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One of the stranger phenomena of women's (and sometimes men's) health is pseudocyesis, a condition of appearing to be pregnant without actually being pregnant. The abdomen grows, the breasts enlarge, menstruation ceases, pregnancy spots may appear on the skin, the belly button inverts itself, there may be morning sickness, there is a "lordotic" (sway-backed) posture during walking, appetite increases, and weight is gained. All of these symptoms appear, however, without a fetus. The only sign of pregnancy missing is the baby.
Physicians typically group pseudocyesis with other conversion disorders, conditions with symptoms that suggest a general medical condition or a brain injury without physical evidence of disease.
Other conversion disorders include "hysterical" blindness, "shell shock," and foreign accent syndrome. Anywhere from 65 to 90% of cases of conversion disorders occur in women, usually between the ages of 20 and 40, but even pseudocyesis can occur in men.
What's Being "Converted" in a Conversion Disorder?
Psychiatrists usually explain conversion disorders in terms of primary and secondary gain. The primary purpose of a conversion disorder is to play out an emotional conflict that the patient has suppressed. Someone who is ashamed of his or her origins may develop a foreign accent. Someone who feels "out of control" may develop psychogenic non-epileptic seizures. Someone who can't bear an everyday sight may develop hysterical blindness, and someone who desperately wants a baby may develop pseudocyesis.
Although the symptoms of conversion disorders are very real, the person who has the disorder may display what Sigmund Freud described as la belle indifference. The person who has the disorder does not care that they have the condition, at least in Freud's analysis of the condition. In modern medical practice, however, only about 22% of people who have a "real" medical problem and 29% who suffer a conversion disorder are truly indifferent to their symptoms. Not caring about symptoms does not mean that a condition is "all in the head."
Not a Delusion
A conversion disorder is not a delusion. People who are delusional have firm but false ideas that cannot be corrected by reasoning. People who have conversion disorders really do experience their symptoms. Like a delusion, however, a conversion disorder may center around a wish that cannot be fulfilled in the real world, or at least that the patient feels and thinks cannot be fulfilled in the real world.