My child won’t get out of the car!

Won’t get out the car!! What to do?

Suggestion from Edward H. Plimpton, PhD

Parents dealing with a child who is anxious may find themselves in a situation where their child seems physically frozen with fear.   It might be that they won’t get into the dentist chair, get out of the car to go to school or join the other children at a birthday party. When it happens more than once, a plan of action is needed. As with all problems, it is important to consider a range of factors that may be at play here. But there is also the practical problem of what to do and there some interventions that may be helpful regardless of the underlying reason.   For sake of discussion, let’s consider the child who won’t get out of the car.

1. We should begin by recognizing that this can be very stressful for the parent. You may be trying to get to work on time, having already been late a number of times because of your child’s struggles, and you are feeling the pressure. In addition, we need to remember how contagious feelings are, which adds to your and your child’s distress. As you are driving to school you are left wondering how you are going to get your child out of the car and into school. So just as in airplanes, when the oxygen mask drops down from the ceiling-first attend to yourself and then you can help someone else. First, try to notice any physical tension in your body.  This is a simple request, but can be surprisingly helpful. Try to slow down and breathe in a calm, relaxed manner. You will more effective dealing with your child if you start from a position of being relatively calm. After all, it is a two-way street: Your child’s anxiety affects you, and your mood affects your child. You have to be calm in order for your child to be calm.
2. If a child is curled up in the far corner of your van or is holding onto the car door for dear life, he or she is clearly overwhelmed by his or her feelings. It may feel like you have a stubborn or manipulative child, but that does not mean that is the child’s motive. It is more a reflection of how overwhelmed they feel rather than manipulation. It may be that just getting into the car was a major accomplishment.              Conceptually, we think of anxiety as reflecting our biological defensive system of fight or flight. But there is a more primitive defensive response that occurs when we can’t engage in fight or flight—we become immobilized or freeze. It is similar to the way in which animals play dead when caught by a predator. And your child in the car may be in a frozen state.  

If you can engage your child in some activity in the car, whether it is playing some version of license plate, listening to a song, or having a conversation,-any activity that helps him/her get out of his/her head and the anxious preoccupation is good. Likewise, if we can get the child to do some relaxation breathing, rather than hyperventilating, that would certainly help the cause.  But I understand that this may not be possible.

1. Don’t pull your child out of the car. It will only make the situation worse and could result in tug of war in which someone gets hurt.
2. Approach your child in a calm manner. Empathize with how overwhelmed he/she must feel. “I can see you shaking and huddled up, I  am guessing you are feeling  pretty scared”, or “I am guessing you are pretty scared, and if I felt that scared, I would hold onto back seat for dear life as well”   Trying to understand how your child feels isn’t the same as giving him permission to miss another day of school. But rather if you child feels understood, then she may become more flexible. It would not be unusual in such a situation for your child not to give any indication of whether you said something useful or it was just stupid. Don’t despair; it is hard to feel eloquent when you are talking to someone huddled in a ball.
3. This really may be the best they can do in the moment. Try to get the child to look at you. Try to see if your child will tolerate any physical contact from you, whether-a hand on the shoulder-or a hug. We are trying to make the child feel safe and calm down her nervous system.  
4. One yardstick to keep in mind is that many panic attacks resolve themselves in about 15 minutes, so stay calm and hang in there. You may just need to give the situation some time.
5. You might say, “Being upset is hard work, let me know if you need something to drink or eat.”
6. It is always helpful if there is a compelling reason for the child to get out of the car that can help override his current feelings. Sometimes schools can give children special assignments such as helping the gym teacher or feeding and caring for a school pet.
7. Although no one wants to jump to put their child on medication, and it shouldn’t be the first intervention,  there is a place for medication in helping children get control of themselves so that they can participate more fully in solution of this problem.  Medication won’t solve any problems, but it may turn down the anxiety dial so that the child can be more available to solve this problem.