Natasha Daniels, Child Therapist & Creator of AnxiousToddlers.com
Worrying is carrying tomorrow’s load with today’s strength- carrying two days at once. It is moving into tomorrow ahead of time. Worrying doesn’t empty tomorrow of its sorrow, it empties today of its strength.
-Corrie ten Boom
Parenting Anxious Kids: Support, Guidance & Survival Tips Page 1 This E-book is for educational purposes and in no way should replace the advice of a medical or mental health professional.
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Parenting Anxious Kids: Support, Guidance & Survival Tips Page 2 This E-book is a compilation of over fty articles originally published on AnxiousToddlers.com. This book was designed to provide these articles in an easy and printable format.
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Parenting Anxious Kids: Support, Guidance & Survival Tips Page 3 TABLE OF CONTENTS
Section 1: Parenting 008 How to Help a Child with Anxiety: 21 Things Every Parent Should Know 011 The Best and Worst Parenting Styles for Anxious Children 017 How to Help an Anxious Child Who Obsesses About Time 023 4 Ways to Handle People Who Don’t Get Your Anxious Child 027 How to Teach Your Kids to Beat Anxiety 031 Want to Help Your Anxious Child? Avoid These 9 Mistakes 036 How to Deal with a Child Who is a Perfectionist 039 When Parenting an Anxious Child, Avoid These 9 No-Nos 044 The One Thing Every Kid with Anxiety Should Be Doing 048 What to Do When Your Child is Suffering from Panic Attacks 055 How to Calm First Day of School Worries 058 15 of the Best Coping Mechanisms for Kids 063 5 Ways Caring Parents Make Teen Anxiety Worse 068 How to Stop the World from Crushing Your Sensitive Children 073 4 Things Parents Get Wrong About Childhood OCD 077 Can You Tell the Difference Between Fear and Anxiety?
Parenting Anxious Kids: Support, Guidance & Survival Tips Page 4 082 8 Things Every Parent Should do When Traveling with Anxious Kids 089 Child Therapist’s Top 5 Things Parents Should Do with Anxious Kids 093 How to Find a Good Child Therapist 099 Is Your Child Scared of Sleeping? 5 Things You can Do to Help 107 Did you Know That Play Can Help Your Child’s Fears? 114 Are Your Child’s Worries Making Them Sick? Are You Feeding Your Kids the Right Food to Help Anxiety? 120 Tired of Meltdowns? Create a Break Tent! 125 Parenting Lessons Only Your Anxious Kids Can Teach You 129 How to Help Your Anxious Kids When Bad Things Happen in Our World 135 If You have a Child with Anxiety: You Should Know These 5 Things 140 My Stomach Hurts. I Can’t Go to School. 145 20 Tell-Tale Signs You Parent an Anxious Kid 148 5 Tips on How to Parent a Child with OCD 153 5 Ways to Help Separation Anxiety and Pee in Peace! 158 Teach Your Child to Fight Anxiety 162 10 Strange Reasons Why Kids Hate Bath Time
Parenting Anxious Kids: Support, Guidance & Survival Tips Page 5 168 End Your Child’s Fear of the Dark with These 9 Sure Fire Tips Section 2: Diagnosing and Understanding Anxiety Issues 178 Signs of Selective Mutism: When it Isn’t Just Shyness 187 Do Your Kids Hate the Sound of People Eating? Misophonia Signs 196 13 Signs of Health Anxiety: Is it Beyond Sickness? 200 The Link Between Sensory Processing Disorder and Anxiety 204 30 Signs of Social Anxiety: When it is Beyond Shyness 209 The Link Between ADHD and Anxiety: Why it is Misdiagnosed 213 Are You Missing These 5 Uncommon Signs of Child Anxiety 217 Is Your Angry boy Really an Anxious Boy in Disguise? 222 Bedtime Battles or is it Bedtime Fears? Are you Missing the Signs? 229 OCD in Children: Are you Missing the Signs? 235 10 Signs of an Anxious Toddler Section 3: Holidays and Anxiety
Parenting Anxious Kids: Support, Guidance Page 6 241 5 Ways to Prevent Kids from Having Holiday Meltdowns 245 What to Do When Your Child is Scared of Halloween 248 Child Therapist’s Tips to Help Anxious Kids During the Holidays Section 4: Inside the Mind of Anxious Kids and Their Parents 253 My Double Life as a Child Therapist and Mother to Anxious Kids 258 Why the World Needs More Anxious Teens 261 To the Mother with the Anxious Child 263 Dear Mom and Dad, It’s Me – Your Shy Kid. 269 Dear Mommy & Daddy, From your Anxious Toddler 273 Dear Mom and Dad, It’s Me Your Anxious Kid.
Parenting Anxious Kids: Support, Guidance & Survival Tips Page 7 SECTION 1: PARENTING 21 Things Every Parent of Anxious Kids Should Know
As a child therapist who specializes in anxiety, I work with parents every week who have questions and misperceptions about anxiety. Anxiety can be confusing at times and being a parent of anxious kids can be exhausting! Parents want to know how to help a child with anxiety? I always start o with helping parents understand these 21 things.
Page 8 Below are 21 things every parent of anxious kids should know...
1. General Anxiety Disorder in children runs in families and has a strong genetic component.
2. Anxiety doesn’t have to be caused by trauma. Most often it’s not.
3. Your anxious children know their fears are irrational.
4. Anxiety doesn’t have to be triggered by anything. Just like Diabetes, kids can develop anxiety at any age.
5. Anxiety grows bigger when children avoid anxiety-producing situations.
6. Anxiety can make kids physically sick. Some physical anxiety symptoms include stomach aches, headaches and difficulty breathing. 7. Kids with anxiety are more likely to pull their hair out or pick scabs for no reason. 8. Anxiety in children under ten is common, in fact it can show up in kids as little as one or two. 9. When parents give in and let their anxious children avoid school continuously, they are more likely to be homeschooled eventually. 10. Anxiety is cyclical and can come and go over time. 11. Children with anxiety tend to be more emotionally intelligent. 12. Anxious kids tend to be better at reading social cues and body language. 13. Anxious kids spend much of their time thinking of “what if” thoughts. Page 9 14. Kids with worries are more likely to have a harder time with change. 15. Anxious kids are more likely to have heightened senses. 16. Young children with anxiety are more likely to be picky eaters. 17. Your anxious kids want to get rid of anxiety more than you know. 18. Anxious kids are less likely to face their fears if their parents don’t gently encourage them to do so. 19. Anxious kids can have panic attacks in their sleep. They do not have to be triggered by stress. 20. Intelligent kids can have worries that don’t make sense. Like a fear of sharks at the bottom of a pool. 21. Anxious kids don’t have to be a victim to their anxiety. With skills and tools, they can be empowered to crush their anxiety. ***
Page 10 The Best and Worst Parenting Styles for Anxious Children
[In this article, descriptions of the anxious children are a composite of the many anxious children I have treated] “No!” Your child screams. Her eyes wide and her pulse racing. You have seen her like this before. Her deer caught in headlights expression. She is paralyzed with fear. You are paralyzed with confusion. Should you make her? Should you give in to her fears? You second guess your next move. What will make this better, not just for today, but forever? This anxiety battle is draining and you don’t know how much more you can take. More importantly, you don’t know how much more she can take. How are you supposed to parent anxious children? Anxious children act in very similar ways, but parents come at it from all different directions. As a parent, what is your role in your anxious child’s battle? Are you to be a bystander, watching this beast overcome your child? Are you to be a protector, paving a path so your child feels no bumps? Or are you to be a coach, training your child for every battle, gearing them up to win the war? Some parenting styles will exacerbate anxiety and some will help conquer it. Let’s talk about each style and what it does…most of us are a little bit of each of these at times.
Page 11 TheParental Bystander Not everyone gets anxiety. Maybe you don’t get it. Maybe your partner doesn’t get it. Usually, I meet these parents in my o ce due to parental frustration. He just won’t listen. He refuses to do things, even when we threaten to take everything away.
Page 12 She just won’t sleep. She is lazy and doesn’t want to go to school! The parental bystander raises their anxious child just like their other kids. They use discipline and consequences to address their child’s behavior. If their child won’t go to sleep, there will be consequences. If their child is afraid to do something, they will force them to face their fears. This can be done out of love and concern. I don’t want my child paralyzed with fear! This can be done out of fear. What if they turn out like me? What if people make fun of him? This can be done out of ignorance. It’s not anxiety. He’s just being stubborn. Carter: Carter refused to go to bed. He would beg to sleep in his parent’s bedroom. They adamantly told him no. He would constantly get out of bed and check on them. Usually, around 1 or 2 am, Carter would make his way to their bedroom. Often at that point, they were too tired to ght any longer. Carter became a permanent fixture in their bedroom. Carter’s parents were fed up with his behavior. They told him that if he came into their bedroom in the middle of the night, he would lose all electronics for a week. Carter perpetually lost his electronics. It made no di erence. His parents tried shouting at him. It didn’t help. They grew angry and resentful at Carter. Nothing was working.
Page 13 The Problem Regardless of what drives this parenting style, one thing is for sure, it doesn’t work. You cannot discipline anxiety out of your child, it simply doesn’t help. Without giving your children the tools to ght their anxiety, you are essentially throwing them into a pool without swim lessons. The Parental Protector It can be so hard to watch our children struggle. We want them to be happy, so when they aren’t it can be very unnerving. The parental protector wants to ght this anxiety battle for their child. They want to cocoon them from the bumps of life and rid them of any anxiety-producing situation. Mandy: Mandy started to have anxiety when she entered junior high. She was twelve and it hit her like a ton of bricks. What was once a happy, easy going child was now an anxious wreck. Her parents didn’t know what happened. Mandy started to worry about throwing up at school. She saw someone throw up at the beginning of the year and it consumed her thoughts. She felt nauseous in the mornings and was convinced that if she went to school, she’d be sick. Her parents watched her struggle and wanted to help. They let her stay home when she felt sick. They had the doctor run all sorts of tests on her. They found no medical origin for her stomach issues. Her mom went to the school and had lunch with her each day. No matter what they did, it never seemed like enough. Mandy wasn’t getting through the school day. She was living at the school nurse’s station and they had her mom on speed dial. When I met Mandy and her family, they were considering homeschooling. They felt like they were out of options.
Page 14 The Problem Even though Mandy’s family was extremely empathetic to her struggle, they never gave her the tools to ght her anxiety. Mandy and her family inadvertently gave anxiety what it loves the most – avoidance. As Mandy avoided situations, her anxiety grew. Mandy needed tools. Mandy needed armor. Mandy was waving the white flag before the battle even begun. The Parental Coach When I met Carter and Mandy’s parents they were both distraught. How were they supposed to help their children? Why was nothing working? I helped shift their perspective. To beat anxiety, you must understand anxiety. I taught them how to recognize anxiety’s hidden symptoms like irritability and opposition. I taught them about anxiety’s physical symptoms like nausea and the constant fear of throwing up. They learned how to detect their child’s anxiety themes. Carter’s parents discovered that he was afraid of dying. He went to bed each night convinced that someone was going to break in and kill his family. By the time his parents put him to bed, his heart was racing and he was prepared for battle. No amount of punishment was going to penetrate that fear. Mandy’s parents learned that she had one of anxiety’s most common themes – fear of throwing up. They learned that her anxiety wants her to avoid. The more she avoided, the more her anxiety grew. They realized by enabling her ability to avoid, her anxiety had grown worse. Moving from Empowering Anxiety to Empowering Their Child Carter’s parents were no longer angry at him. They wanted to help him, but they needed to learn how. They stopped punishing him and started working on his anxiety.
Page 15 They learned that Carter worried often, but had kept it to himself. They taught Carter how to defeat his anxious thoughts and stop them from spiraling out of control. Carter became more open about his worries because he felt his parents nally “got” his anxiety. When Carter had an anxious thought his parents helped him work through it. Carter’s parents set up small anxiety “challenges” where he learned how to face his fears one small step at a time. Carter started to feel empowered and his parents finally felt some hope. *** Mandy’s parents also learned about anxiety. They stopped trying to gure out why Mandy was afraid of throwing up and focused on giving her the tools to defeat it. They started to understand that anxiety doesn’t have to make sense. They taught Mandy that the more she avoided anxiety-producing situations, the stronger her anxiety would get. They taught her how to tackle her anxious thoughts and armed her with techniques to decrease her anxiety. Mandy’s parents also set up anxiety challenges for her. They started o small. She was afraid to eat at restaurants. She was afraid to sleep over at a friend’s house. They tackled these fears one by one. As she got more empowered, she started to feel hopeful that she could go back to school. *** Anxiety can be devastating. As parents, we are often confused about what our role should be. We often haphazardly fall into the bystander or protector role. Anxious children will ourish when their parents take on the coaching role. Fighting anxiety can be a lonely, overwhelming experience. Children need us to train, cheer lead and encourage them throughout their ght. We need to celebrate their victories and pick them up when they are defeated. We can’t ght this ght for them, but we can certainly be by their side. Page 16 How to Help a Child Who Obsesses About Time
I watch my seven-year-old son wring his hands. “But I am not going to have enough time!” He cries. He just got home from school. “Time for what?” I ask. “Time to play outside. Time to play on my tablet. Time to eat a snack…” He rambles on. He has four hours until bedtime. He has nowhere to be and a ve-minute worksheet to complete. His worry is irrational. He constantly obsesses about time. And he is not alone, anxious kids pour into my o ce week after week complaining about the same thing – time.
