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2013 Books on Parenting Your Anxious Child: A Review

29 Dec

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

In 2013 three new books were published on parenting the anxious child: Why Smart Kids Worry: And What Parents Can Do To Help by Allison Edwards, Anxious Kids Anxious Parents by Reid Wilson  and Lynn Lyons, and The Opposite of Worry by Lawrence Cohen. Any book written about how to help anxious children is going to contain some overlapping suggestions and that is true of these books. So in dealing with nonstop reassurance questions from anxious children, Allison Edwards has the “The Five Question Rule,” Lawrence Cohen has “The Fifteen-Second Rule” and Reid Wilson and Lynn Lyons talk about avoiding “the content trap”. And these are similar to my blog essay on reassurance seeking. At the same time, each book presents a slightly different perspective in how they understand anxiety in children and consequently what to do about it.

Allison Edwards’ Why Smart Kids Worry: And What Parents Can Do To Help makes the interesting point that when children have uneven development they may be vulnerable to anxiety. She is focusing on children who have intellectual abilities that are way in advance of their chronological age, such as the 8 year old who can read on a 12th grade level. Their capacity to take information intellectually is not in keeping with their ability to process it emotionally. As she explains, “It’s not that smart kids can’t understand the information, it’s that they can’t handle the emotional pieces that go along with it” (p108). I would suggest that whenever there is uneven development children may be vulnerable to anxiety because of the difficulty of making sense of their experience emotionally and intellectually —and it is not just a problem restricted to smart children. But being attentive to uneven development as source of anxiety is a valuable idea. Some age typical expressions of anxiety such as stranger anxiety in infants may reflect their new found awareness that there is stranger in front of them, but their not having the emotional resources to deal with this awareness. She lists 15 tools or practical suggestions that parents can use to help an anxious child, such as The Five Question Rule for repetitive anxious questions, which “…allows kids to ask only five questions about the same worry within one day” (p168). Perhaps because of the slightly more specialized nature of her book, her emphasis is shaded more towards managing anxious feelings than in articulating more explicitly ways to help face their fears.

Anxious Kids Anxious Parents is coauthored by Reid Wilson, who is one the major figures in articulating the cognitive behavioral perspective in managing anxiety.  Learning how to tolerate uncertainty and face your fears is central in this book. The authors articulate 7 parts or skills needed to solve “the anxiety puzzle,” involving: 1. Learning to expect to worry, 2. Talking to Worry or externalizing it, 3. Being unsure and uncomfortable on purpose, 4. Breathing which helps reset or reboot the system when a child is overwhelmed, 5. Know What You Want or having clear goals which is critical to tolerating the work involved in dealing with anxiety, 6. Bridge Back to Your Success because anxiety makes us forget when we were successful and 7. Take Your Plan into Action. Almost everyone who works with anxious children recommends trying to personify worry or externalize it. This book makes an important point that there are at least three ways that the child can relate or talk to his/her anxiety. 1.  A child can expect, it which would involve saying to the personified worry “I know you’re just trying to help” (p73).  2. A child can take care of it: “yes worry we are going to be nervous and then it will be over”. 3. A child can boss it around as in, “I will get back to you on that one worry”. The book also contains an interesting reading list of books for children that promote the cognitive flexibility  needed to deal with anxiety. A favorite book in their list is The Opposite by Tom MacRae and Elena Odriozola, in which a boy learns to think and do the opposite of what his worry would dictate.  In addition there is a free e-book Playing with Anxiety: Casey’s Guide for Teens and Kids, which serves as a companion volume for their book .

In  The Opposite of Worry: The Playful Parenting Approach to Childhood Anxieties and Fears, Lawrence Cohen recommends incorporating a physical and playful approach in helping the anxious child. As he explains “…like it or not, we have to deal with the physical body because anxiety clouds the thinking brain” (p 93). There has been increasing recognition that our response to danger not only involves the well described fight or flight response but also, when those options are not possible, a freeze or immobility response. The freeze response is a feature of trauma in which it is not possible to engage in either a fight or flight response. And anxious children often look frozen or immobile with an almost “deer in the headlights” presentation.  Cohen emphasizes that an empathic connection with a child is the critical foundation from which the adult can help the anxious child. He then suggests a variety of playful and sensory based interventions  including  the potential of rough house play.  His suggestion for a book is Juggling the Jitters by Deborah Miller, which as the title suggests provides a very physical solution to dealing with worries.  While emphasizing the importance of physical and sensory interventions, Cohen also is quite similar to Wilson and Lyons in stressing the importance of challenging the ever prevalent “What if” thinking found in anxiety and changing it into it with “What is” and learning to tolerate feelings of uncertainty.

Each of these new books on anxiety has something to offer the parent of an anxious child, and there is noticeable overlap despite the different perspectives of the authors. In dealing with children often the most useful advice someone can give is how to say something in a child friendly manner. And I certainly found material I could use in each of these books.

The following are Ytube videos of the authors:

Allison Edwards  http://youtu.be/_bJHJYjlcec

Reid Wilson and Lynn Lyons  http://katiecouric.com/videos/is-anxiety-ruining-your-family/ and   http://katiecouric.com/videos/teens-and-the-anxiety-to-succeed/

Lawrence Cohen  http://youtu.be/423q7PGgIj0

2013 copyright Edward H. Plimpton, PhD

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Using humor to deal with anxiety

14 Aug

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

Anxiety is about getting junk mail

14 Jul

http://www.youtube.com/watch?v=hbDtEv8-o2oFrom Your Anxious Child: Emails to Parents by Edward H. Plimpton, PhD

Junk Mail

Let’s say your child has lots of anxious questions of the type that don’t have a close connection to anything that has really happened in her life, as in “Am I going to throw up today?” but the last time she threw up was two years ago. You have tried reassuring her but she usually comes back to double- and sometimes triple-check your answer. “Are you really sure?”

What is going on here? If the brain has some similarities to a computer, then we could say that the anxious brain is not good at sorting out “junk mail” from regular mail. Junk mail in this case are those worries about the future that are theoretically possible, but rather unlikely to occur. As we know, junk mail can come in all shapes and sizes and can look very convincing because there is always a possibility that this proposed worst-case scenario could take place. This type of anxious thinking is junk mail.

Asleep or awake, we are always having thoughts and images passing through our minds.  It is actually nonstop traffic, although the intensity and clarity of it does vary. For someone with a more anxious nature, this natural buzz of activity can be a significant source of distress. It turns out that there is not much difference between the anxious brain and the non-anxious brain in terms of the thoughts that occur, but there is a difference in terms of how these thoughts are dealt with, and their frequency and intensity. The anxious brain tends to treat all thoughts as potentially significant, and then follows this with a question along the lines of, “What does this say about me that I am having a thought like this?” Perhaps this thought is an indication of who I am truly am. In contrast, the nonanxious brain does not have to grab hold of every passing thought and can let the junk mail float by.

A large part of dealing with anxiety is changing your child’s relationship to it. In another e-mail, I discuss giving anxiety a name, whether it is the Worry Monster or something of the child’s invention. Then a next step is labeling what the “Worry Monster” says as junk mail. Sometimes it looks important, but the Monster is really trying to trick your child into buying something you don’t need. You might want to have your child watch you sort through the mail at home and see that there is some mail that goes straight into the trash can or shredder without even being opened. We might almost say that anxiety is trying to sell you an expensive insurance policy for something that is quite unlikely to occur. But in labeling the anxious thought as “junk mail,” we can begin to respond to it differently and consequently lessen the effects of these intrusive thoughts and images.