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The Deer in the Headlights: Understanding the Anxious Freeze

15 Apr

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

The Deer in the Headlights: Understanding the Anxious Freeze

Perhaps your child will not go to school, or take swim lessons or get that needed shot at the doctor’s office. So you have created a reasonable plan to help her. It involves a series of incremental steps, baby steps or exposures to the source of the fear. But this step by step plan isn’t working. Your child just freezes up and will not budge. What is going on here? The show stopper may be that your child is not engaged in the standard fight or flight response to anxiety but rather a more defensive freeze or immobility response. The importance of the freeze or immobility response has slowly received increasing recognition in the therapy world and it definitely has implications about how you respond to your child.

The freeze or immobility response comes into play when the organism, be it a child, corporate lawyer or zebra, is overwhelmed. But for simplicity’s sake, let’s take the zebra. The lion has caught it, and has the zebra by its throat. Under the circumstances, the poor zebra can’t run away or fight, so it tries to play dead and hopes that this will basically gross the lion out so it will leave her alone. While the circumstance may not be as dramatic, children also can get overwhelmed for all sorts of reasons, and they end up freezing up. So they may stop talking, stop engaging in any eye contact, and become more rigid in their posture. Adults can often get irritated at this lack of responsiveness, and at our worst we assume the child is being manipulative. And that might be part of the picture, but it can also be that the child just feels overwhelmed. And as adults we often discount or minimize events that may be overwhelming to a child because we don’t experience them as such.

So what to do? First, a child in freeze is a child not engaged with people. And we know when someone is highly anxious, their rational or smart brain goes into hiding, so reasons or rational explanations are of little use. Engagement is the thing. You can start with nonverbal engagement when possible, such as tossing a ball or taking the dog for a walk or blowing bubbles, and sometimes simple touch can be effective as well. The child’s body is all revved up and needs some form of physical discharge. The physical activity, in turn, helps the child get out of the freeze response, and then he or she is more available to be engaged with others, such as teachers or parents. Indications that a child is coming out of freeze are smiling, laughter and spontaneous talking.

The freeze or immobility response does not respond to reason and hence requires some special consideration. Failure to recognize freeze responses will lead to a standoff where everyone is just digging in their heels. Think about engaging your child in a more physical manner to help him/her get out of this frozen state.
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

Movie Worries

30 Dec

Maybe you needed some down time, or maybe the children needed to be occupied so that you could get some other things done, so you allowed them to watch a movie. Let’s say you chose Walt Disney’s Snow White, because it is so well-known and you remember it from your own childhood. The kids watch the movie, you have some time to attend to your business, and everything seems fine. But when bedtime rolls around, there is a problem. The image of the old hag who gives Snow White the poisoned apple is stuck in your child’s head, and it will not go away.

What is going on here? This is just a cartoon, after all, and it was made for children. Nevertheless, it is undeniable that movies can overwhelm some children by presenting them with frightening images from which the motion picture rating system provides only imperfect protection. For some children, the possibility presented in the movie — that people can seem one way but turn out to be another — is a very compelling idea. In addition, movies in which a character actually morphs into something else — movies such as Freaky Friday, Spirited Away, Big, and The Incredible Hulk — can produce intense anxiety. Children are often misled by appearances, and believe exactly what they see, even if it is presented in a cartoon format.

Logic cannot help anxious children reason away their fears. Long ago, the Swiss psychologist Jean Piaget did an experiment in which he presented young children with two glasses filled with equal amounts of water. Preschoolers were easily able to see that the two glasses looked the same. However, when he took one of the glasses and, in front of the children, poured its contents into a shorter but wider glass, the children invariably said that the taller glass had more water and the shorter glass had less. Although they had seen the same amount of water poured into a different shaped glass, they still reasoned on the basis of appearance. In other words, it is easy to fool young children into believing that appearances are real, even if you tell them that something is “imaginary,” or created with special effects. So it is wise to use caution in what you allow your children to see, especially those children who are more than ordinarily anxious.

