Archive | July, 2013
Video

The video of girls first ski jump

26 Jul

You hear the endearingly anxious voice of a 4th grade girl and see a 60 meter ski jump. She is about to do her first 60 meter ski jump and we experience the event courtesy of the camera attached to her helmet. If it is still available I would encourage you to watch this Utube video last viewed 7/242013).. It is touching and instructional; touching because of this girls courage and triumph, instructional because what it can teach us about dealing with a version of performance anxiety.

How is she able to do this jump? She has of course spent hours on smaller jumps perfecting her technique, acquiring the necessary skills and so doesn’t have to think about the basics. A mastery of technique. Essential.

But what else?

She has a coach who is calm, supportive and reminds her of the key elements “don’t snow plow”. The support of family and coaches. Critical.

She finds a way to redefine this new experience of a 60 meter jump into something she is already familiar with “it is just a bigger 20”. A perspective on the situation that reinforces the familiar and her previously acquired skills. Reframing the challenge. Essential.

She does not focus on her fear or anxiety, although it is clearly present and not being denied. But rather she focuses on the future “I will be fine, I will do it” suggesting that she is envisioning successfully executing the jump. And she focus on some specifics of the task such as not to snow plowing and that you go a little faster on the end run. Her focus is not how anxious she feels and that is wise because that fear could immobilize her, but rather it is more externally focused on envisioning doing the jump and some specifics involved in the execution of the jump.

The thrill of executing the jump is transformative for her. And although not explicitly stated, we know that having a “Big Why” or compelling reason for doing something so challenging is critical for managing the understandable anxiety that goes along with it. But have patience with your children and yourself, this is a skill that can some practice and discipline to acquire. One task of childhood is learning to manage difficulty feelings, and participating in sports, playing board games or learning a musical instrument is one arena where these skills can be acquired. And if your child has an anxious disposition, she may have to put some extra time in to acquire these skills because the “what if..” questions come a little too easy and are not easily dismissed. In the end of course what we are interested in doing is building “islands of competence” for your children in whatever domain allows their potential to unfold.

Copyright@ Edward H. Plimpton, PhD

Islands of Competence

26 Jul

A parent once told me that the most valuable thing I ever said involved the importance of building “islands of competence.” I can’t claim credit for that one — it was borrowed from another psychologist, Robert Brooks. But I agree that it’s one of the most useful concepts around.

The idea is that one of the most important tasks for an elementary school child is developing areas of growing skill and competence. Self-esteem really comes from developing capabilities, and in the process, children learn the importance of practice and persistence. Maybe it seems obvious, but we need to keep reminding your child not to give up, to hang in there, even when good results don’t happen right away. This can be really challenging with an anxious child, since anxiety is so much about avoiding what makes you uncomfortable.

It’s obvious why all children should have “islands of competence,” but there is also a more specific reason when it comes to an anxious child. When you deal with anxiety, it is essential to remember that you can’t “not think about something.” The more you try not to think about something, the more you find yourself dwelling on it. So it is extremely helpful to have compelling alternatives for how you would like to spend your time. In other words, what would you rather be doing than worrying? You don’t have to pretend you aren’t anxious, but you can still focus on activities and goals that are truly engaging, interesting or comforting. Focusing on these goals can help you ride out the moments of anxiety and make them more tolerable.

I need to insert a note of urgency here about what I am saying. If children do not develop at least several ways of defining themselves as competent by the time they reach middle school, they will be all the more vulnerable to peer pressure, or will seek solace in endless computer time. Learning that you get good things through practice and persistence will generalize over the years to help your child face a variety of other challenges.

copyright@Edward H. Plimpton, PhD

Aside

Books: A very selective list

14 Jul

 

 

Taming the Worry Monster: Basic References for Parents

 

Books For Parents

 

Freeing Your Child From Anxiety by Tamar Chansky

(This is my favorite book and I have borrowed a lot of her phrases for talking about anxiety)

Books for Children

 

You’ve Got Dragons by Kathryn Cave and Nick Maland

 

Wemberly Worried by Kevin Henkes

 

What To Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxidety by Dawn Huebner. (She has a series of books that are very child friendly and I think are quite good)

 

Turnaround: Turning Fear into Freedom    by David Russ et al  is an audio CD program  that I have found quite helpful for elementary school children 

Scaredy Squirrel by Melanie Watt

 

The Kissing Hand by Audrey Penn

 

 

Books on Anxiety

14 Jul

 

 