Page 17 Time can be a big anxiety theme. As parents, this can be ba ing. “What’s the big deal?” You might wonder. They don’t have to juggle work and home responsibilities. Some kids just go to school, do homework and relax. But for some anxious kids, just the very idea of time is stressful. As we drive down the highway on a relaxing Sunday my son asks from the backseat, “How long will it take us to get home?” “I don’t know, maybe fifteen or twenty minutes,” I reply. “Is it fifteen or twenty.” He demands. “I am not sure,” I reply. His anxiety revs up as the questioning continue. He won’t stop. He will be relentless. He will insist on knowing how long it will take, even when we tell him we don’t know. Even when we tell him it doesn’t matter. We will eventually get frustrated and throw out a number. “We will be home in ten minutes!” We’ll spit out. Silence. But, just a brief reprieve. “We have eight more minutes to get home.” He nervously says. It is hard to not get frustrated with conversations like these. I have learned that I cannot say, “Give me a minute.” As I don’t want to have a dialogue about whether I mean sixty seconds or if I am not being literal. Yes, we have had a long discussion on what “literal” means. Anxious kids don’t deal well with ambiguities. Some like to prepare and plan for every minute of the day. Often this is happening inside their little minds and we, as parents, are clueless. Sometimes we are given a small peek into their world, especially when we are flooded with time-related questions.
Page 18 How often have you had to deal with questions like: How long will we be there? When will we go back home? How much time do I have? When are we leaving? I wish this was a stage. I wish this was something kids grew out of as they got older. But I am not naïve. I work with my son’s counterparts in my practice. From toddlers to teens, they xate and obsess about time. “What are we doing next?” The anxious toddler wants to know. “When will I get to relax and watch YouTube?” The teen laments. Worries about time have nothing to do with age. So, how as parents are we supposed to help an anxious child who obsesses about time? Here are some tips straight from the trenches: Let your child know what is happening next. Some anxious kids struggle with time because they want to prepare. Anxious kids tend to be preparers. And frankly, there is nothing wrong with that (said the anxious adult planner)! You can alleviate some of your child’s anxiety by getting into the habit of stating what will be happening. I have a huge calendar in my kitchen that has all activities and events for the month on it. I see my son standing in front of it quite often. He also asked for his own calendar in his room. I watch as he marks o each day as he goes to bed.
Page 19 This structure and routine reduces his anxiety. It lets him know what is coming and how to prepare. Many anxious kids don’t like surprises and they do much better when they are able to mentally prepare for what is coming in the days and weeks ahead. Sudden changes, even when they are good changes, can throw an anxious kid into a tailspin. If your kids learn how to manage their time by using a calendar or planner, they will have the tools to reduce their own anxiety level. When your child worries about time, re- frame their irrational thinking. Anxious kids can have a skewed view of how much time they have available to them. Teens will tell me that they have so much work. They will spend tons of time worrying about how to get it all done, but ironically won’t even get started. Often I will have them write out what they need to do. We will also assign how much time each task will take. When teens write down everything they have to do and how long it will take, they see that they actually have more time than they initially thought. We will also use a large planner to break out their assignments into bite size pieces throughout the week. If they have to read a book, they can read one chapter a night. When it is reframed in that way, it doesn’t seem as overwhelming anymore.
Page 20 For my son, I explained to him that he has nothing BUT time. He anguished over the fact that he won’t be able to do every fun thing he wants to do in his head. I suggested that he pick one for each day and that way he wouldn’t feel rushed or disappointed. He developed a new love for backyard archery. I suggested that he does that maybe Monday and Tuesday. He talked about how his teen sister is nally showing him how to play Roblox on the computer. I suggested that they do that on Wednesdays. As I broke down each day for him, his face began to relax. As I teach him these mental skills, he will be able to do this for himself one day. Setting time limits can ironically help kids who worry about time. Many anxious kids worry about how much time they will have on their electronics. Anxious kids have a tendency to xate far more often than your typical kid and video games are the ultimate nemeses. “How long will I have to play my video games?!” Anxious kids wonder. This can impact absolutely everything else. “How long will homework take? Will it take my free time away?” This fixation can cause irritability, anger and huge meltdowns. For some kids, this stress is too much. Take my little munchkin. He would cry if I woke him up too late and he only had an hour to get ready for school. “It takes you ten minutes to get ready in the morning.” I would explain. “But, I want to go on my tablet.” Evenings weren’t much better. He would get upset when he had to do anything other than stare at that screen. Getting him to do homework was a challenge, getting him to come to the table for dinner was a nightmare and telling him it was time for bed was not for the faint hearted.
Page 21 This week I nally said to him, “This isn’t working out for you. You are stressed all the time.” And then I did the worst thing a mom could possibly do – I set limits. I told him that there would be no more electronics in the morning. I told him he would get one hour after school and then it gets put away. I explained that I loved him and that I didn’t want him to feel so stressed and overwhelmed all the time. And then he turned to me and gave me a hug and said, “Gee mom, thanks. I love you too.”No, just kidding! His head started to spin like Linda Blair in the Exorcist and horns came out of his head. He raged. He screamed. He called me names. I remained calm and told him that this was to help him. He negotiated. He asked if he could watch his tablet during breakfast. To give him some feeling of control, I agreed. But told him that he would have to be completely dressed and ready for school before that could happen. I also let him know that if it made him more stressed we would revisit this new plan. This morning I awoke to a dressed and happy little boy. The morning went smoothly and he had more than an hour to relax and “eat his breakfast.” He also seemed to accept his limited screen time in the afternoons. He talked about doing art and playing outside when he got home. Sometimes we need to save our anxious kids from themselves. Setting limits and time restrictions can help an obsessive child establish new boundaries and limits. Don’t hold your breath for a thank you anytime soon, but you will be repaid in fewer tantrums and hostility (eventually). Hang in there. We are all just trying to get through this one day at a time. If you have a child who worries about time, it isn’t going to change anytime soon (see what I did there). But, it doesn’t mean you can’t give them the skills to organize their life, plan out their responsibilities and set limits and boundaries (even if it is forced at first).
*** Page 22 4 Ways to Handle People Who Don't Get Your Child's Anxiety
“You just need to stop babying him!” “She’ll grow out of it. My kids did that too.” “She just needs a good spanking!” Sound familiar? These comments can make your blood boil – and they should! Unsolicited opinions are the worst. But sometimes they aren’t from strangers. Sometimes these comments can come from your closest friends, your aging parents or even your partner. Just because you are related, doesn’t mean they are instantly going to get your anxious child.
Page 23 So you have two options. Get furious and distance yourself from that person (super tempting) or put your anger in check and attempt to educate the ignorant. Sometimes you’ll spread a sprinkle of knowledge around and other times you’ll want to hit your head against the wall (Just keeping it real people). For those closest to your family, especially those that happened to be married to you, your anxious child deserves to be understood. So how do you explain your child’s anxiety to address those annoying questions and put people in check? Here is a good place to start: #1 Explain that Generalized Anxiety Disorder has a Genetic Component People don’t get that child anxiety has a strong genetic component. They whisper among themselves, why won’t her kid sleep on his own? Why does her kid cry all the way to school? Why does her kid have to know exactly what is happening every moment of the day? The answer is, there is no answer. Child anxiety can be physiological, which means there doesn’t have to be a why, and often there isn’t one. No one questions why a child has Diabetes or Asthma – and they shouldn’t question why a child has anxiety either. #2 Explain the Anxiety Symptoms Behind the Behavior Often people will see the negative or odd behavior, but won’t realize that the child’s anxiety is causing that behavior. Shed some light and understanding by decoding symptoms of anxiety in children for those who don’t get it. Most people don’t have anxiety on their radar and are shocked and apologetic when you explain your child’s behavior for what it is – anxious behavior.
Page 24 I nd myself doing this often for both my children and the children I treat in my practice. Recently I met with my youngest daughter’s teacher for a parent-teacher conference. She commented how cute it was that my daughter always wore this bowler hat to school. I explained to her that although it was a cute hat, she wore it because she is having social anxiety and it helps make her feel secure around her peers. This was eye opening for her teacher, as her anxiety is very subtle and her teacher had no idea that innocent behavior had anything to do with my child’s anxiety. By letting her know about the anxiety behind the behavior, she was able to see my daughter’s behavior in a new light and offer her more help. #3 Explain that an Anxious Child Can’t be “Cured” with Discipline People who are clueless about anxiety will often think it is a discipline problem. This has got to be one of the most frustrating assumptions people make about anxious kids. If my child is having an anxiety attack because they don’t want to be at the doctor’s o ce, my threatening to spank them isn’t going to help much at all. In fact, it will make it worse. Anxious kids need child anxiety treatment, not discipline. If you are afraid to y would it be helpful if the ight attendant came by and told you that they would be ning you every time they saw a nervous look on your face? I think not. Explain that to those loving, but ignorant friends and family members of yours. #4 You Don’t Have to Force Your Anxious Child to Do Things to Make Others Happy Do you cringe when you are at family gatherings? Do you feel like you have to force your socially anxious child to give hugs, make small talk and say a million thank you’s? You don’t.
Page 25 Don’t ignore your child’s anxiety to make other people happy. Beating anxiety takes time and your anxious child may not be up to the task of being fully submerged into an anxiety-producing situation. Even though it can be mortifying to have a child who won’t say “hi” back or won’t say a “thank you,” forcing them to say those things will make the situation so much worse. You can teach your child to smile or wave. You can have your child write a thank you card when they leave. You can give your child skills to handle those situations one step at a time. If you throw them into the water and just expect them to swim, they’ll drown – and they’ll want to avoid water for the rest of their lives. And my bet is there will probably be more family gatherings, right? Some People Just Aren’t Going to Get It or Your Anxious Child! Unfortunately, you’ll have to realize that some people just aren’t going to get it. It sucks, it really does, but it is true. Developing some tough skin seems to be par for the course when you have an anxious child. My children have had many teachers who have not gotten them or their anxiety. I have had to educate far too many pediatricians about behaviors that were part of anxiety. I have sat across the couch from many couples where one partner did not get their own child’s anxiety and had no learning curve on the matter. You can only do your part. Just like it will take time to defeat your child’s anxiety, it will take time for those around you to understand it. Hang in there. ***
Page 26 Teach Your Kids How to Beat Anxiety
It is bedtime. It is also time for the tears and fears. It is school time again. Welcome back stomachaches and tantrums. It is a party invitation. Here come the jitters and clingy hands. New classes and new seasons begin. Hello, late nights and self-doubt. Will your child ever beat anxiety? Anxiety is a beast. It is the silent presence in your family that is wreaking havoc and taking away happiness in its wake.
It doesn’t have to be this way. Parents don’t have to accept their fate and be a lifelong victim to anxiety – and neither do their kids!
Page 27 Teach your kids to ght back and beat anxiety. Teach them that they don’t have to be on the defensive, trying to keep their heads above water. Teach them that they can be on the o ensive, proactively taking the bull by the horns and telling anxiety who is boss! But how do you do this? First educate yourself on how anxiety works. The quickest way for parents to exacerbate their child’s anxiety is to not get anxiety. Anxiety doesn’t make sense. The more parents try to make rational sense of anxiety, the less they are getting it. If you want to help your child beat anxiety, learn what you are battling first. Develop a language about how you talk about anxiety. Anxiety needs to be talked about. If you sweep it under the rug, everyone will trip. Come up with a way to talk about anxiety. I am a fan of personifying anxiety and making it something the whole family is trying to battle. This helps externalize the problem. You are not trying to change your kids, you are trying to protect them from their anxiety dictator who is bossing them around. Understand your child’s particular fears and worries. So many times I work with families who don’t have a true grasp on what their child’s anxiety is really about. Learn what makes your child’s anxiety tick. Do they have anxiety themes that drive their worries?
Page 28 Teach your kids to ght their negative thoughts. All too often we teach kids to take deep breaths and to get their “minds o their worries” instead of teaching them how to defeat those thoughts. Distraction can only go so far. Parents need to go to the root of the worry and pull out that weed. If not, I hope you are a good gardener. Set up challenges to taunt anxiety. Anxiety feeds o avoidance. It loves when it is able to convince a child to not do something because of a fear or worry. Teach your kids that the more they face their worries, the smaller their anxiety dictator will get. Help encourage this by o ering challenge rewards when your kids ignore their anxiety and face their fears. As they do this, challenges will become easier and they will start to beat anxiety. Be proactive and keep an eye out for new worries. Anxiety doesn’t want to go away. Like a weed, it will go where you aren’t spraying. You think you beat anxiety and all the school fears. Hello, new worry about bugs. You think you tackled the whole bedtime issue? Hello, fears of getting sick. Anxiety is relentless and you should be too. Watch your kids and look for new signs of fears and worries. Dialogue about those fears early when they are tiny weeds. You can tell your kids something like, “It sounds like your dictator is bothering you again.” This helps them keep anxiety on their radar as well. The bad news is anxiety doesn’t just go away. The good news is, with your help, kids can beat anxiety and make it a little pest instead of a big beast. Page 29 Take the parenting E-Course: Teach Your Kids to Crush Anxiety to develop life long skills.
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Page 30 Nine Things That Make Anxiety Worse in Kids
Anxiety is draining. Don’t make anxiety worse. If you want to help your anxious child avoid these common mistakes. Are you in the throes of parenting a child with anxiety? If you are, then you know how completely exhausting and frustrating child anxiety can be. It can seem like anything and everything can make anxiety worse. Anxious kids are emotional sponges and are easily impacted by their environment.
#1 Punishing them for being afraid
Your kids refuse to go to bed. They think there is something under their bed. They think there is something lurking in their closet. They are convinced a bad guy is going to kidnap them.
Page 31 You are tired, frustrated and angry. You throw out threats in rapid spit re. They’ll lose TV. They’ll lose electronics. They’ll lose all privileges. But, NOTHING IS WORKING. In fact, it is getting worse. Threatening kids when they are anxious doesn’t work. If you were scared of heights and someone said they were going to take away your TV time if you didn’t jump o the high dive – would you? Probably not (unless you are a Netflix fanatic). Teach kids skills to fight their nighttime anxiety. Don’t discipline it. #2 TV shows Anxious kids are constantly observing and remembering everything they see and hear. Anxious kids have a memory that can rival an elephant. If you parent an anxious kid, you already know this, right? If you want to really make anxiety worse, have your kids watch a tv show that has some of their anxiety themes. If they are afraid of bad guys – don’t watch crime shows. If they are afraid of germs – don’t watch shows with titles like Medical Mysteries I Am Pretty Sure You Have and Germs that Lurk Around Every Corner. Even if you like watching these shows (with these amazingly catchy titles), anxious ears are listening. Unless you want to deal with a major spike in your kid’s anxiety, watch them behind closed doors. #3 Urban Legends Kids love to scare other kids. They love to talk about spooky things. I don’t get it, but they do. As a child therapist, I am privy to the latest and greatest stories that are freaking out your kids.
