Thursday 21 June 2018

Dear David Coleman: My son is still distressed going to his preschool

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David Coleman

David Coleman

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

Q. I have a three-year-old boy who started preschool last September. He has never really settled and now it's gradually getting worse. He hates when I leave him. It's a battle every day trying to think of things to keep him happy about going. I've tried everything to make it easier for him as it breaks my heart to see him upset. He asks, "is it forever mam?" He is the same when I have to go to work. I am a mother-of-four but never experienced anything like this with the others. I hope you can give me some advice to help my little boy.

David replies: Anxiety amongst children seems to be rising. I hear more and more cases of children becoming anxious, often over small things. Helping children cope with their anxiety is a larger and larger part of my work.

It does sound like your son has a lot on his mind. I wonder if the core of his anxiety is about the surgery and what that will be like. Going to hospital, having a general anaesthetic, and having the surgery itself are all very significant events in their own right. Even with the most child-friendly environment, hospitals can be daunting places.

I could imagine that the thought of the surgery, and all it entails, could be very frightening. He is only eight! Even beyond the surgery he may have lots of worries about his hearing and the effect of the surgery on his ears. Imagine how, from his perspective, he may worry about the surgery not working or making things worse.

If something to do with the surgery is a background, or underlying, worry, then it could be that the specific fear of burglary is a useful "hook" to hang the deeper worries on.

If, for example, he is too worried about the surgery to even talk about it (because, for example, he'd prefer to pretend it's not happening, or block it out of his mind), then being able to tell you and show you that he is worried about a burglar attacking him or someone in the family might be a useful way to express his nervousness.

In order to process any feeling, we have to able to attach, or link, the feeling to the experience, event or circumstance that is associated with it. You will probably have lots of examples from your family life of situations where someone displaces a feeling from one situation and expresses it about another.

A typical example might be a child who is upset or frustrated about something happening in school (like bullying) and coming home and acting cross, upset or moody, even though the events at home don't warrant perhaps the nature of the emotional outburst, or the intensity of it.

So, rather than getting too focused on the fears about burglaries, I think it might be more helpful to target your interventions with your son on his impending surgery.

How much have you discussed his surgery with him? What was the nature of those conversations? Generally, us parents are quite good at explaining the practicalities of what will happen, trying to normalise the experiences, or to minimise their impact.

I think parents are reluctant, sometimes, to talk about the emotionality of an experience, in case they "feed in" to a child's feelings.

However, allowing children, even encouraging children, to connect to their actual feelings is critical. So we need to say things like "I could imagine you are really nervous about the operation", or "it can seem scary to be going to stay in a hospital for a few days", or "I wonder if you are terrified about the thought of being put to sleep before the operation".

It matters less what we actually guess about our children's likely feelings, and more that we are simply demonstrating our willingness to explore their feelings and try to understand them. We don't even have to try to "fix" those feelings. Validating them is often enough.

If you can talk to your son in this empathetic way about the surgery, and the hospital, I think it will go a long way to helping him to process those feelings, such that they don't "leak out" into other fears about things like burglaries.

Our eight-year-old son is anxious about robbers and upcoming surgery - how can we help him?

Q. Our eight-year-old son is petrified to sleep on his own, as he is afraid someone will break into our house at night. He unfortunately saw my husband one time reading an article about a house burglary and someone being stabbed and it has left him scared. If we are home during the day he won't walk to the toilet or go upstairs on his own. He is also due to have surgery on his ears in a few weeks under general anaesthetic and this is freaking him out too, so I'm not sure if this is playing a part. We are at our wits' end. Please help!

David replies: Separation anxiety is very common amongst toddlers and preschoolers. Indeed, it makes good sense that a small child would miss their parent and be upset and distressed at the separation. They have relied on that parent or caregiver for their security.

So, at a time when they most need the reassurance and comfort of their caregiver, the separation itself is removing them from that usual source of comfort.

Usually, when we do have to leave our children, to be cared for by someone else, we ensure that that person is warm, caring, understanding and nurturing.

When we respond in this way, to a small child in distress, we can expect that they will allow themselves to be soothed in due course. Most preschool teachers are very skilled at both comforting children and successfully distracting them to some fun activity to take their mind off the fact that mam or dad has just gone.

Your son sounds like he is in the throes of quite a distressing separation anxiety. But, even if it is distressing, it is also, still, probably quite normal. Has he had similar experiences elsewhere?

The fact that your son is still getting very upset when he has to be left each morning suggests that something hasn't settled for him. It would be worth exploring how he is getting on with his teacher.

Check in again to see how she tries to respond to him, when he arrives, paying heed to what she says and how she says it, as well as what she is doing. Check too how long it takes him to settle each day after you are gone. Do you and the preschool teacher have an agreed plan for that key moment when you are dropping him off? This would be a key part of the day for your son.

If it is the case that even though he gets upset every morning, he does manage to calm down relatively quickly when you are gone, that might suggest that the display, at the time of separation, has another purpose apart from expressing an anxiety.

We have to remember that part of his "job" if he is feeling anxious about staying on his own without you is to try to persuade you, by any means, to stay. The way most children will instinctively and unconsciously do this is by protesting, usually in the form of either tears or tantrums.

Crying should in theory tug at the heartstrings of the carer, such that they couldn't conscionable "abandon" their child. So, his distress may be his most effective way to try to delay the inevitable or even prevent you from leaving him altogether.

I note, in your query, you comment that you struggle "trying to think of things to keep him happy about going". I wonder if maybe this is the wrong approach. Your job is not to make him happy about being in preschool (that will be the job of his teacher). Your job is to be calm, firm and really understanding about the fact that he hates when you have to go.

It may be worth reflecting to see if there is anything different about yourself, your son, or the circumstances, that makes this a harder process than with your other three children.

This may help you find the clue and the resolve necessary to deal with this situation.

So, remembering that he is only three, it is still worth showing him that you can understand that it might feel a bit scary, or a bit upsetting, that you have to go each day. Then you can remind him of how well he copes every other day, and reassure him that you will always be there to pick him up (assuming that is that case).

Sometimes it is our belief in our child's ability to cope that, when it shines through, helps them to develop the same belief in themselves.

If you have any parenting queries for David Coleman, please email dcoleman@independent.ie. Please note that David cannot enter into individual correspondence

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