Why Doesn’t My Child Want to Get Help?

21 Aug

Your home is nice, but sometimes you would like to go out for a change of scenery, perhaps a game of mini-golf or dinner at a family oriented restaurant. Is that really asking too much? Well actually, yes, says your anxious child, home is really better. And realizing how much your child’s anxiety is affecting the entire family, limiting positive family activities, you decide to get help. But there is one problem: your child doesn’t want any help and indicates in no uncertain terms that it is not happening. What to do? The situation is getting urgent and your child won’t budge. Here are three items for your consideration.

First, it may be that you have a child whose first response to anything new is an emphatic “no” or perhaps a dramatic scream of bloody murder–it doesn’t matter whether it is mini-golf or a scheduled visit to a therapist. But given some time, he will come around when he senses you are not going to give up. So time and a clear parental directive is what is needed for the child to wrap his head around this new turn of events. Even though an anxious child’s first reaction to a suggestion to do something different might always be a “no”,  often she can end up going to the birthday party and having fun. But sometimes  that doesn’t happen, so of course, we also want to take the time to see if there are some specific concerns we didn’t know about.

Second, the problem may be that it just feels too hard to talk about those anxious feelings. For some children the concern may be that talking about their fears will make them more real or make them come true. This may be a reflection of the magical thinking that can color children’s mental processes. Saying something out loud, they fear, will somehow make the fear more likely to happen. Even adults will sometimes say “don’t say that,” as if silence offers some protection. Another way in which it may be hard to tolerate talking about worries is that some children are extremely self-conscious and tolerating any attention is rather painful.  Or it may be that your child is just very emotionally reactive for any number of reasons, and tolerating any feelings is very hard. And for this type of child, any new situation needs to be introduced slowly so they can build their tolerance or capacity to deal with it.

Third, if your child shows little motivation to change or to deal with an obvious problem, it may be that you have been too helpful and accommodating. It is only natural as a parent, when your child is in distress, to want to provide comfort and reassurance. And if your child is screaming bloody murder, it may feel a lot easier just to give in to whatever is demanded.  However, if things are too easy and comfortable at home, the anxious avoidance is powerfully reinforced. And then there is little incentive for the child to get out of her comfort zone and challenge herself. Accommodation to anxious behavior can take many forms, from indulging a child’s need for  reassurance,  to buying excessive amounts of soap for a child with germ concerns, or not making them go to school. And because it runs against our natural inclination not to provide comfort to our distressed children, most parents of anxious children have done some reinforcing of anxiety by being overly helpful. However, that does not mean giving free rein to the feelings of impatience or irritation that having an anxious child can create. Yes it is pretty frustrating for your child to have a temper tantrum just because you need to go to a clothing store. But that doesn’t mean that a get tough policy (“we have had enough of your games!”) is appropriate or effective. In fact it will probably make things worse because in the potential power struggle that follows, the real point of mastering anxiety gets lost in the midst of a parent-child battle of wills. Rather, think in incremental terms of how to decrease your accommodating actions, so that the child can adapt slowly, not losing sight of the purpose of this change, which is to help him/her be less limited by anxiety.

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