What to Do When Your Child Gets a Tummy Ache Before School (with Dr. Ali Navidi)
It's 7:30 in the morning. You're trying to get everyone dressed, fed, and out the door when your child suddenly announces:
"My tummy hurts. I can't go to school."
And now you're faced with a parenting dilemma.
Are they actually sick? Are they nervous about something? Should you let them stay home, or encourage them to go?
If you've ever been in this situation, you know how difficult that decision can feel.
As a child psychologist and a parent, I've seen how childhood anxiety can show up as real physical symptoms. A child might complain of stomach pain before a spelling test, swim lessons, or the first day at a new school.
But here's the tricky part: The pain can be completely real, even when anxiety is contributing to it.
In this episode of Educated Parent, I spoke with clinical psychologist Dr. Ali Navidi, who specializes in the gut-brain interaction, about why children experience anxiety-related stomachaches and what parents can do to help.
We explored the science behind these symptoms, why school avoidance can become a difficult cycle, and practical parenting resources for responding with both compassion and confidence.
Why Does My Child Get a Stomachache Before School?
Most of us have experienced the connection between our emotions and our stomachs.
Maybe you've felt nauseated before a big presentation.
Maybe you've lost your appetite when you're stressed.
Or perhaps you've experienced that uncomfortable feeling in your stomach before doing something you're nervous about.
Children experience the same connection.
The difference is that younger kids may not recognize what's happening.
They might not say, "I'm anxious about my spelling test."
Instead, they say, "My tummy hurts."
And they're not necessarily exaggerating or making it up.
Their body may genuinely be responding to stress.
My Own Childhood Experience With Anxiety Stomachaches
When I was seven, I took horseback riding lessons.
And I was terrible at them.
I fell off the horse regularly.
Every Wednesday, when I had a lesson scheduled, I somehow developed a terrible stomachache.
Every. Single. Wednesday.
I still remember it.
My parents would tell me I had to go anyway.
And looking back, the connection seems pretty obvious.
I was nervous about horseback riding, and that anxiety was affecting my stomach.
At the time, though, I just knew that I felt sick.
This is one reason I encourage parents to pay attention to patterns.
Does your child complain about stomach pain every Monday morning?
Does it happen before swimming lessons?
Does it disappear when an anticipated activity is canceled?
Those patterns can provide useful clues.
They don't prove that anxiety is the cause, but they're worth noticing and discussing with your child's pediatrician.
Understanding the Gut-Brain Connection in Children
One of the most fascinating parts of my conversation with Dr. Navidi was learning how complicated the relationship between the brain and digestive system can become.
His specialty is GI psychology, sometimes called gastropsychology.
This field focuses on the relationship between psychological processes and gastrointestinal symptoms.
The gut-brain interaction helps explain why stress can affect digestion and why digestive sensations can influence how we feel emotionally.
But Dr. Navidi made an important distinction.
Not every recurring stomachache is simply a direct response to anxiety.
Sometimes a child's nervous system becomes unusually sensitive to sensations coming from the digestive system.
And that can create a much more complicated problem.
What Is Visceral Hypersensitivity?
Dr. Navidi introduced a term called visceral hypersensitivity.
It sounds complicated, but the basic idea is surprisingly easy to understand.
Imagine you're walking down a dark street.
You've heard reports of crime in the neighborhood.
You're already nervous.
Suddenly, every little noise seems louder.
A rustling leaf sounds like footsteps.
A distant sound makes you turn around.
Your brain is scanning for danger, so it starts amplifying signals that you might otherwise ignore.
Now imagine that same process happening inside your body.
Instead of listening for sounds, your brain is paying unusually close attention to sensations in your stomach.
Normal feelings, such as fullness, hunger, or gas, may start to feel painful or nauseating.
Your brain interprets those sensations as threatening.
You become more worried.
And that stress can contribute to additional digestive discomfort.
Before long, you're stuck in a feedback loop.
When One Bad Experience Creates an Ongoing Fear
Dr. Navidi shared the example of a ten-year-old girl who experienced food poisoning.
She woke up during the night with severe pain and nausea and began vomiting.
For a young child, that experience was frightening.
Even after she recovered and medical testing showed no concerning problem, she continued experiencing stomachaches.
She had developed an intense fear of vomiting, known as emetophobia.
Her attention became focused on every sensation in her digestive system.
A small feeling in her stomach could trigger fear that she might vomit again.
That fear could then intensify her physical symptoms.
What began as a real illness had developed into an ongoing cycle of fear and discomfort.
This example illustrates why we shouldn't automatically assume a child with recurring stomachaches is simply trying to avoid something.
Their symptoms may involve learned fear responses, increased sensitivity, and other factors that deserve attention.
Is My Child Really Sick or Is It Anxiety?
This is probably the biggest question parents have.
And unfortunately, there's no single trick that can tell you the answer every time.
