Is your child described as a worrier? Do you often hear the phrase ‘but what if…’ Maybe you are here because your child's anxiety and worries are stopping them from being able to enjoy the things they used to. Here are some top tips from a Clinical Psychologist at The Lotus Psychology Practice, based on principles from Cognitive Behavioural Therapy.
We all feel anxious at times, whether this is before an exam or an interview or because of challenges in our personal lives and relationships. But in some cases, the worries persists, and take us away from the things in life that are important to us. Perhaps your child’s worries mean that they are missing out on sleepovers with their friends, going to parties or even attending school. Anxiety disorders are the most common mental health problem for children and young people, affecting 6.5% of young people (Schwartz et al., 2019). Below are examples of anxiety disorders from the International Classification of Diseases-11. If any of these sound familiar, keep reading for top tips on how to help you manage your child's anxiety.
Separation Anxiety | Your child may become extremely distressed when separated from you. They may struggle to be left at nursery or school, or have difficulty sleeping if you are not present. They may express worries that something bad will happen or they will be hurt if you are not present. |
Specific Phobia | An excessive fear that leads to avoidance or distress when facing a particular place or object. Common phobia’s may be spiders, dogs or injections. |
Social Anxiety Disorder | A fear of doing something embarrassing or being judged by others that can lead to avoidance of social situations, like parties or restaurants. Your child may struggle in social settings or participating in lessons. |
Generalised Anxiety Disorder | Your child may display excessive worries about lots of things, like school, friendships or bad things happening to the world or people they love. |
Panic Disorder | Your child may experience frequent and unexpected panic attacks, described as periods of intense fear, bodily symptoms or sense of losing control. |
Selective Mutism | Consistent selectivity in speaking, in spite of language competence. They may remain silent in school, but display age appropriate language skills at home. |
Tip #1 - Learn about Anxiety
An important first step in managing anxiety, is to understand why we feel anxious. Anxiety is a self-protective system designed to help us survive. We need our anxiety system: when we’re crossing the street and we sense a speeding car approaching, our anxiety system gets us out of the way and to safety. In our brain, an area called the amygdala sets off an alarm system in response to perceived danger. The Fight, Flight, Freeze response is our body's call to action, and when activated, our brain diverts blood and oxygen to our muscles to help us evade danger quickly. This response leads to the symptoms of anxiety: hyperventilating, which makes sure we get oxygen into our blood stream, pulse racing, which makes sure the blood gets around our body quickly, and butterflies or nausea as our body diverts blood away from digestion.
In anxiety disorders, our alarm system is overactive, setting off false alarms in our amygdala, whether this is to putting our hand up in class, giving our order in a restaurant, or spotting a harmless spider. It is important to recognise our brain’s false alarms, to understand that we are not in danger. The next task is to recalibrate our false alarm system.
Tip #2 - Face the Fears!
When our alarm system goes off, it makes sense that we want to 'escape' that situation. This may result in avoiding situations, such as not going to a friends party or walking on the other side of the road when a dog walks past. This may resolve the issue in the short term, but this response feeds the anxiety and keeps the anxiety going in the long run, as we never learn that the alarm system was false. We know that worries won’t go away, unless we begin to face our fears.
However, for a young person that might have a phobia of spiders, holding a tarantula tomorrow may be far too overwhelming to their brain's alarm system! It is important that fears are faced in a gradual way. Together with your child, you might design a step ladder.
At the bottom of the ladder, think of easier fears to face, and gradually work up the steps, increasing in difficulty as you go. Some examples may be ordering food in a restaurant, putting their hand up in class or taking a short trip on public transport. It is important that those fears are confronted gradually, with lots of praise and encouragement given at every stage!
You may think with your child about small rewards for each step to help motivate them when their anxiety kicks in, during this process.
Tip #3 - Reducing Reassurance
When your child is feeling anxious, they are likely to turn to you for help or reassurance. This may involve asking you lots of questions, or asking the same question over and over again. This can become exhausting and you may find that once you solve one worry, you get another 'but what if...' . Giving your child reassurance may help in the short term, but in the long term it feeds your child's anxiety, as it sends the message that there is danger to be protected from and that the alarm system was correct.
For example, Jenny might have a spider phobia. Every time she sees a spider in her room, or on the TV, she might become really anxious and upset. Her parents understandably do not want Jenny to be upset, so they change the TV channel, or remove the spider from her room. This reduces Jenny's distress in the short term, but it never allows her to learn that nothing bad will happen if she faces her fear.
Together with your child, you might develop a plan to reduce the reassurance. Empathic and encouraging responses like "I can see you're really worried, I think you can do this, I was so proud of you last week when you managed to look at a picture of a spider" rather than "don't worry, it's all going to be ok". Many parents have tried to reduce reassurance-seeking, but when their child is very anxious or they are in a rush, they may resort to reassurance. Consistency is key to this tip. With inconsistent reassurance, your child has learned: “If I really keep going, and ask enough times, eventually I will get the reassurance I need”, which ultimately reinforces the anxiety!
Tip #4 - Worry Time
Try to set 'worry time' with your child: 15 minutes every day when they can write down or talk about their worries. Perhaps you could decorate a special 'worry box', and every time a worry pops in their head during the day, they can be reminded to write it down and put it in the box until worry time.
Tip #5 - Distraction
Distraction can be a powerful tool to help to re-focus your child's mind away from the worried thoughts or anxious body symptoms as a result of the faulty alarm. You may write a list of distraction tools together and put them into a jar for when they need them. This may include, listening to music, watching a film, reading a book or star jumps!
What are 5 things you can see? Colour, light and texture.
What are 4 things you can feel? Sensations on your body, the chair under your legs, your clothes on your body.
What are 3 things you can hear? Sounds close and far.
What are 2 things you can smell? Notice any smells in the air. Perhaps there is freshly cut grass or cooking smells coming from the kitchen.
What is 1 thing you can taste? Pop a small snack in your mouth and concentrate on the flavours and textures
Tip #6 - Relaxation
Relaxation and breathing exercises sends a signal to the alarm system in the brain that there is no threat. The below video may be helpful:
Tip #7 - The Worry Tree
The worry tree can be a helpful tool for worries about current problems, and also the hypothetical, 'what if' worries.
The first step is to notice the worry and ask if there is anything that can be done about this worry NOW.
If, no, and the worry is a what if, or hypothetical worry:
- Let the worry go or postpone your worry until later.
- Change your focus of attention - use distraction or relaxation
If the worry is a current problem: Make an plan:
- What to do
- When to do it
- How to do it
It is important to seek support if your child's anxiety is causing disruption to their life. You can contact your GP for advise and support. Alternatively, get in touch with us at The Lotus Psychology Practice to arrange an initial consultation with a Clinical Psychologist.
References and Resources:
Schwartz, C., Barican, J. L., Yung, D., Zheng, Y., & Waddell, C. (2019). Six decades of preventing and treating childhood anxiety disorders: a systematic review and meta-analysis to inform policy and practice. BMJ Ment Health, 22(3), 103-110.
Creswell, C., & Willetts, L. (2012).Overcoming your child's fears and worries. Hachette UK.
Kennerley, H. (2014).Overcoming anxiety: A self-help guide using cognitive behavioural techniques. Robinson.
ThinkNinja: a mental health app designed for 10 to 18 year olds. Using a variety of content and tools, it allows young people to learn about mental health and emotional wellbeing, and develop skills they can use to build resilience and stay well.
Thrive: helps you prevent and manage stress, anxiety and related conditions. The game based app can be used to relax before a stressful situation or on a more regular basis to help you live a happier, more stress-free life.
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