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From the author: Osipova N.V., Markaryan S.V. Stavropol State University, Stavropol Currently, there is a significant deterioration in the health status of children, characterized by an increase in morbidity, changes age structure and increasing incidence of chronic diseases. According to the Ministry of Health for 2005, about 60% of sick children have chronic diseases. [3] Over the past 5 years, somatic morbidity in the population of the Stavropol Territory has tended to increase: in children - by 22%, in adolescents - by 35%. [4] According According to statistics, already in the first grade, students who are lagging behind in their studies show signs of painful conditions (high fatigue, slow switching, slow pace of work, severe inattention, etc.). In the social aspect, chronic somatic diseases lead to difficulties in children’s adaptation at school. In the process of socio-psychological adaptation, children with chronic somatic diseases, to a greater extent than their healthy peers, experience a lack of organization, difficulties in self-control, increased fatigue and decreased performance, as well as motor disinhibition. [5] Many studies have also shown that severity and the nosology of the child’s disease have a direct impact on the success of socio-psychological adaptation to school. The “severe” the disease, the more difficult and lengthy the process of socio-psychological adaptation of a sick child to the conditions of school life. Nowadays, psychological works devoted to the problem of chronically ill children mainly analyze their psychological characteristics and the impact of the disease on the development of the child’s personality. Recently, quite a lot of work has appeared aimed at studying the psychological factors underlying certain chronic diseases. According to research by Bulygin M.V. recognize that most of the child’s somatic symptoms are caused by affective or personality disorders and psychological risk factors for the development of psychosomatic diseases. One of these significant factors is the background of family relationships. Children are so closely connected with their parents that almost any violation of family relationships puts the child at risk of developing a disease. Thus, from the point of view of psychoanalytic theory, disrupted intrafamily contacts at an early age, especially between mother and child, subsequently increase the risk of developing psychosomatic diseases. Representatives of the systemic communicative approach insist that a symptom, illness or behavioral disorder of one of the family members should be considered as a specific communication that plays the role of protection, pragmatically beneficial to all family members. [2] The environment of a child’s development in early ontogenesis is the mother. The child spends the first part of this period in the mother’s womb, and the mother’s body fully provides all the conditions in which the fetus exists and develops. After birth, the child is connected with the mother physiologically and mentally. In the first three years of life, the mother’s influence on his development practically overlaps all other factors; in preschool age it remains leading, and later - unevenly, in relation to various aspects of the child’s physical and mental development. The mother, as the environment for the child’s development, is a social being; she is involved in interaction with the outside world; her reactions to this world depend on her value-semantic sphere, in particular, on her adaptation to the world: resistance to stress, ability to adapt, etc. [9] The primary carrier of the psychosomatic phenomenon is the mother-child dyad, thanks to him the symbolic plane initially exists along with the natural plane of the psychosomatic phenomenon. In the jointly shared bodily actions of mother and child, the mother performs the function of signifying and filling with meaning vital needs and bodily actionschild. In a dyad, the child’s bodily actions initially turn out to be inscribed in the psychological system of the “image of the world.” It can be assumed that the transformation of the semantic side of psychosomatic phenomena is determined by the stages of development of the semantic, intentional component of the child’s activity (change of leading activity, emergence of psychological new formations). Thus, the foundation for the existence of meaningful psychosomatic phenomena is communication with the mother; the mother not only means a bodily phenomenon for the child (verbally and behaviorally), but also reveals with her emotional response the meaning and value of each bodily phenomenon. Thus, before it is designated and endowed with a certain meaning, the child does not distinguish pain from discomfort, and therefore does not receive its specific behavioral equivalent of a response. [5] Nikolaeva V.V., Arina A.G. note that “the perception of one’s own body and the system of ideas about it depend on age, level of verbal intelligence, gender of the child and experience of the disease. Children's perception of their body is based mainly on the affective component, and with age, the importance of the cognitive component of bodily and painful experience increases, the categorical structure of bodily experience expands and the gradual subjective separation of emotional and somatic phenomena at the verbal level of ideas occurs. The category of a complete body is gradually being formed, which helps to overcome subjective isolation and fragmentation of bodily phenomena.” The psychosomatic development of a child through the prism of L. S. Vygotsky’s cultural-historical approach can be considered as a process of the natural formation of mechanisms of psychological regulation of bodily functions, actions and phenomena. The content of this process is the basis of sign-symbolic forms of regulation that transform the nature of given needs (drink, eat, etc.), bodily functions (breathing, pain response) or create new psychosomatic phenomena (body image, image of pain, well-being). The forms of introduction of psychological regulation into bodily phenomena are bodily actions (having a plan of open behavior and therefore formed according to a socially given standard), cognitive means (systems of meaning in intaception and pain), semantic structures and emotional experiences (attitude to the bodily phenomenon).