rivka: (alex age 3.5)
[personal profile] rivka
Alex has been complaining a lot about illness. "I'm sick. I don't feeeeeel good." It's been going on for a few weeks now.

She was actually sick, before Christmas. She doesn't seem to be sick now. She has the occasional sniffle or cough that just seems to go along with winter, but she's displaying no actual symptoms - no fever, no worrying change in her eating or sleeping habits, no changes in her appearance, no apparent activity limitations. Just complaints. When we ask her what hurts: "My whole body hurts." "Everything hurts." Even, she will insist if we ask more detailed questions, her toenails and her eyelashes. Every part. We've started asking "What do you think would make you feel better?" Sometimes she asks for medicine. Usually she doesn't know.

For a while it seemed like it was related to things she didn't want to do, or things she did want to do. "I can't put away my game because I'm siiiiick" and "I need to watch another video because I don't feeeeel good" are pretty easy to interpret and respond to. Or boredom-related "sickness" in the car. But more recently it's been different. Every morning this week, as soon as I mention school: "I don't feel good. I need to stay home." I will usually tell her, cheerfully, that we'll see how she feels once she gets to school. She's started asking: "WHY are you making me go to school when I'm SO, SO SICK?!"

She still doesn't seem to be legitimately sick at all.

I spent some time this morning talking with her about school. Why doesn't she like to go to school all of a sudden? Because she doesn't feel good, she told me. Is anything happening at school that she doesn't like - anyone being mean to her, any problems, anything scary? No, she said. Nothing is wrong at school, she just doesn't want to go anymore because she doesn't feel good.

This morning at dropoff, I spoke to her teacher for a while. The teacher confirms that nothing overt appears to be going wrong for Alex - no friend issues or anything like that. She will play happily for a while at school, and then come over and tell a teacher that she doesn't feel good and that she needs her mommy. The teachers have been treating this as a plea for attention. They offer her the opportunity to sit or lie down and rest when she says she doesn't feel good, but haven't been calling us or taking her temperature or anything.

I think that what may be wrong is anxiety. I think that my questions about problems at school were off-base, and that rather than worrying about school she may be worrying about separating from me. After all, that's the other thing that happens at going-to-school time. And anxiety certainly makes your whole body feel bad.

She knows that Niblet's arrival is imminent, and that I'm going to go into labor and go to the hospital and have the baby. She knows we've been making plans for who will take care of her. I'm pretty sure that she knows that it could happen at any time and we don't know when to expect it or when things will change. That's probably pretty anxiety-provoking. Also, I've started being too pregnant to do certain things: I can't sit in the back seat of the car to keep her company, I can't bathe her, I can't play active games. That might be anxiety-provoking in itself, if she's worrying about how much I love her or how much I'll be there for her.

I think this is a reasonable working hypothesis for what's happening now.

The sibling prep books we've read have focused on having a baby at home, not on the anxious weeks of knowing that major life changes could happen any moment. We're going to have a sibling's hospital tour and meet with a nurse for a while on Sunday, and I guess that could go either way - it could make her more anxious, or less.

My tentative plan: I'm going to tell her that I spent a lot of time thinking and reading about what might be making her feel bad, and that I think she has a sickness called anxiety. I'll explain that anxiety can be treated using exercises, kind of like Dad's physical therapy, and I'll try teaching her progressive muscle relaxation using some kind of PMR script for children. I'll try waking her up a little earlier so that we have time to do a PMR exercise before school.

Separately from that, I will try asking her whether she worries about leaving me or being gone from me all day, and whether she worries about what will happen when the baby is ready to come. I don't know if I'm going to get anywhere with questions like that, though. This is where you'd think that being a psychologist would help, but it doesn't, because I mostly was trained to work with adults and I have zero experience with interventions or techniques for kids this young.

I would appreciate any advice or theories that people have - especially people with lots of young-child experience, like [livejournal.com profile] mactavish, and people with new-sibling-prep experience. Also, if you have any alternative hypotheses about what might be causing these illness complaints, I'd be interested to hear them.

Date: 2009-01-08 04:19 pm (UTC)
eeyorerin: (absorbed penguin)
From: [personal profile] eeyorerin
Well, she gets to stay home with you (or Michael) if she's genuinely sick, and if she gets genuinely sick at school you (or Michael) come and get her. If she wants more time with you, then perhaps if she says she's sick...

I don't think she's necessarily being deceptive -- I just think that she's bright enough to have figured out that being sick equals more parental time and attention, and to try and use that logic to get the attention that she wants because she is anxious about the big changes hanging over her head.

Do you think that perhaps she equates you going into labor/going to the hospital with you being "sick" and is worried about what might happen to you, and this is a way of expressing that concern as well?

Date: 2009-01-08 04:41 pm (UTC)
ckd: small blue foam shark (Default)
From: [personal profile] ckd
Do you think that perhaps she equates you going into labor/going to the hospital with you being "sick" and is worried about what might happen to you, and this is a way of expressing that concern as well?

Alex might also be remembering the second pregnancy, which would add to her anxiety about you being "sick" and something happening to you. (NBHHY NBHHY NBHHY)

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