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SickenedReview - Sickened
The True Story of a Lost Childhood
by Julie Gregory
Bantam, 2003
Review by Christian Perring, Ph.D.
Apr 28th 2005 (Volume 9, Issue 17)

Sickened tells the story of Julie Gregory's abuse by her mother and father. The abuse took many forms, including verbal insults, beatings, threats of suicide and abandonment, forcing Julie to hit her foster brothers and sisters, and insisting that she undergo invasive and painful medical tests and take medical drugs that were not needed. That's not to say that she was a healthy child: she often had shortness of breath, and she was extremely thin. Although it isn't quite clear what the causes of these problems were, it seems that they were mainly due to emotional stress and nutritional deficiencies. However, her account suggests that her mother had a pathological desire for doctors to find serious medical problems with her: she was outraged when cardiologists refused to perform open-heart surgery on her. Once Julie took a psychology course in college and learned about the condition of Munchausen by Proxy, in which parents or caregivers seek out medical care for those in their charge as a way to serve their own needs even when this does harm, she was clear that it perfectly described her mother.

As a memoir, Sickened works well. It is quite short, at 244 pages of relatively large print, so it goes through about twenty years of Gregory's life quickly. Gregory is a talented writer, with a strong ability to write dialog and convey her childhood feelings. She shows not only how her parents were manipulative and hurtful, but also how doctors often collaborated unknowingly with her mother's abuse, and how nobody would believe her when she tried to tell them that her mother was making up her health problems. It becomes very easy to understand how even she would go along with her mother's pathological lying as a way of appeasing her and avoiding trouble. Her story also will provide hope and inspiration for others who have been in similar positions, since it ends with her feeling confident and with a clear understanding of all she has been through.

However, it is worth noting the difficult position of someone writing such a memoir. Gregory tells how she was abused and forced to lie to doctors as a youth. She emphasizes her mother's lying about her to doctors and the ways that her mother has undermined Gregory's credibility more recently when she confronted her about the past. Her mother accuses her of making stories up and being an unreliable source because having been in mental hospital. Obviously, readers are not in a position to independently assess the truth of Gregory's story. A few medical documents from her youth are included in the text, maybe to add to the interest of the book, but possibly also to serve as evidence for the truth of some of the details. They are not all easy documents to decipher and of course we have no proof they are real. It is hard to know what value to assign them as part of the narrative. But as with any memoir, (as opposed to some autobiographies of well-known people), the reader's role is not to sit in judgment over the truth of the story. Rather, the aim in reading such a book is to gain from the other person's life experience. Nevertheless, it is hard to dismiss the question from one's mind when reading Sickened about how reliable Gregory's memory is, for the paradoxical reason that if her story is true, it seems more likely that her experiences would cause her memories to be distorted. My point here is not to throw doubt on the truth of the story, but rather to point out readers of the book are likely to experience an underlying tension in working out what to make of it all. As with Augusten Burroughs' Running with Scissors, the childhood chronicled makes one wonder how the author could have avoided growing up herself becoming a chronic liar.

At the end of the book, Gregory is determined to stop her mother from carrying out the same abuse on other children, and this determination is fueled by the fact that her mother currently has children in her care now. Readers should go to Gregory's website to find updates about her fight to protect children and work to raise the public consciousness about Munchausen by Proxy. Her self-appointed task is an important one, and since her book has been successful, it is likely that she really will do good. Gregory deserves praise and admiration for her courage and persistence in overcoming huge challenges.

Sickened raises questions that Gregory herself does not attempt to answer. What safeguards should be in place to stop parents from getting doctors collusion in medically abusing their children? Normally parents have full decision-making power over their children so long as they are not neglecting or abusing them. But how are doctors meant to find out when abuse is taking place, when they are being put in the role of abusers? Medical practices that are swamped and doctors are generally only able to spend a short time with young patients, so they have to rely on the testimony of parents in order to make a diagnosis. How much effort should be made to verify the reports of parents about their children? These are very difficult questions given the medical system we have at present, especially since a larger problem is that too few children receive adequate medical treatment, and often doctors are only too happy to help when parents do bring problems to their attention.

Another central question the book raises is why people who use the medical system as ways to abuse their children to fulfill their own psychological needs should be classified as having mental disorders for that specific behavior. There are two sorts of reasons one might challenge the categorization. First, one might argue that it is covered by more general diagnostic categories such as depression, anxiety, or more likely, personality disorders. Given that the actions of Gregory's mother were narcissistic, showing no appreciation of the rights of her children, and that Gregory seemed to need to derive her own feelings of self-worth from taking her daughter to doctors, to the extent of threatening suicide if her actions were challenged, it is very tempting to speculate that she would be a prime candidate for a diagnosis of some kind of personality disorder. If so, then what need is there to give the behavior a specific name? It is worth being clear, since Gregory does not mention this, that Munchausen by proxy is not in fact listed in DSM-IV-TR. Maybe then, the main purpose of giving the behavior a name is just to help emphasize that such behavior can be symptomatic of mental disorder. However, and this is the more radical form of challenge the categorization, one might question the whole assumption that such behavior should be seen as a mental disorder of any sort. This would go with the line of thought that denies there are any such things as personality disorders, and argues that the forms of behavior that earn people such labels are much better seen as moral failings rather than psychological or medical categories. Gregory never considers such a view, and indeed her account provides an argument against it, because it is clear that, for her, coming to see her mother's behavior as an example of a particular form of mental disorder was very helpful to her in coming to really question her mother's judgment and actions. Learning about the psychological syndrome was empowering for her, and this gives us a pragmatic reason to think it is a helpful category.

Ultimately, Gregory's book is an uncomfortable read because of the abuse it chronicles, the emotional tensions inherent in the text about the author, the questions it raises about how society should try to prevent such abuse in the future, and the worry that there are children currently in danger from Gregory's mother. Yet even with that discomfort, or perhaps because of it, Sickened is a compelling work that readers will remember for a long time.





2005 Christian Perring. All rights reserved. 


Christian Perring, Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Review.  His main research is on philosophical issues in medicine, psychiatry and psychology.


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