Sunday, 18 November 2012

Anxiety in Children: How Parents Can Help


Courtesy of www.kathyeugster.com

What is Anxiety?

Anxiety is a normal emotional state that we all experience at various times in our lives. It is closely related to fear, which is another normal and necessary emotion that everyone experiences. We need to be fearful of certain situations in order to protect ourselves from danger. Some words used to describe different states of fear include frightened, scared, afraid, panicky, and terrified. It is normal and beneficial for a person to experience fear when faced with real and immediate danger, for example when being chased by a dangerous animal.
Anxiety is usually associated with anticipated fear of something happening in the future. Some words used to describe different states of anxiety include worried, concerned, anxious, nervous, tense, shy, and cautious. Anxiety is normal and beneficial when we are faced with a difficult situation. For example, it is normal for us to feel anxious before a test or speaking in front of a group of people, and our anxiety helps us to prepare for the difficult task.

Anxiety Can be Overlooked in Children

Children experience various states of fear and anxiety from the moment they are born. Sometimes it is easy to tell if a child is anxious by their crying and clinging behaviors. But sometimes, it is difficult to identify anxiety in children. Some children hide their anxiety because it is too difficult for them to express it to others. Some children turn their anxiety into angry tantrums or defiant behaviors.

Sources of Anxiety in Childhood

Some children are born with an anxious temperament and seem to be anxious of many situations right from the start. It is believed that up to fifteen percent of infants are born with a more anxious temperament.
There are developmental sources of anxiety throughout childhood as well and all children experience fears and worries as part of their normal development. Most young children experience fears of the dark, monsters, separation from parents, animals, and strangers. As children grow, these fears gradually change to fears about social acceptance, academic and sports achievements, health, mortality and family.
Other sources of anxiety for children arise from normal life and family transitions. Children go through many changes and transitions as they and their families grow and mature. For example the birth of a sibling, starting school, moving to a new home, death of an elderly grandparent, becoming accepted by a peer group, and mastering tasks in and out of school can all be stressful and anxiety-provoking for children.
In addition, difficult or even traumatic events that are out of the ordinary can happen to a child with the likelihood that anxiety will increase for that child. For example, parental conflict and separation, illness or injury of the child or the child’s family members, the unexpected death of a close family member, extended separations from parents, family or community violence, and natural disasters are all difficult and sometimes traumatic experiences for children to go through.

How to Identify Children Who May Be Struggling With Anxiety

Children struggling with excessive anxiety may show the following:
  • Pessimism and negative thinking patterns such as imagining the worst, over-exaggerating the negatives, rigidity and inflexibility, self-criticism, guilty thoughts, etc.
  • Anger, aggression, restlessness, irritability, tantrums, opposition and defiance
  • Constant worry about things that might happen or have happened
  • Crying
  • Physical complaints such as stomachaches, headaches, fatigue, etc.
  • Avoidance behaviors, such as avoiding things or places or refusing to do things or go places
  • Sleeping difficulties, such as difficulty falling or staying asleep, nightmares, or night terror
  • Perfectionism
  • Excessive clinginess and separation anxiety
  • Procrastination
  • Poor memory and concentration
  • Withdrawal from activities and family interactions
  • Eating disturbances

Impact on the Family

Overly anxious children can have a negative impact on the family. Highly anxious children can be demanding and can become very emotional if things don’t go the way they want. Parents can become confused about how firm they need to be with limits and if they should give in to the child to avoid emotional outbursts.

When Does Anxiety Become a Problem for Children?

When a child is very young, normal fears can be accepted. However, as a child grows, fears and anxieties that were considered normal at a younger stage of development may be less appropriate.
Some indications of excessive anxiety in a child include fear that is out of proportion to the actual threat in the environment or anxiety that is excessive for an anticipated future event. Also, children struggling with too much anxiety will often have difficulties in settling back to a normal state.
Anxiety becomes a problem when it prevents children from enjoying normal life experiences. For example, when anxiety begins to have an impact on school, friendships, or family, then parents or other adults may need to step in to help the child.

How You Can Help Your Anxious Child

Anxious children can benefit a great deal by support from their parents. The following tips will provide you with some ideas for helping your anxious child.

Routines and Structure

Establish consistent daily routines and structure. Routines reduce anxiety and regular daily patterns emphasize predictability. A regular routine will give a sense of control to both parent and child. Anxious children do not cope well with a disorganized, spontaneous family life style.
Take care of the basic needs of your child, especially to prevent fatigue and hunger. Establish a regular bedtime routine consisting of quieter activities (e.g. bath, reading with parent, talking with parent), which helps your child to gradually relax.
Provide opportunities for exercise. Exercise is helpful in relieving stress and helping your child’s body to relax.
It is important for children to have limits set and consequences for breaking the limits. Children feel secure when there are limits setting restrictions on inappropriate behaviors.

Help Children Identify Feelings

Help your child notice different feelings by naming various feelings she or others may experience. Explain how people show their feelings (through faces, bodies, words) and that showing your feelings is an important way for others to understand how you are feeling. Help your child notice how different feelings “feel” in his own body, for example tight hands, butterflies in stomach, etc.

