12 year daughter

my 12 year old has started complaining that when she is not talking ie. working on school work etc. she hears her own voice in her mind screaming whatever it is she is thinking about.  I don't really notice any other behavior problems going on.  She has always been a pretty happy,social kid, gets along with her peers well,a good student etc. At times over the past six month she has been somewhat moody, but honestly I had attributed this to puberty. The screaming in her mind started around the time school started this year, I have questioned her closely to find out if she was worried about starting 7th grade this year and she really does'nt seem to be concerned about school. Do you have any idea what this could be about?

[Kevin Kennedy, Ph.D.]

Dear Ms. Green,

Sometimes we can observe symptoms in children directly - i.e., we see concrete behavior in front of our eyes. Sometimes, though, symptoms are more hidden, because they are part of the youngster's mental life, and we only learn about them to the extent that the child tells us about them.

It is important that your daughter is doing well in the important areas of her life. It is also a good sign that she told you about this mental phenomenon she is experiencing. It is quite likely that it represents anxiety, and to understand this better it would be helpful to know about the content of the thoughts - i.e., what it is she is thinking at those times. If she hasn't divulged this to you, ask her about it, and ask her to keep a little log of incidents. Sometimes simple monitoring of such symptoms in itself is useful. It would also be useful to know how your daughter responds to these voices - i.e., does she do anything to quiet them or to soothe herself, distract herself, etc. Please follow up as you wish.