Page 32 The oldie but goodie is Bloody Mary. For the last twelve years, I have heard kids week after week talk about how they are afraid of this Mary lady. Unfortunately, this makes anxiety worse – especially in the bathroom. Other favorite topics include Chucky and Slender man. In the last few years some newer faces on the scene have arrived including Five Nights at Freddy’s and Annabelle. I cannot stress enough how these stories make anxiety worse. If you want to help your anxious child get rid of any Five Nights at Freddy’s games! Even if they tell you it doesn’t make their anxiety worse – it does, trust me. #4 YouTube videos YouTube is a curse for anxious kids. Nowadays kids like to search everything on YouTube. Unfortunately this feeds right into the fascination with urban legends. You don’t believe Annabelle is real? Let’s check out what YouTube has to say about it. You don’t think Five Nights at Freddy’ is a real place? Let’s get YouTube’s opinion. Unfortunately, every idiot out there can make a YouTube video – and they do. Kids are watching them. They Tell me they know it is real because their friends showed it to them on YouTube. The majority of parents I talk to will say, “Well, my kid’s not on YouTube, so I don’t need to worry.” I hear that all the time, but their kids tell me a di erent story. Even if your child isn’t accessing YouTube at home, their helpful friends are sharing it with them at school and at their home.
Page 33 #5 Horror movie trailers
I would love to ban horror movie trailers! They are the source of so many therapy sessions. Kids can’t sleep because they are afraid of a poltergeist, possessed doll or a serial killer. Did they watch the movie? No! They just saw the trailer. I curse you trailers! #6 News If you have a child with anxiety, don’t watch the news in front of them. It will make their anxiety worse. Nobody needs a ten-minute highlight of all the worst things that are happening in society. If you want them to be educated, pull up CNN on the computer and show them videos of stories that aren’t about death, destruction and crime. #7 Adult conversations The quickest way to make anxiety worse is for your child to hear all the horri c things that are happening to friends and family around them. The neighbor got robbed? Aunt Carla has cancer? If your anxious kids don’t need to know about it, don’t talk about it near them. They are listening, even when they act like they aren’t. #8 Anxious parents There is nothing worse than adding your own anxieties onto an already anxious kid. Anxious kids are emotional sponges. They will soak up whatever you are oozing. It is important to keep your own anxiety in check around your anxious kids. This can be hard. Click here for some tips to help.
Page 34 #9 Spontaneity On a whim, you decide to go on a weekend trip. Or maybe you make a spontaneous decision to go out to eat with some family friends. Some anxious kids cannot handle spontaneity. They are plotters and planners who need warning when there will be any sudden changes to their schedule. If you don’t want to make anxiety worse, tell your anxious kids what is happening as far in advance as possible. This added information will help your anxious child. Catering to anxiety vs. helping your anxious child Before we go, I think it is important to touch on the balance between being careful to not make anxiety worse in kids, while also being cognizant of not catering to your child’s anxiety. This is a balancing act for most parents. Your child won’t live in a bubble, so you can’t protect them from the world around them. However, anxious kids can go their whole lives without having to watch a YouTube video on Annabelle or overhearing a conversation you’re having about their Great Aunt Carla’s cancer. Use your best judgment. Assess how acute your child’s anxiety currently is and whether it is necessary for your child to be exposed to something that will definitely make anxiety worse. ***
Page 35 How to Deal with a Child Who is a Perfectionist
Your kids are up all night working on a simple homework assignment. They agonize over grades like 89 or A-. They feel like a failure if one person in their class got a higher score than them on an exam. They anguish over whether or not teachers notice their hard work. Welcome to the world of perfectionism. How do you deal with a child who is a perfectionist?
Page 36 Being a perfectionist can be more damaging than you might think. These kids often burn out long before they make it to college. They often have lower self-esteem than their peers, even though their performance is far superior. So how do you deal with a child who is a perfectionist? How do you help them reach their full potential without such self-criticism? Set Reasonable Expectations Often children who strive for perfection are well, pretty perfect. This can cause a vicious cycle. As you get used to your child’s perfection, you expect perfection. As you expect perfection, children feel the burden to give perfection. I often hear comments like, “I expect straight A’s because I know she is capable of it.” That may be true, but placing such high expectations on a child can lead to stress, helplessness and an eventual loss of motivation. Help Them Change Perspective Help your children develop a realistic view of success. Many perfectionistic kids are gifted and/or talented. They are used to being the best. Often as kids get older they are placed in higher level classes/teams and they aren’t always the best anymore. I always tell kids, “No matter how good you are, there is always someone better and someone worse than you.” Help them set up their own self- improvement goals that don’t revolve around where they stand against other people.
Page 37 Highlight the Benefit of Failure
Perfectionistic kids do not realize that failure is an integral part of success. When we struggle, we strive to do better. Often it is out of failure that our best work is produced. I love telling kids how Thomas Edison made 1,000 unsuccessful attempts at inventing the light bulb before he nally succeeded. He didn’t see it as 1,000 failures – he saw it as 1,000 steps. That is how we should have our children view failure. Model Non-Perfectionistic Behavior Sometimes the apple doesn’t fall far from the perfect tree. You can’t expect your kids to not be a perfectionist if you are the same way. There is a difference between being a go-getter and being a perfectionist. A go-getter stumbles, falls, gets up and keeps on going. A perfectionist sees every aw, every failure. They are paralyzed by the possibility of imperfection. Show your kids that you mess up. Show them you learn from your mistakes and move on. Don’t verbally beat yourself up about aws and imperfections – your kids are watching. Talk to your kids about how it is not the end result, but the effort along the way that is truly impressive. Helping a perfectionist takes time. Praise your children when they show great e ort, regardless of the outcome. Talk about traits that you love in your children that aren’t performance related. Taking the perfectionist out of a child isn’t going to make the child a failure, it is going to guarantee that child’s success. ***
Page 38 When Parenting an Anxious Child Avoid These 9 No-Nos
Anxious kids are a di erent breed. If you are parenting an anxious child you know what I am talking about. Perhaps this realization dawned on you when you watched your friends interact with their children. What seemed to work for them – completely backfired for you.
Page 39 In my child therapy practice couples who are parenting an anxious child will often tell me things like, “I don’t get it. Everything that worked with our other kids won’t work with our anxious kid.” You can throw your regular parenting book out the window – you need a completely different playbook when parenting an anxious child. Let’s countdown the 9 biggest No-Nos when parenting an anxious child: Each child is unique – even anxious kids. Some of these might actually work with your anxious kiddos – but in GENERAL these approaches are much less likely to work on an anxious mind. 1. RUSHING YOUR CHILD You want to see anxious children have complete meltdowns – tell them to hurry up. Most anxious kids completely implode when we tell them to speed up. I can bark at two of my kids to hurry up and they’ll get moving. If I did that to my third child – we’d have to tack on 30 more minutes to allow for the meltdown that will ensue. Sound familiar? 2. SINK OR SWIM Many parents feel they just need to throw their kids into a feared situation and the kids will do ne. Kind of like the sink or swim mentality. Anxious kids will sink. They will plummet to the deepest darkest depths and will not come up for air. 3. SET A TIMER A great parenting approach for time management might include a timer. Such as, “when the timer goes o it is time for you to stop playing your video game.” A timer is a ticking time bomb for anxious children. Instead of speeding them up – they will ruminate over the clock and will probably explode into tears or screams long before the buzzer sounds.
Page 40 4. MAKE A RACE OF IT Similar to the timer – any type of time-limiting approach is most likely not going to work. Anxious kids get overwhelmed with time limits. Timed tests. Timed activities. None of those go down well. Trying to make things fun with comments such as, “who can get there first?” can turn an anxious child into a puddle of tears. 5. TELL THEM ABOUT THE FUN THEY’LL MISS Your anxious child doesn’t want to go to a party. They don’t like crowds or new social situations. You tell them they are going to miss out on all the fun. Telling your anxious child what fun they’ll miss if they don’t go won’t work. They know they are missing the fun. It upsets them more than maybe you know. Reminding them of what they’ll miss out on will just increase their anxiety. Instead, address the fear that is driving the behavior. Talk about how they can handle the new social situation and give them tools to get through it. 6. FOOD BATTLES You want to see an anxious child throw up? Have a food battle with him or her. Drawing a line in the sand will result in a loss for both of you. You’ll be frustrated and your children will never again touch whatever food you are trying to metaphorically (hopefully) shove down their throat. My twelve year old still won’t touch broccoli due to a food battle she had with a relative when she was three. The tongue never forgets! Anxious kids can be picky eaters due to oral sensitivities and the fear of new foods. Encourage your children to eat new things. Place new foods on their plate. But, don’t make mealtime a battle zone.
Page 41 7. PUNISHING YOUR CHILD FOR TOILETING ISSUES Some anxious kids are slow to potty train. Older kids might fear pooping (yes, that is a thing) and may avoid pooping at all costs. This can cause constipation and conversely accidents. I know this can be a gross and frustrating parenting issue. But shaming, blaming or punishing this behavior will not fix it. Address the fear – not the behavior. 8. SCARE THEM INTO BEHAVING Parents will use facts to help their children do things they would otherwise not do. Brush your teeth or they’ll fall out! Hold my hand or you’ll get hit by a car! Put a helmet on or you’ll crack your head open. I know these things have own out of my mouth at times. I also know that sometimes I say the wrong scary thing and I have to do damage control for weeks afterwards. Try to focus on more positive statements. Brush your teeth and make them sparkly clean. Hold my hand so I can make sure to keep you safe. 9. ALL OR NOTHING RESPONSES Anxious behavior can sometimes be mislabeled as oppositional. Anxious kids might completely freak out when told no. This can be misconstrued as spoiled and entitled behavior – but in reality anxious kids can’t handle the concept of no. They can’t handle the finality of no. Speaking in absolute terms typically doesn’t go down well with anxious kids. When possible, focus on when they can do it or when they can have it – even if it is far away.
Page 42 Tell them things like, “You can have that for your birthday” or “you can have that after dinner.” You can even motivate them with comments like, “You can save up your money and get it.” Now having said that – sometimes “no” will just be “no.” Just like other kids, anxious kids need to learn how to handle not always getting what they want. In reality, sometimes there is no future “yes” to your answer. Parenting any child can be a struggle. Parenting an anxious child can make your head swirl. *** Click here to listen to the AT Parenting Survival Podcast episode on this topic.
Page 43 The One Thing Every Anxious Kid Should Be Doing
Often when I ask a kid with anxiety what helps reduce stress and anxiety, the answer I most often get is “I try to get my mind o of it.” This lets me know that I have my work cut out for me.
Page 44 When people talk about helping a kid with anxiety, they will talk about skill building tools such as relaxing the body, taking deep breaths and staying in the moment. These are all wonderful tools, but I nd without teaching kids how to battle their anxiety, it is like putting a Band-Aid on a bullet hole. If you have a kid with anxiety, teach your child how to battle. Now that might not sound very calming, but either is anxiety. Your kid is in a mental war every day. If you don’t arm kids up with some ways to ght back, they will be in constant battles. Empower your kids. The one thing every kid with anxiety should do is fight back. You can help them do this by: Naming their anxiety Help your anxious kids see their anxiety as an enemy they are trying to defeat. In my book Anxiety Sucks! A Teen Survival Guide, I teach kids to externalize their anxiety and give it a name – like a Dictator – because you know, it is kinda like a big bully. Learning anxiety’s tricks Teach your kids how anxiety works. If you don’t understand this yourself read a book that explains it. Let your kids know that their dictator likes to set o false alarms. That he likes to give them red thoughts (negative thoughts) to make them panic and worry. The truth is, he doesn’t know what he is talking about! Ask your kids what their dictator is telling them? What are the red thoughts being thrown their way? If they can’t tell you – ask them when they are anxious, “What is the worst thing that can happen?” This will give you a window into their red thoughts.
Page 45 Developing thought weapons Tell your kids that they have a choice to either invite their Dictator’s red thoughts into their mind for a long chat or they can ght back with their own green thoughts (positive thoughts). If their dictator tells them they will throw up at school – they need to counterattack with a thought such as “I never have before, so why would I now.” This internal battle can last a while, so it is good if your kids have plenty of green thoughts in their arsenal. Ask your kids to come up with some green thoughts. If they are coming up empty help them out. Just be cautious to not spoon feed them too many green thoughts. The most e ective green thoughts are those that kids come up with themselves. Teaching them the avoidance trap Teach your kids that their dictator wants them to avoid. Avoid school. Avoid what makes them nervous. Avoid challenges. The quickest way to shrink their dictator and make him quiet is to NOT avoid. This can be hard to do, but every time your kids face their anxiety, their anxiety loses power. Teaming up with your kids, not their anxiety Partner with your kids to beat anxiety. Let your kids know that you are there for them. Encourage green thoughts. Help them battle red thoughts. Try to empower your kids to face their anxiety and not avoid anxiety-producing situations. The rest is gravy When you teach your kids how to battle anxiety, the rest is gravy. You are killing the head of the beast, all the other skills will supplement this major tool.
Page 46 Do you like this approach? This is a summary of the approaches I teach in Anxiety Sucks! A Teen Survival Guide. Get it for your teens, read it for yourself. Many parents with younger children nd the book o ers a blueprint of how they can help their anxious kids. ***
Page 47 How to Help Your Kids Survive Panic Attacks
Your child can’t breathe. She is holding her chest. She is starting to hyperventilate. She wants to go to the hospital. She feels like she is dying. You panic. She panics. Welcome to the world of panic attacks.
