False pregnancy – When the body is influenced by fears and desires

A growing belly, morning sickness and even a positive pregnancy test – and still no baby in your belly? How is that possible? We are talking about the so-called false pregnancy. An amazing phenomenon, which is usually based on psychological causes.

Diagnosis false pregnancy

At first glance it seems impossible that a woman mistakenly believes to be pregnant. However, false pregnancy, also known as graviditas imaginata in professional circles, is a clinical picture that can be well explained both psychologically and biologically. Increasing education and modern diagnostic procedures, such as a blood test or ultrasound, now make early diagnosis possible. For those affected, there is nevertheless a high level of suffering when they have to accept that no child is growing inside them and the search for the underlying causes must begin. Signs of a false pregnancy How real such a false pregnancy can feel is made clear by the possible occurrence of the following symptoms:

  • Absence of the period
  • Abdominal growth
  • Nausea and vomiting
  • Tightness in the breasts
  • Mood swings
  • Back pain

In rare cases, the glands in the breasts of fictitious pregnant women even produce milk, and affected individuals claim to feel movements in their abdomen. It may even come to the point that contractions are felt.

Why the psyche tricks the body

The variety of symptoms mentioned shows how complex the condition of false pregnancy is. Now the question is, how does this actually occur? A false pregnancy illustrates very well how strongly psychological factors can influence the body. The most common cause of being affected is a very great and often unfulfilled desire to have children – a so-called desire neurosis. Remaining childless for a long time can eventually lead to frustration and despair, and an imaginary pregnancy can be an unconscious relief for all these emotions. More often affected are therefore single women of higher age or women who have experienced a miscarriage. An opposite reason for an imaginary pregnancy can also be the fear of pregnancy. Here it is important to mention that this case occurs less often, but it is quite possible. Causes for the fear can be traumatic births or conflicts in the partnership. In the course of the two possible triggers it becomes clear that a false pregnancy is often a psychological or psychosomatic disease.

Other causes of pregnancy signs

In addition to the much more common psychological causes, medical reasons can rarely also be responsible for an imaginary pregnancy, which must also be clarified in the context of diagnostics.

Hormonal disorders
Here, an increased prolactin level can be responsible for both the absence of menstruation and for milk production in the breasts. Why this hormone is increasingly produced can have innumerable causes ranging from stress, high physical strain to a benign tumor in the brain. Likewise, obesity or a poor diet can cause increased production of the hormones estrogen and progestin, which in turn can lead to symptoms of false pregnancy. Furthermore, the reason for a positive pregnancy test without an embryo in the abdomen is due to the causeless production of the hormone beta-HCG, which is produced by part of the placenta during pregnancy.

Misinterpretation of other medical conditions
In addition to hormonal disorders, other conditions such as fat deposits, gastrointestinal disorders, benign tumors or an accumulation of fluid in the abdominal cavity can also give the appearance of pregnancy. For example, a cyst on the ovary can be causative for a lack of menstruation.

Sensitivity as a basic prerequisite for psychotherapy

In the case of the latter purely physiological causes, a detailed physical examination by a specialist is usually sufficient to make a diagnosis and initiate the appropriate treatment. If, however, the false pregnancy is due to psychological causes, it often takes a long time for those affected to receive the right help in the form of psychotherapy. In this case, the affected women avoid going to doctors more often or keep changing them. Moreover, very few gynecologists are sufficiently sensitive to the phenomenon of false pregnancy. In extreme cases, the belief in pregnancy is therefore maintained over a long period of time, sometimes until the supposed date of birth. Unfortunately, it is also very difficult for relatives to recognize a condition, since very few can imagine that this condition can be “faked” over such a long period of time. For the above-mentioned reasons, it is very important for both physicians, as well as affected persons and their environment to be quite attentive to this phenomenon and to take advantage of the professional support of psychotherapists at the first symptoms with a negative ultrasound as well as blood test. In psychotherapy, the causes of the false pregnancy can be explored . If, for example, there is an unfulfilled desire to have children, women are supported there to define their value not only by being a mother. Therapists can also explain the option of fertility treatment and support those affected on this path. If, on the other hand, the fear of a false pregnancy is at the root of the problem, the causes can also be sought at this point. Here it would be possible that the woman unconsciously does not want to have a child despite the current child planning, or that a separation or physical abuse has taken place in the past. In any case, an individual coping strategy is found together in therapy and it is possible to let go of the false pregnancy by resolving inner conflicts.

  • Weyerstahl, Thomas & Stauber, Manfred: Gynecology and Obstetrics. Stuttgart, 2013.
  • Bräutigam, Walter; Paul, Christian & von Rad, Michael: Psychosomatic Medicine. Stuttgart, 1997.
  • Hertz, Dan & Molinski, Hans: Psychosomatics of women. Heidelberg, 2013.

Categories: Therapy

Dr. med. Kjell R. Brolund-Spaether
Ärztlicher Direktor und Chefarzt Dr. med. Kjell R. Brolund-Spaether
Dr. med. Kjell R. Brolund-Spaether ist renommierter Facharzt für Psychiatrie und Psychotherapie, bei dem stets der Mensch im Mittelpunkt steht: Dank seiner individuell abgestimmten, ganzheitlichen Behandlungspläne verbessert und personalisiert er die psychiatrische Versorgung kontinuierlich. Seine umfassende Expertise in der psychotherapeutischen und medikamentengestützten Behandlung erlangte er durch sein Studium der Humanmedizin an der Christian-Albrechts-Universität in Kiel, spezialisierte Weiterbildungen sowie seine langjährige Erfahrung in führenden Positionen. Seit 2019 ist Dr. med. Brolund-Spaether als Chefarzt und seit 2023 als Ärztlicher Direktor der LIMES Schlosskliniken AG tätig. 2024 trat er unserem Vorstand bei.

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