I have been reading a thought-provoking and enlightening book by John Bradshaw titled Healing the Shame that Binds Us. The author talks about ‘toxic shame’, wherein a person can come to believe that his whole self is fundamentally flawed and defective(instead of knowing his limitations, moral obligations and potential, which is termed ‘healthy shame’). He goes on to explain how unexplained and concealed feelings of this nature in early childhood operate destructively in adult personalities and interpersonal relationships.
My thoughts went back to numerous children I have met in the outpatient clinics who complain of vague symptoms around their exam time. It is quite a challenge for a pediatrician because we have to be sure that we are not overlooking something significant, and tactfully interact with the child and parents. And many times we conclude that the child is suffering from what is termed somatization disorder. This is a condition where the child has one or more physical complaints for which appropriate medical evaluation reveals no explanatory conclusion. The symptoms are brought on due to anxiety and emotional conflicts that the child is unable to come to terms with. A certain biological sensitivity to somatic feelings could predispose such children to developing symptoms and studies suggest that it is also possible that a person’s body might develop increased sensitivity of nerves associated with pain and those responsible for pain perception, as a result of chronic exposure to stress.
Such being the case it is so crucial for these kids to be understood. Evidence suggests that kids who have a history of physical or sexual abuse are more likely to have this disorder, and it is more common in girls. Somatizing has a significant association with the temperament of the child, experience of life events and psychiatric problems, all of which should be recognized for proper management. Complaints can vary from aches and pain, altered bowel habits to even blindness and transitory paralysis. The diagnosis is made after excluding serious conditions and addressing the family and learning environment of the child with appropriate questionnaires.
Parents often shame children to avoid making them cowardly or needy, but this can permanently affect their relationship. When their feelings are not validated, children develop complex and disturbing inner states and this lays the foundation for alienation, self doubt, depression and compulsive behaviors. It is therefore imperative that children be loved for themselves rather than for their achievements and performances. We must accept them fully, support them whole-heartedly, and give them space to be different. As parents, we need to invest time and attention to direct their problem solving strategies from the early years.