In my own family, I've noticed how differently parents can interpret the same situation.
If my daughter gets nervous before swim lessons and complains of a stomachache, I might recognize the anxiety connection and encourage her to go.
My husband, who's an engineer rather than a psychologist, might interpret the same complaint as a sign that she's too sick to participate.
Neither response comes from a lack of love.
We're both trying to take care of our child.
But we may be interpreting the symptoms differently.
That's why having a thoughtful plan matters.
First, Rule Out Medical Concerns
Dr. Navidi emphasized that recurring stomach pain should be evaluated by a pediatrician.
Even when you strongly suspect anxiety, it's important not to assume that psychological factors are the only explanation.
Some symptoms require particular medical attention.
During our conversation, he mentioned warning signs such as:
Unexplained weight loss
Blood in the stool
Pain that wakes a child from sleep
Fever associated with abdominal pain
This isn't a complete list of warning signs.
If your child experiences recurring symptoms, talk with their pediatrician about what might be happening and whether further evaluation is needed.
If symptoms are severe or concerning, seek medical advice promptly.
Once appropriate medical evaluation has taken place, you and your child's healthcare provider can consider whether a disorder of gut-brain interaction or anxiety-related symptoms may be contributing.
That gives you a more informed starting point.
Why Letting Your Child Avoid School Can Make Anxiety Worse
Here's where parenting gets especially challenging.
Your child says their stomach hurts.
You know they're nervous about school.
You hate seeing them uncomfortable.
And everything in you wants to make the discomfort go away.
So you say:
"Okay, sweetheart. You can stay home today."
Immediately, your child relaxes.
They feel relieved.
You feel relieved, too.
It seems like you've solved the problem.
But sometimes you've accidentally strengthened the pattern you're trying to prevent.
The Problem With Avoidance
Dr. Navidi explained that when a child escapes an anxiety-provoking situation, the immediate relief can reinforce avoidance.
Think about it from the child's perspective.
They were nervous about school.
Their stomach hurt.
They stayed home.
And suddenly, they felt better.
Their brain may begin learning that avoiding school is the way to feel safe.
The next time school feels intimidating, they may experience the same urge to escape.
Over time, that pattern can become harder to break.
This is why school avoidance deserves attention before it becomes deeply established.
A child who repeatedly misses school may also begin falling behind academically.
Then they have another reason to feel anxious about returning.
The original problem becomes more complicated.
Why Kindness Isn't Always the Same as Helpfulness
This was one of the most interesting parts of our conversation.
Dr. Navidi described research examining different parental responses to children with disorders of gut-brain interaction.
He explained that highly protective, overly solicitous responses were associated with worse outcomes than more matter-of-fact approaches.
That doesn't mean parents should become cold or dismissive.
It means we need to recognize that the response most comforting in the moment isn't always the response that helps a child develop confidence over time.
As psychologists, we can sometimes sound ruthless when we talk about anxiety.
We're the people saying:
"You're anxious? Do it anyway."
But there's a reason for that.
When a situation is safe and appropriate for the child, gradually facing it can help reduce fear.
Avoidance often maintains anxiety.
Of course, this advice applies after medical concerns have been appropriately assessed. It isn't a reason to send a genuinely ill child to school.
Four Steps to Help a Child With Anxiety-Related Stomachaches
So what can parents actually do?
Dr. Navidi shared a practical approach that I think families can use when recurring stomachaches have been medically evaluated and anxiety or gut-brain symptoms are part of the picture.
These strategies aren't a substitute for individualized medical care, but they provide a useful framework for working with your child's healthcare team.
Step 1: Get on the Same Page With Your Co-Parent
If two caregivers respond very differently to the same symptoms, children can receive confusing messages.
One parent might say:
"You're okay. Let's get ready for school."
The other might say:
"Oh, your tummy hurts? You should stay home."
Dr. Navidi recommended that parents discuss their approach ahead of time.
Decide how you'll respond to recurring complaints.
Talk with your pediatrician about which symptoms require staying home, further evaluation, or immediate medical attention.
And agree on what you'll do when your child experiences familiar, medically assessed discomfort without signs of an acute illness.
The goal isn't to ignore pain.
It's to create a consistent response that doesn't unintentionally encourage avoidance.
Step 2: Reassure Your Child That They're Safe
One of the most important messages Dr. Navidi shared was that children need to understand the difference between discomfort and danger.
If your child's pediatrician has evaluated them and determined that their symptoms don't indicate a concerning medical problem, you can explain that in reassuring, age-appropriate language.
For example:
"I know your tummy feels uncomfortable. We talked to the doctor, and they checked you out. They aren't worried about something dangerous happening. Sometimes our stomachs feel uncomfortable, and those feelings can pass."
This kind of reassurance can reduce the fear surrounding physical sensations.
You're not telling your child that the pain is imaginary.