Taming the Worry Monster: Basic References for Parents

 

Books For Parents

This is a very selective list of the books available on this topic, but reflects the ones I have found most helpful

 

Freeing Your Child From Anxiety by Tamar Chansky

(This is my favorite book and I have borrowed a lot of her phrases for talking about anxiety. She is a master of explaining anxiety in child friendly terms)

 

 

Books for Children

 

You’ve Got Dragons by Kathryn Cave and Nick Maland

 

Wemberly Worried by Kevin Henkes

 

What To Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety by David Huebner. (She has a series of books that are very child friendly and I think quite good)

 

Scaredy Squirrel by Melanie Watt

 

The Kissing Hand by Audrey Penn

 

Internet Resources

 

 

WorryWiseKids.org. This web site was developed by Tamar Chansky and contains a number of suggestions about how to talk to children about anxiety.

 

Anxiety Disorder Association  web site is also helpful

What to do about nightmares

14 Jul

From Your Anxious Child: Emails to Parents by Edward H. Plimpton, PhD

 

What to Do About Nightmares

A most unwelcome nighttime visitor is the nightmare. We all get them at some point, and they are usually triggered by a frightening event, or major transition such as starting school or a parental divorce, but also something scary in a movie or television show. Significant trauma can lead to recurrent nightmares, s something our military veterans unfortunately often have to deal with. Nightmares involve very intense emotions, usually fear, and the content is remembered. Recalling our nightmares is in contrast to night terrors, which feature extreme panic but no recollection of the dream. Some common themes of nightmares, to mention a few, involve being chased or attacked, smothered, or falling. The intensity of the nightmare can be traumatizing to your child, and may make him afraid to go to sleep because he might have another one.

What can we do for your child who has had a nightmare? While most nightmares are caused by something scary, it is important to consider whether there might be physical cause (e.g., a fever), a recent illness or a drug reaction. Recurrent nightmares, however, are suggestive of emotional problems that are not being resolved and might merit professional attention. With these cautionary comments noted, there are some things to try

Start by calming your child and providing reassurance. The distinction between reality, fantasy and dreams is not always clear to young children and they may need some help on that front. The intensity of the fear needs to be acknowledged and never laughed at or dismissed. Once you have reassured your child, it is time to find about what happened in the nightmare and to get as much detail as possible. Our general goal with nightmares, as with all scary things, is to create a way where your child can become more active rather than being passively victimized. Nightmares put your child in a defensive position, as in having to run for her life in the dream, and we want help her to take a more active and assertive stance against the images in that dream. Basically, we want to help your child rewrite the nightmare and put herself in a more powerful role.

So perhaps we can begin by having your child draw the nightmare or the scariest image in it. A monster drawn on paper can’t move. But if that is too scary, your child might have to begin by drawing a jail for the monster or some special guards against it. The next move depends upon the nature of the beast, the nightmare images, so to speak, but there are a range of options. Let’s try to avoid the most violent options, such as killing the monster. Because we are in the world of dreams, we can’t count on such actions carrying any finality. The monster may come right back the next night with greater intensity just like the sequel to the horror movie playing at the local movie theater. Perhaps your child could render the monster harmless by drawing something silly onto his monster picture, such as diaper, or give it a lollipop. We may also transform the nightmare monster by helping your child ask it questions, such as “What are you doing in my dream?” or “Why are you chasing me?” Anne Wiseman, in Nightmare Help: a Guide for Parents and Teachers, provides a variety of questions you can ask your child to help him with his nightmare. A very basic question she suggests is asking your child what he would need to feel safe or less scared. In general, asking questions to help your child rewrite and transform the dream into something where he is more in control is the goal. Even though dreams take place in your head when you are asleep, there is emerging evidence that is possible during your waking hours to transform your dreams by rewriting them, and thus lessen this nighttime annoyance.

About cleaning up: The Sunday Box

14 Jul

Clean Up, Clean Up

 

It is all too easy for clutter to develop when you have children. Toys and stuffed animals have a way of accumulating despite your best intentions. You are busy and if your suggestions about cleaning up are meet with resistance, then it can seem easier to do it yourself or just to let the matter slide. Perhaps if your child has more than the usual difficulty dealing with transitions, such as from playtime to bedtime, it just doesn’t seem worth the struggle. And then again, perhaps you need to begin with setting a better example yourself. There are also children who can develop unusual emotional attachments to objects, so that they won’t throw away a Lego box because it reminds them of their birthday, or they protest when the old toaster oven has to be thrown away because it has special memories of breakfast. Other children may collect bits of trash because they might be able to find a use for it in some art project; however, the collection continues to grow and grow. Regardless of the reasons, it is important that children learn to organize their belongings and clean up after themselves.

