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Psychosomatic Illness (Somatoform Disorders): Questions & Answers

Questions & Answers

My 8-year-old daughter Lisa comes home from school most days crying and pointing to her legs. When we ask her if she's in pain she nods her head. When we ask her what happened at school she just shrugs her shoulders and won't answer. How can we tell if she really feels pains in her legs?

Lisa is expressing her pain as a younger child would, by crying and physical gestures. Encourage her to describe her pain in words. Reassure her that you know her pain is real and that ways can be found to help her. Try to ascertain if there are situations at home or at school that may be stressful for her.

My son is 16 and likes to eat a large dinner, including dessert. He gets up every night about 1 A.M. complaining of a stomachache or a headache and then can't get back to sleep. Is he just doing this to interfere with our sleep?

If, after a physical check-up, he still has abdominal complaints which are interfering with his daily personal and academic functioning, be aware that the symptoms are not produced intentionally, but may be emotionally based. Try to pinpoint potential causes. He may be experiencing academic pressure, family conflict, a change in school, a move, a reaction to the illness or death of a family member or friend, or possible physical or sexual abuse. Adolescents may attempt to self-medicate with alcohol or drugs.

Are there any practical ways to help an 8-year-old boy who says his throat always hurts him? His pediatrician finds no physical basis for this complaint.

Devise ways to give him a sense of control. For some children, keeping a log will help identify the times and specific situations which are associated with the pain. A particular cause of stress may then be apparent. Life changes, such as a change of school demands, adjustment in family relationships, modification of an overly crowded schedule of activities, may then bring relief.

My 12-year-old daughter has chronic sinusitis. She gets up late every morning and says she thinks she's getting an infection. Should I allow her to stay home from school even when I think she's really not sick?

Be careful not to inadvertently reinforce the behavior by becoming visibly alarmed and overly solicitous, or allowing her to stay home or to avoid social situations. Be sure that she is getting appropriate medical treatment for her sinusitis. If improvement does not occur, consultation with a mental health professional is warranted.