Good physical health, physical resilience, harmonious development of the body and a pleasant appearance also have a positive effect on a person’s mental health. A healthy and normally developed child is more active, enterprising and courageous than a stunted and sickly peer. That is why such a child has more opportunities to become independent and to gain self-confidence. It is very important for a child, especially before puberty, to physically develop simultaneously with its peers. This makes it easier for it to feel equal, to engage in productive competition with them and to adapt to them. Good nutrition raises the child’s psychological energy, increases its working ability, facilitates its learning, and thus enables it to achieve success. This brings the affirmation of its personality, thus satisfying a very significant need of the young person.
For normal mental development, it is especially important to preserve the child’s sensory organs, especially sight and hearing, and to keep his or her exterior intact. These moments contribute a lot to the child’s good management of life’s tasks and its successful integration into various human collectives. In addition, they allow it to create a positive judgment about itself, which will boost its self-confidence.
It is necessary, therefore, that the parents take care of the physical health and proper physical development of their child as much as possible, that they also contribute to its mental health, i.e. the positive shaping of the young personality. It is important that parents pay attention to their child’s diet, to develop various hygienic habits as soon as possible, to regularly vaccinate it against infectious diseases, to allow it to stay in the sun, in nature, at sea, to take it to medical check-ups from time to time.
Impaired physical health can negatively affect a child’s mental development. Physical defects are divided into three basic categories: developmental anomalies, defective conditions, and diseases in the narrower sense of the word that can be acute and chronic in nature. Physical developmental abnormalities that may be associated with mental health are, for example, being too short or too tall, conspicuous ugliness, monstrosity of certain parts of the body, such as deformity of the skull, nose etc. Defective conditions include the consequences of various diseases that have left permanent anatomical and functional impairments, such as partial or complete deafness, low vision and blindness, lack of individual limbs, deformity of the spine, chest and other parts of the skeleton, etc. From diseases that can affect on mental health it is worth mentioning chronic diseases such as tuberculosis, rheumatism, diabetes, epilepsy and others.
When a child suffers from an anomaly or defect, there is a danger that it will build a negative attitude towards itself, which will include doubts about the possibility of achieving average life success, to keep up with its peers, to fully meet its life needs. Such a child loses self-confidence, its sense of security in life declines or is not built at all, so the child falls into increasing passivity, apathy, lack of interest in anything, depression and pessimism. Or, the conflict between ambition and life aspirations, on the one hand, and skepticism towards oneself and discouragement, on the other hand, keeps it in a constant mental tension. It manifests itself in hypersensitivity, irritability, explosive reactions, intolerance and aggression. In other cases, emotional tension is channeled through various neurotic disorders of bodily functions, so such a child stutters, urinates in bed, suffers from tics, etc. A strong feeling of inferiority, which is ingrained in the unconscious spheres of the young person in the form of the so-called inferiority complex, can motivate the child to a very hostile attitude towards the environment. Then the child takes revenge on other people in a more or less unconscious way through rudeness, insolence, malice, deception, ratting, slander, theft and similar forms of antisocial behavior, because it does not feel that it is up to it.
The attitude of a child with a physical defect towards itself depends only in part on the type and size of that defect. It is more influenced by the experience of how it is received by its surroundings, what it thinks of its lack of something. Therefore, the degree of mental impairment caused by a physical deficiency is not always consistent with the intensity and nature of that deficiency. Sometimes minor defects and anomalies, which do not significantly impair the function of the organism, cause severe discouragement and complete loss of self-confidence. In other cases, even relatively large physical defects do not harm the child’s mental health.
If parents and other educators treat a defective child in the right way, if they systematically raise its self-confidence, then it is likely that the child, despite its physical disability, will develop into a more or less orderly personality. There is a tendency to compensate for the defect. This means that the child will persistently practice precisely the deficient functions, i.e. damaged parts of the body. Thus, the rehabilitation of a child who has overcome polio largely depends on how much energy is invested in training the impaired muscles. And the amount of energy invested depends primarily on the confidence that the child has in itself, on its optimism and sense of security.
Physical deficiencies can also be compensated in such a way that instead of impaired function, another one is diligently trained which can partially or completely replace the defective one. In the case of paralysis due to polio, it would mean that a child who before the illness wrote, drew and performed many other actions with its right hand, after overcoming the problem, learned to do it all with its left hand, if its right hand was taken away. In addition to such functional compensation, the so-called psychological compensation is also present. It consists of the compensation for a physical defect by some particularly developed psychic property. Thus physically stunted children are sometimes unusually diligent in school; ugly women know how to be very selfless in working with other people, eg as nurses, babysitters, etc.
