How could hermit hide for 14 years?

How could Karen Morgan live like a "medieval monk" for 14 years, retreating from the outside world to live in her bare bedroom, seeing only her mother and ordering her about through handwritten notes?

The 29-year-old's bizarre existence was revealed last week at Clapham Coroners' Court, south London, which heard how she had shunned the outside world and died with wasted muscles last April. The rest of her family - mother, father and brother - then planned a suicide pact.

Her case is not unique. Earlier this year, Desmond Lockwood died after having locked himself away for 30 years from the age of 19, when he lost his job. He became a recluse who lived on ice-cream and tea and stared endlessly at the TV in his bedroom. By the time he died, his parents were also dead and he was left living with his brother.

An obvious question is why their families allowed them to live such lives, for it was only with family collusion that they could live as recluses for so long.

For most people, a close family is something positive. For psychologists and therapists, however, it can mean something dangerous. The suspicion is that the problems lay not so much with Karen or Desmond as in their families as a whole.

Hugh Jenkins, of the Institute of Family Therapy, sees Karen's behaviour as the end of a continuum which begins with children manipulating parents on a small scale but can end with the child taking control completely.

"We see children and very young people who manipulate their parents with problem behaviour," he said. "We often find parents are unsure of themselves, unable to take a strong stand or tend to back off in an argument and it reinforces the pattern of behaviour in the child.

"Parents have their backs pushed against the wall ... the logical outcome is the death of this young woman."

Parental guilt might have meant that Karen's parents, who are now receiving psychiatric help, were unwilling to go against their daughter's wishes. She had spent some time in psychiatric hospitals, but had hated it. Her parents may have felt they were doing the best for their daughter by caring for her at home.