Pediatric Associates of the NW Blogs

ANXIETY: THE MONSTER THAT WON’T BE QUIET

Shannon Odell, PsyD
September 29, 2016 02:00PM

Does your child’s anxiety give you anxiety?  You’re not alone.

As a behavioral health provider, one of the most common issues that lands on the couch in my office is anxiety. Especially around this time of year. The start and subsequent ramping up of school seems to be a common trigger for the onset or exacerbation of anxiety, for good reason. Getting up early, facing peers every day, academic struggles, tests, assignments, balancing extra-curricular activities and homework; there’s a lot of pressure associated with this time of year and anxiety can be a common and typical response. 

Anxiety can manifest in many forms:  frequent worries, safety concerns, stuck thoughts, compulsive behaviors, catastrophic thinking, fear of social rejection, and more classic phobias like fear of needles, fear of spiders, etc. Anxiety is probably one of the most uncomfortable emotions we have, both physically and psychologically.  And it demands to be felt!  Racing thoughts, beating heart, trouble breathing, shakiness, tight muscles, pit in the stomach; it’s hard to ignore or repress.  One patient described anxiety as that feeling you have when you reach in your pocket to find your phone, but it’s not there…and that feeling is there ALL THE TIME. 

At its core, anxiety is our self-preservation instinct. It’s designed to alert us to danger and ultimately keep us safe.  In some of us, that drive for self-preservation is incredibly strong  but it doesn’t really need to be. For most people, anxiety is irrational or unfounded. For instance, having a fear of clowns or worries about monsters in the closet; rationally, we know we need not fear such things.

As a parent, it’s incredibly difficult to know what to do when your child is expressing worries and fears. If your child struggles with any of these symptoms, here are some suggestions for ways to help – as well as some responses to avoid.

Helpful Ways of Dealing with Anxiety in your Child

1. Reward brave, non-anxious behavior

  • Look out for examples of times when your child does things that are frightening for him/her, no matter how small, and reward him/her.  Make a big fuss over it!!
  • As s/he becomes less anxious, you can reward only the more obvious examples.  
  • By pointing to and focusing on successes, you will help your child build self-confidence as well as help her realize what she’s capable of.

2. Ignore behaviors that you don’t want

  •  Removing your attention from your child’s anxious behavior and attending again (and praising) when the anxious behavior has stopped.
  • When you notice a behavior you are not happy with, you need to stop any interaction with your child as long as s/he is doing that behavior.
  • This strategy must always be used carefully and only in relation to a specific behavior.
  • It’s important that your child understands that it is the particular behavior in which s/he is engaging that is unacceptable to you, and not his or her general character.

3. Prevent avoidance

  • In order to use this strategy, you must be satisfied that your child is actually capable of coping in the anxiety-provoking situation.
  • Do not force him/her to do something s/he is not actually able to do.

4. Communicate your empathy effectively

  • Express your empathy and understanding in a calm and relaxed manner.
  • Children need to feel listened to, understood, and supported, but it’s also important that they’re encouraged to constructively solve the problem of their anxiety rather than focusing on how bad they feel.

5. Prompt children to cope constructively

  • Prompt your child to think for him/herself about how to constructively handle an anxiety-provoking situation.
  • Encourage your child to use detective thinking; what is the evidence that your thoughts are/aren’t true?
  • So much of anxiety is the intolerance of uncertainty, so it’s important to remind your child or adolescent that he’s capable, that he does have the ability to cope, and if plan A doesn’t work out, there’s always plan B. And C. And D. And on and on.
  • It shows your faith in your child’s abilities!

6. Model brave, non-anxious behavior

  • Demonstrate that you experience difficulties, and how you cope with those difficulties.

Unhelpful Ways of Dealing with Anxiety in Your Child

1. Excessively reassuring a child

  • Reassuring with physical affection/closeness
  • Telling the child “everything will be all right, there’s nothing to be afraid of.”

Here’s the problem: 
-It has very little effect, and they keep coming back for more.
-It’s a form of positive attention, which rewards your child’s anxiety.

2. Telling a child exactly how to handle the situation

  • Telling the child exactly what to do, how to behave, and what to say in the anxiety-provoking situation
  • Doing things on behalf of your child

Here’s the problem: 
-It creates a vicious cycle
-Reliance on parental direction is a form of avoidance

3. Permitting or encouraging avoidance

  • Letting your child avoid the feared objects/situations

Here’s the problem: 
-As long as your child continues to avoid, s/he won’t overcome their anxiety.

4. Becoming impatient with your child  

  • It’s normal to become impatient and frustrated when nothing you do or say seems to help, or when it seems like your child is clinging to his/her anxiety.

Here’s the problem: 
-Becoming angry with your child will only serve to make him/her more frightened and dependent.

If these tips aren’t helpful for you and your child, please talk to your pediatrician or schedule an appointment with one of our Behavioral Health providers. Anxiety feels awful, but it is treatable.