The potential of movies to leave children with anxious preoccupations, of course, isn’t confined to very young children still in the grip of very magical thinking. Older children, teens and adults can be similarly affected. And with regard to some excessively explicit movies our culture produces, it may be reasonable to ask, “Who wouldn’t be freaked out?” At the same time, there are a group of children whose excessive reactivity to movies that their peers can tolerate and enjoy is a reflection of limitations in their own anxiety management capacity. While just saying “No” to movies that are too much is one perfectly acceptable approach, for some children it may result in them missing out in group activities with their peers. For the latter children, learning to build their “Movie Muscles” may be helpful and also build their capacity to tolerate tension and suspense in other areas of their life. A simple way to build “Movie Muscles” is to start with a movie such as Finding Nemo and with the remote control handy, stop the movie whenever your child is showing any fear or signs of physical tension. Ask your child whether he can notice what is happening in his body and then wait for his body to calm down. Then repeat the scene that was just played until the child is less reactive before proceeding with the rest of the movie. This exercise will help build capacity to tolerate the tension and suspense of movies.

copyright@Edward H. Plimpton, PhD

Get out of your head

14 Jul

 

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

Helping Your Anxious Child Get Out of His Head and Out of Worry

 

When an anxious thought or image takes hold in your child, it hijacks his attention. In children’s intense preoccupation, a narrowly focused tunnel vision takes hold in which the worry is the only thing in sight. This narrowing of vision makes sense if there were a realistic danger that had to be dealt with. Hitting the reset button involves helping the child get out of her head and refocused onto the world around her. For example, one girl struggled watching movies with her friends because she was much more easily frightened by what she saw compared with her friends. On her own, she came up with the idea that when she was frightened by something she saw, she would look around the room and start naming what things. She would say to herself, “There is the lamp, there is the cat, there is my popcorn…” and this listing would help her reorient and gain some distance from the frightening image.

A slightly different example is provided by a 10-year-old boy who had been anxious about going to school for a long time. There were frequent trips to the school nurse and guidance counselor with complaints about stomach pains. Merely talking about his feelings and providing reassurance didn’t help with his anxiety. Partly in desperation, the guidance counselor started having the child write down his schedule in her office as soon as he got into school. By the time he was finished writing down his schedule for the day in great detail, his anxiety had diminished to the degree that he was able to go to his class without difficulty. This simple exercise did a couple of things. First, the act of writing his schedule down moved him away from his anxious thoughts because he had to think about his schedule, which was not the same every day.  Second, since he was filled with nervous anticipation about what was going to happen during the day, writing his schedule moved him away from the anxious anticipation to visualizing what would really happen during the day. This focus on the external reality of the day seemed to help calm him down. Third, the anxious child is usually operating at high speed, but writing something down can really slow things down so he can challenge some of his anxious thoughts or they can just dissipate on their own.

So helping your child focus on the environment outside of his head can often be an important step in helping him deal with anxious thoughts.

Effort versus Performance

14 Jul

Effort Versus Performance

 

Whether it is an upcoming swim meet or a spelling bee on Friday, children can often suffer from performance anxiety, some of which is perfectly normal and appropriate. However, when the anxiety clearly begins interfering with the child’s participation in the event, then the issue of performance anxiety needs to be considered. Some children who are rather perfectionistic by nature can put a lot of pressure on themselves.

 

Adults, however, provide added pressure depending upon whether they focus on the child’s effort or performance. It turns out that how we praise children can have a big effect on how they perform depending upon whether you focus on their effort or intelligence.  This insight comes from research by Carol Dweck, who discovered an interesting effect on children’s school performance depending upon whether parents comment on the children’s effort and hard work, or their intelligence and talent. She proposes that we tend to understand success as either the result of innate ability and talent, or the result of hard work and effort.

 

However well-intentioned, telling your child that he/she is smart and brilliant can inadvertently put pressure on him as when he encounters a problem in his homework that he has difficulty solving. This child may feel that because he could not solve the problem easily, this is an indication that he is not as smart as he thought he was because it required effort. So he gives up. Anything that requires effort is to be avoided and challenges are not welcome.

 

In contrast, comments that focus on the child’s effort tend to promote greater persistence and a more positive attitude. This has been confirmed in studies on children’s performance on math tests where the feedback in one classroom was on how smart they were and in the other classroom, the feedback focused on their persistence and effort. When given achievement test, the “persistence” group did substantially better.