When the need to compensate for a physical defect motivates a person to especially improve a physical or mental function, which they would not achieve without such motivation, it is called overcompensation. It is known that left-handed children sometimes learn to write particularly well with the right hand or develop a pronounced sense of symmetry. People who suffer from some speech defect sometimes become excellent speakers; those with impaired vision can develop into excellent painters, etc.
But the environment does not always treat a defective child in the right way. If it raises it in any way wrongly, it is likely to react more sensitively to the negative actions of its educators than it would make it physically fit. Deformations of the child’s personality should be most feared in the case when the environment takes a very negative attitude towards the child’s physical disability. It happens that the family is ashamed of the defective child, underestimates it, takes pity on it excessively, neglects it emotionally, does not let it go among other children or is harsh, rude and aggressive towards it. And in such cases, there is a tendency to compensate for the deficiency. But the educator’s misconduct is too discouraging for the child to be able to mobilize the psychic energy needed to actually compensate for the defect. The child therefore tries to free itself from feelings of inferiority in a circumventing way, i.e. by behaving in a way that it tries to prove the value of its personality to itself and its surroundings at all costs. This is the already mentioned aggression of many physically disabled children, then excessive ambition, arrogance, arrogant behavior, systematic underestimation of their peers and the like. Or, a malicious child experiences a certain superiority over other people. But here it achieves only apparent compensation. Because negative behavior provokes repulsive reactions from the environment, it clashes with it and experiences a whole series of failures and troubles. This intensifies its inferiority complex. And this one drives it to the increasingly antisocial behavior that keeps the child in a vicious circle of neuroticism.
The apparent compensation of one’s physical deficiency can also be carried out in such a way that one finds the value of one’s personality in parasitic behavior. This is the type of people who abuse their defect, increase the interference it inflicts on them, and thus try to force the environment to give them unjustified privileges, to serve them in everything, to treat them in an overly considerate way. There are, for example, cases of some disabled people who do their best to support the community, but do nothing to at least alleviate their physical disability. Exploiting their defect or disease sometimes goes so far that such a person consciously or unconsciously intensifies the impairment of their bodily functions.
In this was, a spoiled child was convinced that by stuttering it can force its parents to give in and serve it even more. It stuttered harder the more its parents fell for it and relieved it of any burden. The stuttering of the child began to subside only when the parents stopped cuddling it and when they began to apply more correct methods of upbringing.
It is the task of the educator to prevent or at least mitigate as much as possible the harmful effect of the physical deficiency on mental development. First of all, efforts should be made to reduce or even eliminate the deficiency, for example with the help of cosmetics, plastic surgery and orthopedics. It can contribute a lot to repairing the mental state of young people in puberty who suffer from pimples (acne) on the face if they undergo dermatological treatment. Surgical change of the ugly shape of the nose, removal of large scars and other plastic surgeries can be just as beneficial for the mental life. The same effect can be expected from orthopedic correction of limb anomalies, e.g., congenital hip dislocation, or from treatment of deformity, from alleviation of deafness, reduction of visual impairment, and from similar procedures in terms of physical rehabilitation of a defective child in the same way as with a physically fit child. The principles of proper upbringing are always the same: no matter what kind of child it is; one should always strive to implement them as much as possible. That is why there are no special rules for raising a physically damaged child. It can only be said that in the upbringing of such a child one should be even more careful than in the upbringing of a physically normally developed child, because of its increased sensitivity to the wrong actions of the environment.
Parents and other caregivers often think that a physically damaged child should be pitied. Then they surround it with weeping sentimentality and discourage it with pessimistic divination. This makes it passive, the child becomes depressed and deprived of any initiative, and at the same time arouses intolerance towards the environment. Namely, man does not tolerate pity because it humiliates him. By pity we show the other in an indirect way that we do not consider them a full-fledged being, and none of us can stand that. When a person is in any kind of trouble, even when they are physically damaged, they need constructive help, understanding and emotional support from other people. Sentimentality and whining irritate them, and sometimes make them react aggressively.
This also applies to the child. Therefore, the inappropriate regret of the child should be replaced by an encouraging attitude towards it. A defective or sick child should be surrounded by cheerfulness, humor and optimism. It needs to be shown that despite its physical disability, we consider it a full-fledged person who is expected to have the same success in life and useful contribution to the community as any other individual. It is useful to divert attention from the shortcomings with various activities. Their meaning should be diminished or simply ignored.
It is wrong to serve a defective child in what it can do itself. It is natural that we will spare it from those loads that require the full functional ability of exactly that part of the body that is damaged. It is clear that we will not ask a child without limbs to do athletics, nor will we force a visually impaired child to compete in rifle shooting. But that does not mean that those functions that are completely preserved should be treated in the same way. Moreover, they should be used to the fullest in order for the child to be active as much as possible in different areas. In this way, we will best encourage it to actually compensate for the deficiency.
