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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




My child won’t get out of the car!

14 Jul

Won’t get out the car!! What to do?

Suggestion from Edward H. Plimpton, PhD


Parents dealing with a child who is anxious may find themselves in a situation where their child seems physically frozen with fear.   It might be that they won’t get into the dentist chair, get out of the car to go to school or join the other children at a birthday party. When it happens more than once, a plan of action is needed. As with all problems, it is important to consider a range of factors that may be at play here. But there is also the practical problem of what to do and there some interventions that may be helpful regardless of the underlying reason.   For sake of discussion, let’s consider the child who won’t get out of the car.

  1. We should begin by recognizing that this can be very stressful for the parent. You may be trying to get to work on time, having already been late a number of times because of your child’s struggles, and you are feeling the pressure. In addition, we need to remember how contagious feelings are, which adds to your and your child’s distress. As you are driving to school you are left wondering how you are going to get your child out of the car and into school. So just as in airplanes, when the oxygen mask drops down from the ceiling-first attend to yourself and then you can help someone else. First, try to notice any physical tension in your body.  This is a simple request, but can be surprisingly helpful. Try to slow down and breathe in a calm, relaxed manner. You will more effective dealing with your child if you start from a position of being relatively calm. After all, it is a two-way street: Your child’s anxiety affects you, and your mood affects your child. You have to be calm in order for your child to be calm.
  2. If a child is curled up in the far corner of your van or is holding onto the car door for dear life, he or she is clearly overwhelmed by his or her feelings. It may feel like you have a stubborn or manipulative child, but that does not mean that is the child’s motive. It is more a reflection of how overwhelmed they feel rather than manipulation. It may be that just getting into the car was a major accomplishment.              Conceptually, we think of anxiety as reflecting our biological defensive system of fight or flight. But there is a more primitive defensive response that occurs when we can’t engage in fight or flight—we become immobilized or freeze. It is similar to the way in which animals play dead when caught by a predator. And your child in the car may be in a frozen state.  

If you can engage your child in some activity in the car, whether it is playing some version of license plate, listening to a song, or having a conversation,-any activity that helps him/her get out of his/her head and the anxious preoccupation is good. Likewise, if we can get the child to do some relaxation breathing, rather than hyperventilating, that would certainly help the cause.  But I understand that this may not be possible.

  1. Don’t pull your child out of the car. It will only make the situation worse and could result in tug of war in which someone gets hurt.
  2. Approach your child in a calm manner. Empathize with how overwhelmed he/she must feel. “I can see you shaking and huddled up, I  am guessing you are feeling  pretty scared”, or “I am guessing you are pretty scared, and if I felt that scared, I would hold onto back seat for dear life as well”   Trying to understand how your child feels isn’t the same as giving him permission to miss another day of school. But rather if you child feels understood, then she may become more flexible. It would not be unusual in such a situation for your child not to give any indication of whether you said something useful or it was just stupid. Don’t despair; it is hard to feel eloquent when you are talking to someone huddled in a ball.
  3. This really may be the best they can do in the moment. Try to get the child to look at you. Try to see if your child will tolerate any physical contact from you, whether-a hand on the shoulder-or a hug. We are trying to make the child feel safe and calm down her nervous system.  
  4. One yardstick to keep in mind is that many panic attacks resolve themselves in about 15 minutes, so stay calm and hang in there. You may just need to give the situation some time.
  5. You might say, “Being upset is hard work, let me know if you need something to drink or eat.”
  6. It is always helpful if there is a compelling reason for the child to get out of the car that can help override his current feelings. Sometimes schools can give children special assignments such as helping the gym teacher or feeding and caring for a school pet.
  7. Although no one wants to jump to put their child on medication, and it shouldn’t be the first intervention,  there is a place for medication in helping children get control of themselves so that they can participate more fully in solution of this problem.  Medication won’t solve any problems, but it may turn down the anxiety dial so that the child can be more available to solve this problem.

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.

Floor Time

14 Jul


Floor Time


A recent Nielsen Company survey reports that the average American is spending an average of 4 hours 49 minutes watching TV a day — and that is those ages 2 years on up. Yikes. But then again, your TV time is probably after the children are in bed, unless your anxious child just won’t bite the pillow. TV is a problem inasmuch as it is a regular source of scary images for children that will keep them up at night and you from your late-night show. It is a lean, efficient anxiety-producing electronic machine. But also there is the issue of whether it is being used too much as a substitute babysitter and keeping you and your child from more productive activities.