You're helping them understand that feeling uncomfortable doesn't always mean something dangerous is happening.
That's an important distinction.
Step 3: Help Them Face the Situation
Once you've acknowledged the discomfort and reinforced the medical guidance you've received, the next step may be helping your child participate in the activity they're nervous about.
Maybe that's going to school.
Maybe it's attending swim lessons.
Maybe it's getting into the car for an outing.
The goal is to avoid making escape the automatic solution whenever discomfort appears.
For example, you might say:
"I know your stomach is bothering you, and I know you're nervous about swimming. We've checked that it's okay for you to go. Let's get ready, and I'll help you through it."
This approach combines empathy with a clear expectation.
And when children successfully participate despite feeling nervous, they have opportunities to learn that discomfort can be manageable.
For children with significant symptoms or established avoidance, this process may need to be gradual and guided by a professional.
Step 4: Give Your Child Tools to Calm Their Body
Dr. Navidi also recommended using emotional regulation strategies that your child already knows.
These might include:
Slow, comfortable breathing
Visualization exercises
Redirecting attention toward something enjoyable
Listening to an audiobook on the way to an activity
Practicing calming strategies you've learned together
The order matters.
First, acknowledge how your child feels.
Then reinforce the message that they're safe, based on appropriate medical guidance.
Finally, help them use tools to manage their discomfort while continuing with the plan.
These are some of the most useful parenting resources we can give children: practical skills that help them cope with difficult feelings rather than automatically escaping them.
What If My Child's Stomachaches Have Been Going on for Months?
Sometimes parents catch the pattern early.
They notice that their child gets a stomachache every Tuesday before a particular class.
They consult the pediatrician, make a plan, and help their child work through the discomfort.
But sometimes the pattern has been developing for months or even years.
Maybe your child has stopped participating in activities they once enjoyed.
Maybe they've missed significant amounts of school.
Maybe they constantly worry about nausea, vomiting, or stomach pain.
At that point, additional support may be especially valuable.
How Gut-Brain Therapy Can Help
Dr. Navidi explained that specialized psychological treatment can help children with disorders of gut-brain interaction.
This work focuses on changing the patterns that maintain fear, discomfort, and avoidance.
Depending on the child's needs, treatment may address sensitivity to bodily sensations, fear of symptoms, coping skills, and gradual reengagement with activities.
Dr. Navidi described this treatment as evidence-based and generally short-term, often involving approximately twelve sessions in his practice.
The exact treatment plan and duration will depend on the child and the clinical situation.
For families dealing with persistent symptoms, specialized care may help prevent the problem from becoming increasingly disruptive.
When to Consider Professional Help
Consider talking with your child's pediatrician or a qualified mental health professional if:
Stomachaches repeatedly interfere with school attendance
Your child avoids activities because of fear of nausea or pain
Their world is becoming smaller because of physical symptoms
They remain highly distressed despite appropriate medical reassurance
Your family feels stuck in repeated arguments about whether they're too sick to participate
A professional can help determine what kind of support is appropriate.
This is particularly important because childhood anxiety doesn't always look like obvious worry.
Sometimes it looks like repeated trips to the nurse's office.
Sometimes it looks like refusing to get in the car.
And sometimes it looks like a child who genuinely believes something terrible is happening inside their body.
What I Want Parents to Remember
If there's one message I hope you take away from this conversation, it's that we need to respond to our children's physical discomfort with both compassion and curiosity.
A stomachache can be real even when anxiety contributes to it.
A child can feel genuinely unwell without having an infection.
And a parent can be loving and supportive while still maintaining appropriate expectations.
The challenge is figuring out what your child needs in that particular moment.
If they're genuinely ill, they need care and rest.
If they're experiencing medically assessed anxiety-related discomfort, they may need reassurance, coping skills, and support to participate in everyday activities.
And if symptoms keep returning, they need appropriate evaluation rather than assumptions about what must be causing them.
You Don't Have to Get Every Decision Right
I also want to reassure parents who are thinking:
"Oh no. I've let my child stay home before. Did I make everything worse?"
No.
One decision doesn't determine your child's future.
Maybe they really were sick that day.
Maybe you didn't have enough information yet.
Maybe you were simply trying to make the best decision you could.
What matters is recognizing patterns and adjusting your approach when necessary.
If you notice that your child repeatedly experiences stomachaches before specific situations, pay attention.
Ask questions.
Get appropriate medical guidance.
And work toward a response that helps your child feel supported without allowing fear to make every decision.
That's how we can help prevent school avoidance from becoming a larger problem.
Helping Kids Build Confidence in Their Bodies
One of the things I appreciated most about my conversation with Dr. Navidi was the reminder that our brains and bodies are constantly communicating.
The gut-brain interaction is powerful, and sometimes that communication system becomes overly sensitive.
But children can learn to understand their symptoms differently.
They can learn coping strategies.
They can practice facing situations that feel uncomfortable.
