

She conspired with a boyfriend that she met online to murder her mother.

Okay, great. Not great, but now I remember.

She did go to prison. She was in prison for seven years and she just got out last fall. Her story itself has been covered ad nauseum. She did a lifetime series, partly from prison and partly when she got out. And she has been in the tabloids a lot.

I mean, all the things. I'm really anxious.

Yeah, you don't want to contribute to.

Yeah, and I haven't covered the case at all on the podcast just because it's been covered so thoroughly elsewhere. And so all I really can say is I really wish her the best. Her father and her stepmother seem lovely. I know some people who've met them. Someone I'm really close with, Bjorker, was the expert in the Lifetime series.

I didn't feel bad at all when that was the outcome. That's self-defense.

I agree with you. And I think what we should feel bad about is the fact that that was the only option she felt she had, that she was ever in that situation.

It's never a win if someone has to commit murder and live with having murdered, now, on top of it, your mother.

In particular, their parents. Children who commit patricide, I mean, it's a horrible trauma. I think Gypsy was incredibly traumatized by having been involved in her mother's murder. I really hope she can find a life outside of the public eye for a while. I think that's probably unlikely because I don't know what her other options for employment are at this point.

conundrum. Are they going to make a reality show about her? There's all this. They are, right?

She has a second sort of piece of the lifetime. I'm never judgmental of how people end up carrying on with their trauma. If you're a sexual abuse survivor and you strip, and that's empowering. I'm not to say how anyone should be dealing with their trauma. There was no really old.

boyfriend. in the mix? There's a prison boyfriend. Oh, okay. There was not a big age gap.

I feel like I saw a photo of her. I did think she was married and then got divorced.

Yeah. She married her boyfriend in prison and then they got divorced shortly after. Probably for the best. I don't know that her relationship that starts in prison. This seems like a strange.

dynamic to me. Not to be too judgmental. Well, you marry your coworkers. It's very common. Well, the podcast is tremendous.

for so long. You do. You feel ashamed. You feel stupid. You know, with my sister with the fake pregnancy, you're like, okay, so that happened, and then we acknowledged it happened and we just moved right along.

intervention could be possible there. Oh, this was the last question I actually wanted to ask. Is there any treatment that bears any results for people who get outed and then actually explore?

A couple of my committee colleagues, Brenda Bursch and Dr. Mary Sanders from Stanford, who I mentioned, they do have a treatment model. They have had some success with perpetrators. It is going to be a very, very, very small percentage of perpetrators who are able to be treated, because the very first step in what they call the accepts model. It's sort of similar in some ways to like a 12 step program.

a full accounting of their behavior. I thought my fourth step was bad. I can't imagine making.

that fourth step. Most perpetrators are never going to do that, regardless of whether they're sitting in prison. Hope Yobar didn't do that. I interviewed her. She was not accountable for action.

someone would be tempted to have the erroneous thought, well, they won't kill the child, because that's the source of all of the pity. But no, because that's the last big hit. A grieving parent of a dead child is like the number one. It's also an accident. Right.

that they just pushed it too far and they miscalculated. And I think there are cases like that for sure. And then there are other cases where I think it was 100% intentional. And the point was then to become the face of the foundation that supports that disease. Then their.

identity becomes about being the parent of a dead child. Yeah. Because even Hope's last round of cancer saying, I'm going to die of this. It's almost like she needed to elevate it to that. You can see where the ultimate fantasy for these people would be to be at their own funeral.

I think, even when it's an abuse situation, one of the first introductions for most people to this.

term at all was in the sixth sense. Oh, my God. Yes. The throw up girl. I was so scared of Misha Barton.

and her mother's sitting at her funeral. The thing about that portrayal that felt so emotionally apt to me, and I don't know that this was necessarily intentional, but sorry for a spoiler for a movie that's like 30 years old, that he sees dead people and then the person who sees it. So it's like the idea that only one person can see it. No one else in that scenario understands what's happening. That is such a good description of, I feel like something that I've talked to other family members and survivors about is like, you feel like you're in a horror movie and you're the only one who knows you're in a horror movie.

in like a Hallmark movie. You're still main character energy, but not in the movie you.

want to be in. No, definitely not. I just got chills. That movie's so good. I should rewatch.

I mean, it was so good. The twist. I know. I feel like it's the best of all his twists, and I feel like he really leaned on that formula for a while in it. I think he got a little high.

on that formula, but that movie, wow. Oh, I hated her. I would tie it with Usual Suspects.

Kaiser Sosay. Also, good. Yeah. There's a couple of big old left turns. Well, Andrea, this was awesome.

adjective. Well, it's just fascinating, because we don't know much about it. Again, it's the.

most taboo notion. I mean, if we weren't curious about it, then people wouldn't learn about it. The fascination is what's going to help us get people to recognize that it's a real thing. Yeah. Especially when you're talking about Munchhausen, just doing it on yourself.

I keep saying it's the last question, but you reminded me of a couple I had. One last question is, is there any predictable cause for this? Not that they know of. A lot of people, I think,

when people grow up to be perpetrators of horrific crimes, would really like to have a neat narrative where they can tie it back to some child abuse. And of course, that is also common. We know about ACEs scores and how you are going to be more likely to perpetrate crimes if you suffer from child abuse. But there is no known link. Some of the cases were kids who had child abuse in their past.

It's like sociopathy. They're looking to find origins and they can't.

It's more comforting if you can find an origin, because then you think, oh, we can prevent this.

My child won't grow up and do this. I have no business having this opinion. I don't work in either of these fields. But to me, sociopathy feels very structural. I just feel like that when you're really born with, it's so unique and interesting.

The empathy piece.

Where's the nurture part?

Yeah, the empathy piece. Having grown up with my sister and sort of being able to trace and talking to my parents about their earliest memories of her doing things like this. It does seem to be sort of a wiring thing, at least to an extent.