Page 48 As a parent, you can feel helpless when your child is su ering from panic attacks. It can be scary for both of you. What should you do? How can you help? Panic attacks are a physiological occurrence that can happen to people who su er from anxiety. They can come on suddenly and without warning. Typically panic attacks can last ten to fteen minutes, but the fear of having another one can be more debilitating than the panic attacks themselves. Although stress and anxiety can exacerbate the likelihood of having a panic attack, panic attacks can happen at any time – even during sleep. Here are the most common symptoms of a panic attack: *Racing heart *Feeling dizzy, faint or light headed *Chest pain and/or heart palpitations *Numbness or tingling of hands or feet *Difficulty breathing *Difficulty swallowing *Feeling unreal or disconnected *Fear of dying or losing one’s mind *Hot or cold flashes *Feeling nauseous or having gastrointestinal distress *Trembling or shaking uncontrollably Sounds nasty, right? It doesn’t feel good either. Trust me, I know. When I went to college I gained new knowledge, as well as a new enemy – panic attacks. Panic attacks ruled my life for my rst year at college. I didn’t know what they were or what was happening to me. With determination and anger – I bullied my panic attacks back and rid my life of them. With patience and time, your kids can too.
Page 49 As a child therapist, I see the impact panic attacks have on kids. Although you may not be able to eradicate panic attacks completely from your child’s world right away, there are some things you can do to help. Educate them on the signs and symptoms of a panic attack. When a child is su ering from panic attacks they often think they are dying, and rightfully so. Panic attacks are scary and they feel scary. Their body is having a false alarm, but all the feelings and sensations they are experiencing are real. Teach your kids that panic attacks are a false alarm in their body. Let them know the physical sensations associated with a panic attack so that when they experience them, it won’t be as scary. If your child is a pre-teen or teen, have them read books on how to get through panic attacks so they can feel empowered. Make a list of what is helpful during panic attacks. Panic attacks typically last ten to fteen minutes, but for you and your child, it can feel like a lifetime. When your child is not having a panic attack, get with them and brainstorm activities that they would nd calming when in the throes of an attack. This can be vastly di erent for each child, therefore it is important to sit down and discuss what might work for them. I always feel that doing an activity that engages the mind (watching TV or reading) is more e ective than a passive activity (listening to music or drawing), but each kid is different.
Page 50 Some ideas you might explore with your child can include: Distraction techniques *Watch your favorite show or YouTube channel *Look at videos or pictures on your phone *Text friends for a random conversation *Look at Instagram *Play the alphabet game (come up with a word for each letter) *Play eye spy around the room *Talk about a fun event that is coming up Physical techniques *Exercise *Do jumping jacks *Go jogging *Go biking *Jump on a trampoline *Punch a punching bag *Use an ice pack on your face *Eat something *Run your hands under hot or cold water *Get a back or head massage *Take a shower or a bath Thought techniques Have your child write down positive thoughts that they can read when having a panic attack. These thoughts can help empower them and reduce the acuity of the attack.
Page 51 Sometimes it is helpful to personify panic attacks and see it as a character your are trying to defeat. This approach de nitely helped me beat panic attacks when I was in college, but it is not for everyone. Some empowering thoughts might include: *I am not dying, I am having a panic attack. *Although panic attacks feel scary, there is nothing medically wrong with me. *People do not get injured or die from panic attacks. *My panic attacks always end. *I am not going crazy, I am having a panic attack. *I am sick of my panic attack dictator! I am not going to let him rule my life. Avoid minimizing their distress. Try to avoid telling your child things like, “You are okay.” Although this can seem reassuring, when you are going through a panic attack – you are not feeling okay. So, you don’t want your child to feel like you don’t “get it.” Instead say things like, “I know you don’t feel okay. Having a panic attack can feel scary. I will help get you through this and it will end soon.”
Remind them that panic attacks always end. It is good to highlight to your child that panic attacks always end. When in the middle of a panic attack any positive thoughts y out the window. Helping your child remember that they always get through these attacks will offer some hope.
Page 52 Help distract them and go to their list. Teach your child to articulate when they are having a panic attack – if they don’t do that already. When your child is having a panic attack, redirect your child to the list you made together. Pick one or two items from the list and help your child engage in that activity. Help them to avoid the panic attack trap. The worst part about panic attacks aren’t the panic attacks at all. It is the fear that goes along with panic attacks. People get worried about having another panic attack. They feel exposed and vulnerable to this debilitating feeling. Often due to this fear, when a child is su ering from panic attacks they will start to avoid activities that they feel will trigger a panic attack. Unfortunately, this will often include school, restaurants and extracurricular activities. For some kids it can get so bad that they want to be homeschooled. In more extreme cases it can lead to agoraphobia (the fear of leaving one’s house). Help your kids by not feeding into that cycle. Let them know that this is how panic works. Explain that panic wants you to avoid things – but the more you avoid, the worse the panic grows. The best way to defeat the panic is to face it head on and continue with your life as normal, as hard as that can be.
Page 53 You can teach them some tips to survive a panic attack in public, such as:
*Look at your phone or photos as a distraction *Go to the bathroom to get space away from other people *Go talk to the school nurse or counselor *Carry mints or gum to help give you a physical distraction *Keep items in your pocket that help ground you like a worry Stone *Read a book on your phone *Text a friend *Text a parent *Go outside and get fresh air Panic attacks are not fun. Luckily the more you build coping mechanisms to defeat them, the quicker they go away. Remember to remain calm when your child is su ering panic attacks. When you are the calm during their storm, they will get through these attacks much quicker.
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Page 54 How to Calm First Day of School Worries
You survived. It was touch and go at times, but you made it through another summer with the kids. As you excitedly scamper around buying backpacks, school supplies and lunch boxes – your kids may be more than a little less enthused. Some might even be developing a knot in their stomachs as the idea of a new school year approaches.
First day of school nerves are normal. I remember wanting to throw up on the rst day of school every year. It was not fun, but after the rst few days, I would find my beat and survive.
Page 55 If you have children that struggle with transitions and new situations – they might experience the back to school nerves as well. Here are 5 ways to make that first morning feel a little less…pukey. Prepare, prepare, prepare Nothing calms the nerves better than preparation. When you know what to expect, your imagination can’t ll in the gaps for you – and often that is a very good thing! Make sure to take your kids to meet the teacher night. This will help them get acquainted with their teacher, show them what their class will look like and give them a preview of some of their classmates. If you are out of town or busy that night, call the school and ask if you can pop into the classroom with your child or arrange to meet the teacher a di erent day. Most schools are open several weeks before school starts and would be more than happy to ease a worried child’s mind. Make them feel good about themselves
This is going to sound like a super cial tip – but it can make a di erence. Buy your child a rst day out t that they feel great in. This will help build confidence and may even create a little excitement around the first day. Walk them to class Even if they have been going to their school forever, ask your children if they would like you to park and walk them in. Nervous kids will welcome the extra reassurance and comfort on the first day.
Page 56 Discuss What If scenarios
Worried minds love What if scenarios. If your children are showing or vocalizing fear for the rst day, ask them “What is the worst that can happen?” This is better than saying something like “What are you afraid of?!” Children might misinterpret that question as judgment. Once you discover what your children are afraid of – address each concern with a possible solution. Be understanding This might seem obvious, but be extra caring the rst week of school. Your children might not express their stress and worry, but that doesn’t mean that it is not there. Be more forgiving and less demanding. Realize that there might be a bit more attitude and agitation during the rst week and give them space to readjust to the new schedule. The good news is a rst day only happens once a year! Help your children prepare and make their rst week slightly more enjoyable. Then you can do your summer-is-over happy dance. ***
Page 57 15 of the Best Coping Mechanisms to Survive Those Scary Moods!
Kids are not born knowing how to handle these strong feelings. It is our job to teach them. We can model it, by showing how we work through our own emotions and we can teach coping mechanisms that work for them.
Page 58 I recently came across this great book, Coping Skills for Kids Workbook by Janine Halloran. She lists over seventy- ve di erent coping mechanisms for kids. What a resource! Even as a child therapist, I found some new, creative ideas.
I asked the author if I could reprint a few of her many suggestions. Below are 15 coping mechanisms from her book. In her book, she goes into detail about each coping mechanism and how to use it. She also has printable worksheets for kids to do – so they take an active role in creating their own plan. I love it! Here are 15 coping mechanisms for kids to get started: 1. Deep breathing using bubbles 2. Remember the words to a song you love 3. Calming jar 4. Play with a pet 5. Create a music playlist
Page 59 6. Write what is bothering you and throw it away 7. Make a comic strip of what happened and what you can do next time 8. Jump rope 9. Yoga 10. Make an obstacle course 11. Talk to someone you trust 12. Use positive self-talk 13. Take a shower or a bath 14. Bake or cook 15. Laugh [watch YouTube videos or movies that encourage laughter] I recommend talking to your children about what activities they would nd most useful when they are trying to calm down. Pick a handful of ideas and have them fill out something like this:
Page 60 When I am upset I can… 1. 2. 3. 4. 5. When I am upset you can help me by… 1. 2. 3. 4. 5. Even though this may seem like an obvious thing, all clarity gets lost when a child is in the throes of an emotional meltdown. You can hang this sheet somewhere your children can see it (in their closet, on their door) as a visual reminder when they need it.
Do your kids crumble when they are having a meltdown? Do they turn into a puddle when they are overwhelmed? Whether it is anger, anxiety or sadness – many kids have a hard time handling their strong emotions. Coping mechanisms for kids can help with these struggles.
Page 61 Janine Halloran is a Licensed Mental Health Counseling and creator of Coping Skills for Kids. Her book Coping Skills for Kids Workbook is available on Amazon and on her site.
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Page 62 5 Ways Good Parents Make Teen Anxiety Worse
Your happy-go-lucky child has turned into an anxiety-ridden teen. It is a painful thing to watch.
Activities that were once enjoyable are now avoided. Going to school is a daily miracle. Instead of driving to the mall, you are driving to the doctor with mysterious stomach issues. Teen anxiety is not only debilitating for your teen, it is debilitating for the whole family. So how do you make this nightmare go away? How do parents help with teen anxiety?
Page 63 You can start o learning what not to do – and then go from there. Teen anxiety can look very similar among teens, but how parents deal with teen anxiety can look vastly different depending on the family’s parenting style. Here are 5 common mistakes I see good parents making in my therapy practice: ACCOMMODATING THEIR TEEN’S ANXIETY Parents feel bad. They don’t want their kids to have teen anxiety. They want to make it all go away. And so they do just that.
Their kids don’t want to go to school. They switch them to online schooling.
Their kids don’t want to sleep alone. They give them a permanent spot in their bed. Their kids are afraid to do new things. They never push them out of their comfort zone. Helping kids with teen anxiety is a balancing act. You don’t want to push your teens too hard, but you don’t want to not encourage them at all. Help your teen develop coping mechanisms and then encourage them to slowly fight back! FORCING TEENS TO FACE THEIR FEARS TOO SOON The ip side of the issue above – are parents who are too overzealous when addressing teen anxiety. They hate to see their teens su er, so they force them to face their fears.
Page 64 The intention is good, but the delivery is bad. These parents do not understand anxiety. They believe they can strong arm their teens to face their fears and that will “get them over it.” Unfortunately teen anxiety doesn’t work that way. Forcing teens to do things that they are not ready to do can back re. Like I said before, handling teen anxiety is a balancing act. Accommodating their fears is not helpful, but too much pushing can have a similar effect. They can both stop any progress from occurring. Give your teen coping mechanisms and then let them face small challenges. Small challenges add up to big results. PUTTING TOO MUCH PRESSURE ON FIXING ANXIETY Some parents get anxiety. They get it so much that they are ready to beat teen anxiety for their kids. They are the ones reading the books. They are the ones participating in therapy. They are the ones hand holding their kids through the battle of teen anxiety. I get it. It is frustrating to see your teen move at a slower pace than you would like. It is frustrating to understand the skills that they need to use, only to watch them not use them. Unfortunately this is a battle you cannot ght for them. When you ght teen anxiety harder than your teens you do two things. You make them hide their anxiety – which is the opposite of what you want to do. And second, you make them feel overwhelmed. When this happens, many teens just give up. This is your teen’s battle, not yours. Be a supportive passenger. You are not the driver.
Page 65 BELIEVING THEIR TEEN IS MANIPULATING THEM I meet many parents who completely believe their teens are using anxiety as an excuse. I hear things like, “He is just lazy and doesn’t want to go to school” and “She is not scared at night, she just likes sleeping with us.” Most teens are embarrassed to have teen anxiety and would do anything to NOT have this problem. When you view your teen’s anxiety as manipulation you are going to parent it with discipline and annoyance – both of which will exacerbate the issue. HAVING MISPERCEPTIONS OF ANXIETY I often hear parents say things like, “I don’t understand why she is afraid of that – nothing bad has ever happened to her?” Parents rack their brains with questions like “Is he being bullied?” And “Did she go through a trauma we don’t know about?” Usually, the answer is – no. Anxiety has a strong genetic component and runs in families. Children are born with the predisposition to be anxious. That doesn’t mean they cannot learn skills to beat their anxiety, it just means you should stop trying to answer the question “But why?” Teen anxiety is often irrational and is not usually based on actual experiences. So now that you know what not to do – what should you do? Arm your teen with coping mechanisms. Take them to a therapist that can help them build these skills. Have them read a teen self-help book that will teach them skills or watch a parenting video to learn how to teach those skills yourself. Whatever you do, give your teen support.
Page 66 Click here to order book
Help your teen with these three steps:
1. Identify anxiety themes and triggers 2. Teach them coping mechanisms to face their anxiety 3. Set up bite-size challenges to help them face their fears 4. Repeat ***
Page 67 How to Stop the World From Crushing Your Sensitive Child
Your sensitive children are the helpers on the playground. Your sensitive children are the rst ones to notice when other people cry. She is kindhearted. He is considerate. They go out of their way to make sure everyone is happy. They look for your approval, their teacher’s approval. Their heart is big. Their armor is small.
