Where do you begin when you have an anxious child whose head is filled with thoughts such as, “Am I going to die?” or “Am I going to hurt you? Obviously, the first step is to get a complete picture of what is going on with your child with a professional consultation. But for discussion’s sake, let’s assume that the basic problem is what we might term “an overactive alarm bell.” Be warned: anxiety can be a stubborn creature, so dealing with it can take a lot of work and persistence. Anxious children can become quite negative when you start to do things differently, so it is important that you and your child learn something about how worry operates. Here are the first three things you need to help your anxious child.
First, anxiety narrows our perspective and how we see the world, so we need to get distance by labeling and personifying the problem with names such as “the worry monster,” “brain bug,” or “Mr. Worry.” It is best if your child can come up with his/her own name for worry. It may seem that these names are silly, but doing this is actually an important step for the child in getting some psychological distance from these ever present concerns. The book You’ve Got Dragons by Kathryn Cave can be helpful in conveying this point to elementary school age children.
Second, we need to get out of the reassurance trap. Our natural inclination as parents is to provide reassurance—arguably, it is perhaps what we do best. Unfortunately, all of the reassurance we give our anxious children does not really help, and in fact it actually makes the anxiety worse, since it gives the fears a measure of credibility. Easing away from giving reassurance requires a thoughtful plan, and a way to explain the change to your child. Otherwise, he or she will simply freak out. Simple interventions can involve “putting worry on a diet” by only allowing so many worry questions a day, or making worry wait 10 minutes before answering questions. It is important to emphasize that the child really needs to understand the rational for the intervention, since this way of responding is so different from how parents and children normally communicate.
Third, these initial efforts must be supported by communications that first connect with how the child is feeling, and then redirect him/her. I call these “ two-part sentences.” Examples might be: “This is a scary thought, sounds like a worry monster question,” or “I can see you are worried, let’s play catch for a bit.” And there are many variations of these types of statements which first connect with how the child is feeling and then try to help him/her get off the worry channel.
Remember that anxiety is quite persistent, so it is important to really understand how worry works. Your child is really hoping for some magic cure, and may be quick to say that nothing is working, so you both need to understand that conquering worry does not happen overnight. In addition to my blog and podcast there are a number of helpful books that clarify the process of dealing with anxiety, I like Lawrence Cohen’s The Opposite of Worry, Reid Wilson and Lynn Lyons’ Anxious Parents, Anxious Kids, Dawn Huebner’s What to Do When You Worry too Much or What to Do When Your Brain Gets Stuck, and the online program GoZen.com. So these are first step., Next will be helping your child begin to face his/her fears.
copyright@Edward H. Plimpton
The first three things to do when you have an anxious child
5 NovFear of Throwing Up: Emetophobia-suggestions for school
5 Nov1. If the child does not feel you understand how hard and scary it is to have this fear, he/she will not listen to anything else you have to say. This fear can be extremely distracting for those children struggling with it and it definitely feels very real to them. So we want to validate the feeling, even if we don’t agree with the child about what to do about it.
2. Unfortunately, answering the constant reassurance seeking questions such as “Do you think I am going to throw up?” provides only momentary relief at best. And likewise, frequent phone calls home are not typically helpful. But to wean the child off this reassurance seeking, incremental steps are needed. Otherwise all you will get is unproductive panic. So in the classroom a manageable first step might be that when the child asks to go the nurse, a teacher could say, “Would you consider waiting 10 minutes to see if this feeling goes away, and pretend to put your worries into this stress ball while you are waiting.” The language needs to clearly communicate to the child that this is a choice. The hope is that by not leaving immediately for the school nurse’s office, the child might give the fears a chance to dissipate. Likewise, if frequent phone calls to home are occurring, it is important to work on cutting them down, perhaps by starting with putting a limit on the amount of phone calls during the school day.
3. A distinction can be made between a “sick stomach” and an “anxious stomach.” A “sick stomach” is an indication of a flu or bad food, whereas an “anxious stomach” is the result of some stress or worry. The problem is that both types of stomachs feel pretty much the same and they certainly grab the child’s attention. The solution is not to focus on the unpleasant sensation, which typically amplifies the discomfort. On a boat or in a car, when you feel nausea, the common suggestion is to look at the horizon. In doing this, turn the focus away from the sensation and onto your surroundings. In a similar manner, we want to enlist the child in thinking about the context in which the stomach discomfort developed. Of course, the school nurse has to make a determination about whether the child might have a “sick stomach.” But if it seems more like an “anxious stomach,” the nurse might ask questions such as “when did your stomach begin to freak out?” or “has there been any point today where you were feeling better?” or “I wonder what was going on when you decided you needed to come see me.” Although it is a challenging endeavor for children, we want to help them see a connection between their reactive stomach and the various stresses that they encounter every day.
4. Basic concepts caregivers need to know to deal with Emetophobia include: problem with reassurance (see Reid Wilson and Lynn Lyons, Anxious Parents, Anxious Kids), what I term a two part sentence or connect and redirect (in Siegel and Bryson, The Whole-Brain Child, personifying worry, covered in all books on anxiety, distinction between anxious stomach and sick stomach, capacity to think in incremental terms, and of course creative ways of facing the fear. And of course these topics are covered in my blog and podcast: edwardplimpton.com and on itunes “Your Anxious Child: 5 minute solutions”.
Your anxious child 