It sometimes can take some time to figure out why your child is anxious or having a hard time in school. Does your child have a short attention span because he/she is anxious or because of attention deficit disorder or both? Or, does your child have some learning disabilities that need to be clearly identified? Whatever the reason, you know that you have a stressed-out child on your hands and the answers to these questions may take some time. When all else fails, consider going back to the basics. A lot of undesirable behavior in children is inappropriate attention-seeking. Children crave attention. The most basic mental health intervention you can give your child is 20 minutes of undivided attention everyday. In a way, it may not sound like much, but actually it can really do a lot to take the edge off things. The activity can take many forms, but please try something more interactive than video games. Sometimes you have to try out a few ideas to find ones that are a good match between you and your child. It will probably be more fun if you engage your child in an activity that you find interesting than one for which you have no aptitude. But then again, being a parent is a way to expand your horizons and develop some new interests.


Time spent with your child is important because children often do not respond promptly and efficiently to such well-meaning inquiries as, “How was your day at school?” The response often suggests that you don’t have security clearance to have access to such information. However, given some time, often children will spontaneously blurt out a concern or share an experience. The time you spend with your child also communicates to her that you consider her important and worthy of your time and that of, course, will help her feel that she is worthwhile. It is one instance where quantity of time is as important as the quality of time.

What Happened? The Follow-Up Question

14 Jul


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



What Happened? The Follow-up Question


In the heat of the anxious moment, it is hard for children to have any perspective. Furthermore, they may not feel very receptive to the best-intentioned efforts of their parents. All they know is that they feel lousy, and when the anxious moment passes, children often act on the “out-of-sight, out-of-mind” principle. However, the mastery of anxiety involves recognizing that the feelings are “false alarms” and that they will go away on their own. By asking some simple questions, parents can help children begin to realize that their initial anxieties were not good predictors of what actually happened in real life.

Say, for instance, that the child has a big test in school and complains about feeling cold and asks, “Do you think that I have a fever?” You feel his forehead and it is as cool a cucumber, and you tell your child that he does not have a fever. The follow-up involves a simple question when the child returns from school, such as, “Whatever happened to that cold feeling you had this morning?” And hopefully the child will respond with something like, “Oh that feeling went away as soon as I entered the school building.” Such questions and comments slowly help children make the difficult connection that their initial reactions are not always good indications of what will actually happen. Since children, especially in the early and mid-adolescent years, are very sensitive to any adult suggesting that they know how they feel, it is probably prudent to take on the role of the curious bystander, rather than the “know-it-all adult.” But over time, the child will be quietly building a bank of accumulated experiences, so that he or she will be more accepting when a parent says, “Do you remember how you felt when you (…went to your last birthday party, sleepover, started last semester)?”

Two part sentences

14 Jul

Two-part Sentences



In the heat of the moment, the anxious child typically needs “containment statements.” These statements do not provide any magical relief, but do help far more than some less productive things desperate parents might say in moments of frustration. These are two-part sentences in which the first part is empathic toward the child, and the second part reminds her of the reality of the situation. Both parts are needed. If you just remind your child that the fears don’t make sense, you are likely to get back a statement such as, “You just don’t understand,” or “I’m so stupid I might as well be dead.” Even if you don’t hear this type of negative response, you may inadvertently be providing the child with the type of reassurance that actually increases anxiety over the long term.


What not to say


  1. “What?      You are saying makes no sense.
  2.  “Don’t be silly”
  3. “Of      course there are no sharks in the bathtub.”
  4. “That      is just the worry monster”
  5. “No,      you don’t have a bleeding ulcer.”


All of these statements emphasize the facts, but don’t empathize with the feeling. When you don’t acknowledge the feeling, you might get an angry, “But you just don’t understand”. So what we want to do is create two-part sentences that empathize with the feeling, but also remind the child of the facts


What to say


  1. That is a scary thought, but sharks needs lots of water and need to live in the ocean.
  2. I am sorry your stomach doesn’t feel quite right, but I have noticed you often have complaints like this on Sunday night.
  3. I am sorry your stomach doesn’t feel quite right-what else could it be besides an ulcer?
  4. I am sorry your stomach doesn’t feel quite right-what makes you think it is something that serious?


Admittedly, there may be a cumbersome quality to such comments. In general, they tend to work better when they are formulated ahead of time, rather than trying to invent them on the spot. While these statements won’t do anything miraculous, they will provide a respectful acknowledgment of the child’s feeling and a gentle reminder of the facts