Author Archives: Dr. Marc Feldman

Advice for patients with factitious disorder who are seeking change.

Though I always knew that I had a factitious disorder–at least on some level–it was difficult to admit to it on a practical level. I can go about discussing my childhood, which was not a happy one, but I don’t care to relive it. One of the reasons I found it difficult to admit to it is that there is little if any treatment in the eyes of most professionals; it is generally considered to be a hopeless diagnosis. I really thought that if this was true for me, I must be a lost cause. But God does not create lost causes. Feeling like FD was a hopeless diagnosis kept me from being able to admit it first to myself, then when trying to find any kind of treatment. Some also consider borderline personality disorder to be a hopeless diagnosis. None of this is true. It does get better and there is always hope.

What I want to say is that even a serious factitious disorder is not hopeless. Believing that it is makes it harder to admit to it. There is psychotherapy which can help you to develop some insight into how FD developed and strategies to prevent an occurrence. These strategies can include DBT (Dialectical Behavioral Therapy) or STEPPS (Systems Training for Emotional Predictability and Problem Solving) for coping skills, as well as CBT (cognitive behavioral therapy) and EMDR (Eye Movement Desensitization and Reprocessing). A whole-person approach also includes the treatment of existing (legitimate) health conditions, even if it involves pain that would drive anyone up the wall. And in some cases, though medications won’t make you honest, they can treat depression or anxiety or help to stabilize mood.

But as someone who suffers (or did) from a factitious disorder, what I can tell you is that a 12-step program is absolutely essential. This is what truly saved my life. And recovery is about healthy boundaries–with yourself and with others such as family members and friends. There is an excellent series of Christian and self-help books by Drs. Cloud and Townsend on boundaries that have been helpful to me (Safe People, Boundaries, Changes that Heal, and How People Grow).

Finally, what I want to discuss last is forgiveness. When I thought about what I had done to myself, I had a panic attack. When I thought about the good people who had been hurt by what for me was an addiction (to medical treatment) as well as a basic problem with a lack of honesty, I spent weeks, if not months, wanting to take my own life. I would give anything to take back all of it, but I can’t. I can only stay on the right path. Forgiveness takes time. It does help to make amends if and where you can, but to forgive myself I had to ask God for His help. And I had to come to view myself as a sick person mentally and spiritually. But I also had to learn to forgive myself because not doing so is like swallowing poison and expecting not to die.

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