Provide Opportunities for Communicating About and Feelings

It is helpful for children to talk about their feelings, however talking about feelings is not easy for children, especially when they are asked directly. It is important for parents to watch and listen carefully for the times when a child does express feelings, either directly through words or indirectly through behaviors. At these times, you can help your child by acknowledging and accepting her feelings through simply reflecting them back to her and refraining from providing advice or asking questions. When a child’s feelings are criticized, disapproved of, or not accepted by a parent, his internal sense of self is weakened.

Provide Soothing and Comforting Strategies

Comforting and soothing a child are very helpful strategies that parents can use in relieving anxiety. These strategies communicate to the child that she is safe and cared for. Verbal reassurances of safety and love, rocking, cuddling, holding, massage, singing, and telling stories are just some of the soothing and comforting strategies that parents can use. Parents may be surprised to realize that children may sometimes need comforting and soothing that seems to the parent to be too “babyish” for the child’s age. However, anxious children do need extra soothing experiences that relax and relieve the tension in their bodies.

Respect Your Child’s Fears

Children are generally not helped when parents tell them to stop being afraid of something. What is helpful to most children is an approach in which you acknowledge their fears and at the same time let them know that you will help them overcome these fears.

Model Brave Behavior

Children look to others for guidance on how to respond in unfamiliar situations. They usually watch for cues from their parents and use these cues to help determine if the situation is safe or not. If the parent’s response is fearful or anxious, the child’s response is also likely to be fearful or anxious.
Although it is important for parents to model appropriate cautionary and safety behaviors when appropriate, it is important for parents to act as confident and brave role models as well. If a parent is overly anxious and over-protective, this anxiety can be easily communicated to a child with the accompanying message that the world is too dangerous. As well, the child also receives the message that he is incapable.
Parents need to acknowledge and understand their own anxieties and make an effort to contain them when appropriate in the presence of their children. Sometimes, parents need to act brave even if they don’t feel brave. An important and helpful message for an anxious child to receive from a parent is that the parent has confidence both in the child and in the situation.

Encourage Brave Behavior

While children are generally not helped when parents demand that they face their fears all at once, they are helped when parents can gently encourage them to approach feared situations. This is because exposure to feared situations leads to desensitization and reduction of the fear and anxiety.
However, approaching feared situations can be difficult for anxious children since they would rather avoid them. One way of helping a child approach a feared situation is to go about it in small steps so that each step is achievable and gradually becomes a little more difficult. Another important strategy for parents is to reward a child for trying to approach a feared situation. A child will also find it helpful to be reminded that the fear will get smaller over time. In addition, children can be reminded of fears and difficult situations that they have overcome in the past.

Teach Relaxation Skills

Learning relaxation skills will help children feel better when they are anxious, worried or scared. It will also help them learn that they have some control over their own bodies rather than being controlled by their anxiety.
One way to help your child relax is to encourage slow, deep breathing. You can help your child practice this by getting her to imagine slowly blowing bubbles. Another way to relax is to ask her to alternately tense and relax her muscles. Additionally, some of the soothing and comforting strategies outlined above work very well to relax children.
You can also help your child use his imagination to relax. Help your child to imagine a safe and relaxing place and to notice the good relaxing feelings in his body. Or, have him imagine a container (such as a big box) to put his worries in so they are not running wild in his mind and bothering him when he needs or wants to be doing other things.

Encourage “Feeling Good” Activities:

When children are anxious, encourage them to engage in activities they enjoy such as playing with a favourite toy, doing a fun art or craft activity, doing something active outside, playing a game, reading a book, or playing with friends. Children will often need the assistance and attention of their parents to engage in these fun activities if they are anxious.

Storytelling

There are many children’s books available that deal specifically with anxiety, fears and worries. These books can be very helpful for children as the stories will often model various ways of coping with fears and anxiety. When searching for books, use keywords such as anxiety, worry, fear, scary, scared, shy, etc.

Teach Problem-Solving Strategies

Help your child with their worries and problems by teaching them how to problem-solve by defining the problem, brainstorming all possible solutions and their consequences, and choosing the best solution.
Be aware, however, not to jump in too early to help “fix” your child’s problems. Remember to give your child lots of time to express his negative feelings around worries and problems first where you are just listening and acknowledging feelings before helping him to figure out a solution.

Challenge Unhelpful Thoughts

Help your child to understand that the negative and pessimistic things she says to herself about herself are not helpful and can influence how she feels and behaves. For example, thinking (or saying), “I’m so hopeless, I’ll never do it,” can make her feel angry, hopeless, sad and ultimately even more anxious.
By changing the unhelpful thoughts with more helpful and positive thoughts, for example by saying or thinking, “If I keep practicing, I’ll get better,” or “Even if I make a mistake, I can learn and do better the next time,” your child’s anxiety levels will be reduced.
Again, remember to allow your child lots of time to express her negative thoughts around worries and fears first before helping her to figure out more helpful ways of thinking about the situation.
Copyright Kathy Eugster, 2007. All Rights Reserved.

Kathy Eugster, MA, RCC, RPTMA, Counselling PsychologyRegistered Clinical CounsellorRegistered Play TherapistChild and Family Counsellor

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