And with appropriate support, many children can make meaningful progress.
As parents, we don't have to eliminate every uncomfortable feeling our children experience.
We can help them understand what's happening, recognize when medical care is needed, and develop confidence in their ability to handle difficult moments.
That's an important part of helping kids manage childhood anxiety.
And it's why I love sharing conversations like this on Educated Parent.
The more we understand our children's experiences, the better equipped we are to respond thoughtfully.
Whether you're dealing with an occasional tummy ache before swim lessons or a more persistent pattern that's affecting your family's daily life, there are effective strategies and parenting resources that can help.
You don't have to choose between being compassionate and helping your child face something difficult.
You can do both.
And sometimes, that's exactly what your child needs.
LET'S CONNECT:
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CONNECT WITH DR. ALI NAVIDI:
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[00:00:00] Leah Clionsky Clionsky: Have you ever noticed that when something big is going on in your child's life, suddenly that day they might have a tummy ache and tell you they're too sick to do it? I know this is a really common parenting dilemma a lot of us run into, and we're sitting there thinking, "Are they sick or is there something else going on?
[00:00:23] Leah Clionsky Clionsky: Could this possibly be psychological?" That's what we're going to be talking about today. I have a wonderful guest, and I'm about to introduce him to you, and then we'll be talking about how to know if what could be going on is not really sickness, and then ways that you can talk to your kids so that you can get through that hump if that's happening to you.
[00:00:45] Leah Clionsky Clionsky: I hope you enjoy. I'm here today with Dr. Nivedi. I am so thrilled that you're here, and I would love for you to introduce yourself and talk about your specialty.
[00:00:57] Dr. Ali Navidi: Sure. Thank you. I'm glad to be here. And my specialty's a little strange, I admit. I'm what's called-- There's a lot of different names, but I'm a clinical psychologist. However, I have a specialty in something called gastro psych. Other times it's called GI psychology. And that's looking at the connection between the brain and the gut.
[00:01:24] Dr. Ali Navidi: And in fact, there's there's 20 different disorders that are actually related to that connection. But maybe I'm getting a little ahead of myself. But basically it's how do we treat those disorders? How do we work with kids who have what's called a brain-gut disorder? How do we help them?
[00:01:45] Leah Clionsky Clionsky: Isn't it so interesting that being anxious about something can actually give you a stomachache? I always found that to be fascinating
[00:01:55] Dr. Ali Navidi: Yeah. I, I've-- Actually, throughout my career, I've just been fascinated with the entire mind-body connection in general, whether it's a stomach ache, whether it's a headache, whether they their back or their knees hurt. And it turns out that the, the mind-gut connection is especially powerful, and I think we've all had that experience where we have some stomach issues because we're anxious about something, or at least we have that feeling in our stomach.
[00:02:28] Dr. Ali Navidi: It doesn't become a disorder, it doesn't become a problem until it starts becoming a regular pattern.
[00:02:37] Leah Clionsky Clionsky: Yeah.
[00:02:38] Dr. Ali Navidi: So as... i've got two kids. They're not kids anymore, but they used to be. We all are familiar with our kids complaining about their stomach and then, "Oh, wait, I remember there's that thing coming up that they are nervous about."
[00:02:54] Dr. Ali Navidi: I think that's very normal, and I don't think parents in general make too big of a deal about it. We all kinda know. But what do you do when that becomes a pattern where they're missing school or they're regularly missing things or they're regularly complaining about their stomach? How do we handle that?
[00:03:18] Leah Clionsky Clionsky: It's interesting 'cause it can sometimes be a tough call for a parent. If if my daughter gets anxious before swim lessons and she says she has a tummy ache, if I'm home, I'm like, "You're going to swim class. You're nervous, you're anxious, and it's making your tummy hurt." If my husband, an engineer, is home and I'm not there, he's like, "Oh, she's too sick to go."
[00:03:40] Leah Clionsky Clionsky: So it's interesting how the interpretation of that is really different. I think part of it too is I've experienced that a lot, especially as a kid. I used to take horseback riding lessons, and I was really bad at it. I fell off regularly. So every Wednesday, which is when, I still remember this, I was seven and I had my horseback riding lesson, I would somehow that day have a terrible stomach ache, and my parents would be like, "You still gotta go."
[00:04:08] Leah Clionsky Clionsky: But there was that very clear connection. Why do I feel sick literally every single Wednesday? Anxiety, right?
[00:04:16] Dr. Ali Navidi: And it is so com- common. I'm sure my daughter will love me telling this story, but, when she was young, she would get carsick, right? That's pretty normal, but her carsicknick- sickness was conditional. When she had to ride with certain friends and not when she had to ride in other situations. And so how is this happening? I think I would say it's an oversimplification to say it's just anxiety. And I say that very deliberately because a lot of patients will come in, and maybe the anxiety connection is very clear. Other patients will come in and they will say, "I'm not anxious. I'm not anxious about that."
