Rethinking Resiliency In Relation To Teenage Girls: Part 1

Working with inner-city teenagers, I always want them to defy expectations often put upon them by society, their community and even themselves.

Those expectations usually include:

  • getting pregnant
  • dropping out of school
  • being promiscuous
  • abusing drugs and/or alcohol
  • never getting out of the low social economic status they were born in

Resilience is the strength and stress resistance to defy those expectations and to achieve ones dreams.

These are the things I always try to instill in the youth I work with, after all I have faced many of those same societal expectations growing up as an African American male including:

  • going to jail
  • being violent/angry
  • being on drugs/alcohol
  • fathering multiple children with multiple women
  • being lazy and uneducated

Time and time again, especially when it comes to teenage girls, I seem to be facing an uphill battle when asking them to be resilient. Not that I don’t face the same battle with boys, just that the girls often seem to have it all together and then quickly sabotage themselves.

An example of this comes from a 3 year longitudinal study of poor, inner-city adolescent girls called “Understanding adolescents: A study of urban teens considered to be at risk,” directed by Jill McLean Taylor and Deborah L. Tolman.

“Anita” was an African American girl who who stated that she wanted to be a lawyer, and acknowledged in the 8th grade that the only things that could stand in the way of her dream were “kids, kids, kids”.

It’s amazing, that as early as the 8th grade, she realized that having kids that young was a possibility.

In the 9th grade she is still passionate about her goals and dreams to become a lawyer because she felt that there was a need for good African American lawyers, and states “I ain’t going to let nothing get in the way. The only thing that could probably happen is a baby.”

Once again, despite her passion and determination, she is vividly aware that getting pregnant was a real possibility. After all, she had probably seen some of her friends and family members get pregnant at her age. Her mother also had children in her teens.

In the 10th grade she seems even more determined to be a lawyer, stating “there’s a lot of people that I  know that don’t want a Black kid to be somebody.”

That year she still has concerns that a baby might get in the way of her dream, but seems less worried about it. Unfortunately, she also tells the interviewer at this time she has been sexually active and hasn’t been using protection.

By the fall of her 11th grade year, she becomes pregnant and drops out of school.

How could this happen to a young girl that seemed so determined and resilient?

Well, for one, perhaps asking her (and other poor inner-city teens) to be resilient and defy expectations, was also asking her to be different from and possibly even disconnect from people that mean the world to her, including her mother.

Anita and her mother were very close; “(she) is a part of me and I am a part of her… we have trust in each other and rely on each other… we are not that different.”

Her decision to have a baby brings her closer to her mother, although it moves her farther away from he dreams, even if they were dreams both her and her mother shared.

That’s what makes reaching out to poor inner-city teenagers so difficult.

How can we expect them to make better choices, take positive risks and reach for something different and better when doing so also puts them at risk of disconnecting and alienating themselves from important people in their lives.

It’s all mostly subconscious, but I see it all the time. A motivated, successful student gets pregnant and starts missing school more and more to stay at home with her mother, who is not working and is at home with either her own children or one of her other children’s kids.

It is a complex psychological dilemma. On one hand by reaching for and achieving their goals, they may isolate themselves, and betray cultural and family connections. However, by not following through on their dreams and goals, they will be betraying themselves, and possibly the hope and dreams of their family and community.

Asking them to “break the cycle”, is in some ways asking them to distance themselves from people they most love, admire and identify with.

Is Pretending to be Pregnant a Mental Illness: Part 2

In my original  post, Is Pretending to be Pregnant a Mental Illness, I discussed a high school teenager I have known for three, now going on four years, who has been “pregnant” every year and has had a “miscarriage” every year as well.

Last year was no different, but for some reason I believed she was pregnant, even when her closes friends did not. Still I remained skeptical, especially as the “pregnancy” went along and she didn’t get any bigger and refused to tell her mom about it.

Then summer came and I waited anxiously to see her when school started, knowing she should be close to her due time. Yet, when I saw her last week, she was no bigger than she was almost three months ago.

She told me that she had also “lost” that baby (big surprise), but now she is pregnant again and this time she isn’t making it up… and I believe her!

Why would I believe she is pregnant this time when she has lied about being pregnant four previous times?

Well this time she told me she told her mom, something she never did in her previous “pregnancies” even when I offered to talk to her mom with her.

Also, I know she has wanted to get pregnant for the past four years and so it was bound to eventually happen for real. I knew she was having unprotected sex with different guys.

And then today she showed me a picture of her getting a sonogram… a real picture this time and so yes, the girl who pretended to be pregnant for four years is finally pregnant.

