A: Dear jaymehale:
Children experience emotions as physical situations--as of course adults often do also, when they are in the grip of a powerful feeling. If your pediatrician has ruled out any medical problem, then perhaps you daughter has something bad inside in her feelings rather than in her gall bladder or her appendix. This does not make her reports fake or dishonest. It means that you face a different kind of challenge as a parent than if your daughter needed the doctor to take out her appendix. She needs you to help her understand her feelings, so that she can learn to get them out in words. This will help her mature in her ability to negotiate and to solve conflicts successfully with others.
Through your empathy for your daughter's emotions, you can help her begin to recognize that she is experiencing something inside: you can already tell pretty clearly that she likes certain foods and does not like others, she doesn't have the energy to clean her room, or she is frustrated or bored by parts of her homework. For her to come to recognize her emotions and to give them accurate names, she will need to feel that you respect her emotions--even when these emotions are not so convenient.
Your letter suggests to me that you are a person with high standards for your daughter. It upsets you that she wants to miss school, that she doesn't want to eat everything on her plate, that she doesn't want to clean her room, that she doesn't want to do all of her homework. These are natural reactions for a mother to have, and perhaps you set high standards for yourself as a mother. Possibly your daughter feels discouraged in her hopes to please you, and that her complaints of "hurts" inside reflect her belief that you will find medical issues more sympathetic than feelings. Possibly she is looking for a way to be let off the hook for all of these expectations.
Your daughter may be telling you that she needs a break from all of the pressure. Of course, you want her to grow up over time to be educated and well nourished, and to learn to be a tidy and organized person with her belongings. But right now, she may need fewer tasks and more emotional support. You might try three weeks of showing a sympathetic interest in "why" she doesn't want to do something, finding a compromise, and cutting her some slack--then evaluate whether she demonstrates less resistance and complaint with this approach. She may grow to be more self-disciplined in the long run if you step back a bit in your efforts to impose discipline from the outside!
Elizabeth Berger MD
Child Psychiatrist and author of Raising Kids with Character