According to the Cleveland Clinic, the death rate for victims of Munchausen syndrome by proxy — or as it’s now known, fictitious disorder imposed on another (FDIA) —  is about 10 percent. That means that one in 10 children who are victims of FDIA will eventually be killed because of it. And that’s exactly what Gypsy Rose Blanchard‘s step-mom, Kristy Blanchard, worries would’ve happened to her daughter. If you’ve watched HBO’s documentary Mommy Dead and Dearest or you’ve been tuning in to Hulu’s fictionalized series The Act, you already know about the horrible abuse that Gypsy suffered at the hands of her mom. You also know that it only ended because of a murder.

Dee Dee, who likely had FDIA, put her daughter through a series of unnecessary medical treatments over the course of her life, including the removal of her salivary glands, the insertion of a feeding tube, and several other surgeries. The abuse only ended when Gypsy conspired to kill her mother with her then-boyfriend, Nicholas Godejohn. Though Kristy and her family by no means excuse the murder, they do support Gypsy — and they worry that the mother-daughter relationship would’ve ended in death one way or another. If Gypsy hadn’t killed her mom, they fear the violence could’ve gone the other way around.

Dee Dee would tell me, ‘When I die, I hope she dies with me, because one can’t live without the other,'” Kristy exclusively told In Touch. “Now thinking back, it’s like, ‘Oh my god, she would’ve ended up — She would’ve killed Gypsy. She would have.'” In the past, Kristy and writer-turned-family friend Fancy Macelli have broken down episodes of The Act, and, in real life, the abuse went even beyond what’s been portrayed on screen. Instead of attempting to restrain Gypsy with fabric, Dee Dee actually chained her daughter to the bed for days on end. After smashing her computer, she also threatened to smash Gypsy’s hands.

As Gypsy grew older, Dee Dee fought hard to maintain her control over her daughter, both psychologically and medically, and the family worries that never would’ve ended. “I honestly think she would’ve killed Gypsy,” Kristy told In Touch, suggesting that there would’ve been “no autopsy” and that dealing with FDIA would’ve meant that Dee Dee used Gypsy’s death in much the same way that she used her medical treatments. “[She would] still depend on the community to help her out,” Kristy continued. Or, worse: “She would’ve killed Gypsy and killed herself.”

According to Dee Dee, “one can’t live without the other.” Though Gypsy has thrived now that she’s no longer under her mother’s control, even despite the fact that she’s behind bars, Kristy looks back and worries about what might’ve been. “I don’t know,” she said. “I know it wouldn’t have ended well if she would’ve stayed with her mom.”

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