[00:05:05] Dr. Ali Navidi: And sometimes it's just denial or whatever, but sometimes they really aren't anxious, or they aren't aware of their anxiety. And that can happen because there are also other factors happening. Once these disorders have been established, anxiety can be a trigger, but also there's something called visceral hypersensitivity. And that's when the area involved, whether it's, your stomach or feeling nauseous or whatever the sensations from your digestive system are being amplified and distorted. So what they're experiencing truly is, pain or nausea and it might not anymore be triggered by anxiety.
[00:05:56] Dr. Ali Navidi: Sometimes it can be conditioned to other things as well
[00:06:01] Leah Clionsky Clionsky: All right. So I wanna make sure I'm following you, 'cause I've always understood this as a much more of a pure anxiety situation. So it sounds like the early stages of this before it becomes really problematic, you're looking at the situation. You're like, "Why is my kid-- Why do they-- Where-- Why does their stomach hurt?"
[00:06:17] Leah Clionsky Clionsky: And you look at what's their day gonna look like, and you're like, "Ah, spelling test. Ah, swimming class. Ah, new school," or whatever, and you link it.
[00:06:25] Dr. Ali Navidi: Very straightforward
[00:06:26] Leah Clionsky Clionsky: very straightforward, but it sounds like what you're telling me is that if this has been going on for a while, just starting to have, maybe just digesting food would make you think, "Oh, there's something wrong.
[00:06:37] Leah Clionsky Clionsky: I'm gonna, I'm going to now feel bad." And then that sensation would make you anxious. Is that correct? Is-- Am I
[00:06:44] Dr. Ali Navidi: correct. And there are different scenarios. I'll give you an example. I treated a patient, a 10-year-old girl who had gotten food poisoning but didn't know it. Ate something, something was bad in there. Woke up in the middle of the night, intense pain, nausea, and then started vomiting, right?
[00:07:07] Dr. Ali Navidi: And imagine that as a little kid, how scary that is, how confusing it is. Following that episode, after she recovered from the food poisoning, she kept having stomach aches They got her checked out. Everything looked good. What had occurred? Essentially, she had developed what's called emetophobia. So for your listeners, a f- an intense fear of vomiting. So she-- After that event, she essentially had PTSD, I call it PTSD of the gut, where she was intensely scanning and anxious about internal sensations. So it wasn't necessarily any external anxiety anymore. It was just any, almost any feeling in the gut was now a trigger. But then there was a feedback loop that then created more of those feelings
[00:08:09] Dr. Ali Navidi: because of that anxiety
[00:08:11] Leah Clionsky Clionsky: So if I nerd out with you for a second, is this sort of how like panic disorder like can intensify where at first someone has a huge stress response and then they have a panic attack and a panic attack is where you just you're so anxious you can't catch your breath, your heart is racing, it feels scary, almost like a heart attack.
[00:08:30] Leah Clionsky Clionsky: And then after that, whenever your heart starts racing, you start thinking, "I'm going to have a panic attack," and then you get so scared that you then in fact do have another panic attack. And so then you start avoiding everything that you think might make your heart race, and then maybe you develop like a fear of leaving your home.
[00:08:46] Leah Clionsky Clionsky: So it starts with one thing, and then it expands because as human beings, we're so conditioned to be afraid of danger because avoiding something is usually so much safer than doing it. It's really easy for us to become afraid of lots of related things that make our world really small and painful
[00:09:05] Dr. Ali Navidi: Exactly. And if you think about-- So the term I used, visceral hypersensitivity, if we can nerd out a little bit more, you could imagine that as another, as a variation on the fear response. 'Cause what it's doing, imagine... I have people imagine let's say you're walking down the street and it's completely dark, and you start-- and you heard some news reports that there's been some crime in the area.
[00:09:35] Dr. Ali Navidi: So you're like, you're on alert. And now what's happening is your brain is so tuned in to any noise that it hears that it's almost amplifying it. A little noise becomes somebody starting to walk after you, right? It's, it's-- we're so tuned in that it's starting to almost distort the signal because our brain is looking for danger, so it's cranked...
[00:10:03] Dr. Ali Navidi: I say it, it cranks the volume up really high,
[00:10:06] Dr. Ali Navidi: right? Imagine if your brain's doing that, but not with sound, but with internal stomach sensations
[00:10:14] Leah Clionsky Clionsky: So you're scanning yourself. "I threw up and it was really bad. What if I feel sick again? What if my stomach hurts? Could it be hurting? It's hurting right now. That makes me really anxious. Now I'm afraid of my stomach hurting," and pretty soon you're making yourself sick, but
[00:10:27] Dr. Ali Navidi: And then with visceral hypersensitivity, it could just be normal sensation of your stomach being full
[00:10:34] Dr. Ali Navidi: Or your, or the feeling of your stomach being hungry or having gas. But the volume gets cranked up so high that it's not perceived as just fullness it's perceived as pain or it's perceived as nausea. And then the hypervigilant brain that's already been conditioned to be scared gets that nausea or pain and then freaks out even more, and then sends that stress and anxiety back down into the gut, which causes more symptoms.
