The idea that people with disorders like Munchausen syndrome cant be helped needs to be challenged. The important question is HOW to help people with entrenched self-destructive coping mechanisms. What doesnt work is to simply confront and challenge them. People who become self-destructive invariably grew up in psychologically and/or physically destructive circumstances. Confrontation only replicates their early experience of being attacked and perpetuates their unhealthy response to the world. What helps is offering kindness and understanding sometimes just listening to their stories.