دانلود کتاب درمان درد عملکردی شکم در کودکان

Welcome! This program will help you support and treat chil­dren who experience frequent and impairing abdominal pain. You will help these children trust their bodies and feel safe in them, a mission we accomplish by training everyone (yourself included) to be Feeling and Body Investigators – FBI agents – Pain Division. Through this training, we create an emotional context of exploration and inquisitiveness toward body sensa­tions and provide concrete strategies so that the experience of pain is not scary, but rather a clue, an object of curiosity, and a mystery to be investigated. We treat our strategies as crypto­graphic tools that help children decipher and respond to the various messages their bodies are communicating, whether these messages are the cramps of hunger pain, the butterflies of anxiety, or the pressure of gas pain.

It may surprise you to think that focusing more on physical sensations can actually reduce the frequency and intensity of pain experiences and improve children’s emotional awareness and regulation. The key to improvement lies in the quality of that attentional focus: it should be one of playful inquiry rather than of anxious hypervigilance. We teach children a new way to interpret their bodies’ physical signals. And perhaps equally important, we foster this same mindset in the parents of these children – both in how they relate to their own bodies and in how they respond to the experiences of their children.

Who can put the FBI program into practice? We have writ­ten for a broad audience. Any health professional who works with children in pain, whether in a primary care, school, or therapy setting, can implement this treatment. It should be accessible enough for a trainee but also interesting enough for seasoned clinicians.

By the time you have learned this program, the way in which your practice engages with patients about body symptoms gener­ally and pain specifically will have become a lot more fun as well as more effective. You may even find that your own relationship to your body will have improved. You are officially on the path to becoming a certified Feeling and Body Investigator – Pain Division. Congratulations! We are an elite group of special forces.

The FBI intervention actually arose from my work with an entirely different patient population – children, adolescents, and adults with eating disorders. Amidst numerous other com­plexities, individuals with eating disorders did not trust the messages their bodies were sending. For example, instead of recognizing a growling stomach as a sign of hunger, they might interpret this discomfort as the body trying to trick them into eating. They saw the emotions and drives of the body as threat­ening. They treated the body not as an essential life-partner, but as an enemy – something that needed to be subdued, ignored, or punished. This kind of thinking led to life-threatening disorders such as anorexia nervosa; but also, at a more basic psychological level, these individuals did not know themselves – what they wanted, needed, or cared about. Thinking about their experi­ences led me to wonder how children learn to develop a sense of trust in their body’s wisdom and how to teach this trust when it was not present.

I began to ask myself a lot of very interesting questions. How do children learn to develop a sense of trust and awe at their bodies’ power and wisdom? What type of life experiences could interfere with the emergence of this sense of trust? Could you teach children to trust their bodies when they already had some life experiences that challenged this sense of trust? When do you start? If you do intervene early, can you actually prevent the emergence of psychiatric disorders rooted in distrust of the body? Among many answers to these questions, one theme appeared repeatedly: children with early medical conditions, particularly those resulting in pain, may come to distrust their bodies.

My colleagues and I began to look for a target population of children for whom an intervention might make a difference. Our goal was lofty. If we could (a) take children who were vul­nerable to developing feelings of distrust toward their bodies (or perhaps already had) and then (b) help them experience, instead, that their bodies were invincible, and then (c) show them that this invincibility actually arose from the very thing that they thought made them weak – their pain or other prior vulnerability – that could be something very powerful! We wanted to design an intervention that would help vulnerable children (or really any children) to learn to trust deeply in their bodies, to feel safe, and to feel equipped to handle all of life’s challenges.

The FBI program was thus born. Through funding by the National Institutes of Health in the United States, we conducted a clinical trial targeting five- to nine-year-old children with chronic abdominal pain.