A transgenerational conceptualization of psychosomatic distress during pregnancy: Implications for infant mental health

A conceptualization of psychosomatic distress during pregnancy is suggested, stemming from a developmental psychopathology framework and based on contributions from the psychosomatic and attachment literature. A link is suggested between psychosomatic distress during pregnancy, patterns of representational activity, and transgenerational risks of relationship disturbances. Developmental transformations during pregnancy are reviewed, with an emphasis on the vicissitudes of integrating internalized relationships with a person's family of origin. Psychosomatic theory is used to generate hypotheses about the representational activity of mothers who experience psychosomatic distress during pregnancy. Attachment theory is used to discuss the link between maternal representational activity and the transgenerational transmission of relationship patterns. As an example of psychosomatic distress during pregnancy, relevant literature on severe nausea and vomiting during pregnancy is reviewed, and clinical vignettes are presented to illustrate how this condition may sometimes be a forerunner of mother-infant difficulties.