Samenvatting

FIVE MYTHS ABOUT FEIGNING AND WHY WE BELIEVE THEM
H. MERCKELBACH
Since the days of the old German speaking psychiatrists, myths about intentional symptom overreporting (i.e., feigning) circle around in psychology and psychiatry. I discuss fi ve of these myths: clinicians can easily recognize feigning patients; feigning is a rare phenomenon; people who feign are not able to do that for an extensive period of time; people who feign are, in a way, sick in their heads; and clinicians must approach feigners in a warm and understanding way. Clinicians readily believe these myths because they appeal to the basic idea that the clinician oversees the patient rather than the other way around (which is what feigners try to do). Misconceptions about feigning are dangerous when they are held by members of disciplinary bodies. In that case, clinicians might be criticized by such bodies for designating in their clinical reports feigning as a real diagnostic option.


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Alan Knight simuleerde dat hij verlamd was. Dat hield hij twee jaar vol. Zijn geval staat haaks op het idee dat simulanten snel uit hun rol vallen. Harald Merckelbach inventariseert allerlei misvattingen over simulanten. Hij begint bij Carl Gustav Jung en eindigt bij Anton Tsjechov. ‘De simulant wil de regie voeren over de arts of psycholoog.’

Een simulant is iemand die klachten veinst of in elk geval dan schromelijk overdrijft. Over simulanten doen allerlei mythes de ronde. Zo wordt er vaak beweerd dat simulanten bijna niet voorkomen. Deze en andere misvattingen over het onderwerp stammen uit de koker van de oude, Duitstalige zenuwartsen. Het gaat dan om auteurs als Carl Gustav Jung (1875-1961), Fritz Siemens (1849-1935) en Heinrich Többen (1880-1951). Waarom deze dokters stellige meningen verkondigden over, zoals zij het noemden, die Simulationsfrage, is duidelijk. Het was een generatie artsen die nog uit de eerste hand beschrijvingen had gehoord van hoe psychiatrische patiënten met koude douches en dwangarbeid werden geïntimideerd als de verdenking van simuleren rees. Daartegen zetten zij zich af. ‘Want,’ schrijft bijvoorbeeld Siemens (1888, p. 9-10), ‘de humaniteit eist dat we iemand die zich voor zieke uitgeeft zo lang als zieke behandelen totdat het tegendeel is gebleken.’ Om eraan toe te voegen: ‘Men is arts, geen inquisiteur.’

Dat sympathieke standpunt

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