It’s so sad because at 18 she is lost, she’s barely passing school, is extremely immature, admitted that her baby’s father is no good, that she doesn’t like him and her family doesn’t either, but yet they are bringing a child into this world.

There is no way she is ready to be a mother and yet, if everything goes right, she will be soon enough.

I’m concerned because this is a young lady with obvious mental issues and if she doesn’t get the help she needs she will raise a child who will potential have further issues because of being raised by an ill-prepared mother.

On top of everything, I really think this girl wanted to get pregnant to fulfill something missing in her life, maybe attention, unconditional love, purpose, who knows, and if having this baby doesn’t meet her conscious or unconscious expectations then where will that leave her and the child?

I see many mothers who had children for the wrong reasons (to keep a man, to fulfill a void, to prove that they can accomplish something, etc.) abandon their children physically, mentally or both when those expectations weren’t met.

Many of those parents end up abusing their kids, resenting them or being negligent in the way they raise their kids.

I’m not saying that this is definitely the case with this young lady, who knows? For a very few, having a baby serves as a catalyst to get them to step up and change their lives for the better so that they can be the best parent they can be for their child.

Unfortunately, that is rarely the case. Many impoverished, poorly educated, single, teenage moms end up dropping out of school and remaining in poverty.


The psychological issues that made this young girl persistently pursue to be pregnant for years will probably remain after she gives birth so I won’t be surprised if she isn’t pregnant or “pregnant” again and again even after she gives birth for real.

Stress During Pregnancy and it’s Affects on the Unborn Child

I have two close friends who are both first time mothers to be and although both are in healthy relationships and are overall healthy individuals, both of them are incredibly stressed, so much to the point that they both at times get very dysthymic, have trouble eating, sleeping, being intimate, feeling attractive and are easily irritable. 

When asked what exactly they are stressed about, they both answered that they are worried about being good mothers, about being financially secure enough to properly take care of their child, how their child will change their lives and mostly, if their child will be healthy despite all the signs that they are having a normal, healthy pregnancy. 

I found that last part to be very interesting. Their biggest concern was that their child is developing normally and that they will have a healthy child, yet the stress that they are experiencing may play a vital role in the health of their baby. 

Stress is a Part of Life

We all experience stress and pregnant women often experience stress more than any of us. Often times women who are pregnant are busy trying to run house holds, hold down jobs and balance a busy schedule. While stress is normal, how much stress is too much and does it affect the fetus?

It used to be considered a myth that too much stress affects the unborn child, but researchers, including Dr. Calvin Hobel, a perinatologist (an obstetrician who practices maternal-fetus medicine) in Los Angeles who studies the affects of stress on pregnancy, are providing more and more evidence that stress is bad for pregnant women and their unborn child. Stress not only increases the risk of pre-term labor, but also a number of problems after the child is born. 

Women who are stressed release hormones and those hormones “wash” over the fetus. Genetically the fetus is forced to react to environmental cues about how to best construct and respond within the capabilities of that specific gene to what is going on. According to Dr. Pathik Wadhwa, assistant professor of behavioral science, obstetrics and gynecology at University of Kentucky College of Medicine, “The fetus builds itself permanently to deal with this kind of high-stress environment, and once it’s born may be at greater risk for a whole bunch of stress-related pathologies.” 

Some of the most recognizable effects of maternal stress on pregnancy: pre-term births and low birth weight.

Baby’s who are born premature (before 37 weeks) are at risk of many complications later such as developmental delays, learning disabilities, chronic lung disease, pervasive developmental disorders, and even death. There is even research suggesting that babies who express stress in utero are more likely to suffer from heart disease, diabetes and high blood pressure as adults. More recent evidence is pointing to stress in utero affecting the baby’s temperament and possibly IQ. Baby’s who experience a lot of stress in utero are more likely to show signs of depression and irritability and are less likely to tune out repeated, unimportant stimuli, a predictor of IQ. 

Who the Mother is and What She is Like During Pregnancy Affects Who the Baby Will Turn Out To Be

According the the biopsychosocial model, we are who we are determine in part by biological, psychological and environmental influences. Mother’s who experience a lot of stress and anxiety during pregnancy are bathing their unborn child in those chemicals that affect the baby. Stress causes the mother’s nervous system to stimulate the release of epinephrine and norepinephrine which are stress hormones that restrict blood flow and oxygen to the fetus. Research also shows that the placenta in pregnant women who are stressed, releases more corticotropin-releasing hormone (CRH) which tells the body how long a pregnancy should last and helps the fetus reach maturation. This is probably largely responsible for the increase in pre-term birth and low birth weight. 

