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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.

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

What to do about nightmares

14 Jul

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

 

What to Do About Nightmares

A most unwelcome nighttime visitor is the nightmare. We all get them at some point, and they are usually triggered by a frightening event, or major transition such as starting school or a parental divorce, but also something scary in a movie or television show. Significant trauma can lead to recurrent nightmares, s something our military veterans unfortunately often have to deal with. Nightmares involve very intense emotions, usually fear, and the content is remembered. Recalling our nightmares is in contrast to night terrors, which feature extreme panic but no recollection of the dream. Some common themes of nightmares, to mention a few, involve being chased or attacked, smothered, or falling. The intensity of the nightmare can be traumatizing to your child, and may make him afraid to go to sleep because he might have another one.

What can we do for your child who has had a nightmare? While most nightmares are caused by something scary, it is important to consider whether there might be physical cause (e.g., a fever), a recent illness or a drug reaction. Recurrent nightmares, however, are suggestive of emotional problems that are not being resolved and might merit professional attention. With these cautionary comments noted, there are some things to try

Start by calming your child and providing reassurance. The distinction between reality, fantasy and dreams is not always clear to young children and they may need some help on that front. The intensity of the fear needs to be acknowledged and never laughed at or dismissed. Once you have reassured your child, it is time to find about what happened in the nightmare and to get as much detail as possible. Our general goal with nightmares, as with all scary things, is to create a way where your child can become more active rather than being passively victimized. Nightmares put your child in a defensive position, as in having to run for her life in the dream, and we want help her to take a more active and assertive stance against the images in that dream. Basically, we want to help your child rewrite the nightmare and put herself in a more powerful role.

So perhaps we can begin by having your child draw the nightmare or the scariest image in it. A monster drawn on paper can’t move. But if that is too scary, your child might have to begin by drawing a jail for the monster or some special guards against it. The next move depends upon the nature of the beast, the nightmare images, so to speak, but there are a range of options. Let’s try to avoid the most violent options, such as killing the monster. Because we are in the world of dreams, we can’t count on such actions carrying any finality. The monster may come right back the next night with greater intensity just like the sequel to the horror movie playing at the local movie theater. Perhaps your child could render the monster harmless by drawing something silly onto his monster picture, such as diaper, or give it a lollipop. We may also transform the nightmare monster by helping your child ask it questions, such as “What are you doing in my dream?” or “Why are you chasing me?” Anne Wiseman, in Nightmare Help: a Guide for Parents and Teachers, provides a variety of questions you can ask your child to help him with his nightmare. A very basic question she suggests is asking your child what he would need to feel safe or less scared. In general, asking questions to help your child rewrite and transform the dream into something where he is more in control is the goal. Even though dreams take place in your head when you are asleep, there is emerging evidence that is possible during your waking hours to transform your dreams by rewriting them, and thus lessen this nighttime annoyance.

Story telling for Children

14 Jul

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

Story-Telling for Anxious Children

Nighttime is a favorite time for worries to emerge. In another email, I talked about building a worry motel as a way of containing and labeling worries. But there is also another time-honored way of helping children with worries, which is making up bedtime stories. I have also discussed the value of books in promoting a sense of security and safety, as well as reading books that specifically address anxiety. However, there is nothing like a bedtime story that you have created. It can be tailor-made for your child in a way that no book can ever possibly approximate. And the act of storytelling creates a special moment of intimacy between you and your child in which you let her know that she not alone in feeling scared.

Understandably, when I the mention the idea of bedtime story-telling, parents remind me of how tired they are night and that they don’t have the imagination for it. But it is important to remember that your audience will be appreciative of any efforts you make and the act of engaging in an imaginative activity can actually be relaxing and decrease your stress level. There is a wonderful book for parents by Chase Collins, Tell Me a Story: Creating Bedtime Tales Your Children Will Dream On, which provides many suggestions about how to find the creative story-teller within you. It can be as a simple as picking an event that occurred during the day and providing “feelings” for both the animate and inanimate objects involved. So if a child is afraid of going into the bathroom by herself, there might be a talking toilet or bath towel as part of the story. Bedtimes stories can also be structured around the classic fairy tale plot line that involves a likeable hero, who goes off on a journey, encounters a problem and comes up with a solution and there is a happy ending (Collins, 1992, p73). But there are many variations on how to create a story, including making it much more a joint effort. Here is one example.

