Annie’s Mailbox: Grooming habit sounds like fetish

Dear Annie: I have been dating “Edgar,” a 37-year-old man, for about four months. Everything is great, but I have one question.

Edgar likes to groom me. This means he looks over my skin, face and body and tries to remove any blemishes.

He does all this in a very loving and respectful way, but I think it’s very foreign to me. Edgar says it shows he is taking care of me.

I love him very much and don’t want to break up over this. I am just curious about such a practice. What do you say?

Want to Know in West Yarmouth, Mass.

Dear Want to Know: Edgar has a fetish. Either that or he’s a little closer to his primate ancestors than most of us.

Still, as with all fetishes, if this one doesn’t particularly bother you, then it isn’t a problem. To each his own.

Dear Annie: This is in response to the letter from “A Brokenhearted Mother,” whose son injures himself repeatedly. You said he might be suffering from Munchausen syndrome. The medically correct diagnostic terminology is “factitious disorder.”

First, this patient needs a referral to a psychiatrist and psychologist. As this patient is potentially a danger to himself due to the psychiatric condition, a court order may require him to see a therapist as well.

All these mental health specialists will work in concert with a single primary care physician.

That physician should be the only point of contact for this patient. Every doctor, surgeon or medical caregiver needs to be informed of this man’s severe illness. It is life threatening.

Next, if the patient is hospitalized, it should be authorized through his primary care physician and followed by psychiatric care—either a psychosomatic medicine consult (also known as consulate liaison services) or preferably by the psychiatrist and other mental health care providers.

If he is admitted again, it should be through the same physician and hospital team.

Lastly, direct confrontation with a patient with this disorder will often result in the patient switching doctors, which is bad, as the new physician will not have the patient’s history and will presume there is an underlying medical issue—which means the primary physician, psychiatrist and clinical psychologist should all be involved, and an “escape” statement for the patient needs to be in place to indirectly deal with the hospital admission, so as to not lose the patient to follow-up care.

By the way, accidental death is a significant risk, but more importantly, so is death due to multiple unneeded medical procedures.

Shane B. Russell-Jenkins, M.D. Psychiatry,

Yuma, Ariz.

Dear Dr. Russell-Jenkins: Thank you for your expertise. We certainly hope his family can help him get the appropriate care.

Annie’s Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please e-mail your questions to annies mailbox@comcast.net, or write to: Annie’s Mailbox, P.O. Box 118190, Chicago, IL 60611. Copyright 2008 Creators Syndicate Inc.