[00:11:07] Leah Clionsky Clionsky: Right? You get stuck in a, a feedback loop that's really hard to break. It's so fascinating how the way that your brain interprets what different sensations can mean completely affects just your entire experience, and that this can happen to you as a pretty young child too, who doesn't even really understand the entire situation
[00:11:28] Dr. Ali Navidi: And so if you're a kid, what are you thinking? You're thinking, "I'm sick. There's something wrong with me. This is not safe. I need h- like, I need help." And so they're gonna, they're gonna get upset. They're gonna not wanna go to things. They're gonna not wanna go to school. And if they were already nervous about school in the first place, imagine having to go to something that you're already nervous about when you've got stomach pain or when you're afraid that you might have diarrhea or that you're constipated and you have gas.
[00:12:05] Dr. Ali Navidi: So it's adding this, this huge extra layer to something maybe they were already anxious about
[00:12:12] Leah Clionsky Clionsky: Okay. So let's imagine you're the parent in this situation, right? And your child is, anxious about something or, they-- you know they're probably anxious about something, but suddenly they have this stomach ache when they have to go do something that you interpret as hard. And we're sitting here being like we can't let them not go to that thing, because now we're gonna make them more anxious."
[00:12:35] Leah Clionsky Clionsky: We also can't just say, "Suck it up. This is just, this is just your active gut and your brain misinterpreting the signals. Just deal with it." So what can parents do? Because I do think this happens quite often with kids, and maybe the first couple times we think they really are sick, and then we're like 15 minutes later, they're running around outside, and they ate a whole bowl of cereal, and you reDr. Ali Navidize, eh, they weren't.
[00:13:00] Leah Clionsky Clionsky: So what can we do as parents when we run into this situation?
[00:13:06] Dr. Ali Navidi: If it's if it's becoming repetitive, let's at least do a, a pediatrician visit,
[00:13:11] Leah Clionsky Clionsky: Okay
[00:13:12] Dr. Ali Navidi: right? Let's at a minimum go in there and get it checked out 'cause there are some red flags, and they're gonna review them. And this isn't all of them, but some of them are, for example, weight loss, blood in the stool, waking up at night from the pain or having a fever that's related to the pain.
[00:13:30] Dr. Ali Navidi: So there's some red flags and the parents out there, you all don't need to remember all those. You just need to know if there's repetitive symptoms like that. Even if they're feeling better after the event, it's worth a trip to the pediatrician. Let's say you go to the pediatrician, everything's fine. Now you've got, now you've got a question to answer "What do we do with this?"
[00:13:56] Dr. Ali Navidi: Now, in, in my perfect world gut-brain therapy is available to everybody, and it's a short-term treatment. This is my little pitch for gut-brain therapy. It's evidence-based and it's short-term. It's usually about 12 sessions and it tends to be very effective, especially for children.
[00:14:16] Dr. Ali Navidi: But putting that aside, let's say you're just a parent, you just wanna deal with this on your own. The first thing I think you need to do is is get together as a team, and the par- parental team, right? So you threw your example out there, so that's just stuck in my mind right now. And so what you wanna do is you wanna come up with rules between the parents.
[00:14:38] Dr. Ali Navidi: "Okay, when do, when does our child stay home? When do they go to school?" Because with a kid that doesn't have these problems, it's easy. If they feel sick, they stay home. If they... If not, they go to school. But when they have a disorder of gut-brain interaction it becomes more complicated, and we don't wanna encourage them to avoid.
[00:15:05] Dr. Ali Navidi: And also, the more they avoid something, then the harder it is to get back to it. And God forbid they're missing a lot of school because then the problems just compound on themselves. They fall behind in school. They get anxious about going to school. All, all these things start happening. Sorry, go ahead.
[00:15:24] Leah Clionsky Clionsky: So what do we do? So let's imagine for a minute that this is not that serious. This has just been going on for two weeks. We're not at a huge problematic level here. This is like what your average parent is deDr. Ali Naviding with their like, just run-of-the-mill, not like we need to be in therapy yet for this.
[00:15:41] Leah Clionsky Clionsky: What-- what-- Should they still have that conversation? Okay, this has happened a couple times. Here is the bar. Is that still the first step in that kind of case?
[00:15:50] Dr. Ali Navidi: I think you need to have a bar. And I think the bar it's silly, but unless something is coming out of them or there's like a fever, there needs to be something we can verify for them to stay home. If it's pain or discomfort or nausea, we can't see it, we can't measure it, we need to go to school.
