A systemic explanation of denial of pregnancy fitting clinical observations and previous models

Introduction: The etiology of denial of pregnancy remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. Furthermore, the involvement of mother-fetus interactions cannot result only from psychology causes in the mother. Although instructive, the few available evolutionary and systemic explanations proposed remain insufficient. This article synthesizes and extends previous knowledge within a systemic model which is fully compatible with clinical observations. Methods: A systemic intrapersonal conflict theory opposing primitive, evolutionary-inherited forces to psycho-sociological forces embodied across individual’s childhood is developed. Results: As members of a social species, human beings have a dual character of independent organisms and of social group members that is a source of customized intrapersonal conflicts. Authors explain denial of pregnancy as a standby-in-tension response to such an unresolved intrapersonal conflict between forand against-pregnancy forces. As long as the woman’s brain is unable to renounce one option in favor of the other, denial of pregnancy offers a standby-in-tension means to postpone conflict resolution. It may thus be considered as temporarily adaptive response. Conclusions: The proposed systemic psycho-evolutionary explanation of denial of pregnancy is fully consistent with clinical observations. It brings into agreement the previously reported models with the advantage of being more synthetic. It is thus compatible with a large diversity of causative events in accordance with the actual life story of each woman concerned. The systemic intrapersonal conflict approach developed herein provides a new means of investigating body-mind problems, especially pseudocyesis.