Many educators are too lenient with a physically damaged child, thinking that cuddling will compensate for its mental suffering due to a physical defect. But this only makes it harder for it to cope with life, because it becomes egocentric, capricious and inflexible. Such a procedure should be opposed by independence and as intensive as possible accustoming of the young person to the discipline of community life. A defective child should not be given any special benefits that go beyond what necessarily requires only physical harm.
It is a heavy blow for a child with a physical disability if it is emotionally neglected, if the environment does not pay enough attention to it, or even openly shows it that it underestimates, despises and dislikes it. Such an action provokes a very negative reaction, usually in the form of severe aggression or depression, apathy and withdrawal. If anyone needs the love and tenderness of an educator, then it is primarily needed by a physically damaged child. It must feel as often as possible that its parents love it, that they have full confidence in it, that they respect its defect and that they are neither disappointed nor unhappy because of it. Emotional warmth strengthens the child’s self-confidence and gives it the courage to accept the persistent development of its abilities in order to compensate for the defect. The feeling of being accepted as a full-fledged being enables it to engage in the human community in a constructive way despite its disability. But love for such a child must not be painful. Let it be firm, cheerful, optimistic and stimulating.
It is a big parenting mistake when a defective child is separated from other children ostensibly to protect it from ridicule and abuse. Such a procedure deprives it of the opportunity to practice making social contact. Due to the deformity, the child finds it harder to get along with its peers, and if we raise it in isolation from other children, it will be very difficult for it when one day it finds itself in a children’s team, for example at school. Therefore, it should move as much as possible in the company of its peers. By discreetly warning other children, what can be achieved is that they won’t mock their physically damaged friend. Children usually do not mock someone’s defect as much as their inadaptability and incompatibility. If a child with a physical disability cooperates with its peers – and this can only be learned through exercise – they will be happy to accept it into their company and will not make fun of it.
Children who suffer from severe damage to the sensory organs, i.e. the deaf and the blind and visually impaired, should be provided with education in special institutions where the teaching method is adapted to their perceptual abilities. But when such a child is not in school, it is desirable to move as much as possible among normally developed children, and not among equals. It will not stay in the company of equally damaged peers all its life, but will sooner or later have to get used to a work collective and various other groups of healthy people. This will be difficult for it if it has not practiced adapting to people with normal sensory functions at a young age.
Acute, short-lived illnesses, the most common infectious diseases that often occur in childhood, lead many parents to make educational mistakes. Indulgent parents take advantage of their child’s illness for unlimited cuddling. The extraordinary and sometimes dangerous condition in which a sick child finds itself is a great opportunity for compliant educators to find justification for their wrong upbringing in front of themselves and then in front of others.
Thus, the grandmother, who normally runs the household for a large family, stops cooking, cleaning the apartment and all other household chores when her grandchild falls ill. Everyone in the household is then forced to eat cold food or to eat outside the house, because the grandmother sits by the sick child’s bed all day and sews new dolls for it. If the illness lasts for a long time, a whole hill of dolls will have accumulated next to the crib.
It is clear that a sick child is in a special position and should be treated differently than when it is healthy. It is understandable that it should be relieved of various tasks and obligations. It is the duty of educators to nurture it, to show full understanding for its problems, to calm it down, cheer it up and entertain it. It should never be forgotten that every physical illness also affects the mental life. Therefore, it is necessary not only to treat the disease and nurture the body, but also to try to keep the child’s mental balance and optimism during the illness. This is achieved in such a way that the sick child is paid attention not only as a patient, but also as a person who, regardless of the disease, has certain emotional needs. A sick child should be approached in a calm and gentle way, optimistically, it should be talked to, played and joked with.
Impatient, authoritative educators are often shaken up with a sick child, they are unfriendly, angry at its illness, scolding it when it complains about something, underestimating its difficulties. This saddens the child, frightens it, fills it with guilt and worsens its emotional relationship with the environment. Indulgent educators shower a sick child with a series of privileges and gifts, completely unnecessary service that has nothing to do with care, they allow it things that they would not otherwise allow. In addition, they burden it with excessive concern, inappropriate fear and pessimism. They annoy it by constantly asking about its subjective problems, so they immediately turn every symptom into a huge problem; a whole small tragedy.
If an ill child is shown excessive concern and too much attention is paid to his or her problems, there is a danger that the child will become irresistible and hypersensitive to any physical ailments. It will become a mollusk and an “imaginary patient.” When a child is over-pampered during an illness, it is encouraged to unconsciously exploit the illness. If some benefits can be achieved with the help of the disease, if any benefit can be derived from it, it is logical that the child desires the disease even when it has already passed. Then some of its symptoms can be maintained in a psychogenic way, even though they have long since lost their objective, physical basis. Therefore, in spoiled children who have experienced that their parents are much more lenient during their illness than usual, cough, lack of appetite, general weakness and other ailments last much longer than in properly raised children.