A mother had been desperate to help her 8-year-old daughter who had a combination of ADHD and OCD, but nothing was really working.

“The answer presented itself at bedtime.  Leah’s vivid imagination has been focused on fairies that could show up at all times of day, but especially at bedtime.  I realized that it might help if I tapped into this playful and imaginative side of her.  One night, while Leah and I were playing together, I asked if she would like the fairies to speak to her through me. She was thrilled with the idea. I would “become” one of the many fairies that I had named, on a nightly basis, and we would talk. At first, it was getting to know the fairies, so we “talked” about such things as what games they like to play and their favorite snacks. But gradually with the fairies doing the talking, her worries and struggles emerged. As with many children with ADHD, Leah sometimes has difficulty falling asleep at night and she had resisted doing any relaxation breathing. That is, until “Goldenmist” arrived on the scene, who has become Leah’s “relaxation” fairy. When Leah has trouble falling asleep, “Goldenmist” will breathe along with her, and she will sometimes ask her to close her eyes, and imagine herself lying in a field full of beautiful flowers. With the help of Goldenmist, Leah is now doing her relaxation breathing …With the help of these “fairies” and our joint story-telling, Leah has become less anxious. It has been interesting to watch how the characters have evolved, in particular how OCD has been morphed productively into “Fluffy.” Leah will readily take advice from “Fluffy” that she would never accept from me. I have made sure that many of the fairies meet a particular need for Leah. Over time, I have come to realize that it is not just the content of the play that Leah has responded to, but it is the story-telling itself.”

 The process of story-telling can communicate to your anxious child that you empathize with him and he is not alone in his struggles. Once you focus on the creative activity, it can actually be a lot of fun. So everyone benefits and that is simply good medicine.

The Worry Motel

14 Jul

The Worry Motel

 

You may have noticed that worries love nighttime, especially bedtime. This is the time when there are no distractions, and worries can have your child’s undivided attention. Fears, darkness, some creepy shadows and some anxiety about tomorrow are the perfect recipe for a restless night, and lots of calling out for Mom and Dad.

 

Here is a serviceable, standby solution that is quite simple and can also be a lot of fun. It draws its value from the idea that fears can be labeled and contained. You and your child need to go into the hospitality business and open a “Worry Motel.” An empty shoe box, decorated with your child’s help and guidance, makes a perfect motel where worries can stay for the night—and hopefully, once they check in, they won’t check out!

 

Here is how to use a Worry Motel. Before bedtime, you and your child should draw or write down any worries that might be lurking around, left over from the day or waiting in ambush for tomorrow. You can model this process by writing down some hypothetical worries that anyone might have. Put the slips of paper in the Worry Motel, and leave them there.

 

Of course, we all know that worries do not cooperate. So ask your child to gather up some action figures, stuffed animals or dolls that would be willing to stand guard overnight and remind the worries to stay in the motel. It is important to emphasize that the worries will need to be taught to stay in the motel, and that this takes a lot of practice—there is no “presto, change-o” magic here. The more you enliven the situation by being playful, the more likely your child is to participate. So you may want to talk to the “guards” and give them special assignments, such as “We really need your help to watch this throw-up worry…he’s a real pest!”

 

When you put the worries in the motel, it can also help to give the child some alternative ideas to absorb him. Have him help you put together a scrapbook with about ten pictures of things he finds interesting or comforting. These might be pictures of a family pet, a summer vacation spot or a favorite sport. If a person is interested or engaged in something, it is hard to be anxious at the same time. So give your child something productive to think about, because trying not to worry does not work.