PSYCHOSOMATIC PROBLEMS IN CHILDHOOD1

Abstract

Since this paper is presented as part of a discussion of Biological Factors in Personality Formation, I shall center my comments about the intimate relationships between common somatic symptoms and disturbances encountered in infancy and childhood and disturbance or deviation of the developing personality of the child. These relationships are more readily observed in small children than in adults because of the more obvious vulnerability of the child in his exposure to a healthy or to a disturbing physical and social environment. In childhood, the nature of the disturbances that may be designated as psychosomatic are dependent upon the biological maturity of the organism (I), and the nature of the nursing and training care to which the child is exposed (2). In the very young infant, the state of physiological maturity and susceptibility to the particular kind of care offered are reflected most commonly in the gastro-intestinal behavior. Appetite disturbances ranging from those that are mild to anorexia that threatens life, reflect errors on the part of the mother in meeting the child's initial need. For the growing infant and child, maternal love and care are essential for the development of security in all life relationships. The feeding situation is, for the child, an experience that initially secures for him comfort and a sense of well-being. When a good nursing or feeding regime and satisfying initial relationship between mother and child are not established, deep discomfort for both follows. There centers about the gastro-intestinal system and its functioning an essential expression of child's need, mother's readiness or capacity to meet that need, and all the possibilities of fundamental gratification or deepest deprivation for the child. Throughout life, the gastro-intestinal system continues to mirror the emotions better than any other body system. Menninger (2) remarks that this in part may be because it is partially under voluntary control, and adds, Next to the skin, the gastro-intestinal system has more contact with the external world than any other part of the personality. It receives more direct demands for adjustment and accommodation, more insults and abuses, and a greater variety of opportunities for gratification than any other set of organs suffers or enjoys. In early life when there is adequate gratification through establishment of a healthy nursing or feeding regime by a stable mother, the clinical picture of a normal infant who thrives physically and gives evidence of comfortable adjustment to his protective environment is usually presented. The implications of such a favorable situation for the healthy personality development of the infant need not be stressed here, and is abundantly