Stress management and the psychosomatic approach

Since November, three families have consulted me regarding their children, who each began to display psychosomatic symptoms that caused a prolonged absence from school. Psychosomatic symptoms are physical manifestations in which both emotions and thought patterns are believed to play a significant role, and usually develop when a person's ability to fight disease is weakened by stress.

It is possible the physical complaints are caused by illness, such as acute infectious diseases or post-infectious chronic fatigue. However, in situations with chronic or overwhelming stress or distress, a minor illness can trigger these manifestations. Though the root may be mental or emotional, the discomfort and symptoms are real.

All three youngsters are students of top-band English-language secondary schools in Hong Kong. Their symptoms include headaches, migraines, common colds with continuous fever, and rectal ulcers with severe pain. These symptoms show up primarily during school days and subside on weekends.

This pattern confuses the parents. They wonder whether their children are 'really' sick or just pretending to be ill to stay home from school. Although the youngsters have all had problems adjusting to life at their secondary schools, they deny that their health problems are tactics to skive off school.

These problems have divided the parents: two of the mothers, who are the main caregivers, have witnessed the concrete physical discomfort of their children. Both are ambivalent about whether to force their children to go to school despite these psychosomatic symptoms. In these two families, the fathers, who see the youngsters at night and on weekends when the symptoms are less acute, blame the mothers for being overprotective and encouraging them to stay home from school. In the third family, the mother does not trust her child and blames the father for failing to be authoritative.

All three families are now having 'trust' issues in the parent-child relationships, and disagreements or conflicts in the parents' marriages.