Page 68 They are crushed when people are mean to them. They are confused when others go out of their way to be cruel. They are devastated when they think they have disappointed anyone. The same wonderful qualities that make your child kindhearted are crushing your child’s spirit and optimism. How do you raise sensitive children to survive in the harsh world around them? To handle the cruelness of other kids – the harsh tones parents and teachers sometimes deliver? I have worked with some of the most giving, loving and caring children in my practice. Their hearts are wide open. So wide open that they come wounded into my office – from a world that isn’t as kind as them. Unfortunately, the world isn’t changing anytime soon. BUT YOU CAN TEACH YOUR SENSITIVE CHILDREN…
PERSPECTIVE Just like athletic skills or academic skills – emotional intelligence is not evenly distributed among children (or adults for that matter). Some people lack the ability to empathize. Sometimes this can turn into callousness and sometimes it can turn into something far worse.
Page 69 Highly sensitive children do not get this at rst. It is a harsh lesson that they start to learn as they go through school. At rst there may be wonder and concern about why another child would be mean to them. I explain it to kids this way:
Unfortunately, there will always be a sprinkle of mean kids in your classes. This world is full of really thoughtful, kindhearted people and a sprinkle of mean spirited people. Some kids like to be cruel. You can be the nicest person on this planet – but some mean spirited kids are still going to find it fun to be cruel to you. The good news is kindhearted people outnumber the mean hearted people. So for the three or four mean kids you might encounter each school year – they’ll be just as many kindhearted people silently wishing you the best. NOT TO BE A TARGET Teach your sensitive children how to avoid being targets. Their natural personality doesn’t come with any armor – which makes them very vulnerable. Bullies look for big reactions. Unfortunately, sensitive children often have a hard time containing their sadness. They also don’t typically fight back. They will need to develop skills to handle these situations – as their natural instincts aren’t going to help. For some tips on how to help your sensitive children with bullies click here. TO ASK – IS IT REALLY ABOUT ME? Sensitive children often think things are directed at them–even when the situation has nothing to do with them.
Page 70 When the teacher has scolded the class – they feel they are being personally attacked. When the teacher is disciplining the child sitting next to them – they feel they are being disciplined. Help your children reassess the situation. Teach them to look at whose behavior the teacher is really addressing. THE DIFFERENCE BETWEEN A TONE AND A SHOUT I hear parents say over and over again, “She thinks I am yelling at her – when I’m just using a rm tone.” When you are stern they think you are shouting. When you redirect them they think you are scolding them. This can get frustrating and tiring. Sensitive children aren’t crazy – they are just emotionally more open and sensitive. Some even have sensory issues. That being said – their experiences are magnified – and that, unfortunately, includes your tone. Play fun games to help them learn the di erence between rmness and yelling. You can play a guessing game and name it Being Firm or Yelling and get them to guess which one it is. Although this will seem obvious in the moment – it will help your sensitive children generalize the difference. TO AVOID WATCHING UPSETTING TV AND VIDEO GAMES Usually sensitive children have wonderful memories. They archive everything you’ve ever said to them along with every negative experience. Some of us can watch a disturbing TV show or play a violent video game without any residual e ect. Sensitive children often have an unusually good visual memory. I often hear sensitive children complain to me that they just can’t get the scary or upsetting image “out of their head.”
Page 71 Teach your sensitive children how their brain les away upsetting material for later. Teach them how their brain doesn’t have a separate le for fantasy or fiction. Their subconscious brain is ling all that they see in one ever growing disturbing le. A le that will be reviewed late at night or when a similar situation pops up. Once your children understand the impact those disturbing images have on their brain – they will begin to be more careful about what they watch. In the meanwhile, you might have to do that for them. Sensitive children are the most beautiful and considerate children I have ever met. They ll my o ce with love and understanding. If you can teach your sensitive children how to overcome some of the above obstacles –they will blossom bigger than the rest of us! ***
Page 72 4 Things Parents Get Wrong About OCD
The most misunderstood issue in my therapy practice is childhood OCD. I have lost count of how many parents I have talked to who completely misinterpret their children’s OCD behaviors. These are caring, well intentioned parents. Parents who have been bombarded with media images of stereotypical, one dimensional characters who distort and simplify OCD.
Page 73 We can also blame OCD itself for being the master of disguises. OCD can manifest in a large amount of unique ways – all of which look completely different from one another. It is not surprising then that parents often miss the mark completely when it comes to childhood OCD. Parents have many distorted beliefs about OCD, but there are a few that are consistent among most of them. You have to be clean, neat and organized to have OCD Often when I tell parents their child is exhibiting OCD symptoms, I will get a look of ba ement and comments such as, “Oh no. He de nitely does not have OCD. If you saw his room you wouldn’t say that!” I wholeheartedly blame the media for this one. Not everyone who has OCD is a neat freak. In fact, most are not. OCD is about obsessive thoughts and compulsive actions. These obsessive thoughts can be an array of themes – most of which have nothing to do with cleanliness. Kids with childhood OCD might constantly have to tap or touch things. They might have to count their steps. They might have to confess behaviors they have never done. Kids do rituals for attention Out of all the misperceptions one can have about OCD – this one saddens me the most. Parents will sometimes argue with me that their children are doing rituals for attention. I will hear comments like, “He just wants our attention, so we punish him” or “We ignore her because we know she is just trying to bother us.”
Page 74 These perceptions couldn’t be farther from the truth. Children with OCD are tormented by their ritualistic behavior. If anything, they are more likely to try and conceal their behavior than draw attention to it. OCD rituals are just tics, quirky behavior or habits Sometimes when I am getting background history from parents they will mention things like, “He has these quirky habits he does sometimes. We just ignore them and they usually go away, but something pops up in its place.” When I explore further – they will often proceed to describe an OCD ritual. It is understandable that some OCD rituals can be misinterpreted as tics or strange habits. If you don’t know what to look for, these behaviors can look very similar. I have worked with kids that have to move their eyes in a certain pattern, that have to touch their hands to their heart, that have to blow air out of their mouths or have to clear their throats after certain thoughts. All of these behaviors can be easily misinterpreted. OCD is a phase children will grow out of eventually The most dangerous assumption is that OCD is just a phase. Parents shouldn’t take a wait and see approach with OCD. Childhood OCD doesn’t typically just fade into the sunset. No, it makes itself cozy in your children’s head constantly creating more rules and more rituals. The longer parents wait to get treatment, the harder it will be to help their children overcome their OCD.
Page 75 If you suspect your children might be exhibiting signs of childhood OCD, have them evaluated by a mental health professional. It is better to be proactive than reactive when it comes to childhood OCD. An evaluation can’t hurt, but holding on to these false assumptions can. *** Click here to listen to the AT Parenting Survival Podcast episode on this topic.
Page 76 Can You Tell the Difference Between Worries and Anxiety?
Your son gets nervous before his doctor’s appointment. Your daughter worries the night before an exam. Do they have anxiety or are they just kids getting scared? How can you tell the difference?
Parents often ask me that question in my practice. What is the di erence between worries and anxiety? Not much. They feel the same. They look the same. The difference is in the frequency and duration of the worry.
Page 77 So when should parents worry about their kids getting scared? Here are 3 ways to help di erentiate worries from possible anxiety. When in doubt always seek out the advice and guidance of a child therapist. ARE KIDS GETTING SCARED OFTEN? It is normal for children to worry about various things throughout their life. Worrying is a natural, normal feeling that we all have once in a while. So, when your children are up all night worrying about an exam or they are getting white knuckles at the doctor’s o ce – that is not an indication that they necessarily have anxiety. Anxious children will not have isolated worries. They will be consumed with worries. Even if they have one worry – for instance, the fear of bugs – that worry will encompass many smaller worries. They might be scared of bees. Worried about spiders. Consumed with the idea of bugs in their bed. For example: Most likely a worry: Johnny was stung by a bee when he was 4. Ever since then whenever he sees a bee he gets frightened and runs to his mom. Most likely anxiety: Sarah has always been a nervous child. Out of the blue, she started to become deathly afraid of bugs. She makes her mom check her bed at night. She refuses to go outside and play – worried something will bite or sting her. She wears shoes in the house because she’s afraid she might step on a spider.
Page 78 THEY WORRY ABOUT THINGS THAT AREN’T GOING TO HAPPEN Another way to di erentiate common worries from anxiety is the context of the worry. If a child is going to do a presentation the next day and she is feeling nervous about going to school – that makes sense. If a healthy boy is having a hard time going to sleep each night because he is worried about dying – that doesn’t make sense. Kids with anxiety will worry about the typical stu , but they will also worry about life’s “What if’s.” They create scenarios in their heads that have no basis in reality. When trying to assess if kids are having typical worries or anxiety – look at the theme of their worries. Do they spend much of their time worrying about things that are unrealistic or out of context for the situation? Are most of their worries “what ifs?” Are their worries misaligned with their actual life experiences? Such as worrying about a car accident – even though they have never been in one. Or worrying about throwing up in front of people – even though that has never happened. For example- Most likely a worry: John worries about being in a car accident. His family was in an accident last year and he worries it can happen again.
Page 79 Most likely anxiety:
Sarah has never been in a car accident and she doesn’t know anyone who has either. She is consumed with worry that they might crash one day. She gets panicky when she is riding in a car and she will watch her mom closely as she drives. WHEN THEY WORRY, THEY FEEL SICK When kids get sick from worrying – that is a sign that you might be entering the world of anxiety. Common worries do not typically make kids sick to their stomach. Anxiety can wreak havoc on the body. Some physical symptoms of anxiety include a racing heart, nausea, vomiting and headaches. If children are having frequent stomach aches when they are worried, that may be an indication that they are suffering from anxiety. Anxiety isn’t just in the mind, it can be felt in the body as well.
Page 80 WHY DOES IT MATTER? It is helpful to learn the di erence between worries and anxiety. When kids are having common worries – you can address the worry and typically move on. When kids are having anxiety – addressing the worry will not su ce. Anxious kids will need to learn lifelong coping mechanisms and approaches to beat their anxiety. *** .
Page 81 8 Things Every Parent Should Do When Traveling with Anxious children
Traveling with children can be a very exhaustive, tedious experience, but add a nervous child to the mix and you may swear o traveling completely! Trust me – I have been there!
Page 82 Although nothing will make your trip completely stress-free, there are a few steps you can take when traveling with anxious children to at least stack the deck in your favor! Prepare your anxious children If you have an anxious child you probably already do this in your daily life, but let this just be an extra reminder. Tell your children what will be happening on the trip. Keep it simple and brief. Often in the hustle and bustle of our travels, we forget to keep our kids abreast of what is going on. Anxious children need to know what is happening every step of the way. Taking the extra time to let them know what to expect will help eliminate their nervousness – which can cause anxiety meltdowns. Give them a broad overview such as, “First we are going to drive to the airport and then we are going to ride on an airplane and after that we will go to our hotel” (this is called previewing). After you have given your children a broad preview, give them a snapshot of what the next few hours will bring – “We are going to get on the plane and we will be sitting in our seats playing. After lunch on the plane – the plane will start to land.” Be sure to give your child an update on what will be happening every few hours or when a change in activity will be occurring. It is better to overkill previewing than to under do it. Be over prepared! When you are over prepared, your anxious children can be more relaxed – knowing that you have it all covered! If you are neurotic like me, you might already have many of these things in your purse.
Page 83 Okay, rst the obvious – have Band-Aids, ibuprofen (for those sudden late night fevers that are perfectly timed for your trip) and sunblock. If your child has sensory issues – don’t forget hats and sunglasses. Keep a change of clothes (including underwear and socks) in a Ziploc bag. You can use the Ziploc bag to store soiled clothes when you are on the road. This has been a life saver more than once in my life! Anxious children like their hands cleaned often, so carry extra wipes too! I like the ones that are individually wrapped because they don’t dry out as quickly. Have a small bag of kid activities that are portable within your reach. Making the car or airplane ride more pleasant! Whoever said it is not the destination, but the journey….has never traveled with anxious children! How many of us arrive at the hotel and feel like we are already done! When I am traveling with anxious children, I often feel like the trip is a marathon and that I need to pace myself. I know that sounds slightly pessimistic, but if you don’t have anxious children – it may be hard to understand! If you sprint in the rst few hours of the trip – you won’t be able to run the rest of the marathon! That car or plane ride can make or break you. Anxious kids don’t travel well. They are nervous, impatient and worried about what is happening. They need distraction and entertainment – non-stop! Go to the dollar store and buy lots of small toys and activities. I like those invisible marker pads for traveling – so I don’t have to worry about them drawing all over the plane or car. Sticker books are always an easy and time consuming activity. Those clingy gels that stick to windows are wonderful for car and plane windows. You can also cut a small piece of contact paper (clear shelf lining that is sticky) and tape it to the window. Bring a small bag of colored tissue paper and sequence that they can stick to the paper.
Page 84 Buy a handful of these activities (depending on how long you will be trapped riding in a car/plane/boat) and wrap them up individually in giftwrap as surprise presents. Making them into presents adds another layer of excitement for your child. Stagger out your gift giving to make them last until you get to your destination. Save the same amount of presents (wrapped in di erent gift wrapping) for the trip back. For those that are comfortable with their children watching movies – download several movies that your children have never seen before or a few of their favorites (if it will keep them captivated). For those very very long trips – this can be a life saver too! Let your children bring their own little backpack. The last thing you might want is another useless bag that you have to drag around, but it can go pretty far in giving your children some security. Ask your children if they would like a small, kid sized backpack that they can wear and carry. Tell them they can put a few objects in their bag. Make sure to keep it light so they will be able to carry it themselves. This might be a nice place for their comfort object (stu ed animal or a blanket), their favorite toy or a favorite snack that they can get to themselves if needed. Anxious children like comfort objects and for many of them – “stuff” is comforting.
