Compiled and coordinated by Edward
Exam phobia in school children
A large number of school children undergo exam related fears.
Sometimes these fears are overwhelming. It can cause low performance and
failure in exams. As a matter of fact most of the children who are
shattered by exam phobia have a good IQ and positive motivation.
They show favourable performances in the classroom. But when they go
to the exam these students become highly stressed, have fear and they
are unable to face the exam with confidence.
Exam in progress
Students with exam phobia feel extremely fearful and unsure.
Following the increased fear they are unable to grasp theoretical
material and find it difficult to remember.
Exam phobia is a form of anxiety condition which is common among
school children. In the verge of the exam the fear increases and some
manifest psycho somatic ailments such as abdominal pains, vomiting,
headaches, dizziness, tremors, etc which have no apparent medical basis.
Some students with exam phobia manifest following anxiety related
features during the exam period.
* Dizzy or light headed
* Heart pounding or racing
* Feelings of choking
* Hands trembling
* Fear of losing control
* Difficulty breathing or chest pain
* Indigestion or discomfort in the stomach
* Feeling Faint
* Feelings or unreality or disorientation
* Amnesia or difficulty in remembering studied material
Self Revealed Story by Miss H
When I was doing my O/L exam I had an unexplainable fear and anxiety.
I was not a mediocre of course. I worked very hard at school and at
home. I could understand the study material when the teacher was
My teachers and parents thought that I was a bright student who would
perform well in the exam. But one month before the exam I had headaches
and loose motions.
My memory was fading. I could not memorize the material that I had
learned. I was extremely afraid of facing the exam. At nights I could
not sleep. I was weeping and thinking of giving a medical certificate
without doing the exam.
Master L and his Fear
Two days before my A/L Chemistry paper I was confused. I could not
recall the stuff that I had studied for the exam. I was frightened and
The chemistry formulas were roaming inside my mind. It was an
unpleasant intrusion. I thought my life was over. Two years hard work
and all the hopes my parents had about me would go for nothing if I had
failed the exam. I was blank, totally blank. I did not know what to do.
How Miss K Fought Her Fear
Miss K was a bright student who had lost of hopes for the A/L exam.
Her parents and the school teachers were so sure of her that she would
enter the university at the first attempt. This premature hope on her
became a big burden for her. Sometimes she had irrational feelings about
She often asked from her self what my parents and the teachers would
say if I get a lower grade in the exam? This very feeling gave her fear
and a nxiety. Miss K had low appetite, suffered from headaches and
experienced many sleepless nights. Sometimes she was unable to recall
the studied material and write correct answers to the past papers.
Eventually her fear was liquidated via counselling and psychotherapy.
Imagery techniques helped her to simulate the artificial examination
room atmosphere and build more and more confidence. Relaxation therapies
reduced her outpouring anx iety. Miss K. was able to pass the exam with
excellent marks and today she is a Medical student.
Treatment of Exam Phobia
Counselling and Psychotherapy are indicated in treating exam phobia.
Counsellors who work with children and adolescents who suffer from exam
phobia may be required to use effective counselling strategies to help
These interventions may be required to allow the students to achieve
a greater academic autonomous functioning ability and face the exam with
confidence. Empathetic listing to the student would ease his
difficulties and create a growth promoting atmosphere.
The client will begin to trust his abilities and challenge the
fright. In Psychotherapy it is necessary to establish a positive and
functioning relationship with the therapist.
The therapist should help the client to become consciously aware and
able to express their anxiety and fear about exam and performance
situations. The therapist should direct the client to fight his fear.
Hence the student gets more confidence to face the exam. Simulating
exam atmosphere in therapeutic sessions the fears and stresses can be
Implementation of positive self-talk to reduce or eliminate the
anxiety is vital. Instead of negative coping skills (Avoidance of the
exam, expressing self directed anger, blaming others) healthy coping
skills (avoidance of the exam, expressing self directed anger, blaming
others) healthy coping skills must be taught.
While working with the student the therapist must increase client’s
participation in educational activates, combating fear and building
Appropriate relaxation and diversion activities would decrease
anxiety levels. Therefore relaxation techniques (especially breathing
techniques) are indicated in exam phobia. To enhance the therapeutic
purpose parents/guardians and teachers support should be taken.
Some therapists perform Hypnotherapy to reduce the fear. Hypnosis is
an altered state of consciousness and heightened responsiveness to
During the hypnotic sessions positive suggestions are given to build
confidence and illuminate the exam fear.
The modern research indicates that EMDR or Eye Movement
Desensitisation and Reprocessing is one of the effective modes of
psychotherapy that can treat phobias successfully. These therapies
should be performed by qualified and trained professionals.
Role of Medication
Some children who suffer from exam phobia go in to depression.
Depression can cause negative self image, low motivation, difficulty
in concentrating and remembering things that would affect the learning
Therefore depression must be managed effectively. Sometimes
depression and anxiety go hand in hand and students find difficult to
cope. If the anxiety level is high and difficult to control anti
anxiolitic or anti depressants are prescribed by a qualified medical
These medications combined with psychological interventions
accelerate the recovery process.
