Thursday 18 July 2019

Raising children in an age of anxiety

'Safe space' or 'tough love'? Parents of anxious children face a difficult - and delicate - dilemma, write psychotherapist Stella O'Malley

'When a child learns to overcome their anxiety, a positive circle can begin'
'When a child learns to overcome their anxiety, a positive circle can begin'
Stella O'Malley

'Mammy, my tummy hurts, I don't want to go," says your little girl, giving you her most pleading eyes. Outwardly, you assume a cheerful tone: "Go on in - I'm sure you'll feel better soon!" But inwardly you grimace: "Am I doing the right thing? Should I let her stay home with me? Am I underplaying this issue or am I blowing it out of all proportion?"

Every day, all over the world, parents of anxious children agonise over these questions - should the parent force the anxious child to join in, knowing that, once they start, they're generally OK? Or should they allow the child stay in their comfort zone, feeling safe and secure but missing out on all the fun that makes for a happy childhood?

Of course, there is no simple response - one day, reassurance will work and they'll trot in happily; another day, a determined order works better, while yet another day, gentle cajoling is what gets the child over the line. But, ultimately, over the line the child must learn to go. For if the child is allowed to stay in their comfort zone every time they feel fear, then the parent is in danger of providing short-term comforts that may lead to long-term difficulties.

Far better to support your child as they learn to confront their inner demons than inadvertently communicate the message that they can't handle their fears. As the author Andrew Solomon tells us, "If you banish the dragons, you banish the heroes." Children will benefit more if parents can help them to confront their fears and overcome them; in this way their children will, in time, have more strength to slay future dragons.

Many loving parents bite their lip and hope that with enough love and kindness, the problem will simply go away. But sometimes it is more helpful - and honest - if the parent admits that there is a problem here that needs nipping in the bud.

When the child learns to overcome their anxiety, a positive circle can begin. This means the child learns that, with support, effort and determination, many obstacles can be overcome and so the next time they're faced with an obstacle, the child will be more willing to put in the effort required.

On the other hand, a negative circle can also be created where the child is allowed to believe that they can't do certain achievable things, and then they presume that there are other things that are unsurpassable and they become more easily defeated by life's difficulties.

When we feel highly anxious, our brains are flooded by chemicals and our emotional brain runs the show. The amygdala in the brain is activated and it immediately prepares us for a 'fight', 'flight' or 'freeze' response. The brain is made this way so that we can handle sudden attacks. Unfortunately, our brains can't distinguish between a real attack and an anxiety attack and so children who feel anxious can be overwhelmed by chemicals flooding their brains. At this point, the more logical part of their brain - the prefrontal cortex - is put on hold while their body gears up for the attack.

If you can somehow penetrate the wall of emotion and activate the child's rational brain, then the flooding feeling will start to subside and your child will begin to think more clearly. The more the child becomes aware that anxiety skews their thought processes, the better they will be able to handle their fears, and so it is important that the parent takes the time to educate their child about anxiety. Parents can explain that the reason why their heart pounds, their hands get clammy and they feel light-headed when they are panicky is because their body's resources are flying towards their arms and legs in preparation for this non-existent attack.

Sadly, anxiety is the most common mental health issue in Ireland today - it is now even more common than addiction or depression and, in my work as a psychotherapist, I see variations of anxiety ruining people's lives every day.

Indeed, this era is often described as 'the age of anxiety', as there is an undercurrent of pressure and tension ever-present in our busy culture that is leading to many of us feeling tense and anxious. The reasons are many but the consequences are stark: more children than ever before are becoming consumed by anxiety and panic.

So, what can parents do to help their anxious child? A combination of empathy, gentle humour and calm logic can penetrate the heightened emotions. While many kids find that talking through their worries with an understanding listener can be very helpful, on the other hand, other kids benefit from a more physical approach such as using distraction or deep breathing to help calm their jangled nerves. Whatever works is fine, and don't be afraid to use light humour in a bid to overcome anxiety - indeed, giving your worries a funny name is a well-known therapeutic technique that keeps the emotion in its place, e.g. "My gremlins are bothering me again."