How much stress is too much stress?

It’s hard to say, it really comes down to the woman, her personality and how she copes with stress. One woman can work two or three jobs and be fine, while one woman may find herself in trouble just trying to hold down one job. The woman needs to listen to her body, her doctor and even her family member’s if they are worried that she is too stressed or anxious. Studies show that extra help for the mother to relive some of the psycho-social stress as well as work leaves as early as 24 weeks cut down on the risk of premature birth by about 21%

Ways to Relieve Stress

Somethings pregnant women can do to relieve stress include yoga (not strenuous yoga of course), biofeedback, guided imagery and deep breathing techniques. Also, having a great support network is crucial. It is important for the pregnant woman to slow down when she starts feeling stressed, even if that means cutting back on certain things and delegating tasks to others. 

Pregnant Women Should Take this Questionnaire! 

One way to measure your stress is to take this questionnaire developed by Dr. Hobel. For every question answer “yes”, “no” or “sometimes”. If you answer “yes” or “sometimes” to three or more questions, Dr. Hobel believes you may be stressed enough to warrant talking to a counselor or your physician to help put together an intervention to help protect you and your unborn child from stress.   

  1. I feel tense
  2. I feel nervous
  3. I feel worried
  4. I feel frightened
  5. I have trouble dealing with problems
  6. Things are not going well 
  7. I cannot control things in my life
  8. I am worried that my baby is abnormal
  9. I am concerned that I may lose my baby
  10. I am concerned that I will have a difficult delivery
  11. I am concerned that I will be unable to pay my bills
  12. I live apart from my partner or spouse
  13. I have extra-heavy homework
  14. I have problems at work
  15. Have you and your partner or spouse had any problems?
  16. Have you been threatened with physical harm?

Is Pretending to be Pregnant a Mental Illness?

In The Pregnancy Project: A Memoir, Gaby Rodriguez faked her own pregnancy as a social experiment, but teenage girls pretending to be pregnant is not a new phenomenon.

Over the past three years I’ve grown more and more concerned about teenage girls pretending to be pregnant, the reasons they do this and the mental and social rewards and consequences of it. I have to wonder if part of this is because of shows like 16 and Pregnant and Teen Mom, but I also think that the alarming number of their peers who actually are pregnant or have kids has an effect on them. Why would a teenage girl want to put up with the scrutiny and criticism that comes along with being pregnant in high school? This is what I think:

1. Attention

  • Some of these young girls are starving for attention no matter if it’s positive or negative. Perhaps they see all the attention their peers or siblings got when they were pregnant and crave some of that same attention. I often see that their friends, while at times judgmental, often start bonding with the young girl in a nurturing way, something that she doesn’t get normally from them.

2. To Keep a Boy Interested

  • I think this may be the most common reason young girls pretend to be pregnant. I see it played out over and over again each year in the high school I work at. A relationship ends or is on the break of ending and all of a sudden the young girl blurts out she’s pregnant or thinks she’s pregnant. This usually sends the young man into a panic and even if he’s skeptical, he tends to at least try to stay on her good side until the pregnancy is confirmed or denied. Like a lot of young teens who pretend to be pregnant, these ladies may go through great lengths to convince their boyfriends (ex-boyfriend) that they are pregnant and often times in the process, continue to try to really get pregnant. These drastic attempts to keep a boy are seldom successful.

3. Biology

  • Evolutional psychology may say that it is normal for young teens to pretend to be pregnant since it’s in their biology to want to conceive children. During my research it appears that pretending to be pregnant is to some extend normal, but I think what is abnormal is the way that some young adults go about pretending to be pregnant. Perhaps pretending to be pregnant to yourself is normal, while pretending to be pregnant and in effect lying to your friends/boyfriend is more on the abnormal end of the scale. However, if it is to some extend normal to pretend to be pregnant, can it ever go so far that it can be classified as a mental illness. To what extent does a young girl have to go to inorder convince people she is pregnant, before she moves into the realm of psychopathology?

More recently, Annette Morales Rodriguez was arrested and suspected of stalking, beating and choking to death a pregnant woman and using an xacto knife to remove her unborn child because she had had four miscarriages and had been faking her pregnancy.

One source said that she panicked as her fake due date approached and she had to produce a baby. She was willing to kill in order to “have” a child.

