In most children with chronic abdominal pain, no serious organic disease is found. In such situations, the child's stress and emotional problems are considered the main cause of abdominal pain. This article, written by an experienced psychologist, a specialist in clinical psychology, explains what are the mechanisms causing the development of chronic abdominal pain on emotional grounds. The importance of psychological intervention in children with chronic abdominal pain is highlighted.
Working in a paediatric hospital, it is a daily occurrence to encounter the problem of abdominal pain in patients of different ages. This is an important problem because it affects our children. It is well known that their well-being and state of health is often of greater importance to parents than their own good health. Abdominal pain accompanies every child and at every age. From the neonatal period through early childhood, pre-school, junior high and high school. Many people also experience these complaints during adulthood and adulthood.
The abdomen is a part of the body that, in any case, is of enormous importance for our somatic as well as mental functioning. If all the processes of regulation and functioning of the body run smoothly, we usually do not remember about the abdomen. It is worse when it reminds us of itself by pricking, squashing, pressing, causing nausea and vomiting or diarrhoea or constipation. When a child signals his or her pain by contorting his or her face, crying, shouting, weakness, unusual behaviour, e.g. withdrawal from social contact, or aggressive reactions, and this pain is repeated and will not go away, the parent becomes determined and usually takes steps to diagnose the illness from which his or her child is suffering. He or she sees a general practitioner and starts treatment. If the complaints persist, the child is referred to a paediatric hospital, where further procedures are undertaken.
As part of the routine diagnosis of abdominal pain in a modern hospital, the patient is examined psychologically. The examination is designed to answer the question of whether there are and what are the psychological indicators that influence the occurrence of the emotional component in the course of abdominal pain. In other words, whether the abdominal pain is due to the stress experienced by the patient or whether it has a mixed or merely somatic origin.
In psychological terms, abdominal pain is directly related to the patient's life situation. The child is a member of the family in which he or she is raised. He or she often takes part in social life by participating in preschool or school activities. He or she runs around the yard, talks to people, goes to grandma's, church, etc. The younger the child, the narrower the circle of people around him or her. The older he gets, the more people around him. A stomach ache is a manifestation of a problem that is affecting them. The reflective parent recognises how stress can change the child's behaviour. He or she guesses what might be causing it. From psychological practice, it is known that the most common cause is overload, suppression, repression of emotions, the formation of counter reactions to a situation or factor that generates stress and subsequent pain. E.g. the child does not want to separate from his mother, wants attention, has too many responsibilities, wants to meet the expectations of parents, teachers, adults manipulate the child by dragging him into their conflicts, unfulfilled dreams, expectations or issues that are too difficult for the young person. Reduced mental and physical resistance to stress is a contributing factor to the development of abdominal and other human organ complaints.
Psychological treatment of abdominal pain includes the following activities:
- Paediatric diagnosis.
- Psychological diagnosis - counselling.
- Discussion in the child and with the child's parents;
- Examination with psychological tests - discussion of results;
- Identification of the patient's problems;
- Formulation of a programme of therapeutic activities for the child and his/her family;
- Periodic therapeutic meetings - reinforcement of positive attitudes, behaviour, actions, achievement of goals.
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The process of diagnosis is essential as it provides the basis for identifying ways to address the child's problem. The most common problems are those occurring in the area of the family and the home in which the child is raised, followed by the pre-school, backyard, school and student environment. The respondent interacts with the environment, influences it and is himself an object affected by all kinds of positive and negative stimuli from the point of view of his psychological, somatic, social functioning.
