QUESTION: I have been divorced from my 10-year old daughter's dad for over four years. We have had an amicable relationship and have worked together to maintain a good quality of life for our daughter.

A little over a month ago, he called me to tell me he was leaving the area and may never return because he learned he is HIV+. No one in the family has heard from him. I immediately filed a missing persons report, and I also notified the district attorney's office because he has not paid any child support for this month.

Besides the legal issues, my primary concern is for my daughter. She was very close to her dad. I have shared with her what has happened and what he told me about his health status. She does not want to talk about him. Lately she has been complaining of headache, stomachache, dizziness and other vague symptoms. I know that I have had trouble myself dealing with this loss, and have just kept going to work every day and dealing with the realities of our day to day lives.

My question is, what can I do to help her? She almost appears to be unaffected in her outward behavior, but I am sure that she is deeply troubled. She has told me that she definitely does not want counseling. How can I, as a single parent working full-time and dealing with my own grief, help her?

ANSWER: Your daughter is most likely somaticizing her feelings. Her body is expressing the overwhelming pain and confusion she is unable to express in words. It is critical to her emotional and physical health that other avenues of expression become available to her. Drawing her feelings may be an effective precursor to language.

Her symptoms may also serve to maintain her only available connection to her father, through imaginary sharing of physical ailments. Other ways to validate her relationship with him will need to be found. It may become necessary for her to write a letter to him about her feelings, whether or not she can send it to him. Her father has cut-off contact with her, but this does not mean that she must cut-off her own feelings for him. It will be important for her to not only express her feelings, but ask questions and get as many answers as she can.

Your daughter is only 10 years old and not in a position of decision-making about seeking professional help. As her mother, it is your job to insist that she gets help through this very painful period. Maintain your authority in knowing what is best for her. She will eventually feel loved and cared for by your ability to take charge of the decision-making and act in her best interests. Show her that you, too are in distress about the loss of her father, even though you have been divorced for quite some time. She may need to know that it is OK to show you her feelings about her father, particularly if she has developed a very separate relationship with him over the years.

Do take her to your pediatrician to rule out other physical causes, but insist on consulting a professional child psychologist or counselor with expertise in HIV. Support groups of other children and families going through a similar experience are the treatment of choice. A hospital which specializes in children and disease (such as Children's Hospital in the San Francisco Bay Area) may be a good starting point. You, too will need help sorting through your own tumultuous feelings. A support group will be important in providing you with a sense of membership and inclusion at this time. Clinical studies show that membership in a group handling a similar transition in life can be tremendously healing. You will also serve your daughter by helping yourself. Not only will she have you to share her feelings with, but she will experience the power of a parental role model reaching out for help in time of need.

This "reaching out" behavior is very important, as it may be what she is not seeing her father do, right now. Though this may change in the future, currently she is seeing her father cut-off from relationship (with her and with you) during a period of crisis. Hopefully he will re-connect with the important people in his life and she will get an opportunity to process some of her grief with him. If this is not the case, unfinished grief and anger will need a place along with understanding in the future.

It is important that your daughter learn to reach out when she is in need, to her family, her friends and the larger community. This is the crux of emotional hygiene throughout your lifetime. Your behavior will be a role model for how to cope. Her father's way of dealing with his diagnosis will also serve as a role model in life.

When we grow up with little support it is tempting to believe that expressing feelings is a sign of weakness instead of strength. By reaching out for help yourself, you will gain strength for coping with the situation while simultaneously providing your daughter with a healthy role model.

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