 

   The Sunday Box is a simple and highly effective way to get your children to clean up after themselves. It has the hallmark features of a good behavioral intervention in that it involves very little talking and lets the consequences make the point. The Sunday Box involves picking a certain time each evening, perhaps right after dinner, when your children need to have finished putting away their belongings. At that designated time, you walk around with a large box or trash bag, “the Sunday Box” and put into the box anything that has not been put away. You repeat this patrol with the Sunday Box every night until the clean-up habit is well established. The Sunday Box is securely put away so the children cannot get to it. Some parents have resorted to putting it in the truck of their car, and then bringing it out on Sundays, when any items can be retrieved by the child. Any item that the child does not take out of the Sunday Box remains in the box and if it stays in there for more than two weeks, perhaps this is an indication that the item in question has outlived its usefulness and should be donated to charity or “disappear” for a while — to reappear at a later date when it may be more appreciated.

 

Before starting with the Sunday Box, explain to your child what the Box will involve. It is also important to develop an organizational strategy with your child about where things go, so that at clean-up time he doesn’t have try to figure out where to put things. Thus, there is a box for Legos, crayons, action figures/dolls, and everything has its designated place. One reason that clutter develops is that there is not a system for filing and putting belongings, so things get piled and not filed. Do not threaten your child with the Sunday Box. Just simply announce “Oh it is 7 o’clock, time for the Sunday Box,” and let the actions speak. When your child complains that he doesn’t have a particular item, listen compassionately and remind him that the item will be available on Sunday. If it is an item such as a winter coat, you can substitute a less desirable item until Sunday. But the learning is in the experiencing of the consequences and not with a lot of discussion and reminding by the parents and that is why this is a very effective intervention.

 

 

Tics

14 Jul

From Your Anxious Child: Emails to Parents by Edward H. Plimpton, PhD

Tics

 

The landscape of the anxious child can include learning disabilities, sensory sensitivities, and other problems such as ADHD and, sometimes, tics. In a tic, a part of the body suddenly makes a repetitive and stereotyped movement. Tics tend to be fast movements without any purpose. Common tics involve eye blinking, shoulder twitches and the neck jerking. Tics are categorized medically in terms of the length of time they have been present and the range of tics displayed — Tourette’s syndrome representing the extreme. Medical evaluations are important here so that certain diseases can be excluded from consideration. In various manifestations, tics have been estimated to occur in 12% to 18% of all school-aged children. Tics often first manifest themselves at ages 5-7, and are most intense around 12-14 years of age. After that, for many, they gradually decrease over time. So while early adolescence isn’t a great time to stand out and be different, for most children tics decrease in severity over their childhood. Another commonly noted feature of tics is that they tend to wax and wane over time and can change in form and appearance. Because they can’t take their body as a given to behave itself, a consequence is that these children often develop a precocious self-awareness. The presence of tics forces them to become more aware of themselves in a way that other children are not forced to do.

For many parents and children, the tics are an annoyance but the least of their concerns. Other problems such as OCD, ADHD and various learning problems may exert a more disruptive effect on the child’s life.

What can be done about tics? First, it is important to note that for many children, as mentioned above, the tics get less severe and pronounced over time. So the thing to do is nothing and not to make a big deal about it. Second, for some children medication may offer some help in decreasing tic severity, but unfortunately there is no panacea right now. Third, tics can draw attention to a child and consequently the potential to be ridiculed or bullied by peers is a possibility.  What is helpful here is educating other people about tics. School-based educational interventions around Tourette’s can be helpful in decreasing the ignorance and fear that is often behind bullying. Fourth, the intensity of the tics may be also managed by a behavioral training program involving habit reversal or developing a competing response. For many children, the tics are preceded by a feeling that has been variously described as “an inside itch” “inner tension” or “not right feeling” and performing the tic provides momentary relief from this feeling. The treatment involves performing a response that is incompatible with the tic until the urge for it goes away. Finally, identifying the situations in which the tics occur in can provide valuable clues about how to either reduce the stress or manage the boredom that triggers the tic.

For the child and the family, it can be extremely annoying to have your body take on a life of its own, but fortunately for many it is a problem that decreases in severity over time.