ABSTRACT
Many clinicians claim that individuals with FD are driven by motivations that simply cannot be explained. Chapter 5 considers the murky world of why someone would want to be sick, and argues that FD patients are often themselves unaware of why they perpetrate the behavior. Chapter 5 investigates a variety of possible motivations, such as the “rush” that treatment and deceit give them. Some patients describe a “high” during a hospitalization that can be likened to the impulses keeping an addict returning to their substance of choice. In another parallel with addictions, FD patients often must go to greater and greater lengths to feel that initial excitement. Childhood trauma is widespread in this community, and this recognition offers insight into the mindset of the patients. FD patients often suffer with “legitimate” depression, anxiety and personality disorders, and use FD to “self-medicate” their emotional pain. Chapter 5 carefully examines FD patients’ need for nurturance and attention, the impact of the adrenaline rush in life or death situations, and the thrill of deception as they pursue their illness fantasies.