[6] The emergence of a new direction of research - the psychology of physicality, which is currently actively developing in domestic science (Nikolaeva V.V. (1987,1991,1993,1995,2003,2004), Sokolova E.T. (1989,1991,1995,2000) , Tkhostov A.Sh. (1989,1990,1991,1993,1994,2002), Arina G.A. (1990,1993,2003,2004) Rupchev G.E. (1997,1998,1999,2001), O.G. (2001,2004), etc.), contributes to significant progress in theoretical concepts on the problem of somatoform pathology. The study of somatoform disorders from the point of view of disturbances in psychosomatic functioning, the study not of the body-organism, but of corporeality as an integral psychophysical phenomenon, makes it possible to identify the features of the structure of corporeality, the characteristics of bodily experience, and disorders of psychosomatic development. The boundaries of the body are the area where the balance of subjective and objective influences reaches a value , in which it cannot be considered as “mine”, but cannot yet be attributed to “not belonging to me.” The physicality of the structure that forms the internal space turns out to be “embedded” precisely in this simulated external world. There is a boundary between external space and internal space that defines the subject-object division of reality. According to the ideas of A.Sh. Tkhostov, the mechanism of formation of the boundary of corporeality and the place of its localization are associated with a change in the autonomy/predictability of the object, its controllability/independence: “... a phenomenon receives its phenomenological existence insofar as it reveals its opacity and elasticity...” A bodily illness, especially a chronic one, creates special conditions both biological and psychological life, andthereby provokes a change in the normal path of development and, in general, human existence. In the literature devoted to mental ontogenesis, the term “social situation of development” (SDS), identified by L.S., is widely used to characterize the complex and inextricable combination of a child. Vygotsky. It is precisely these combinations that result in a chronic somatic disease. Within the framework of the concept of SSR, biological factors (which are of particular importance in the case of a physical disease) are considered primarily in the context of their influence on the social life of the child. A chronic disease, in the normal course of a child’s ontogenesis, creates the conditions for its development , a new, complicated life situation. This situation is due to the interaction of the child’s current mental and physical state, internal mental and organic processes and external environmental factors, primarily such as relationships with others. [8] Studies have shown the role of the mother to the child both physiologically and mentally. In the first three years of life, the mother’s influence on the child’s development practically overlaps all other factors; in preschool age it remains leading, and later – unevenly, in relation to various aspects of the child’s physical and mental development. About 80% of parents of children with somatic illnesses implement a family education style of overprotection. The child's life is confined to the family, and communication is limited to communication with the mother. The whole family must adapt to the disease, and everyone has to deal with strong emotions and feelings. Many families fear the death of a child. The role of the family is extremely important in supporting a child with disabilities in terms of his development, education and behavior: firstly, the family is the most significant and reliable development resource for the child; secondly, parents are experts about their child's illness, as well as family culture and ecology. Finally, parents have unique information about the culture and ecology of their family, including family values ​​and goals, daily customs, resources, social supports and stress. Almost all mothers of children with somatic illnesses are characterized by “rejecting with elements of infantilization and social disability” parenting attitude: mothers emotionally reject the child, low value his personal qualities, see him as younger than his real age, and sometimes attribute bad inclinations to him. At the behavioral level, this attitude manifests itself either in constant tugging at the child, or in excessive guardianship and constant control of any action of the child. [1] The qualitatively different nature of the development of a somatically ill child is largely due to the child’s personal characteristics (their severity, in turn, depends on the characteristics of the child). influence of the microsocial environment), his subjective knowledge and feelings, as well as the standard of health available to the sick child, and not the objective severity of the disease. All this determines the child’s unique adaptive behavior in a situation of illness. The child’s development occurs in the process of interaction with the mother. These relationships are carried out at the physiological and mental level, the ratio of which and their role in the regulation of maternal-child interaction change in ontogenesis. In general, the relationship between these levels goes through the following stages (the specific boundaries are currently not yet fully understood and should not be considered as definitively established):• first, the interaction takes place at the physiological level (in the first part of the prenatal period);• then the interaction takes place at the psychophysiological level ( non-separation of physiology and psyche) (from the middle of the prenatal period to the end of the newborn period); • gradually there is a separation of the physiological and mental levels of interaction, which occurs unevenly in relation to different lines of development of the child (infancy - early age); • interaction is carried out on the mental., №2.

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