Page 85 To poop or not to poop – that is the question! Anxious children (and adults – you know who you are!) have a hard time pooping when they are traveling. For anxious children this can be further complicated if they already have toileting issues! Fear of new toilets, self- ushing toilets and dirty toilets can all cause your little one to go into a tail spin (no pun intended). One way to keep your children regular while traveling is to be proactive and give them ber gummy vitamins each day. This can help encourage regularity without using something stronger that might work too well! Another tip is to buy a cheap foldable potty seat cover for your younger kids. If you do buy one of those portable seats, I would recommend using it at home a few weeks before your trip so your little one can acclimate to the change. Now, what to do about those scary automatic ushers? Once a parent of an anxious child I was seeing in therapy had a great suggestion. She said she always covers up the little sensor with a post it note and the toilet doesn’t automatically flush – perfect! Keep as much as you can the same. This is not the time to bring a bunch of new clothes that have never been tried and tested by your picky or sensitive children. If the tags are still on them – leave them at home! Bring their most comfortable clothes and shoes.
Page 86 I bring double the clothes I need because I never know what might not feel right that day or what will happen. My children can’t stand to get wet and heaven forbid they get a drop – and I mean drop – of water on their clothes – we are looking at a whole out t change. By having additional out ts (in my purse nonetheless!), I am avoiding a huge meltdown. Similar to clothes, food can be quite an issue. Anxious children are often picky eaters. I have had periods with my children where I could count on one hand what they were willing to eat. They would literally rather starve than eat anything new. For those with picky eaters, pack familiar snacks. Food can be unpredictable when you are traveling and the more comfort foods you have, the better. Depending on your children’s level of anxiety, you might even consider bringing their water bottle, sippy cup and even their plastic plates to help keep things familiar. For seriously picky eaters, you might want to bring some PediaSure or other high protein children’s shake as meal replacements if they refuse to eat. Once you feel you have almost gotten to the nish line – you face your biggest challenge yet… The dreaded bedtime! Bed time can be a challenge for anxious children even at home – add a strange room and an exhausting day and you are facing an uphill challenge. The most e ective way to make bed time – less painful – because it will probably be painful on some level – is to try and make the room as similar as your children’s bedrooms at home. At the peak of one of my child’s anxiety, I would pack her lamp with us! Luckily it was one of those ber optic lights that expanded, but folded up nice and neatly. At the very least, you want to bring all of their bedding.
Page 87 I would recommend packing their nightlight and bringing whatever music they listen to at home. You want the room to look as similar to their room in the dark, that way if they wake up in the middle of the night, the room will look somewhat familiar. Don’t overextend yourself or your child. When traveling with anxious children- know their limits. Kids need breaks – even if they don’t realize they do. Schedule in some time to go back to the hotel room and give your children some down time. Even if they look like they can go longer, it is better to be proactive than to nd out too late that your children are starting to implode. Plan shorter vacations if you feel your children’s level of anxiety cannot handle a longer trip. It is better to have a successful short trip than bailing halfway through your long trip (Been there, done that!) ***
Page 88 Child Therapist's Top 5 Things Every Parent Should do with Anxious Kids
Parenting anxious kids is like walking through a mine eld. Explosions happen. You have to side step and walk around obstacles. You never know when the next crisis will be. But, it doesn’t have to be that way. Anxious kids are also some of the most caring, empathetic children I know. I have to admit, they are my favorite little people.
Page 89 The anxious kids I see (and the few I am raising) have taught me many things. We should never underestimate them. When we believe in them, they are more likely to believe in themselves. In my child therapy practice I spend a large amount of time giving parents the tools to parent anxious kids and help them blossom. Below is a quick list of the best survival tips I teach: PARTNER WITH YOUR CHILDREN – NOT THEIR ANXIETY Name your child’s anxiety and work as a team to defeat it. In a perfect world you don’t want to accommodate the anxiety. As parents, it can be so hard to watch our children su er. It is very tempting to help your child avoid anxiety- producing situations. In the short run you are reducing your children’s stress, but in the long run they aren’t learning any coping mechanisms. The more children learn to fight their anxiety – the smaller their anxiety becomes.
Recently my 6 six year old named his worry a cloud. He said it blocked the sunshine. I thought that was a sad, but poignant comment. Each day I partner with him against the worry cloud. We joke, “It is the worry cloud again!” I encourage him with comments such as, “Fight that worry cloud – don’t let him be the boss of you!” Sometimes he beats the worry cloud and sometimes he doesn’t – but I always praise him for trying. LEAVE YOUR EMOTIONS AT THE DOOR Parenting an anxious kid can trigger an array of emotions. You can feel rage. Why can’t he just do it already? You can feel compassion. I don’t want him to suffer. You can feel anxiety. Will he ever get over this?
Page 90 Unfortunately anxious kids are emotional sponges. They soak up whatever you are spilling. When you are angry it makes them shutdown. When you over identify with their anxiety – it can be crippling. When you feel anxious they get more anxious. We need to be an anchor for our children as they go through their emotional storm. Try to remain calm – even if you are feeling like you want to pull your hair out or curl up into a ball and hide. HAVE SMALL VICTORIES, NOT BIG FAILS We want our children to sleep in their own beds. We want them to go to school without crying. We want them to go upstairs on their own. Sometimes we can see the big goals, but forget that it is the little goals that get us there. Anxious children aren’t going to overcome their fears over night. They will need small challenges. Bite size victories. Do not set your children up for failure by having them go out of their depth. The key to overcoming anxiety is success. The more successes your children can experience – the more empowered they will become. PRAISE EFFORT DON’T HIGHLIGHT DEFEAT When you believe in your children –they will believe in themselves. When your children are trying to ght their fears – praise their e orts. Let them know what they did well. Every word of encouragement goes a long way. It doesn’t matter if they didn’t accomplish the challenge. Did they try? My youngest child is currently working through her swim fears. When we get ready for class she typically says, “I am scared.”
Page 91 I tell her, “It is normal to be scared. When we do things that are tricky it can be scary. But you are brave. You used to not want to go in the water. But you fought your fears and now you do. You used to not be able to oat by yourself. But you fought your fears and now you do. Last class you even jumped in all by yourself. You are so brave! You are a fighter!” We usually end this with me chanting, “Brave face!” and her doing her super girl pose. I know we are weird, but it works. HELP YOUR CHILD COMFORT THEMSELVES When our children are scared it is our natural instinct to swoop in and provide them with words of encouragement. For instance, if our children say something like, “I don’t want to go to the party. What if no one talks to me?” We might quickly try to squash their fears with calming words such as, “You’ll have fun. There will be cake and games.” When we give our kids our own thoughts it doesn’t stick. Trust me I know – in my early days of child therapy I came to that conclusion rather quickly. Kids retain thoughts they’ve come up with themselves. You can encourage your kids to generate their own positive self-talk. You can do this with comments like, “What’s something you can tell yourself to make you feel less nervous?” or “If no one talks to you – what can you do?” The next time your child has the same anxiety – you can ask them, “What do you normally tell yourself?” This will build long lasting coping mechanisms. Parenting an anxious kid can feel completely overwhelming. Take it day by day and give yourself a break. This is your child’s journey, you are just there for support and encouragement along the way.
***
Page 92 How to Find a Good Child therapist
You feel over your head. You’ve hemmed and hawed, but last night’s behavior solidi ed it – you need to nd a child therapist. Your child needs help. Your family needs help. But, where do you start?
Page 93 You thought the decision to pursue therapy was hard, but nding a child therapist seems even harder! Where do you nd one? What makes a good child therapist? Relax, I’ve got you covered. As a child therapist, I will shed some light on what to look for and what to ask. Let’s get started: WHERE TO FIND A CHILD THERAPIST Finding a child therapist doesn’t have to be di cult. Many people feel more comfortable with a referral from someone they know and trust. Talk to friends and family – you’d be surprised at how many people have seen a child therapist. Also, a good child therapist will have connections with people in your community. Ask your pediatrician’s o ce if they have a referral for a child therapist. Many o ces will have a referral list. The school is another great resource. If your child’s school has a counselor or social worker – ask them who they typically recommend. Another easy place to start is on the Internet. Most child therapists have a website. If you do a search for a child therapist in your city – chances are some websites are going to pop up. This will give you a chance to weed out your options. Therapists commonly join therapy directories. You can nd psychcentral’s therapy directory here. Other popular directories include PsychologyToday.com, GoodTherapy.org and Find-a-Therapist.com.
Page 94 WHAT’S THE DIFFERENCE BETWEEN A PSYCHIATRIST, PSYCHOLOGIST AND A THERAPIST Okay, you have gathered a pretty hefty list of names and numbers – but what are all those letters after everyone’s names? LMFT, LCSW, LPC, MD, PhD, Psy.D. – I am pretty convinced that mental health professionals have more letters than any other profession. For help making heads and tails of this alphabet soup click here to read this helpful article. MAKING AN APPOINTMENT I always meet with parents alone the rst session, but not all child therapists do this. I think it is helpful for parents to get an opportunity to connect with the therapist without their child present. This gives you and the child therapist the freedom to ask questions, without worrying about how this would affect your child. If the child therapist usually meets with the child the initial session, ask if it would be okay if you have a parent-only session rst. A good child therapist will be flexible. AT THE PARENT-ONLY APPOINTMENT At the parent-only session ask yourself these questions: Did we connect? Is the child therapist warm and engaging? If you are not connecting with the child therapist, chances are your child won’t either. Child therapists are human and just like people in the real world – you will connect with some and not with others.
Page 95 How did I feel after the session? Did you leave feeling uplifted and hopeful or overwhelmed and doubtful? How the child therapist made you feel is an indication of how they will make your child feel. When I hear parents tell me, “I feel so much better just talking about it” or “I feel better about everything already” – I know it was a successful parent session. Do they work with kids? Okay – you might think that is a dumb question. Of course they work with kids – they are a child therapist. But, some therapists work with everyone. They may have put on their website or pro le that they work with kids – but that doesn’t mean they specialize in children. I am a big believer that you can’t be an expert in everything. I don’t work with couples – because I know next to nothing about couples counseling. Having said that, not everyone understands how to work with children. You may know how to treat anxiety – but treating anxiety in kids is a whole di erent ball game. Some therapists have lots of experience working with teens, but may be lost with a toddler. Ask the therapist if they are comfortable working with your child’s age range and primary issue. Having to switch to a new therapist mid-stream can cause major setbacks. Avoid the hassle and ask these questions before you start.
Page 96 What did the room look like? No, I am not being an o ce décor snob. What the o ce looks like is a key component to child therapy. You might be able to overlook a small, unwelcoming space – but kids can’t. Kids don’t just sit on a couch and talk in child therapy. If that is the expectation – keep looking. Kids talk the most when they are engaged, distracted and having fun. I get more from a child who is doing an art project or playing mini-basketball, than I ever would get from a child just sitting on my couch. MOVING FORWARD So you are all set. You found the perfect child therapist and you are ready to start therapy. Here are some tips as you progress through therapy: Try to avoid giving updates in front of your child Try to be aware of what you say in front of your child. You want therapy to be a positive experience. If you have updates for the therapist – leave a voice message or use email if you feel comfortable. Meet with the therapist alone every few sessions I always meet with parents alone every three sessions. I think it is nice to be able to have a whole session to discuss my clinical impressions, what goals I am working on and what parental approaches might work. If your child therapist doesn’t routinely meet with you alone – ask them if they can. Schedule a few sessions ahead A good child therapist is a busy child therapist. Therapy is more fruitful when you have regular and consistent sessions. If your child therapist doesn’t o er regular time slots – be sure to schedule two or three sessions at a time.
Page 97 Do not grill your child after each session The worst thing a parent can do is grill their child after each session. This behavior has the risk of shutting your child down. Ask your child, “How did it go?” and leave it at that. If they want to talk about it – they will. When you meet alone with the child therapist, you should hopefully get a clear picture of how therapy is going and what types of goals they are working on. If you don’t – ask. A child therapist can be a wealth of support. They can help you and your child cope with basic issues like communication to more serious issues with clinical diagnoses. Once you nd a good child therapist they can be an ongoing resource whenever you need some extra help. ***
Page 98 5 Things You Can Do Tonight to Help Nighttime Fears
You’ve been up since 5am. You think, only 30 more minutes and then it will be my time. You give your child a bath, read them a bedtime story and give them a kiss good night. And then…the nightmare begins and so begins the nighttime fears. When your child is scared of sleeping – there is no sleeping.
Page 99 I am scared. I can’t sleep. Can you lie with me? What if… You’ve tried all the usual tactics. Yelling. Punishment. Pleading. Nothing works. If your child is scared of sleep – your typical parenting judo won’t work. Your child isn’t trying to infringe on your time. They aren’t trying to be di cult. Children who are scared of sleeping feel like there is a real threat lurking around every corner. The quickest way to help your child’s sleep issues is to address their nighttime fears. Until your child learns to overcome their fears– their nighttime troubles won’t go away. So – how do you help that little mind relax and feel safe? Here are 5 steps to help kids who are scared of sleeping:
FIND OUT WHAT SCARES THEM AND MAKES THEM SCARED OF SLEEPING
Don’t assume you know what scares your child. Ask them. Their answer might surprise you. For a great list of questions to ask your child, read the article Bedtime Battles or Bedtime Fears: Are you Missing the Signs? 8 Questions to Ask Your Child to Find Out.
SET UP THEIR ROOM FOR OPTIMAL SUCCESS Lots of parents will splash out on expensive bunk beds, cute bed spreads and fun décor to entice their child to sleep in their own room. Save your money. When I talk about setting up their room for success – I am not talking Star Wars or Elsa – I am talking shadows and noises.