This point was recognized a long time ago in the book How to Talk So Children Will Listen and Listen So Children Will Talk, by Adele Faber and Elaine Mazlish, who recommended simply describing what you see rather than lavishing praise on your child. Rather than saying to your kindergarten child’s quickly drawn picture, “Oh that is so beautiful,” instead comment, “Wow, there are so many colors in this picture and the house has four windows.” The latter does communicate that the child’s effort was worthy of detailed attention and it brings her attention to what she did that helped make the picture interesting.

 

So when it comes to providing encouragement for your child, try to focus more on describing the way in which you see him displaying effort and persistence rather than praising him for being talented or smart.

copyright@Edward H Pllimpton, PhD

 

 

 

How to Panic

14 Jul

How to Panic

 

Did you know that you can induce an anxiety state? Your child can do it too. And sometimes it helps to know that you can control this process — if you can make anxiety happen, perhaps you can understand it better and help it go away.

 

Here are some instructions for improving your chances of having a genuine panic attack:

 

1.)    Breathe in a shallow and rapid manner. In other words, hyperventilate.

2.)    Scan your body for anything that doesn’t feel quite right. It’s especially useful if you can notice some tightness in your chest, but other body parts can do the job quite well. For instance, perhaps your stomach doesn’t feel well, or the back of your throat feels funny. Remember, if you have a strange feeling, or any feeling at all, there is a reason—and it’s probably not a good reason, either.

3.)    Now, take those feelings and use your imagination. Think of the worst thing that could happen. Consider that you might die, have a heart attack or throw up in school. Be sure to think hard about these possibilities and how frightening they are.

4.)    If you have ever had these feelings before, try to forget that they eventually went away. Try to imagine these feelings as being worse than anything that has happened before.

5.)    Hope for a quick fix.

 

For more straightforward reading on this topic, I would recommend Reid Wilson’s book Panic for adults, and Tamar Chansky’s Freeing Your Child From Anxiety for dealing with children.

Reassurance Questions

14 Jul

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

 

Reassurance Questions

Consider these questions: “Will everything be OK?” “Am I going to throw up?” “Are you sure this food is safe to eat?” These are more than just questions. They are simple requests for reassurance, something we all need from time to time. As a parent, providing comfort to a distressed child is one of the things we do best, and with infants we are biologically wired so it happens automatically. But when no amount of reassurance seems to calm your child and you have the feeling that you are dealing with a bottomless pit, different measures are called for.

It is not just information that is needed, because you have provided that and your child is still an anxious mess. In fact, when you are at your wit’s end, it can feel like your child doesn’t think you are a credible source of information. Much of dealing with anxiety involves learning to tolerate uneasiness and recognizing that our prior attempts to feel better don’t work and in fact actually make the situation worse. Without intending it, your repeated efforts to reassure your child have acted like an addictive drug, providing quick relief, but leaving her craving more. What we need to help your child learn is to teach her that when an anxious worry pops into her head, if she leaves it alone, it will go away by itself, but if she gives it serious consideration, it hangs around.

So what to do? Your response needs to be informed by how anxious you gauge your child to be. For the highly anxious child who is near panic, utilize the  breathing techniques to bring down his anxiety, and the two-part sentences discussed in a previous chapter, which involves  empathizing with the feeling, but reminding him  of the facts. These are more management strategies for intense moments when there isn’t too much rational thinking going on. However, it will be more helpful if we can make “anxiety” wait and not respond to it right away. So you might say, “That sounds like a worry monster question, I would like you to wait five minutes and see if you still need to ask this question.” If the child gets busy doing something and forgets about the question, then mission accomplished.  If the child still has the question after waiting the requisite amount of time, then answer the question. The child at the very least has learned to tolerate some discomfort for a short time. With practice, she will be better able to tolerate not having these questions answered automatically — and for most children, the anxiety will diminish. The amount of time you ask your child to “make worry wait” needs to be also gauged to what you think he can tolerate, but the goal is have him tolerate increasingly longer periods of time so that the thoughts truly have a chance of floating away.