Sunday 23 October 2016

My 11-year old has a fear of sleeping after jet lag

Published 27/09/2016 | 02:30

Photo posed by models
Photo posed by models

Clinical psychologist and parenting expert David Coleman on how to reduce anxiety for an 11-year-old son and how to tackle unbearable behaviour from a pre-school child.

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Q. Following a return flight from the US last year my 11-year-old son has now developed a fear of being the last person to be awake in the house. He had two nights of severe jet lag and was awake when everyone else was asleep. This distressed him greatly. Since then he insists on me settling him to sleep and I have to keep checking on him until he falls asleep. It's like something clicked in his brain those two nights he couldn't sleep and now he can't reverse it. He is social and confident by day, but really stressed every night. He used to be great to sleep.

David replies: It is amazing to consider the power certain experiences have, in our lives, to affect our mood and our behaviour.

For many adults and children, jet lag is a temporary nuisance, causing little more than exhaustion and grumpiness as the body readjusts its rhythms to a new cycle of light and dark.

Your son, though, has had a long-term disruption. It does seem like the experience of being awake while others slept was very disconcerting, and probably anxiety-provoking for him. As you say, he has developed a fear of being the only one awake.

How much have you explored this fear with him? For example, what is the meaning, for him, in being the only one awake? If someone else is awake, how does that help him or what does it do to reduce his anxiety?

You may discover that your son has a core belief that something bad will happen to him, if he is the only one awake. Or you may find out that he is very lonely and, perhaps, frightened of being alone with all his thoughts without the potential for distraction. Maybe the noises of the night are amplified, and scarier, if nobody else is awake to reassure him that they don't indicate danger.

It is difficult for me to hypothesise what might be the underlying assumptions, or core beliefs, that are now guiding him, since his experience of being the only person awake, but this is certainly something for you and him to aim to understand.

Talking with him about the experience of those nights might also help to identify if there are specific things that frightened him during his sleeplessness. Maybe it was just his distress that he "couldn't" sleep during a time when he felt he "should" be asleep, that was distressing for him.

The long-term resolution of his insecurity at night probably does lie in being able to identify what he is now associating with his sleeplessness and what it is about it that is frightening for him.

You may find that accessing this information is difficult for you, especially since you are, undoubtedly, close to him.

He may not be able to talk about his real fears because he is reluctant to distress you, or appear silly or foolish in your eyes.

Bringing him to a good cognitive behavioural therapist, who is experienced working with children, might be a good thing at this point. The CBT model can be really effective in understanding and dealing with anxiety.

In the meantime, your current approach, of settling him to bed, and then checking on him regularly, is effective in terms of giving him the comparative security he needs to feel comfortably able to sleep.

It might also be worth doing some simple mindfulness exercises with him, to help him to focus on the here and now and to draw his attention away from his worries. Guided visualisation techniques can be a nice way, especially at bedtime, to allow children to focus on positive and uplifting images and thoughts.

Another benefit of these techniques, is that they give him some sense of his own power to influence his mood and his thinking, where he may currently feel powerless and at the whim of his anxieties.

Taking back a bit of personal control might be good for him and might also reduce his reliance on you for his night-time comfort and security.

I think you are on the right road in trying to identify what it was about those two nights of sleeplessness that was so disruptive and upsetting for him. Something definitely changed at that point and so the solution probably lies there too.

Our preschool son hits, bites and pinches us.  His behaviour is unbearable, what can we do?

Q. Our second son is almost three and has always been what you could call a very difficult child. We have often wondered if there is something not quite right. His behaviour can be unbearable. He bites, pinches, and hits, almost attacking us. His temper is ferocious. He has rigid things that he will do, like wanting all his clothes on backwards. His tantrums are explosive until he gets his way. He's not let away with bad behaviour. He's told what's unacceptable, we've ignored him, we've smacked him but nothing seems to work. What can we do?

David replies: Your son sounds like he is a very intense version of a typical toddler. While the behaviours he displays are relatively common, the intensity with which he displays them seems extreme. So, you may be correct that something is not "right" about him. You will know if, compared to his brother, he seems different to you.

Bearing that in mind, your starting point might be to go to your GP or PHN and get a referral to your local HSE Early Intervention Service. Seeking a comprehensive developmental assessment might help to understand if some, or all, of his behaviours are explained by some kind of "ism", or a sensory issue, or possibly a developmental delay.

It is, of course, also possible that your younger boy just has a different, more choleric, fiery, temperament than your older boy.

This temperament, or personality, difference may lead him into different kinds of interactions (probably less positive) with the adults around him. Sometimes negativity breeds negativity and so, when we start into a particularly negative pattern of responding to our children (who are pushing all of our buttons with their behaviour), we, and they, can get stuck in that pattern.

You do mention several of the interventions you have tried with him. Simple ignoring and/or slapping rarely work, in my experience. When children are ignored they often increase the intensity of their behaviour to provoke a response.

When they misbehave at that more intense or destructive level they do often get a response from us, negating our efforts to ignore the behaviour in the hope that it would fade away from lack of attention.

Slapping, too, tends to increase aggressive and violent behaviour in children. Often the simplest message they learn, from being slapped, is that when someone doesn't do what you want, you hit them, since that is what they have experienced.

It is well worth doing a bit of detective work about the various incidents that your son is involved in. Note the incident (like hitting you) and then think back to what was happening before, recall what happened during the incident, and then what happened after it.

Observing the Antecedent (the before), the Behaviour (the during) and the Consequence (the after), often referred to as "the ABC" of the behaviour, often shows up a repeating pattern.

A typical pattern might be that your son is denied something, he gets frustrated, his frustration builds past the point at which he can regulate it, he acts out by hitting, then he gets some kind of punishment.

The issue, then, might be about your ability to recognise and diffuse the frustrations he might experience (remember that he may also have some kind of sensory issues with things like his clothes), before they rise past the point at which he can manage them.

So diverting him from misbehaviour might become more effective than ignoring him or punishing him after misbehaviour.

That might mean that you have to empathise with, soothe, distract or remove him from situations before they escalate. This gives his emotions a chance to calm down and might help him avoid the misbehaviour.

Remember that he is only turning three and so still needs lots of calm but firm parental intervention to help keep him on the straight and narrow.

A good, comprehensive, assessment should also be able to point you in the right direction of how to best help him.

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