Dear Therapist:

Our 10-year-old daughter has been complaining of headaches and stomachaches.  This seems to happen whenever something is going on in her life, particularly when there are changes such as school starting, camp, and around yom tov time when there is a change in schedule. We discussed it with her pediatrician who said there is nothing medical going on. She suggested that we begin by having a conversation with her about what it means to feel nervous and how that can sometimes make us feel things in our body. She didn't give us much more than that and I was hoping you could give us more information and tools to educate our daughter about this and have a productive conversation that will resolve this issue. Thank you. 

Response:

What your daughter is experiencing is absolutely normal. As we all know, there is a direct connection between our minds and our bodies. We have all felt our hearts jump into our throats when we are scared. We all feel nervousness in our bodies as well in our minds. When we perceive some sort of danger, our brains send a message to our bodies to react appropriately. This is known as a fight-or-flight reaction.

When there is an actual danger, this reaction is not only appropriate, but it is often necessary. It amplifies our sense of danger so that we can react. When our bodies receive a danger message from our brains, hormones like adrenaline and noradrenaline are released. These increase the body’s abilities in terms of strength and speed.

On a simplistic behavioral level, anxiety can be viewed as the fight-or-flight response being triggered unnecessarily. This means that our minds are telling our bodies that there is a danger when, in fact, no danger exists. It is likely that, on some level, your daughter feels anxious about the changes that you described—or about change in general.

The fact that your daughter seems to complain about her somatic symptoms rather than about her feelings of anxiety may indicate that she is more cognizant of her bodily symptoms than she is of her emotions. When focus is placed on specific symptoms rather than on their cause, it is very difficult to address the underlying problem.

Your daughter’s pediatrician probably recognized this. Her suggestion seems to be twofold. She suggested that you explain to your daughter that feeling things in her body can mean that she is actually feeling nervous about something. This can help her to both normalize her somatic complaints and begin considering her fears. Normalizing her bodily symptoms can help your daughter to feel better about the fact that she has these symptoms. This, in itself, can help to reduce the severity of these.

Acknowledging her fears and discussing them can help your daughter in two ways. Simply recognizing that her issue lies with her emotions rather than with her body can help to reduce her somatic symptoms. It may also reduce her anxiety to some degree. Expressing her feelings can help her to normalize these, thus allowing her to feel better about the fact that she has fears. More in-depth discussions can help her to better deal with her fears. This gives her a better, and more direct, outlet for addressing her feelings of anxiety.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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