Exam phobia is a self damaging factor which negatively affects the
students and their performances. The student is unable to give is
maximum productivity and the end result would be critical.
Usually exam phobia is a slowly developing factor and sometimes early
signs like physical and mental fatigue, irritability, difficulty in
concentrating and negative self talk can be detected by the teachers and
School counsellors can do a lot to help the students with exam
phobia. Counselling and building confidence, educational therapy help
the students to gather mor strength and accomplish the exam.
Heavy school bags a mental strain too?
school bags which students are now carrying to schools daily are
believed to be causing a mental strain on them affecting their studies
to some extent. Healthwatch organised parent - doctor discussion was
held on this in collaboration with Apollo Hospital in 2005.
In the picture in progress at Apollo auditorium with doctors.
Neurologist and Sports Medicine Unit Head Dr. Githanjana Mendis, Family
Physician and former SLMA Head Dr. Dennis J. Aloysius.
Colombo Medical Faculty also took up this issue later and the study
report is due to be out shortly.
This picture was taken by Daily News photographer late Roland Perera.
President Doctors’ Wives Association writes
An efficient and cost effective system of management is an essential
component of a well-organised Family Practice Unit. It is an asset to
the Family Physician in the delivery of optimal care to his practice
A kind and caring Family Physician who has a good doctor-patient
relationship, diagnostic and therapeutic skills, can work more
effectively in a disciplined, orderly and patient-friendly environment.
There should also be a patient centred approach and clinically competent
and broad-spectrum care.
The Family Physician’s job is a multifaceted one. He has to provide
personal, comprehensive and continuing care, have a dialogue with the
patient, communicate with him, listen to him, explain the nature of his
illness, make a plan of management and prescribe treatment.
The family physician is also expected to give advice on lifestyle,
diet, provide health information and education.
He must be sensitive to the patient’s feelings, fears, and hopes and
be aware of the socio-economic background and family dynamics.
The services of a Family physician must be
A Family Physician must be updated and keep abreast with fast
evolving medical knowledge and technology.
This is achieved by attending lectures, seminars, participating in
Continuing Medical Education programmes.
With this heavy workload, a family physician has very little free
time to relax, take exercise, indulge in hobbies and spend quality time
with his family.
With a varied and exhausting agenda a Family Physician requires the
assistance of administrative staff to help him with the day-to-day
running of the Practice Centre.
In Sri Lanka, genuine Family Medicine is practiced entirely in the
private sector on a fee for service basis. Family Physicians are not
paid by the State or National Health Service but by the patients.
The patient is the employer and the doctor is the employee.
There are about 550 Family Physicians practising in different parts
of the country in the urban and rural areas but they are concentrated
around the bigger towns.
Don’t eat and run
you are not used to regular exercise, don’t try to run around the block
immediately after that large New Year or Hari Raya dinner.
A study of nearly 2000 heart attack survivors presented at the
American Heart Association’s Scientific Sessions 2000 found that the
risk of a heart attack was four times greater within two hours after
eating an unusually heavy meal.
The researchers suggested several ways in which a heavy meal may
adversely affect the heart. Eating and digesting food increases heart
rate, blood pressure and oxygen needs thereby placing an extra burden on
High blood pressure may trigger the formation of a clot that in turn
could block a blood vessel or increased insulin secretion following a
heavy meal may affect the normal relaxation function of the coronary
arteries that supply blood to the heart.
This study is one of the first to show that overeating may increase
the risk of heart attack and further studies are needed to confirm the
Current recommendations on fluid intake may need to be reviewed if
the results from a study on hydration in healthy males are substantiated
by further research.
A study by the University of Nebrasaka Medical Center, Oklahoma, has
found that optimal fluid intakes in 18 healthy males may be higher than
currently recommended intakes of 8 glasses (about 1.8 litres) a day.
The researchers used a counterbalanced crossover study using water or
water plus varying combinations of fluids, including caffeinated drinks.
They found that there were no significant differences in the effect
of various combinations of beverages on hydration status and concluded
that “Advising people to disregard caffeinated beverages as part of the
daily fluid intake is not substantiated by the results of this study.”
This is good news for those who enjoy coffee, tea and cola drinks.
Further research is needed to confirm these results and to identify
optimal fluid intakes.
Nutrition for Athletes
Knowledge in the area of nutrition and athletic performance continues
A point paper released by the American Dietetic Association,
Dietitians of Canada and the American College of Sports Medicine reviews
the most current science in this area.
The paper, which was published in the Dec 2000 issue of the journal
of the American Medical Association, provides important guidance for
nutrition and health professionals, athletes and coaches in optimising
nutritional intake for both the elite and the recreational athlete.
Courtesy Food Facts Asia
Laughter the best Medicine
It was early morning, and the milkman rang the bell.
The wife was fast asleep, so the hubby put on her kimono for
convenience and went to the door.
The milkman gave him two bottles of milk and a great big kiss. Hubby
went back to bed chuckling to himself.
“Why are you laughing?” the wife asked.
“This is too funny” said the husband “I got the milk from the milkman
wearing your kimono and he kissed me. I guess his wife has a kimono just
Sent by Ahamed Sherrif, Maradana