When a tummy ache has little to do with the stomach…

In my clinic today, I noticed a theme.  Several children came in with symptoms that had arisen or become worse after an emotional upset.  A ten-year-old girl developed a painfully sore throat after a sleepover which went badly.  A thirteen-year-old girl, who suffers from chronic fatigue (post-viral) syndrome, deteriorated when her mother went away for a few days.  The symptoms of a twelve-year-old boy with severe motor tics became worse after a row with his parents.

It is now widely accepted that our emotions have a profound impact on our physical health, and vice versa. However, it often seems as if we pay lip service to this fact rather than truly understanding and applying it.  

This is especially the case with children.  Many children do not have the awareness or the vocabulary to explain how they are feeling.  This may be because they are simply too young, but also because we, as parents, do not teach them how to do it.  It is all too easy to regard a symptom as a ‘medical’ problem and give a child some Calpol (paracetamol) to relieve it. Often it is well worth taking the time to explore with them what has led to it and if there is an unacknowledged emotion involved. 

The classic example of this is the Monday morning tummy ache.  It is much easier for a child to say she has a tummy ache than it might be to say ‘I am really worried about school today because my new teacher shouts a lot.’  It is not that the child is lying or that the discomfort they feel in their tummy is not real.  But an unacknowledged emotion (in this case, anxiety) often manifests as a physical symptom.  Research in America indicates that in 8 out of 10 primary age children, their tummy ache stems from anxiety. [1]

Chinese medicine has always understood that emotions, when they are unacknowledged, intense or chronic, may cause physical symptoms.  This is because emotions interfere with the smooth flow of qi in our bodies.  Most of us experience this on a regular basis.  Have you ever noticed that your neck and shoulders are tense and painful in the lead up to a particularly stressful event at work?  Or do you literally feel ‘sick with worry’ when your teenager is not back when they should be and is not answering their phone?

We all somatise our emotions at times, and this is especially true for children.  So how can we do it differently?  And, more importantly, how can we support our children to see a physical symptom as a potentially helpful clue or signpost that something in their life might need to be addressed?  

  • Look at what happened just before the symptom came on.  If it is a recurrent symptom, look to see if there is a pattern in terms of when it arises or gets worse
  • If you suspect your child is feeling an emotion they don’t yet have a word for, name it for them.  Phrases such as ‘Perhaps that has made you feel angry’ or ‘I wonder if you are feeling frightened’ can be helpful 
  • Avoid saying things such as ‘Don’t be sad’ or ‘You shouldn’t be angry about that’.  Don’t make feelings taboo.  We all have them and if we tell our children they shouldn’t, the feeling won’t go away.  It will be suppressed and become even more likely to create physical symptoms (as well as more emotional issues in time)
  • Spend time conversing with your children, and do not wait until they have a physical symptom to do this.  It sounds almost too simple to say but the busy-ness of life can mean that many of us simply do not spent time just chatting with our kids.  If the contact between you and child is good, and they get the sense you are relaxed and unrushed, they are much more likely to share with you how they are feeling.  
  • Talk about your own feelings.  Of course, it would not be appropriate to burden our children with our feelings, and we should always be mindful of what is age-appropriate.  But sometimes saying things such as ‘I am feeling upset today because work didn’t go very well’ lets your child know it is acceptable to experience and talk about lots of different emotions. 

Of course, unacknowledged emotions are only one of many possible causes of physical symptoms.  However, they are the cause that perhaps is most often overlooked in children.  This may be partly because, as parents, we do not like to think of our children as being anything other than happy.  It is more comfortable for us to think that our child is wetting the bed because they drink too much in the evening and have a ‘weak bladder’ than because they feel insecure about something.  In many cases, it is not a matter of ‘either/or’.  It is often when a combination of factors comes together that a physical symptom occurs.  It is of course beyond our control to eliminate all possible causes of physical symptoms in our children’s lives, but supporting them to become emotionally literate is something we can do that has the potential to be of huge benefit.  

[1] Campo, J. Pediatrics, April 2004: vol 113; pp 817-824

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