Pretending to be Pregnant as a Mental Illness

I have a client I’ve known for three years and each year she “gets pregnant”. I was originally referred to her when she “gave birth” to a premature baby and was back at school the next day showing pictures of “this baby” in neo-intensive care. One of her teachers was concerned about her physical and mental health and referred her to me. When I met with her she told me that the baby had died and I spend several weeks helping her get through the grieving process and even helped her with a memorial ceremony. A few months later I found out that this was all a lie. She was never pregnant. The pictures of the baby in NIC-U had come from Google Images, and this wasn’t the first time she had pretended to be pregnant. The extend to which this young girl went through to convince people she was pregnant and had given birth to a premature baby that died concerned me. I thought surely she was mentally ill, but I let it go as the next year her problems turned to the more normal problems teenage girls come and see me about (boys, family, school, friends, drugs).

And then this year she said she was pregnant again. This time I believed her (call me gullible, but I tend to believe people until I have evidence not to) because from her pretending to be pregnant last year, I felt like she wanted to get pregnant, and from my experience, young girls that talk a lot about being pregnant, pretend to be pregnant, and are sexually active, they usually end up pregnant within twelve months. Well this young girl started to gain weight, starting looking pregnant (even wore too small clothing to enhance the effect) up to a certain extend when she suddenly stopped “growing”. She claimed to feel the baby moving and said she went to doctor appointments, but would never let her friends go with her. She told her boyfriend she was pregnant and all of her friends, but not her family. She even went as far as to have her friends plan a baby shower. I offered over and over to help her break the news to her mom, but she refused and then one day her best friend came to my office in tears, telling me that she thinks the young girl is “crazy” because she really isn’t pregnant and keeps pretending to be pregnant. Her best friend told me that all of her friends and even her boyfriend are concerned for her, but they haven’t confronted her out of fear that she really is mentally ill.

After an intense session with the young girl she admitted to me that she really wasn’t pregnant, but couldn’t tell me why she kept pretending to be pregnant and was still planning on letting her friends and boyfriend think she was pregnant. As of Friday she was still planning her baby shower. That lead me to truly believe that this girl has a mental illness, but if so, what?

Factitious Disorders

The first thing that came to my mind was that she had a factitious disorder. Factitious disorders occur when a person acts like they have an illness and purposely produces symptoms of that illness. They may go as far as contaminating urine samples, manipulating documents and taking substances to make themselves ill. The benefits they seek usually are attention, sympathy, nurturance and mercy. The old term for factitious disorder is Munchausen Syndrome, and many of you have probably heard of Munchausen by proxy, which is when the person uses someone else, usually a child or elderly person, to produce the sick symptoms of an illness unto, often times with alarming and deadly results. But does a young girl who continues to pretend to be pregnant and goes to great lengths to convince people she is pregnant suffering from a factitious disorder? Through all my research I couldn’t find a definite answer, but this as of right now is my number one guess.

Personality Disorders

Borderline Personality Disorder

I also have to wonder if this girl and others like her may have some type of personality disorder. Borderline personality disorder is very popular these days, but I have only known about three people I would diagnose with borderline personality disorder and only  one of them have pretended to be pregnant in a very similar manner to the young girl I’ve been talking about. I also don’t think this young girl qualifies to be diagnosed with borderline personality disorder, but it is possible.

Histrionic Personality Disorder

People with histrionic personality disorder are always seeking attention and can be very inappropriately seductive, have exaggerated emotions and feel shallow. I’m not sure if this describes the young lady I’m talking about either.

Dependent Personality Disorder

People who have dependent personality disorder are dependent psychologically on other people. Pretending to be pregnant would increase the likelihood that the people this person is dependent on will be more nurturing and present, but from knowing this girl I highly doubt she has dependent personality disorder, but it may explain why some other young ladies pretend to be pregnant.

Psychopathy

Some people are just psychopaths as defined by:

  • lack of remorse or empathy
  • shallow emotions
  • manipulativeness
  • lying
  • egocentricity
  • glibness
  • low frustration tolerance
  • episodic relationships
  • parasitic lifestyle
  • persistent violation of social norms

Is it necessary that I diagnose this young lady and those like her? Probably not. I prefer not to diagnose clients unless I have to or it is a diagnoses that is literally screaming in my face. I don’t like labeling clients, but there are many reasons to give a diagnosis. Most insurance companies require a diagnosis and a diagnosis does help give a framework for developing a treatment plan. It is however, in my opinion, essential that I figure out what is driving this young girl and others like her to go through such great extents to pretend to be pregnant in hopes of helping them deal with whatever it is they are trying to get externally, and be able to give it to themselves so that they can develop into emotionally and mentally healthy adults.

If you have any opinions or if you’ve been through this or even pretended to be pregnant before, please comment. I would love to hear your story.