This article is part of our Villains Week series.
Over the past year and a half, an often ignored mental illness has been brought to the forefront of television. In two miniseries — Hulu’s The Act and HBO’s Sharp Objects — Munchausen syndrome by proxy (MSbP) defines two of the most unique villains of the 21st century. Dee Dee Blanchard, a real woman whose story of deception, abuse, and death brought Emmy gold to Patricia Arquette in the former, and Adora Crellin, played to prickly perfection in the latter by Patricia Clarkson, draw attention to the nuance, intricacies, and ramifications of the disorder, especially in relation to motherhood.
Both of these maternal characters suffer from MSbP (also known as Factitious disorder imposed on another, or FDIA). While the disorder has previously received public and pop culture attention — songs, autobiographies, documentaries, and news stories covered the topic heavily over the past two decades — Sharp Objects and The Act offer unique insights into the minds of the women behind the sickness. While the handling of this material could’ve been insulting, shallow, or outwardly sexist, these two miniseries take care to respect their characters and the real people suffering from the condition.
Munchausen syndrome (or Factitious disorder imposed on self) is a disorder that causes those suffering from it to feign illness or cause themselves to be sick. It’s primarily used to curry favor or attention for oneself, but there are other justifications and intentions behind it. Alternatively, Munchausen syndrome by proxy is where someone, primarily a parent or caretaker, will make another person sick or will lie about another person’s health for the purpose of being needed, perceived as heroic, or sympathized with. Most often, those suffering from MSbP are mothers.
The Act is based on the true story of Dee Dee and Gypsy Rose Blanchard (played in the miniseries in an Emmy-nominated performance by Joey King), a mother-daughter duo who were heavily discussed in the media after their shocking story of murder and deception unfolded in 2015. The eight-part series mixes flashbacks with flash-forwards, detailing the real-life events that culminated in Dee Dee’s murder without ever turning into a suspenseful soap opera.
While the entire writing staff deserves credit for the show’s thoughtful approach, Michelle Dean is The Act‘s not-so-secret weapon. Having interviewed Gypsy Rose beforehand for her Buzzfeed article “Dee Dee Wanted Her Daughter To Be Sick, Gypsy Wanted Her Mom To Be Murdered,” Dean understood the young girl and her motives more so than most writers covering the same story.
Dee Dee claimed her daughter suffered from multiple illnesses that she didn’t have (including muscular dystrophy, epilepsy, severe asthma, sleep apnea, and leukemia) and required surgeries, drugs, and medical equipment that she never needed. She also had the girl believing she was much younger than her true age. Dean directly heard the extent of the emotional manipulation and physical abuse Gypsy Rose endured, and the empathic tone of her article expresses that.
In the series, which she co-created with Nick Antosca, Dean takes a similarly sensitive approach to the material, avoiding easy answers or cliché villains. Dee Dee never killed anyone, and, yet, she’s more of an antagonist than her murderer, Nick Godejohn (Calum Worthy), who was Gypsy Rose’s boyfriend and accomplice. Along with her lies, exploitation, and manipulation, Dee Dee would tie up her daughter and control whom she could hang out with or talk to. She even destroyed Gypsy Rose’s computer on one occasion to prevent her from pursuing romantic relationships online.
Dee Dee typifies clinical diagnoses of MSbP, caring so much that one physically and emotionally jeopardizes those they love. What can’t be forgotten in this, though, and which the show spotlights well, is the role of exploitation. Dee Dee heavily guilted Gypsy Rose into playing the part of the sick child in order for them to receive money and other benefits from the government and non-profit organizations.
Dean’s article and The Act both detail the importance of perception for those with MSbP and how it’s often more about how one is regarded by the public than by those for whom they’re unnecessarily caretaking. Dee Dee was seen as an extraordinarily kind, well-intentioned mother by her neighbors and friends, but the bizarre truth about her relationship with her daughter wasn’t known until after her death.
Dee Dee’s actions were also motivated by her strained relationship with her own mother, as seen explored in the episode “A Whole New World.” Her mother, Emma (Margo Martindale), mocks and berates her, particularly on the topic of parenting. Shortly after giving birth, Dee Dee is arrested for check fraud, leaving Emma to take care of Gypsy Rose. When Dee Dee returns, she and Emma fight about Gypsy Rose’s health and the proper style of childrearing.
