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

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

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

Islands of Competence

26 Jul

A parent once told me that the most valuable thing I ever said involved the importance of building “islands of competence.” I can’t claim credit for that one — it was borrowed from another psychologist, Robert Brooks. But I agree that it’s one of the most useful concepts around.

The idea is that one of the most important tasks for an elementary school child is developing areas of growing skill and competence. Self-esteem really comes from developing capabilities, and in the process, children learn the importance of practice and persistence. Maybe it seems obvious, but we need to keep reminding your child not to give up, to hang in there, even when good results don’t happen right away. This can be really challenging with an anxious child, since anxiety is so much about avoiding what makes you uncomfortable.

It’s obvious why all children should have “islands of competence,” but there is also a more specific reason when it comes to an anxious child. When you deal with anxiety, it is essential to remember that you can’t “not think about something.” The more you try not to think about something, the more you find yourself dwelling on it. So it is extremely helpful to have compelling alternatives for how you would like to spend your time. In other words, what would you rather be doing than worrying? You don’t have to pretend you aren’t anxious, but you can still focus on activities and goals that are truly engaging, interesting or comforting. Focusing on these goals can help you ride out the moments of anxiety and make them more tolerable.

I need to insert a note of urgency here about what I am saying. If children do not develop at least several ways of defining themselves as competent by the time they reach middle school, they will be all the more vulnerable to peer pressure, or will seek solace in endless computer time. Learning that you get good things through practice and persistence will generalize over the years to help your child face a variety of other challenges.

copyright@Edward H. Plimpton, PhD

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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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.

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