Fibromyalgia in children and adolescents

Fibromyalgia is a poorly understood pain disorder that can become disabling. Much less is known about fibromyalgia in children and adolescents and this paper will add to this body of literature. Recognition and treatment of children and adolescents provides an important opportunity to prevent illness from becoming a way of life. Fibromyalgia is a pain disorder that can become a way for the body to speak what the mind does not know. The authors clinical experience indicates that fibromyalgia symptom severity can exist on a continuum from mild to severely disabling and those unconscious conflicts can move fibromyalgia from a mild pain disorder to a chronically disabling condition. It requires bridging the mind and body, both in understanding the mechanisms of the disorder and in guiding the treatment. The authors elucidate physiological and psychological mechanisms for this complex syndrome as well as a model for treatment intervention with children and adolescents. In doing so, they make bridges between literatures of medicine, neuropsychology, cognitive behavioral therapy and psychoanalytic theories; thereby paralleling the treatment process which moves from the physical through different layers of psychological depth. They provide a detailed clinical discussion of a young girl with a complex case of fibromyalgia that illustrates an application of this type of clinical theorizing applied to an individual and family treatment on an inpatient psychiatric unit.