An American biologist points out that when people get sick these days, it isn't necessarily because they catch something contagious or have an accident, but it is often because humanity doesn't get along well with the environment. . . .

"Psychosomatic disorders" are illnesses where the mind affects the body. Nervous and anxious adults are the most common sufferers, but even children, who are supposed to be so carefree, can fall victim to them. It makes you wonder: Who is ill, the patients or society? And is it a problem with the children or with their elders?

The son of a government bureaucrat who is in junior high school often had stomachaches. Although he went to various hospitals for all sorts of high-tech tests, no cause had been found. When he was in the hospital for observation, the doctors discovered that every time his mother came to visit, his illness flared up, and when his mother was away not only did he not feel any pain, but he happily played ping-pong with the doctors. When the doctors talked to the boy's parents, they discovered that he had always ranked among the top in his class, but when sections were divided according to ability and he entered the top class, his rank fell into the thirties, and his mother said, "If your rank is in the thirties, how are you going to test into a good high school?" That's when his stomachaches started. When the parents took the doctor's advice to put the boy into a regular section, the pain stopped.

The son of a pediatrician had a headache every morning for some unknown reason. One of his father's senior colleagues discovered that the child's problem was psychosomatic. Planning to emigrate, they had enrolled the boy in the Taipei American School, which was for him a strange environment where it was hard to communicate. As a result, he began to reject school, and got a headache whenever it came time for it.

Not faking it

There is no scarcity of such illnesses in pediatrics. Huang Fu-yuan, the vice superintendent of Mackay Memorial Hospital, points out that some children have inexplicable tics in their cheeks, blink constantly, or stutter. All are signs of pressure.

Psychosomatic disorders commonly come in the form of nervous or muscular problems, such as headaches, stomachaches, aching joints, linguistic blocks, etc. They can also manifest themselves as problems involving the digestive tract, such as poor digestion or stomach ulcers. For children, ailments like these with pain in the belly are most common.

Emotional and behavioral problems can also be manifestations of psychosomatic disorders. Wu Yu-yu of the children's psychiatry department at Chang Gung Memorial Children's Hospital explains that some children become nervous, anxious and depressed; others steal things, hit people or skip class; some even hurt themselves.

Bulimia and anorexia, which are common in America and Europe, have been on the rise here too in recent years. Wu Yu-yu says that the smallest sufferer she has seen was a fifth-grader. "Being thin is currently the standard for beauty. My own daughter is only five, and she has told me that she doesn't want to get fat, that being fat is ugly, that she wants to go on a diet." Wu notes that this is just the result of children being influenced by the greater environment.

No one knows my heart

Some children use illness to resist pressure; others escape by smoking, drinking and doing drugs; others protest by taking to crime or illegally racing motorbikes.

According to a study carried out by the John Tung Foundation in 1994, 16.6% of teenagers in the ROC smoke and 20.5% of them drink alcohol. The study revealed that the most common age to first smoke is in the fifth or sixth grade. Children most often smoke when they are "in a bad mood." The youngest-ever participant in Taiwan Adventist Hospital's smoke-out class was nine.

Chen Chien-wei, an associate professor at NTU, points out that tobacco and alcohol are the "entryway" to drug use. Children usually start with easily obtainable substances, and only then go a step further to illegal drugs.

The root of the problem

Chiu Yen-nan, a doctor at NTU's Child Psychology Support Center, points out that some children's psychosomatic disorders are "just a stage," and when the problem is resolved that will be the end of it. But if the problem lasts, it requires treatment.

The children who suffer from these psychosomatic disorders aren't feigning illness to get out of going to school. They are truly in pain. Chiu Yen-nan points out that mental pressure can affect the nerves and blood vessels and cause muscle contractions.

Physical examinations will reveal the causes of bacterial diseases or viruses, but they won't make sense of psychosomatic disorders. Hence, children who suffer from them will go from doctor to doctor before finally turning to child psychiatry.

Children diagnosed as having a psychosomatic disorder usually first take pain killers "to treat the symptoms." Often it is also necessary to give them some anti-depressants and anti-anxiety drugs. These help to calm their nerves, which is important when treating a psychosomatic disorder. But only by finding the source of the pressure and adjusting adults' expectations or by teaching children methods to cope with pressure can the problem be tackled at its roots.

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A scene from the last leg of the joint-entrance exam marathon. The exams may involve a "general family mobilization" as here, but can every child bear the pressures to succeed academically? Are the growing number of pyschosomatic disorders among the children of Taiwan the downside of progress?

(photo by Hsueh Chi-kuang)