Page 100 Sit down with your child in their dark room. Ask them what areas of their room scare them the most. I can’t tell you how many times I have talked with children in my practice who have referenced a shadow or toy that scares them at night. Often – they haven’t mentioned it to anyone else. Remove toys and shadows that transform into creeptastic monsters when the lights go out. Save your breath and don’t tell your child there is nothing in the shadows. Instead – alter shadows, remove toys and rearrange objects that cast those monster shadows on the walls. Ask them what areas they are afraid of the most. Under the bed? The closet? The window? Clear out any clutter under the bed that may be misconstrued as a monster in the dark. Get a ashlight and leave it under the bed. Tell your child that if their fears bother them – they can squash their fears by looking under their bed. Initially you might have to do this with them – and that’s okay. Ask them if they prefer the closet door closed or open. Do they want the closet light on or o ? Accommodating these requests will help them feel safer at night. Are they afraid of the window? Sometimes kids feel like someone can break their window – even on the second oor. No one said fears make sense! Show them how the window is locked. If you are on the second oor – show them how it would be impossible to get to their window. Ask them if they prefer their blinds open or shut. Many kids report feeling watched through their window.
Page 101 Adapt the light and noise in your child’s room to help their nighttime fears. Often children want more light than we feel is necessary – but reducing the amount of dark corners in a bedroom can help your child relax and move past their nighttime fears.
Use a sound screen or play soft music to help your child avoid hyper focusing on sounds around the house. Children with nighttime fears are constantly listening for noises that seem unfamiliar – and this can keep them awake.
Page 102 Page 103 REFRAME THOUGHTS Ask your child what they worry about at night. Do they worry about bad guys? Monsters? School the next day? Their health? Do not make fun of their worries – as they are real to them. Do not try to convince them that their worries are silly.
If your child is six or older – you can help them problem-solve their nighttime fears. Have them develop rational thoughts to fight their fears.
USE GUIDED IMAGERY TO HELP DISTRACT YOUR CHILD
Guided imagery is one of my favorite methods to help kids at night. After you have made the room feel safe and you have worked on reframing their thoughts – you want your child to focus on something else. I like to have children create a world that they can go to when they are falling asleep. You want your child to make this world as real as possible. Often children will pick themes like a candy land world or a Lego land world.
Page 104 You want your child to imagine this world with all ve senses. Ask them what their world looks like. Ask them what it sounds like. What it smells like. When putting your child to bed ask them to tell you about their world. When you leave their room – prompt them to think about their world.
DO NOT ENABLE YOUR CHILD’S NIGHTTIME FEARS As parents we are tired and have a nite amount of energy to devote to these nighttime fears. The temptation to cave and lie down with our child as they go to sleep is hard to resist. We might have our child sleep in our bed. Or it might seem easier to sleep with our child halfway through the night. If your parenting philosophy includes co-sleeping – this is not a problem. But, if you would prefer that your child sleep in their own bed – you aren’t doing your child any favors. In a perfect world you want to teach your child that they can ght their nighttime fears and that you believe in them. You do not want to inadvertently send your child a message that they are not safe unless you are lying with them. Often getting our scared children to sleep independently will take some time and won’t happen overnight. It has to be done in small steps – from sitting in their door frame, to walking them back to bed in the middle of the night. The key is to empower them – not desert them. You want to help your child build those coping mechanisms – and slowly encourage independent sleeping along the way.
Page 105 Nighttime sleep issues are by far one of the hardest parenting issues. Everyone needs their sleep and when parents and children don’t get it – no one is happy. Hopefully this article has jump started a few ideas to get those little people snoring.
*** Click here to listen to the AT Parenting Survival Podcast episode on Childhood Sleep Issues.
Page 106 Did You Know Play Helps Fears?
Have you ever watched your child’s play and felt seriously alarmed. Wondered why in the world your child would act out certain things? Children’s play can sometimes be aggressive and disturbing – but unlock the doors and relax that worried face. Child’s fears are often expressed through playing.
Page 107 In fact, it is more natural for young children to play through their fears than talk them out. If you have a fearful child hold on tight – because your child might have some interesting play. Young children have the amazing ability to immerse themselves into a fantasy world. A skill we sadly lose as we get older. This fantasy world often incorporates fears children are trying to work through. It is important to note – not all children have signi cant play themes when they are playing. Sometimes play is just play. Also –I would caution reading into your child’s play. I was recently disturbed when I saw my four year old throwing her baby doll repeatedly all over the house. Before I shipped her o for some serious therapy I asked her why she was hurting her baby. Her response, “This isn’t my baby. This is a bad guy mom!” I cancelled my appointment…for now.
Page 108 So how does this disturbing play help your child’s fears? Let’s take a look: HELPS THEM EXPRESS THEIR FEARS When a child’s fears become overwhelming they often turn to play to work things out. Children may not have the words to express their fears, but they have the play skills to act them out. Play is a perfect place to work out what is going on in their little minds. It can also give parents a window into their child’s fears. Try to not interrupt your child’s play, but observe their themes. When they are done playing – ask open-ended questions like, “Who were you hiding from?” or “What was the dragon going to do to you?” These open-ended questions will help facilitate a conversation and will give you extra insight into your child’s fears. If you ask questions while your child is playing you take the risk of altering or ending their play. LETS THEM VENT KID-STYLE As adults when we have fears –we might tell our partner or our best friends. Some of us feel relief just by venting our stress. Young children are less likely to do this. They get relief by acting their problems out. I call this venting kids-style. Kids will re-enact certain themes over and over again. This may be an indication that they are working on a problem in their play. Once a child has worked through a particular issue, you may not see them playing out that particular theme anymore.
Page 109 BUILDS THEIR EMPOWERMENT
Many children will act out their fears – but when children move into beating their fears that is empowerment play. Empowerment play is the best type of play because the child is working through their fears – not just processing it. There are two ways children act out empowerment play. They are either the source of the fear – such as: They are the bad guy They are the dinosaur They are the monster They are the zombie
Page 110 Or they play the role of the hero by taking down the fear by being things like a: Superhero Police, firefighter or soldier Dinosaur hunter Zombie killer Either type of play can create empowerment. This can be disturbing for parents who see their child choose to be a bad guy rather than a superhero. But, some children might be too frightened to be at the receiving end of the fear and therefore choose to be the source of the fear itself. DEVELOPS PROBLEM-SOLVING SKILLS You and I might gure out how to handle our fears by asking the advice of our loved ones, but young children rarely ask for help. Children will problem-solve through their play. They play out various scenarios and develop a fantasy world lled with solutions to address their fears. These solutions may be very unrealistic and fantasy-based – but that is okay. Often young children have fears that blur fantasy and reality – so their solutions do not have to be reality-based either. How to tell when your child’s play is stuck. Some children’s fears are so overwhelming that even in play they are not able to face and/or overcome their fears. Here are some indications that your child’s play might be stuck: They play out the same identical theme over and over again with no change. Their play typically ends with them losing or being hurt.
Page 111 They always play the losing character (regardless of whether the character is good or bad). In a perfect world it is ideal to let your child play and work through their own issues without intervening. If you choose to enter into your child’s fantasy play – it is advisable to play a supportive role – and let your child lead the play. However, sometimes kids get stuck. They are trying to work through their fears, but the play is unproductive. At this point – you might want to move into directive play. Let’s take a look at what that entails. HELPING YOUR CHILD WITH DIRECTIVE PLAY When your child is stuck in a rut you can introduce a way out. Enter your child’s play and help them develop a solution to the fear they are acting out. Here are some examples: If your child is continually getting eaten or killed by bad guy/monster- You suggest superpowers the child can utilize (e.g. Invisibility cape, ability to fly etc.). Your child is afraid to go potty and they repeatedly act out their baby doll refusing to go potty. You suggest that your child become the baby doll’s mom and you take on the role as the baby doll. Your child is now in a position to encourage the baby to go potty, while you act out the doll’s fears. The child is more likely to develop solutions for their fears when they play the role of the parent. Imaginary play is not only fun for children, but as we discussed, it is therapeutic as well.
Page 112 Stock up your house with dress up clothes and imaginary play props to help encourage and facilitate play. Young children usually have great imaginations and can make a dinosaur costume out of a green shirt, but the more inspiration they are given – the richer their play will become. If you are concerned with the intensity of your child’s fears seek out the help of a child therapist. There are play therapists that can help guide your child’s play and can give you the tools to help empower your child at home.
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Page 113 Are Your Child's Worries Making Them Sick?
Did you know your child’s worries can cause constant throat clearing, scab picking and constipation? And that’s not all – add headaches, stomach aches, nausea, di culty swallowing, sleep disturbance and constant urination to the list. The mind-body connection is stronger than many of us think. Your child’s worries aren’t just causing your child stress – it can be physically harming them.
this article is for informational purposes and should not replace the guidance of a quali ed medical professional. It is always important to go to your doctor to rule out any and all medical origins when your child is exhibiting these physical symptoms.
Page 114 When our child’s worries take over – their body goes into overdrive. Their mind might understand that they are not in immediate danger, but their body does not. This biological response revs up their ght or ight response – arming your child for battle. A battle they are not ghting. A battle that will wear them down and create physical distress. These physical symptoms are real. The pain is real. Your child has no control over these physical symptoms – and cannot just make them stop. When you address your child’s worries – eventually the physical symptoms will dissipate. So what are these physical symptoms and why are they happening? Let’s take a look at the obvious and not so obvious issues: THE MORE OBVIOUS PHYSICAL SYMPTOMS:
STOMACH UPSET AND NAUSEA
Worries love to hit the stomach rst. Often children do not even know they are worried until they start to feel nauseous. Children with worries will often feel nauseous when faced with situations that make them uncomfortable – like going to school, giving a speech or meeting new people. When your child is worried their body releases adrenalin. Hormones interact with their gut letting their stomach know that they are in distress. Their body tenses and abdominal muscles tighten. All of this leads to a very uncomfortable stomach – to say the least. There is also new research pointing to the gut – as the cause of anxiety.
Page 115 DIARRHEA AND/OR CONSTIPATION
In the short-term – when a child’s worries are immediate – they might experience abdominal distress and diarrhea. In the long-term – a child’s worries slows down all unnecessary functioning (as it arms itself for an imaginary battle) causing constipation. Unfortunately pooping just isn’t high on the body’s priority list. HEADACHES
When many of us are stressed we are more prone to getting a headache. Children are no di erent. As we talked about earlier, worries cause your child to tense up. They can tense up everywhere – including the muscles around their neck, eyes and head. This can cause a feeling of pressure or sharp, sudden pains. To learn more about the di erent types of headaches anxiety can cause click here.
Page 116 SLEEP DISTURBANCE/NIGHTMARES/INSOMNIA
When a child’s worries consume their thoughts – it is not surprising that they have a hard time going to sleep and staying asleep. It does not help that false alarms may be going o in their brain – telling their body to prepare for battle rather than to prepare for sleep. Children tend to worry more at night because they have less distraction. Safety worries – including health fears and bad guys tend to rear their ugly head at bedtime. DIFFICULTY BREATHING
When children are in a panic – breathing can get shallow and it can be hard for them to get a deep breath. Unfortunately this perpetuates their panic and they start to fear there is something medically wrong with them. DIZZINESS
When your child’s false alarm is going o in their body – internal havoc is playing out. Their heart is racing and they are having a hard time getting a deep breath – this can lead to sudden feelings of dizziness. Which again – perpetuates the worry that something is medically wrong with them. RACING HEART
When our body is preparing for battle – one of the rst reactions is an increased heart rate. When faced with worries, adrenalin is released causing the heart to race. Some kids will hyperventilate when stressed – causing an imbalance of carbon monoxide and oxygen in the blood stream. When this happens their heart has to work harder to get blood throughout the body. Unfortunately feeling your heart race can be anxiety-producing in and of itself.
Page 117 CHEST PAIN
Chest pain is a common symptom that accompanies anxiety. When people hyperventilate – this can cause their chest to hurt. Often when kids are having a panic attack they will have tightness around the chest and may believe they are having a heart attack. LESS KNOWN PHYSICAL SYMPTOMS OF ANXIETY:
THROAT CLEARING/CONSTANT COUGHING
If a child has worries – they are more likely to constantly clear their throat. That might seem bizarre, but anxiety causes extra mucus. Mucus that likes to sit at the back of the throat. Not fun. You can read more about this issue over at Calm Clinic. CHOKING SENSATION/DIFFICULTY SWALLOWING
Along with the need to clear their throat, some children feel like they can’t swallow – or worse that they are choking. In the most severe cases, children will stop eating due to this fear. For more information on this phenomena click here. URGE TO URINATE CONSTANTLY
The need to urinate constantly can be blamed – yet again – on that ght or ight response. When a body thinks it is in danger – it wants to get rid of any and all bodily fluids so it is not slowed down. Unfortunately this creates the constant sensation that one needs to pee. Some anxious children also have sensory issues which further heightened their awareness to bodily sensations.
Page 118 CONSTANT SCAB PICKING
Children with a predisposition to anxiety – are also more at risk for compulsive behaviors including picking behavior. Children with this issue feel a constant urge to pick their scabs. This can become an issue when children do not let their scabs heal and they get infected. HAIR PULLING
Along with scab picking, Hair pulling behavior can be a comorbid condition to anxiety. Trichotillomania is the constant urge to pull one’s hair, eyelashes or eyebrows out. The urge is strong and children may need professional help to learn how to manage this issue. INSIDE CHEEK BITING
Often children who worry bite their inner cheek. Parents may not notice this behavior until their dentist points it out. This becomes a concern when children are breaking the skin – leaving open sores in their mouth. RED RING AROUND THE MOUTH
Some children who worry tend to frequently lick their lips. Some children will then wipe their mouth with the back of their hand repeatedly. This can cause a red ring to appear on the upper and/or bottom of the lip. The lips will have a red, chapped look to them. Having a child who worries too much can be a challenge. Add these physical symptoms to the picture and it can be overwhelming. As discussed at the beginning of this article – go to your doctor and get a complete medical evaluation. If your doctor determines the issue is caused or exacerbated by worries – treating the worries can help alleviate these physical symptoms.
Page 119 Creat a Break Tent
Some children have more intense meltdowns than other kids their age. If you have one of them – you know what I am talking about. These children don’t have mild tantrums – they have MELTDOWNS! Meltdowns that last not just a few minutes – but hours – do you hear me – hours!