After one of her fights with Emma, Dee Dee gives Gypsy Rose more cough syrup than is necessary, marking the first time chronologically that her disorder manifests. As Emma’s own health wains, Dee Dee becomes her primary caretaker, too. It is during this period when the show indicates the fusion of care and abuse for Dee Dee. She seems to relish the pain her mother endures, uttering “sometimes the only way out is through,” echoing a similar phrase Emma demeaningly said to her earlier.
In the case of Sharp Objects, which is based on Gillian Flynn‘s novel of the same, Clarkson plays the cruel, sharp-tongued mother of Amy Adams’ protagonist, Camille. The show begins as Camille, a crime reporter, hears about a series of violent crimes committed against young girls in her hometown. Her editor sends her back to rural Wind Gap, Missouri, where trauma, self-harm, and complicated family relationships come to haunt her. Adora criticizes and controls her daughters to extraordinary degrees, and, while Camille internalized those messages to self-destructive lengths, Amma (Eliza Scanlen), Camille’s half-sister, understood them differently.
Adora’s disorder isn’t revealed until the penultimate episode. It becomes increasingly clear that she unintentionally killed Camille’s younger sister, Marion (Lulu Wilson), by poisoning her. In the show’s climactic scene, Camille and Amma become trapped in their childhood home as Adora force-feeds them rat poison, which she refers to as medicine. They narrowly survive when Detective Richard Willis (Chris Messina) puts the pieces together and saves them from their mother, arresting her for poisoning her daughters as well as for the murders of two young girls whom she tutored and grew close to.
That climax is followed by a post-script that seems light-hearted and jolly as Camille and Amma make a life for themselves in St. Louis, now free and far away from their mother’s verbal and physical abuse. That is until Camille looks into Amma’s precious dollhouse — which is modeled identically off of their childhood home — and sees that the murdered girls’ teeth have been used as material for the iridescent tile floor in the miniature recreation of Adora’s bedroom.
While both Adora and Amma are villains in Sharp Objects, only one of them is responsible for Ann and Natalie’s deaths. It complicates our ideas of female murderers and why women kill. Adora is undeniably cruel to Camille, but her mental health and overwhelming grief must also be taken into consideration when judging her character. She’s sick and horrifyingly desperate to be needed by her daughters. She lashes out in a disgusting and abusive manner, but it’s clear from Flynn’s writing and Clarkson’s beautiful portrayal that Adora carries deep, unmanaged pain with her. Her ticks, general tenseness, and explosive outbursts are all signs of the overwhelming anguish under her cold facade.
As for Amma, her lines during the dinner scene in final episode — starting with “I hope he gets the death penalty, baby killer Keane” and culminating in the foreboding words “I’m Persephone, Queen of the Underworld” — hint at the volatility of her own mental state; she sees the murders she perpetuated through a lens of fiction, as if it were all Greek mythology. Amma’s long-established poisoning at the hands of her mother is certainly a factor in her psychological deterioration, and it’s clear from her final killing in St. Louis that she’s primarily motivated by jealousy, not exclusively for Adora’s attention but also Camille’s.
The Act and Sharp Objects offer different yet undeniably parallel depictions of MSbP, stressing the roles of control, power, and codependency in the women’s disorders, as well as cycles of violence they both inspire in their children. In The Act, Gypsy Rose doesn’t harm her mother herself, but she convinces her boyfriend to kill on her behalf. Although she occasionally feels remorseful, some scenes that follow stress her idealization and romanticization of life without Dee Dee.
And for Amma, Adora’s disease became so normalized to the point where she craved that kind of destructive care. As Adora grew closer to Ann and Natalie, Amma resented her mother’s affection for them. She idolized her mother and spent years suffering for her benefit, so killing the girls was effectively killing two birds with one stone. She removed any competition for her mother’s love and made her dollhouse as perfect as possible. It’s an extraordinarily eerie finale, made all the more frightening by Adora’s willingness to take the fall for her homicidal daughter.
These two series provide carefully nuanced looks at the oft-sensationalized syndrome and its relationship to motherhood, opting for more realistic, messy approaches instead of oversimplified ones. Neither Sharp Objects nor The Act offers straightforward conclusions, but their respective strengths lie in their murky morals, challenging images of love, and realistically complicated characters.
Adora and Dee Dee contrast each other in many ways, demonstrating the variety of individuals who can become susceptible to the disorder and the different ways it can manifest in them. On their own, each show could seem plain and uncomplicated, but, together, they unearth the subtle and elaborate distinctions in this form of parental abuse and mental illness.