[00:16:16] Dr. Ali Navidi: That's when the parents are talking to each other,
[00:16:19] Dr. Ali Navidi: right? When you want to talk to the child about it, what you want to say is, we took you to the doctor, and the doctor checked you out, and you've got a really strong, healthy digestive system. They really liked what they saw.
[00:16:34] Dr. Ali Navidi: They thought it was strong and healthy. Now, sometimes you're gonna have all these uncomfortable feelings, and that's okay. And that doesn't feel good but the good news is that it's safe, that your system is healthy even if it feels uncomfortable, and that discomfort won't last. It will go away."
[00:16:57] Leah Clionsky Clionsky: So basically you're taking the fear out of it. You're saying to them, "We had you medically checked out. Your stomach is strong, and you are safe." So all of that worry of "What if I really am sick? And what if something's terribly wrong with me and no one knows how to help me?" That goes away, so we don't have the add-on anxiety.
[00:17:14] Leah Clionsky Clionsky: Is that the
[00:17:14] Dr. Ali Navidi: Yeah, exactly. Because I think that's a fundamental message for, for anybody with this type of problem is, yes, it's uncomfortable, I know it doesn't feel good, and you are safe.
[00:17:30] Dr. Ali Navidi: We got it checked out. You're gonna be fine. Everything is working well and so it's safe for you to go to school. In fact, let's go now.
[00:17:42] Leah Clionsky Clionsky: Mhm.
[00:17:42] Dr. Ali Navidi: Because again, cannot emphasize this enough, you don't wanna get into that pattern where avoidance works,
[00:17:52] Leah Clionsky Clionsky: Right
[00:17:52] Dr. Ali Navidi: Where you're reinforcing the pain or the whining or the crying because those are appropriate responses when there's a real problem, right?
[00:18:06] Dr. Ali Navidi: And when you get them checked out and you know the system is healthy, then we don't wanna reinforce it. We wanna give empathy and love, but we also wanna have good boundaries too.
[00:18:19] Leah Clionsky Clionsky: Do you wanna talk s- just for a second more about how anxiety gets reinforced? Like, why is it that when we let someone avoid something, their anxiety grows instead of going down? 'Cause that's what we think will happen, right? It's like, okay, they're scared, they're uncomfortable, they don't have to do it.
[00:18:37] Leah Clionsky Clionsky: That's the kind thing to do. And then the next time, instead of being less scared, they're more scared than they were before
[00:18:44] Dr. Ali Navidi: You're-- It's killing them with kindness, right? And everybody feels good, right? So your child is super anxious and their stomach is hurting and they're like, "I just wanna stay home. I don't feel good." And everything in you wants them to feel better, right? Then you don't like to see them sad. And so you say "You know what?
[00:19:06] Dr. Ali Navidi: It's okay. You're not feeling good. Don't go to swim lesson. Don't go to horseback riding." And what happens in that moment when you say that They feel relief. They're like, "Oh." And you feel relief, right? And what is that relief? That relief is positive reinforcement. In essence, if you were training your dog or something like that, that'd be like giving them a treat right then.
[00:19:38] Dr. Ali Navidi: That relief is positive reinforcement. And what have you reinforced? What is the thing that just got reinforced? 'Cause we-- what we know is when you reinforce something, it happens more often. What you've reinforced is that feeling of anxiety and then the behavior of whatever they were doing to convince you that they needed to get out of this situation
[00:20:04] Leah Clionsky Clionsky: The avoidance feels so good. And it's interesting how we're wired for that, right? Because if you really were avoiding something dangerous like a lion then like it would be good to be reinforced for that. It's like, "Good job, you escaped danger." But when you've escaped school for a non-existent stomach virus, then, your body processes that the same exact way, and then you have to now undo this thing that you've created later on.
[00:20:32] Leah Clionsky Clionsky: I think psychologists, we sound so ruthless because we're like, "Oh your child's anxious? Do it anyway. You're anxious? Do it anyway." And that's 'cause we just know that is the treatment for anxiety because avoidance makes it worse.
[00:20:46] Dr. Ali Navidi: And the, the hard thing with this is that we are tr- we are so trained that when we-- our body doesn't feel well, we need to take care of it.
[00:20:57] Dr. Ali Navidi: And 99% of the time, that's the right thing to do. You feel sick, you feel run down, you're getting a cough, you're getting a cold, your stomach hurt, take care of it.
[00:21:09] Dr. Ali Navidi: Take some time off. Take it easy. And then suddenly that signDr. Ali Naviding system isn't working reliably anymore That goes against everything we've learned previously,
[00:21:23] Dr. Ali Navidi: Right? And so I think a lot of parents can make that mistake where they start letting them avoid things. And once you go down that road, it becomes harder for you to change and harder for them to change too.
