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Some resources to help with sleep

4 Aug

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

Basic Sleep References and Material

Sleep is easily disrupted by anxiety. Without daytime distractions, worry thoughts can fill the child’s bedroom. In addition to the references listed below, consider my essay on making a Worry Motel, it has been an extremely useful intervention for many children. The suggested age ranges are approximate because some children are more indulgent of material that might be geared towards younger children and others have decided intolerance of anything seems babyish. These references are not geared towards the issue of helping your child sleep independently, which is a related issue, but rather providing some alternatives to the “worry channel” that can be playing loud at nighttime.

Dawn Huebner What to Do When You Dread Your Bed: A Kid’s Guide to Overcoming Problems with Sleep
This is good parent child workbook for the elementary school age child (8-12). It has a very child friendly format and discusses some very sound ideas to help with sleep.

CDs

Finding a CD that might be helpful to your child may take some experimenting. We tend to have strong preferences about the type of voice we find calming and the type of music or sounds we enjoy. It is hard to predict what might work for your child. However, I have good luck with the following CDs.

For 5-8 years olds

Jim Weiss Good Night: Enchanting story visualizations with sleeptime music.

Jim Weiss Sweet Dreams: Enchanting story visualizations with sleeptime music

I found the two CDs by Jim Weiss to be very enjoyable for children to listen to.

For 12-18 year olds.

Mark Grant calm and Confident: based on Eye Movement Desensitization Reprocessing

I like Mark Grant because he places no demand on the listening to do anything and consequently removes any performance pressure that can get in the way of sleeping.

Books

The books that have been written to help children ease into sleep are too numerous to list and there are many delightful books in this category. Often it just may be a good book that is engaging and interesting. I suspect each family has their favorite bedtime books.

For 5-8 year olds

Maureen Garth Starbright: Mediations For Children

In order to fall asleep on their own, children need to develop some coping skills. In this book, the parent provides the beginnings of a visualization story to help set the stage and then invites the child to continue the story on his/her own. This helps builds the child’s imaginative capacity to deal with nighttime worries.

Lori Lite A Boy and a Bear: The Children’s Relaxation Book

This is nice book that teaches relaxation skills in which a boy and bear relax on top of the mountain.

Melanie Watt Scaredy Squirrel at night

Melanie Watt has written a series of books on Scaredy Squirrel dealing with fears in a variety of situations.

Sleep problems can be complicated and a professional consultation may be indicated when simple measures don’t work.

Picture Books Part 2-The Foundation of Bravery

15 Apr

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

 

Picture Books Part 2-The Foundation of Bravery

 

Sitting on the living room couch, a parent reads a picture book to his or her young child. A small body cradled and attentive to the unfolding story-one of life’s pleasurable moments. Quietly and without fanfare, an important conversation is transpiring about how to grow up and be safe. And the following books charmingly begin this conversation: The Runaway Bunny, by Margaret Wise Brown, and Pouch, by David Ezra Stein. Children will outgrow these books, but the question gets repeated at each stage of life in more complex and subtle ways. 

 

For children to actively engage the world, they must be able to affirmatively answer the question of whether they will be safe and their needs will be met. Without an affirmative response, children will be more oriented toward protecting their bottom line of simple survival. In other words, to tolerate the experience of anxiety, there needs to be some foundation of security or safety and at a young age this especially involves a sense of connection with a parent or caregiver. In The Runaway Bunny, the little bunny is asking this question to its mother in a series of challenges. 

 

Once there was a little bunny who wanted to run away.

So he said to his mother, “I am running away.”

“If you run away,” said his mother, “I will run after you.

For you are my little bunny.”

 

The little bunny suggests a variety of ways he may run away and to each possibility the mother creatively answers how she will be there to catch him. Eventually the little bunny is reassured and can settle down and eat a carrot. 

 

In Pouch, the baby kangaroo is more confident of his mother and   goes off exploring the world.  When the tension becomes too much, it runs back to its mother with the cry of “Pouch,” mirroring the behavior of many  young children.

With its mother as a constant source of security, the baby kangaroo gains more confidence to explore the world. 

