Monday 27 February 2017

Persuade your child to face a fear and they can overcome it

David Coleman

David Coleman

Q: My son is an exceedingly smart eight-year-old, is very affectionate and loving. However, he says he doesn't like exposing his skin in public (he recently refused to take off his socks in the doctor's office).

He also does not like noise and crowds and has refused to go to birthday parties. He has always been fussy about the clothes he wears and will not wear anything tight, short or inflexible.

His standard clothes are long-sleeved T-shirts, long trousers, woolly socks, and shoes. Our problem is that, in his school, all second-class kids are expected to go swimming once a week. Since he was in senior infants he has been dreading this and has asked repeatedly if it is compulsory.

When he was told that it was 'part of the school curriculum', he started to insist that he would not go. When he was younger he learned to swim and became very good and went regularly until he was six.

But the anticipation of swimming in school has been on his mind since he stopped swimming with us and he brings it up regularly. Classes begin imminently. Should we force him?

The swimming pool needs him to overcome all of these issues (noise, crowds, exposing his skin) at the same time.



A: It sounds like your son has some significant anxieties that are akin to a phobia. A phobia is an irrational, intense and persistent fear of certain situations, activities, things, animals, or people. The main symptom of a phobia is the excessive and apparently unreasonable desire to avoid the feared thing.

In your son's case I am not sure if the fear he has of exposing his skin or of being in crowds is very intense, but it sounds persistent and appears irrational. It may be that it is related to some sensory hypersensitivity. It is also significant that it interferes in his daily life (he avoids parties and can't participate fully in school or sports).

Going on the information you have given, I think that your son has some level of a social phobia. Because of this I strongly recommend that you bring your son to a child psychologist or psychiatrist who can help him (and you) to deal with the fears that he has.

Manage

It is interesting that even though your son has always wanted to keep his clothes long enough to fully cover his skin, he did manage to get undressed in the swimming pool when he was younger and get into the pool area enough to learn to swim and become good at it.

I wonder why his fears of exposing his skin in public intensified, at the age of six, to the point that he could no longer go swimming. It may be that there are some clues to the origin of his fears in a review of anything significant that occurred at this time.

The most common intervention for a phobia is cognitive behavioural therapy (CBT). CBT takes advantage of the interconnections between our thoughts, our feelings, our behaviour and our physical selves. It operates on the basis that if we can change our thinking about situations and/or our behaviour in situations that this will lead to a knock-on change in our feelings.

A significant element of phobias are the irrational thoughts about potential harm or danger that might exist in relation to the feared situation or thing. It would be good to talk to your son to try to understand his thinking and reasoning for why he needs to keep his skin covered up and what will happen to him in crowds.

Typically, children with phobias overestimate the risk and extent of harm that might befall them.

These kinds of irrational beliefs need to be challenged and this is one area that a trained therapist will be best able to help you and your son.

Phobias

Another key part of overcoming phobias is changing your behaviour such that you begin to face the situations that you fear. However, you can't do this until you have learned and can use some anxiety-management techniques.

When you know some techniques to relax yourself, then slowly and in gradual steps you can practice coming closer and closer to the feared situation while actively reducing your anxiety. This then gives you a sense of mastery that you can regulate your feelings and that you won't be overcome by your fears.

This is all best done with the support and guidance of a trained therapist. So, make an appointment for your son with somebody.

Explain to the school about his fears and ask for him to be excused from swimming while you are addressing them. This gives you both the opportunity to deal with his social anxieties so that they don't remain an issue into his adolescence and adulthood.

Irish Independent

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