Sunday 25 February 2018

Dear David Coleman: How can we help our 14-year-old socially shy and anxious daughter?

Image: Getty
Image: Getty

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. I am concerned about my 14-year-old daughter. She is very quiet, has not really settled into secondary school, and doesn't seem to have made any real friends. At night, she goes through a routine, making sure there is nobody underneath her bed and no one in her wardrobe. She could go through this numerous times before getting into bed. She seems to worry about the house getting robbed and I am concerned that this might get worse. We have tried to get her to change the routine going to bed, but to no avail. Can you help?

David replies: It sounds like your daughter is experiencing quite a lot of anxiety. This might be linked to her struggle, socially, in secondary school. It isn't necessarily a causal relationship between the anxiety and the social struggle, but the two are likely to go hand in hand.

For example, it may be that your daughter has found it very hard to make friends and may feel "on the edge" of the social groups that have formed. Feeling a bit excluded, or a bit of an outsider, may now be causing her to feel anxious, with that anxiety showing as a fear of robbers or general insecurity.

It might also, however, be that your daughter experienced anxiety first, and that anxiety is what has inhibited her socially in school. Her nervousness, perhaps, about making new friends, or how others will perceive her, could have caused her to hold back.

Her possible isolation, now, in school may have just added to her anxiety.

There are echoes of compulsions in terms of the routine, repetitive checking that your daughter does before she goes to bed. I would guess that the checks are designed to reduce her anxiety and increase her sense of physical security. The fact that she repeats them and follows them, nightly, in a stereotypical manner does give rise for concern.

If it is not already established as an Obsessive Compulsive Disorder (OCD), it could easily develop further into OCD.

OCD is, essentially, an anxiety disorder and so its development would fit with the pattern of anxiety, and the compulsive-type behaviours your daughter uses to reduce the anxiety that you describe.

I think you are right to be concerned about her, as the anxieties may well worsen over time without support or help. While it is good that you try to distract her from the repetitive checking by changing her routine and interrupting it with more positive activities like reading, it is unlikely to be enough to help her deal with the underlying anxiety.

I would suggest that you bring her to meet with a clinical psychologist who is experienced working with teenagers. I think there is a twin-track approach that might be needed to help her move forward.

She will definitely need some skills for regulating her anxiety, finding ways to be able to relax and quell the adrenalin-fuelled fears that circulate in her thinking. While she may achieve this with self-help manuals and your support, I think it would be more effective to have some professional direction.

Similarly, since the anxiety is quite likely to be tied into her social isolation, either as a cause or as an outcome, she might benefit from an additional focus on how to make friends and build up her social confidence.

If the anxiety does develop into OCD, then having good-quality therapeutic help available to her, and to you as a family, may be invaluable. Whatever about relying on book-based or online relaxation, meditation and mindfulness tuition for anxiety, OCD can be a little more resistant to self-help.

Often, the most useful thing that a good therapist can offer youngsters who are struggling with anxiety is the hope and belief that they can overcome it. Anxiety can often, otherwise, feel like it has grip on us that we are powerless to resist.

Check too with her school to see if they have observed the struggles she seems to have, socially, and to see if there are any supports they can offer her in the next academic year.

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