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| Faking it, malingering or hypochondria?
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When kids try to get out of child care & school
by Sophie Cross
Every child tries to get out of school or preschool from time to time and when you're working and need them to be there, it's very tough to be sympathetic when you get a whiff of fakery.
We've all been there. As fakers ourselves and now as the parents of fakers. And it's not always easy to tell whether your child is really ill or putting on a show to get a day at home with mum or dad.
Do you risk taking them in kicking and screaming, just to be called in an hour's time and asked to come in and collect your child who's just thrown up in the classroom/day room, making you feel like the worst parent in the world?
I have on a couple of occasions not listened to my daughter's insistence of having a "stomach ache" or feeling sick (her go-to illness) only to regret my hard line when she's thrown up in the back of the car on the way into school.
Every child does it from time to time, just because they're tired and fancy a day at home with mum. But if it happens a lot we should really be asking why they are so hell-bent on not going to pre-school or school. Is there an issue? Are they unhappy? Are they worried about something? Are they being bullied?
Although there are certainly occasions when the child is totally fine, just faking it, but often even a slight tummy pain, headache or other symptom can lead a child to unintentionally over-dramatise, misunderstand or exaggerate something in their own mind and they truly believe what they're telling you.
When I was young we used to call getting out of school "skiving" school or just "putting it on". There is a technical term for knowingly exaggerating illness to avoid school etc., and that it "malingering". A great word!
However knowingly faking illness can sometimes get out of hand and become a psychological disorder, known as Munchhausen's syndrome. This, in its clinically diagnosed form, is really quite rare. But while many of us can hold our hands up to having been guilty of a spot of malingering (hello "pulling a sickie", "having a doona day" and systematically using sick days as holidays), most of us will never be diagnosed as having Munchhausen's syndrome!
There is another word though to describe unrealistic illness and that's "hypochondria".
We use the word hypochondria as a generic term for making out you're sick when you're not, but it is in fact a bona fide disorder and a child with "hypochondriasis" actually believes he or she is ill, which is the difference between hypochondria and Munchhausen's.
The CHILD MIND INSTITUTE in the USA says that a child with hypochondriasis misinterprets real minor physical symptoms and truly believes that he is ill. Worries about illness cause him severe anxiety. Anxiety, in turn, can cause further symptoms like muscle aches, dizziness and chest pains, which may reaffirm his belief that something is terribly wrong.
Faking illness or believing you're ill when you're not can also be a way of seeking attention, but children who have hypochondriasis do not know that they are exaggerating routine ailments; they believe themselves to be seriously ill and may be consumed with anxiety as a result. And often no amount of reassurance from parents or even doctors will convince a child he or she is not ill.
Children with the disorder are consumed with anxiety that seriously disrupts their lives. They do not understand or believe that they are not actually ill, even when a doctor assures them that nothing is wrong.
Hypochondria needs to be treated. Hypochondriasis is an anxiety disorder that causes acute suffering and impairment. Cognitive behavioural therapy can be very effective in helping children identify when their symptoms are not, in fact, proof of any physical illness. Antidepressant medications such as SSRIs are sometimes prescribed to help relieve symptoms of anxiety.
All this said, the most likely reason for your child trying to get out of school is for a particular reason that day or week.
Reasons can be simple tiredness or nervousness about a particular aspect of school (for my daughter swimming days have always been the watch days – she hates swimming!). It can be for having fallen out with a friend or group of friends; the dislike or mistrust of a particular teacher or even things like that day having a particularly detested dish on the lunch menu!
More serious reasons that need to be got to the bottom of can be things like teasing or bullying, or worry or anxiousness about another aspect of their lives at home, such as divorce, family illness or a particular family issue.
If your child fakes illness to get out of school or preschool more than one or twice, you need to look for patterns and sit down with your child to ask if there is something bothering or worrying him/her. Make this sound casual to begin with if you're not sure if there is anything or not. Children are extremely clever and if they get a whiff of a dramatic situation they can use to their advantage, they will take it for sure!!!
At the end of the day it's very hard to gauge, but suffice to say if it's happening a lot, there is something at play that more than likely needs to be dealt with. It's very important to help your children to know they can talk about anything that's bothering them at this early age… it will help them develop more of an open personality and willingness to talk to you about issues that can only be better for them as they get older and have more emotional and physical issues to work through.
So if you do get that whiff of fakery, be sure to nip it in the bud or get to the bottom of it as soon as possible.
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| Sophie Cross is a public relations consultant and writer who has publicised and written about everything from makeup to The Muppets, child care to celebrity chefs and perfume to Partners in Population and Development! Originally from the UK and as a languages graduate she has worked around the world, living in Australia for the last 11 years where she runs, PR Chicks. Read Sophie's blog
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