School Phobia

Q. In the past month or so, my son (aged 10) hasn't wanted to go to school. Almost every morning he says he doesn't feel good. Our family doctor can find nothing physically wrong.

— T.O.

Lancaster, Pennsylvania

A. Though the term “school-phobia” was briefly in vogue, it has recently become rarer. The vast majority of school “phobia” is best called school resistance. Something about attending school bothers or upsets a child. Some anxiety may be involved, but rarely is it the main factor.

The reasons behind school resistance are almost as many as kids. Sometimes a parent can identify the source of the resistance, and maybe even do something about it: An earlier bedtime means less morning sluggishness; a brief chat with a bus driver can cue him to intercept a bully.

Just as often, you can't figure out what's going on, or if you can, you can't change it. Jim has to take P.E. The driver won't let a parental bodyguard on the school buses and, besides, a few punches in the back from some bigger kid are far more tolerable to Homer than having mom on his bus.

It's also not uncommon for a child who previously liked school to develop a temporary dislike for it. Something has changed, either with school itself (a new teacher?) or with a youngster's attitude, and his distaste evolves into resistance.

Resistance often takes the form of professed sickness, usually involving the stomach, head or throat. Symptoms may be severe enough to prompt at least one visit to the doctor yet vague enough to be cured spontaneously by late afternoon. Remarkably, the illness almost never flares up on Saturday or Sunday.

Since I know little about your son, I don't know if he's primarily anxious or resisting. Judging from this problem in general and what you've said, chances are high he's more resisting than anxious. Even if he were genuinely distraught over school, you would approach the problem similarly. Your first and foremost concern is to keep your son in school. The longer he stays home, the stronger his resistance and anxiety become.

Address the problem with your son. Explore what might have changed his feelings toward school. Talk to anyone else you think may give you some perspective — a teacher, principal, bus driver, friend, crossing guard. If there is a clear trouble spot and you can influence it, you may smooth things out quickly.

On the other hand, it's most likely that the cause will be beyond your knowledge or influence. You must then move in other directions. What directions will be the topic of our next visit, assuming I'll be here. Lately, I've been not wanting to come to work. My stomach hurts.

Dr. Ray Guarendi is a clinical psychologist and author.