In this way, the child becomes accustomed to “fleeing into illness” from various burdens and tasks, i.e. to play around the disease, by unconsciously producing various symptoms of physical illness, to achieve relief and special consideration of the environment towards itself. The child complains of abdominal pain when it needs to eat a food that it does not like too much; when it needs to learn a lesson that does not interest it, it starts complaining of headaches, etc. If a person learns to escape from various troubles in life as a child, it is understandable that they will do it even more often in adulthood, when they are in conflict with much larger life problems. This is how neurasthenics arise- psychogenic patients who constantly suffer from some physical ailments, and without any adequate pathological changes in their organism.
All these dangers also occur when a child suffers from a long-term, chronic disease. During such an illness, the child usually spends some time in the hospital, separated from the family, so the consequences of a lack of parental love can occur. When a child is in the hospital, especially if it is a small or preschool child, everything possible should be done to prevent hospitalization. First of all, it is necessary for the doctor who refers the child to hospital treatment, rehabilitation or recovery in a health resort, to think carefully about whether it is really necessary. Whenever possible, the child should be left in home care. If it is necessary for its physical health to leave the parents for a while, it is necessary for the parents to stay in touch with it and to visit it as often as possible. They shouldn’t be bothered by the fact that the child will cry when they leave it again. It is better for its mental health to experience more small emotional shocks due to short-term separation, than to be exposed to long-term, continuous separation, which will be interpreted as the loss of parental love. It is this belief that harms the child the most in terms of hospitalism.
The hospital staff, i.e. educators in another children’s institution, can do the most against hospitalism. They should replace the parents of the sick child as much as possible. This can be achieved by not admitting a small patient to the hospital in the official way at the first step, but with as much warmth, tenderness and serenity as possible. It is necessary for nurses and child caregivers to play with their little patients, to show them their interest in words and deeds, and not to deal with them only as a “case”. The same goes for doctors. A calm, friendly and cheerful procedure with a child can instill confidence in it and free it from the fear of various medical procedures. In this way, doctors make it easier for themselves to work with the child, because it calmly endures examinations and treatment if it is not scared.
In addition to emotional care, it is necessary for the sick child to be active as soon as possible. As soon as its illness allows it, let it start playing on its own, washing, feeding, reading, drawing or engaging in any other activities. Hospital staff are required to procure a variety of toys, dolls, picture books, paper, pencils, paints, various empty bottles and boxes, and other small items that the child can have great fun with. For mobile children who can get out of bed, it is necessary to arrange a corner with toys in the hospital ward, where they will be able to move freely without paying attention to tidiness and cleanliness. The same procedure should be applied when the child is left in home care. In this way, it guards itself against apathy and general mental reticence, into which it is necessarily drawn by a lack of activity, and which can hinder its mental development.
Chronically ill children, for example with chronic rheumatism, with a heart defect, with some pathological process in the lungs, etc., are in danger of being too limited in activity and in social life. Physicians and parents need to think carefully before banning a child from an activity that he or she aspires to and that allows him or her to be on an equal footing with peers. It is wrong for a child with a heart defect to be forbidden to do any physical effort and sports activity. Among the various possibilities of physical activity, one should choose those that such a child can tolerate without any harm to their health. With a little good will, a sick child can be allowed to participate in games, sports, entertainment and schooling with its peers, without its health being endangered.
Otherwise, if a sick child is denied the opportunity to show initiative at every step, if it is excessively restricted in its activity, if it is not allowed to play among other children, if it can only watch from the side as its friends run, jump, bathe, swim, play football and the like, the child will certainly suffer mentally. A strong feeling of inferiority will appear in it, which will hinder it in its own improvement, in achieving life affirmation and in creating normal relationships with other people. Such children often become timid, grumpy, passive, weak students, or prone to fantasies; they are too sensitive and painfully sentimental, withdrawn and unsociable. Sometimes they become aggressive, vicious and bitter.
If a sick child is to be banned from any important activity, a replacement should be found for it. An instructive example is a mother whose 14-year-old son fell ill with rheumatic inflammation. After that, a serious burden was left on the boy’s heart. He loved football and gymnastics, but now he had to give up both. His mother realized how difficult it was for him, so she immediately took care of compensating for the medical bans. She managed to interest him in chess and archery. She enrolled him in appropriate clubs and constantly encouraged him to persistently train in these disciplines. Until recently, the boy developed into a good chess player, he started competing in competitions, and in rifle shooting he even became the champion. This gave him so much pleasure that he completely forgot about his earlier “passions” which he had to give up, and no longer considered himself ill.