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Copyright Centre For Effective Living © 2016
I got a phone call one afternoon from a mother who was anxious about her child’s anxiety. I could hear the desperation in her voice as she related that she had run out of ideas to assure her child that he was going to be alright. Though previously able to comfort and help her son, she felt that she was out of her depths to help him through this particular worry. When I listened in more closely to what she was saying, I realised that her anxiety for her child had surpassed the child’s anxiety. She was now feeling helpless and predicting catastrophes for how this unresolved anxiety in her child would lead to future phobias and undermine his overall resiliency. I felt a great deal of compassion for this mother and I pictured her standing in a corner of her home trying to be strong for her child and trying to find a professional to help her work it out. She was lost in his anxiety. In this article I will not attempt to outline the theory, mechanisms and forms of anxiety. I will instead try to distil it down to the most common anxiety presentations we see and the common ways we tackle anxiety in general, in the hope that it will give some initial prompters to what you can do when your child feels anxious.
Being in Clinical practice and working with children I have come to see that in the primary school years children become aware that the world that they live in is not always safe or predictable. Their imagination catches up to the reality of their unfolding world, and they begin to articulate “what ifs”. This can also be where a lack of life experience and information is a breeding ground for their imagination to fill in the blanks. They are aware that there are winners and losers. They are aware of different family situations – some mummies and daddies do not live together, some are not alive. Increasingly the complexity of what they see interacts with what they can predict will happen, in their imagination. Anxiety that spirals out of control has these mechanisms: physiological responses due to heightened levels of stress hormones circulating in the body, over-evaluation of the Reality and Likelihood that a catastrophe will happen, avoidance of any further situations which will provoke these physical or cognitive vulnerabilities and seeking reassurance from parents or adults in their world to help bring their anxiety down. Avoidance prevents children from testing out their fears and seeing whether or not their predictions do indeed come true. A reliance on reassurance seeking breeds a dependency on others, instead of learning coping and soothing mechanisms which can be relied upon whether alone, in school, or away from home.
So firstly, take heart. It is likely that your child’s anxiety is something that has been experienced by another child at some point. Here are some general tips to help a child with anxiety:
1. Find out what the anxiety is: I draw a Worry Sponge Brain and ask kids to fill it up (in pictures or words) with all the worries that their brain has soaked up. I also get them to colour in how much of their brain is soaked in worry. It gives an indication not just of what, but how much anxiety a child is storing up.
2. Find out the predicted outcome: Before we can help them, we need to also know what they predict is the catastrophic outcome. You can ask a child to draw out a comic strip of what they think is going to happen at the end if their worry comes true
3. Taking back my body: Help children to see that when they feel anxious their minds have decided that a dinosaur threat is in front of them and is bossing their body around with those anxiety sensations (shallow breathing, tingly hands, sweaty palms, butterfly stomach) because it thinks we need to fight it or run away from it. However, because there is no dinosaur out to eat them, they can take back their body and relax it back to calm. Here deep breathing and some simple stretching exercises can help the body to relax back down to a resting state.
4. Delay the worry: I say worries are like pesky flies. The more we swat them, the more they come back at us, and the more they do that the more we focus on it. Soon the pesky flies are all we can think about. Instead, create a Worry Box with a note pad beside it, where children can write down the worries as they come, deposit it in the box and not hold it in their head. Every time the worry comes back they can simply write it down and put it in the box. Delaying the worry this way helps a child feel like they have acknowledged the worry and done something with it and not have to deal with it straight away.
5. Fill-in-the-blanks: Particularly for anxieties that have a realistic basis (thunderstorms and floods do exist), help them to work out how LIKELY this will happen. You may point out that you live on a hill and there has been no reported flooding in your area in the last 10 years, for example. You might point out that houses are built to withstand great forces – and demonstrate this by thumping around and checking for vibrations. You may simply just give them the information that seems missing in their hypothesis and predictions. One child who had a terrorism worry was not convinced that it would never happen, but was satisfied to learn that after 9/11 great steps were taken to revise and Improve security measures in Australia.
6. Graded Exposure: Particularly for anxieties where there isn’t a realistic basis (fear of the dark, for example) it is helpful for children to work out how to evaluate perceived threats. Here you set up gentle experiments together to test out if their prediction of a bad outcome will definitely happen. Together with your child staying in a dark room for 5 minutes and then switching on the lights and seeing that everything in the room is exactly the same, then building the time up until they can see that time in the dark does not change the room or introduce any new threats, and therefore it is the same in the light, or in the dark.
7. Remembering and Re-scripting: For anxieties where there is a worry they will be evaluated negatively or fail somehow. In exam anxiety children tend to minimise their past successes and magnify their impending failures. Helping them to remember past tests where they thought they were going to fail but didn’t, and identifying what steps they took in the past that helped them to prepare brings their focus back to what they can do, and how they have managed in the past. This re-scripting gives children a renewed sense of control and helps to focus the natural stress response into concrete steps.
8. Gut, instincts and probable responses: This is probably not a very scientific way to describe this step, however, it’s handy. Childhood is a time when we can encourage young ones to see that their best unprepared attempt is actually going to be ok. Give it a go, take a risk, because you are not stepping out from point zero. They forget that they have had many years of experience working things out and coming up with great responses. For example, many children worry about reading out loud in class. They worry that they will suddenly lose all prior foundations, and make major pronunciation mistakes, and everyone will laugh at them. Of course even the best of us make reading errors. However, even when this happens we can see that we just continue to read, get on with it and recover. So, spontaneously in session, I might whip out a very technical piece of writing, like from a science journal (for older kids), or from the newspaper and ask them to read it to me. By doing a few of these, they come to see that their best attempts to sound out words and read, actually isn’t too shabby, and that the actual percentage of words they had to sound out was quite small in the entire piece of writing. They might even see that fudging some words actually sounds quite plausible!
If the anxiety in your child has reached the level of frequent school refusal, panic attacks, impacted sleep, decrease in appetite, or significant changes in his behaviour and social interactions, and you are concerned that he is not himself, then seek help. A visit to your local GP or a chat with your school counsellor is a good place to start.