[00:21:40] Leah Clionsky Clionsky: Yeah. Yeah. It's such a hard place as a parent. So it sounds like if this is the first time and you're like, "All right, I think my child is really sick," and you let them stay home, you haven't ruined everything. Maybe they were that day. But then if you're noticing again, like this pattern we're talking about, then that's the time where you're like, "Wait a minute, they're not really actually sick.
[00:21:59] Leah Clionsky Clionsky: There's something else going on here and I need to make them go anyway."
[00:22:05] Dr. Ali Navidi: And once-- And then that's when you can reinforce that message of safety,
[00:22:10] Dr. Ali Navidi: And then whatever affect regulation tools you and your child have in your back pocket. What do I mean by affect regulation? Skills that you've worked with your child on in terms of calming themselves down, right?
[00:22:27] Dr. Ali Navidi: Whether that is some breathing techniques, whether that is some visuDr. Ali Navidization whether that's distraction, or refocusing their attention on something more positive, right? Whatever you have in your toolkit as a parent, use that. And but use it after you've re-en- you've shown empathy and then reinforced safety, then you can help them to calm down.
[00:22:57] Leah Clionsky Clionsky: Yeah. I love this. So I'm just gonna, I'm gonna repeat your steps, make sure I fully understood them. After you medically check out, make sure there's not actually something physical going on that requires medical attention, you get on the same page with any co-parents you have with some clear standards between you about what constitutes getting, being too sick to go to something so that you both know.
[00:23:21] Leah Clionsky Clionsky: And then after that, you give this message of reassurance that you've had them checked out, that they're actually okay, that they are strong, and that they can go to this situation. And then you go, you take them, and you give them some strategies to take care of themselves and some calm down tools, maybe an audiobook in the car on the way to that activity, but you make sure they go.
[00:23:45] Leah Clionsky Clionsky: And that keeps you from accidentally making this something that starts taking over some time.
[00:23:50] Dr. Ali Navidi: And that kind of reminded me also I know you talked about psychologists being a bit ruthless but when you look at the research regarding these types of disorders, these disorders of gut-brain interaction, and they-- what they did is they looked at parenting styles, and they were looking at kind of two major styles, right?
[00:24:10] Dr. Ali Navidi: The really very empathetic, "Oh my gosh, my baby, my..." Like that versus more matter-of-fact. More like, "Okay I know your stomach hurts. I know that's no fun. But we do have to go to school," right? So these two kinds of styles, and the very empathetic style, the very warm, super kind style actually resulted in worse outcomes for the kids.
[00:24:39] Leah Clionsky Clionsky: Oh, it's such a balancing act. Being a
[00:24:41] Dr. Ali Navidi: I know,
[00:24:42] Leah Clionsky Clionsky: nuanced.
[00:24:44] Dr. Ali Navidi: And it's interesting because in other situations, that empathy and kindness is actually very functional, and you need it. But when it comes to these kinds of problems, that's when you need to go into more matter-of-fact, mode. So it's not just about being one or the other, but it's about being flexible as a parent
[00:25:07] Leah Clionsky Clionsky: It's about knowing like, is this my child with the flu? All the empathy in the world. Is this my child who doesn't even reDr. Ali Navidize that they're avoiding something that they're worried about and, and now what they need is like a little bit of a firmer but still empathic approach. I am, I'm so glad that you came on and talked about this.
[00:25:28] Leah Clionsky Clionsky: I know that parents are gonna wanna find you because some people will hear this and be like, "Oh, I think we've gotten farther into this situation than I wanted to." Yeah. How can everyone contact you if they reDr. Ali Navidize that they've gone over and maybe they've been trying to be kind, but it started to backfire with avoidance?
[00:25:47] Dr. Ali Navidi: And my hope is, parents listening to this will catch it early on in the road, and they're not gonna need the kind of work that we do. Like you said, if they've gone further down that road, if this has not been a few weeks but months or maybe even years, maybe they're avoiding things or have dropped out of things we have a basically a c- it's a clinic called GI Psychology, and it-- and the website is the same thing, gipsychology.com. And it's telehealth in all 50 states, and we just-- we speciDr. Ali Navidize in this. This is what we do. We treat kids with these kinds of disorders. And the treatments work, and they're not that long-term, so your kids don't have to live with it. It's not something that defines who they are. It's something that can absolutely be treated
[00:26:46] Leah Clionsky Clionsky: Yeah. I think that's what's so nice about basically all treatments that are related to anxiety is they're effective if we do the right ones, and they can be life-changing. And I'm so glad that you offer that. It's such a great specialty, and we will definitely put a link to all of that in the show notes.
[00:27:03] Leah Clionsky Clionsky: So hopefully in the midst of norovirus, flu, and cold season, you as a parent can figure out what is what. Knock on wood, it won't actually hit your house. And if you reDr. Ali Navidize it's something else, there is help and you know how to reach Dr. Nabity. So thank you so much for listening to the podcast, and I'm excited to talk to you again next time.