3. Get to the Bottom of the Problem -- If There Is One continued...
Mazyck recalls a student in a school where she worked who would begin to feel sick at the same time day after day. She discovered it was always right before math class and linked the symptoms to anxiety.
This is a case of psychological problems leading to physical symptoms, says Barry Anton, PhD, a clinical child and adolescent psychologist at Rainier Behavioral Health and professor of psychology at the University of Puget Sound in Tacoma, Wash. Faking becomes "malingering," he says. "Malingering is defined as assuming a sick role to avoid something."
The child in this case may not even be aware that the psychological problems led to the physical ones, Anton says. "The pain is real, the cause is psychological," he says.
These scenarios are more common, he says, in younger children who haven't yet learned to verbalize their emotional feelings. "As they get older, they have better coping skills," he says, and are better able to talk about their anxiety and other problems instead of having it manifest in pain.
Depression might be another underlying reason for your child to fake illness, Anton says. "It allows you to withdraw."
4. Decide if You're Contributing to the Problem
Children in "high achieving" families whose parents have very high expectations often have high anxiety levels, Anton finds. "They may be much more likely to fake it."
Children from "chaotic and disorganized families" in which the parents themselves may complain about physical symptoms due to psychological stresses are also more likely to fake it, he finds. They are modeling their behavior after their parents' behavior, begging off school when the stresses turn into physical problems. "The pain is real," Anton says. So to call it faking isn't quite accurate. "But they can't identify that the pain is from the anxiety."
Often, Anton finds in his practice, the child's symptoms mimic those of the parents. So if a mother complains of a bad headache the day before her salary review, her son may do the same before an important math test.
If this sounds like your house, Anton says, consider getting professional help -- for you and your child -- to learn to deal with the anxiety and depression and other problems that may be leading to the physical symptoms.
If you are convinced the sick day request is just about playing hooky, don't "reinforce" sick behavior, Anton says. What's reinforcement? "When you go in and say, 'Here's some chicken soup, let's turn on your favorite TV show," that makes staying home look way too good compared to school, and is likely to encourage your child to try faking it again. If your child's really sick, the chicken soup and love route is fine, he says, for that limited period of illness.