 

And how does this relate to your anxious child who has perhaps outgrown these books? Successfully overcoming anxiety involves incremental steps and building the internal resources to tolerate the tension that may go along with this process. And it starts with the foundation of safety that starts without fanfare on the living room couch. 

copyright@edward plimpton

The Lessons of Goodnight Moon

30 Dec

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

                                      

When you have a baby, and you live in the United States or some other developed nation, then chances are you have a copy of Goodnight Moon by Margaret Wise Brown. If that book escaped your notice, then  rest assured that it is easily obtained-sometimes even in large grocery stores.   Worries, fear and anxiety have a favorite time of day to make an appearance, which is, of course, bedtime. Hence, the numerous books written about bedtime for young children. In Goodnight Moon, a mother rabbit is helping her bunny to sleep and the dialogue consists of saying goodnight to all of the objects in the room. It begins with:

“In the great green room
there was a telephone
And a red balloon
And a picture of the cow jumping over the moon.
And there were three little bears sitting on chairs…”

So at time when anxiety might be increasing, what does the mommy do? She helps the little bunny get out his/her potentially anxious thoughts by bringing attention to the concrete aspects of their surroundings. What is in the room?  A telephone. What are on the walls? A picture of the cow jumping over the moon. She is helping the little bunny get out of his/her head and focus on reality of where they are. Any thought of monsters under the bed are interrupted by reminders that they are in a very familiar bedroom. So this focus on what is in the room helps keep the little bunny grounded rather than drifting off into an anxious sea of bad thoughts.

But the mother bunny is also doing something else. She is remaining very calm. We know that anxiety is very contagious. An infant or young child has an immature nervous system and consequently relies on adults to help them regulate it. Children are consequently checking in with their parents to see how they appraise what is going on-technically this is referred to as social referencing. And the mommy is indicating to her little bunny that she views the situation as totally safe. In a similar manner, you will help your anxious child by conveying a calm and confident manner that the situation is safe and you will take care of any problem that might develop.

This classic bedtime story illustrates the importance of orienting to the external environment in dealing with anxiety and demonstrates how parents can help children manage their anxiety by providing a calm presence. A similar point is made in another essay on this blog, “Helping Your Anxious Child Get Out of His Head and Out of Worry.”

copyright@Edward H. Plimpton, PhD

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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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

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Books for Anxious Children

14 Jul

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

 

Books For Anxious Children

 

There are many ways in which books might help anxious children, from engaging them in a different world — and thus taking them away from cultivating their anxious thoughts — to more directly educating them about the specific problem of dealing with anxiety. If “anxiety” were to write a book, the characters would be seeking safety at all times, avoiding anything that isn’t guaranteed to be safe, and consequently leading a very dull and predictable life. This point is neatly captured in the book Scaredy Squirrel, in which the squirrel is too afraid to leave his tree and therefore has a very boring life. Sometimes the best books have nothing to do with anxiety per se, but deal with an appealing character overcoming significant challenges in the service of an important goal, such as the Harry Potter series, or the Lord of the Rings trilogy. Other books deal directly with specific anxiety problems, such as Go Away Bad Dreams.

 

Recommending books for specific children can be complicated by the need to match the book with the child’s developmental level, and more individual factors that might suggest especially good choices. As children advance through elementary school, they might find books about animals or fairies with anxieties “too babyish,” whereas a few years earlier these might have provided just the right psychological distance to make the story attractive and useful.

 

Books that help children with fears should normalize those fears and suggest solutions. Since other children do not necessarily have the same fears, worrying can make a child feel inadequate and different. Thus, it is helpful for the story to have characters with a wide range of worries, to illustrate that worrying itself is not so very “different.” For younger children, the message is more digestible when delivered indirectly, in stories whose main characters are animals or magical creatures.

 

Anxiety itself is a bully, intimidating children with constant threats of disaster and implications that they can’t overcome it. As a result, children often need help to feel comfortable being more assertive with their anxiety and being less passive about suffering it. Books such as Go Away Big Green Monster give preschool children permission, as the title indicates, to tell their worries to get lost. In There Are Monsters Everywhere, an older child becomes more assertive by learning karate and knowing he has these skills to help him when he goes into a basement.

 

For some children, just knowing they can be more assertive in fighting anxiety works wonders. However, if the worries are especially stubborn and persistent, setting up a situation in which there is a winner and loser might simply make the child feel that he is trying to fight anxiety, but it isn’t working. In this case, the child may need specific tools to disarm anxiety. In There’s a Nightmare in My Closet, the boy discovers that the nightmare is just as afraid as he is, and he befriends it. Thus, interacting with the worry and turning it into something silly can be very helpful tools. Currently, my favorite book is You’ve Got Dragons, because it addresses some basic features of anxiety, is more general in its recommendations, and is therefore applicable to a greater range of situations.