Factitious Disorders: Too Comfortable for Change

Transforming from being sick to being well is a painful and challenging process.  That’s because being well pertains to going through tremendous changes in one’s life; both external changes and internal changes.

Take the case of Anna*. She came for counselling as a depressed young adult. After some sessions in counselling, we figured that it was in her best interest to remain depressed. As long as she is depressed, her dad won’t pester her to find a job. More than that, her mom will continue buying and preparing food for her.

In Christian Counselling, I always begin with a measurement of client expectations. One important question I always ask is: how will your life look like if you are no longer depressed?

Anna’s silence made me nervous as she can no longer share to her therapist what seems to be the selfish rewards  of being sick. How about telling your counsellor that: “if I become well, my dad will force me to get a job and when this happens  I can no longer sleep through the morning”?  At that point we see that the incentive to be well didn’t exceed the rewards of being sick.  Cases such as Anna where the client plays the sick-role are termed Factitious or in the medical field, Munchhausen’s Syndrome. 

I have encountered a lot of clients who didn’t want to be well. There were even some who got angry at me for telling them that there’s nothing wrong with them.  And this is what we have to be on the look out for as counsellors: counselling seekers who do not want to be well. They want the world to change but not them.

People playing the sick role are not aware that they are doing this for various gains and rewards. For starters, people naturally give in to the sick person. In the school setting, the sick are excused from class, excused from examinations and are even excused from deadlines.  We simply adjust to their needs without question and a lot take advantage of this. That if I am sick, I do not have to change, people around me naturally will!

Society itself become more lenient and more graceful to the sick; so why would they want to be well if it is so great to be sick?

This is what Christian Counselling aims to do: it seeks to empower the person so that the person stops taking and relying from others. And thus, the beginning of counselling is giving the client the motivation to become well (remember that the vision of hope should be greater than the rewards of staying sick). Once we can stand on our own, we will stop TAKING from others and become a pillar for them instead of being a burden.

So before you decide to come for counselling, check for your self: are you ready to be well?

The future is great and it is there for the taking. But you will need to get up and take that great future for yourself. It may be comfortable to be taken cared of by our love ones but this won’t give you the power to dictate the course of your future.  Give up this passive existence and live life to the fullest!


*Case of Anna occurred before 2010 and the real name (or even gender) will never be disclosed.