China News Service, Beijing, September 30 (Reporter Zhao Fangyuan) Some children often experience various inexplicable discomforts: dizziness, stomachache, general discomfort, and even being unable to go to school or take exams normally. He could be taken to the hospital for blood draws, X-rays, and various examinations. The results were all normal, and the doctor found no obvious organic problems. Many parents will inevitably wonder: Is their child lazy or deliberately pretending to be sick?
Li Hongna, the attending psychiatrist at Beijing Children's Hospital, pointed out in an interview with Sino-Singapore Health that this may be a manifestation of somatization symptoms. Children whose physical and mental development are immature often lack the ability to accurately identify and express complex inner emotions. When negative emotions such as academic pressure, interpersonal troubles, and worries about the future accumulate to a certain extent and cannot be effectively vented through language, the body will manifest them in the form of symptoms.
Why does psychological stress turn into physical discomfort?
Li Hongna introduced that somatization means that psychological emotions such as anxiety, sadness, and tension cannot be expressed through language and are instead presented in the form of physical discomfort.
Before and after the start of school, changes in work and rest rhythms, return of academic pressure, and readjustment of campus interpersonal relationships can easily induce somatization symptoms. Common symptoms of children include repeated abdominal pain, headache, chest tightness, palpitation, nausea, etc. However, multiple medical examinations often fail to detect corresponding organic diseases.
This phenomenon is closely related to the body’s own “fight or flight response.” When a child is under great internal pressure and continues to be tense, the sympathetic nerves are activated, and the body will misjudge that it is in danger, thereby reducing the blood supply to the gastrointestinal tract, causing continuous muscle tightness, and causing a series of discomforts such as abdominal pain and nausea.
Compared with adults, children are more likely to "use their bodies to speak" for two main reasons: First, physiological development characteristics. The brain's prefrontal lobes don't fully develop until around age 25, and children have limited ability to express emotions. Young children cannot even distinguish between "feeling uncomfortable" and "physical discomfort". They cannot understand abstract feelings such as anxiety and depression. They can only perceive real physical pain such as stomachache and dizziness, and it is difficult to describe their inner feelings of fear and helplessness. The second is the lack of family emotional guidance. Some parents only focus on homework and grades, ignore their children's inner feelings, and rarely guide their children to express their emotions. Over time, children slowly lose the ability to talk about their feelings and express their emotions.
What situations are likely to trigger somatization in children?
Li Hongna classified the conditions that easily trigger children's somatization symptoms into three major categories: learning pressure, social pressure and family pressure.
Learning pressure: the return to school period, preparation for large-scale exams, competitions, or parents who have high expectations for a long time, and children are always worried that they will not meet expectations;
Social pressure: Isolation from classmates, peer conflicts, school bullying, fear of teachers, or separation anxiety;
Family stress: parental quarrels, divorce, parent-child conflicts, etc.
There is also a hidden high-risk group that is easily ignored by parents: "good children" who are usually sensible and obedient. Such children are accustomed to suppressing their inner dissatisfaction and are unwilling to take the initiative to express negative emotions. They are at a higher risk of somatization.
It is worth noting that some children do have organic problems first, such as gastroenteritis, and then emotional factors add up. "This situation is very common in clinical practice and is a comorbidity phenomenon. It is also a common consultation scene in children's gastroenterology department." Li Hongna explained, for example, if a child first suffers from acute gastroenteritis, but the abdominal pain continues to recur after recovery, especially when it is aggravated by stress; examination may reveal slight inflammation in the intestines, but it is not enough to explain such severe pain. At this time, it is necessary to go to the psychiatric department to screen for emotional problems. The treatment direction is two-way intervention and simultaneous treatment of body and mind: the internal medicine department deals with physical diseases, and the psychiatric department evaluates and intervenes in emotional problems such as stress and anxiety.
How to identify and respond?
Li Hongna gave some suggestions to parents:
First, accept your child's feelings and avoid blaming. Don’t repeatedly ask your child, “Are you faking it?” Instead, first acknowledge the reality of the pain. You can tell your child, “I know your body is really uncomfortable.”
Second, set aside dedicated communication time. Set aside about 10 minutes every day to chat with your children about happy and interesting things on campus to help them gradually adapt to campus life.
Third, adjust your work, rest and diet smoothly. Eat three meals as regularly as possible, insist on going to bed early and getting up early, and gradually adjust your work and rest to adapt to the rhythm of school.
Fourth, teach your children simple ways to relax. For example, breathing exercises: inhale and imagine smelling flowers, exhale and imagine blowing candles, which can help your body relax in just a few minutes.
At the same time, communication methods are particularly critical. Many parents are used to saying: "Don't think so much, just concentrate on studying." This sentence seems to be comforting, but in fact it denies the child's feelings. To children, it sounds like "my pain is not understood", which in turn aggravates anxiety and loneliness. If emotions cannot be listened to and expressed for a long time, they will continue to manifest themselves through physical discomfort, and somatization symptoms will worsen.
Li Hongna recommends the communication idea of "acceptance - naming emotions - figuring out a solution together".
Acceptance: You can say "Seeing you in such pain makes mom or dad feel bad";
Emotion naming: You can say "You feel nervous, wronged, and scared now, right?";
Think of a solution together: You can say, "Let's think of a way to make you feel better."
Li Hongna reminds parents that when their children complain of physical discomfort, they should not rush to label them as "pretending to be ill." The child's discomfort is actually a signal of nervousness. Only by accepting emotions and understanding the signals will the physical discomfort slowly ease and subside. (over)