It can be helpful for kids to have a personal checklist that they can use whenever they feel threatened with questions such as: "Am I in danger? Am I worrying needlessly? Am I ruining my fun? What will help me right now?" Parents need to teach their child that in this life, things will inevitably go wrong, and it is more useful if we can learn ways to cope with this. Some children find that writing worries down can be very helpful. Keeping a 'worry book' and then each night operating a tick list to track whether their worries were exaggerated or accurate, and to what extent their worries impacted on their feelings of joy, can also be very effective.

More than anything else, the authentic connection between the parent and child during the time of crisis can create feelings of solidarity and courage between the two. During her acclaimed TED talk, research professor Brené Brown pointed out: "The truth is, rarely can a response make something better - what makes something better is connection." Genuine connection sends the message that we are not alone and that we are valued; the good news is that if parents can connect with their child in an authentic manner, the rest will often follow.

Stella O'Malley is giving a series of public talks in April and May; see for details. Her new book about bullying will be released by Gill in August

Do's and Don't of handling anxious children

1. Do stop reassuring your child. When your child is panicking, their brain won't process your calm reassurances. As a parent, you can instead connect with them by genuinely reaching out and communicating that you understand they are deeply distressed and that you are willing to help them in any way that works.

2. Don't avoid everything that causes anxiety. If your child tries to convince you that the only way to calm their fears is to avoid them, then you can point out that this is a false solution because there will be similar challenges tomorrow, and the day after that, and so a true solution is required.

3. Do listen fully to your child and allow them to worry. Many children find it helpful if they are allowed a specific 'worry time', when they can release all their worries to you, to their teddy or by privately writing them in a journal. Worrying comes naturally to them anyway, but 'worry time' is time-limited - perhaps to 10 or 15 minutes per day - and it allows the child to stay in touch with their feelings without giving these emotions free rein.

4. Don't dismiss their worries. Anxiety is a self-protective mechanism that rings an alarm in our system so that we can immediately prepare ourselves for danger. Children worry when they feel threatened on some level, so perhaps you can make your child feel safer in other parts of their life?

5. Do guide your child towards deeper self-knowledge by teaching them how to become a 'thought detective'. After an anxiety event - maybe while relaxing with your child at the end of the evening - be sure to explore the reasons for their worry so that your child can learn to notice certain triggers and patterns that tend to set them off. Suggest to your child that they should think like a detective about their worries and encourage them to spend some time exploring the pattern of events.

6. Don't be dismissive of seemingly simple techniques. Although many adults may look askance at certain strategies such as the 'worry plaque', deep breathing, distraction, mindfulness CDs or fidget cubes, they often work. However, there is rarely just one solution and it is much more likely that a combination of solutions will help your child.

7. Do challenge black-and-white thinking. While bland reassurances might not work, neither does allowing your child to catastrophise a situation. If they become nervous before school, then gentle but continuous challenges to their random fears may help them. Accuracy is the main goal and it is helpful if your child can learn to understand this.

8. Don't minimise their fears. Treading the fine line between connecting with the child, challenging catastrophic thinking and, at the same time, not dismissing or minimising the child's fears is difficult - but it is essential if the child is to move away from being stuck in anxiety and panic. It takes time and much practice but it'll be worth it in the long run.

9. Do create mini-goals to get closer to the bigger goal. For example, some children might always feel frightened at night and come in to their parents' bed for comfort. Ultimately, the child needs to learn to self-soothe and if the parent becomes the only person who can soothe the child, then the parent is allowing their child to give their inner power away. By establishing mini-goals, the child might initially agree to have their story in their own bed, then the child might be willing to stay for an hour in their own bed; after that, they might be willing to return to their bed in the middle of the night and, ultimately, they might learn to stay in their own bed. The child can repeat each step until the exposure becomes too easy: that's the sign that they are ready to move to the next rung on the ladder.

10. Don't forget to empathise with your child. Take some time to feel what it is like to walk in your child's shoes, and communicate that you understand their distress. This will deepen the bond between parent and child and ensure that the child emerges from their anxiety with more strength and courage.

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