Page 120 Children have meltdowns for lots of reasons. Usually it is a culmination of things that have amassed into the perfect storm. They might be too tired. Too overstimulated. Too overwhelmed. Or your “No” has pushed them nally over the edge. Whatever the cause – the fact is usually the same – they have a hard time regulating their emotions – so they meltdown. In my child therapy practice I suggest parents make a break tent. A what?! A tent where your child can take a break. A break from the ghting. A break from the overstimulation. A break from the sensory overload. A break where they can learn to accept the “No” that was dealt to them. No, it is not going to magically x your child’s anger – but it is another tool to add to your parenting tool box! The rst step in helping your child learn how to self-regulate is to remove yourself from the battle. Your child needs to learn how to calm themselves down – and if you remain there ghting, talking, soothing and begging your child to stop crying – they can’t do that for themselves. Instead – tell them that they seem very angry and that they need to take a break in their tent. Children will most likely not want to go to their tent voluntarily at first. You can give your child two choices (over the screaming): 1) Go to your tent and take a break or 2) Stop crying If your child is in the throes of a meltdown I am betting they won’t choose either option (sorry I am just a realist). I usually recommend that parents keep the tent in the child’s bedroom. You can’t force your child into the tent – that would defeat the purpose of it being a safe, comforting place – but you can escort them to their room.
Page 121 If you make your break tent just right – your child will most likely choose to go into their tent down the road. They might even use it proactively – before they have a meltdown. Now wouldn’t that be nice?! There will be some kids who may not take to the idea of a break tent– just like any parenting approach – some things work – and some things don’t. But, you won’t know until you try. Okay – let’s stop all this chit chatting and get down to business. How can you create the best break tent possible? It is very easy – de nitely not rocket science. Here are some simple steps:
Find the perfect tent, space or closet for your break location.
Some children have bunk beds with space underneath the top bunk – other children have large closets that they already love to hide in. If you already have a perfect space – you do not need to get a tent. In a perfect world you would like your area to be 1) enclosed on all sides and 2) cozy (whatever that might mean to your child).
Make your tent cozy with lots of fuzzy pillows and a blanket.
You want your child to snuggle up in their tent – therefore the cozier the better. Get soft pillows to put on the oor of the tent. I like fuzzy pillows that are super soft to the touch. Add a blanket – as some kids fall asleep from exhaustion after their meltdown. The more inviting a potential nap is – the better!
Page 122 Have your child help you decide what they would like in their break tent. You want to ll your break tent with items that will help your child calm down and reset. Here are some suggestions on what that might be. Go down this list with your child and see which ones they prefer. Maybe they have ideas that are not listed? That is even better! Light:
Place a small, unbreakable light in the tent. You can get some of those battery-operated push lights or a portable night lamp that they can grab when they go into the tent. This helps soften and warm up the break space. Music: you can put wireless bluetooth headphones and an MP3 player with your child’s favorite music in the tent or include noise cancelling headphones for those kids that want complete silence. Smells: You can have your child pick out their preferred aromatherapy spray and make their tent smell good. Squishy balls: If your child wants to get their anger out – it is nice to ll up the tent with some ways for them to channel their aggression. Stress balls are de nitely a start.
Page 123 Construction paper: Some kids want to be destructive when they are angry. Leave construction paper and crayons in the tent. Some kids will want to rip up paper, scribble with crayons or draw out their feelings (eventually). Stuffed animals: If your child loves stu ed animals – have them pick out a few that will live in their break tent. Some kids nd great comfort in their stu ed animals and will find it soothing to be surrounded by some of them. Sensory toys: Some children get comfort from toys that address their sensory needs. You can place various sensory toys that appeal to your child’s particular sensory issues. Don’t forget to involve your child in the making of the break tent. When it is ready to go – explain to your child that they can go into their tent whenever they want. Let them know that you will prompt them to go to their tent when they are really upset, as this is a great place to calm down and it is not a punishment.
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Page 124 Parenting Lessons Only Your Anxious Kids Can Teach You
I decided I wanted to be a child therapist long before I ever had children. I nished graduate school before I even began motherhood. I knew all the signs and symptoms of every childhood mental health disorder before my first child entered the world.
Page 125 You would think I was well prepared. You would think if anyone could handle anxious kids – it would be me. Apparently the universe shared the same sentiment – as it dutifully delivered me child after child with some form of anxiety in their DNA. At rst I was in denial. I quickly rebuked my education and my profession and thought, “Come on! These things seem normal to me. My kids do all of those things. What’s the big deal?” Eventually the reality started to sink in. No, not every kid does that. No, not every parent has to worry about going on the highway – because their three year old goes into a panic. No, not every parent has to talk to their ve year old about what will happen when they die. After twelve years and three children later – I have embraced anxiety as much as I embrace my children. My children have taught me more about life than any textbook ever did. I have realized that anxious kids have much to teach us. They teach us… That we need to believe in them – not in their fear. Early on I found myself accommodating my child’s fear. She doesn’t like highways – I should nd an alternative route. She doesn’t like elevators – let’s nd the stairs. Over time – she would surprise me with her tenacity and her ability to dig deep and face her fears. I realized that she was more of a ghter than I was allowing her to be. That she was tired of her worries and she wanted them to go away. Instead of turning away from her fears – I began to hold her hand and we faced them together. One small step at a time.
Page 126 That our fears aren’t always their fears.
Time and time again my children have awed and inspired me. I have inadvertently put them and their worries into tiny, predictable boxes. I play out scenarios in my head and anticipate how situations will unfold. Luckily I have often been wrong. I have realized – I can’t underestimate my children.
I think I was more nervous about kindergarten than my son. I walked him to the gate on the rst day – waiting for the meltdown. Waiting for the battle to start. Wondering if the school counselor was in on the rst day. He turned to me and said, “You can go. I’m good.” And – he didn’t look back. Not once.
That our words can tear them down and lift them up. Anxious children tend to be much more sensitive in general. My kids are no exception. They love hard and hurt hard. Sensitive children often have the biggest hearts. My three year old is the rst to notice when I am having a bad day. She is also the rst one to sulk in a corner for hours when I correct her behavior. She is the one who frequently asks, “Are you proud of me?” ve zillion times a day. I realize that my words have weight. They are actively shaping the way she views herself. I have learned to be cautious with my words – as they can tear my little girl down in a heart beat or they can lift her up. I am in the process of helping her develop her own inner dialogue. That could be good or that could be bad – it was up to me.
Page 127 That our children are watching.
They are watching our reaction. They are watching our emotions. They are watching our choices. Anxious children are observant. My kids notice my subtle tone change. They hear the high pitch of my nerves. Emotions are contagious. Especially when your children look for you to be their anchor. When I am nervous – they are nervous. Sometimes sadly when they wouldn’t have been otherwise. I have had to develop a good poker face. Sometimes I can do this – and sometimes I fail. But, I always try my best. I have learned to stop worrying about their worries – as much. I take one day at a time. One fear, phobia, struggle – at a time. I remember when my oldest daughter couldn’t sleep unless she was holding my hand. I thought she’d sleep next to me forever. She is now twelve and would deny that ever happened. Oh, it happened. I remember not too long ago when I thought my youngest would never go poop in the potty. Her fear was palpable – as she walked around holding her bottom saying, “I no poop. I no poop!” That too has passed. We are on to the next challenges life inevitably brings – but with a new belief. A belief in my children. In anxious children. A belief in their strength. In our strength. A knowledge that we can get through whatever life wants to throw at us – one day at a time. ***
Page 128 How to Help Your Anxious Kids When Bad Things Happen in Our World
I sometimes wish I could take my children and live in a bubble – immune to the violence, hatred and tragedies our world experiences. But, bad things happen. Although living in a bubble is tempting, we would also miss out on the wonderful sounds, smells and laughter this world can bring. And so is life.
Page 129 As adults we can usually put things in perspective when bad things happen, but if you have an anxious child – this might be a major challenge. There are children that already imagine all the what-if’s life can bring them. They already believe bad things happen. They are consumed with thoughts of What if I die? What if I get sick? What if we get in a car accident? Public tragedies can only add to the credibility of their fear. A tragedy has the potential of derailing an anxious child and magnifying all their fears. So when bad things happen – how do you help the child that already worries about diseases, kidnappings, school shootings and natural disasters? One small step at a time. Awareness
Depending on your child’s age – they may or may not be aware of news events. If your child is very young, they may not have exposure to the news. If you have a very young child who is already su ering from acute anxiety, I would recommend not discussing these news events unless they become aware of it. Those young children who are not school aged, may not encounter the news and unless we bring it to their attention – it may not be on their radar. These young children who already worry, sleep in our beds and live in our shadows throughout the day – do not have the coping mechanisms to process a tragedy on a global scale.
Page 130 For older, school aged children we cannot cocoon them from such events. For these children I suggest: -Avoid watching the news. Anxious children have detailed memories – especially for images. Anxious kids have a hard time getting images out of their head for months –even years later. Do not supply their brain with negative images. -Take your child’s lead on what they already know and start from there. -Keep graphic details limited, but give enough information to meet their need to understand the event. -Ask you child if they have any questions. Don’t be presumptuous, even as a child therapist, I am often surprised by what questions kids ask. Their questions will help guide where your discussion should go. -If the perpetrators of the tragedy have been caught be sure to mention this to your child to help them feel more secure. -Watch adult conversations around little ears. Children in the other room are frequently listening. Perspective
Anxious children have a talent for taking a small event – (e.g. missing a homework assignment) and jumping to catastrophic conclusions (e.g. I won’t get into college)! Upon hearing about a news tragedy, your anxious child might jump to the conclusion that their immediate safety is at risk.
Page 131 They might become fearful that they are not safe at school or in public. This can be debilitating for your child. To help put a tragedy in perspective you can do the following: -Show your child on a map where the tragedy happened. Although as adults we realize that tragedies can happen anywhere, children are much more egocentric. Distancing the tragedy from the children’s life and their town will help them feel safer in the short term. -Talk about the odds of a news tragedy happening in your community. You do not want to sugarcoat or lie about the risks the world has to offer, but anxious children already magnify all of life’s risks. Help your child put the tragedy into perspective. There are roughly 7 billion people in the world. Tell them the number of people who were hurt (avoid the word killed) in the tragedy. For example, “That’s 200 people out of 7 billion.” The odds of winning the lottery are 1 out of 175 million – not billion. You have better odds of winning the lottery than being in a tragedy. When bad things happen highlight the good in humankind
This point is so crucial for all of us. It is so easy to get consumed by the hatred and senseless violence of humankind. It can feel scary and hopeless for the best of us. For anxious children – who are already worried about bad guys around every corner – this fear can be paralyzing. -During tragedies focus on the random acts of kindness and unity it brings out in others. -Tell your child stories about those that helped during the tragedy.
Page 132 -If you come across pictures that emphasis kindness and unity – show them to your child. Avoid pictures that have any graphic images in them. Channel your child’s emotions into positive action Anxious children tend to have huge hearts. They often feel other people’s pain and su ering more deeply. Channel your child’s emotional energy into making a positive change. Having them do something to help in the crisis can make them feel like they have the power to make a di erence. It gives a feeling of control in an uncontrollable situation. -Children can earn money to donate to the Red Cross. -They can make art for the victims that can be posted on social media. -If they ask how they can help – you can search the web for ongoing ways to help the victims of the tragedy and share that with your children. In the days, weeks and months after a tragedy, observe your children’s behavior to assess how they are handling their anxiety. If you have concerns seek out professional help. Some warning behavior might include, but is not limited to: frequent nightmares fear to go to public places increase in somatic complaints (stomach aches, headaches and other physical complaints) new fear of sleeping alone new fear of separation excessive worry and talk about the tragedy frequent questions about their safety, weeks and months after the incident
Page 133 I wish we didn’t have to have these discussions with our children. For those little minds and hearts that already worry about so much – I am saddened that this has to be added to their plate. But with rain comes rainbows and with lemons comes lemonade. We need to teach our kids that darkness cannot extinguish the light. That we will not let that happen. ***
Page 134 If You Have a Child with Anxiety You Should Know These 5 Things.
Because I eat, live and breathe anxiety – I have made the ridiculous assumption that everyone fully understands child anxiety. Working as a child therapist and having the genetic curse of anxiety in my family’s DNA – I get anxiety and unfortunately it gets me.
Page 135 Over the years I have found some common misunderstandings about anxiety. If you know anxiety like I do – this list may not surprise you at all. For some of you however – it might shed some new light on anxiety. 1. Anxiety runs in families. Just like diabetes, hair color and baldness – anxiety runs in families. If anyone in your extended family has a history of anxiety or OCD – your children are at risk of dealing with anxiety too. Anxiety can manifest di erently in di erent family members – and it doesn’t have to look the same in each person. Your Great Aunt Hilda might have been a hoarder, your mother might have had panic attacks and your child get’s too nervous to go to school – it is all anxiety.
2. Anxiety does not have to be caused by a trauma or a negative experience.
I am often asked – “Why is he anxious? He has nothing to be anxious about. His life is good.” Parents wonder why their children are afraid of bad guys, nervous to go to school or terri ed of being separated from their parents. They tell me – “Nothing bad has ever happened to him!” Anxiety does not have to come from trauma or a bad experience. You can be afraid of dogs without ever being bitten. You can be afraid of bad guys without ever meeting one. You can be sick to your stomach about going to school – without being bullied. If you have anxiety – you can be worried, afraid and nervous about situations that have never happened to you or that pose no real threat.
Page 136 3. Anxiety can cause many physical symptoms that are not always understood as anxiety.
Anxiety can do some crazy things to our body. The most common symptoms include stomach upset, nausea and vomiting. It can cause frequent headaches. It can cause ongoing constipation or diarrhea. Many of the anxious children I work with have a history of constipation. It can cause panic attacks that make you have shortness of breath, dizziness, chest pain and clamminess.
Some of the rarer symptoms can include di culty swallowing along with the belief that there is something stuck in your throat. Constant throat clearing can sometimes be a symptom of anxiety. Anxiety can give you the urge to pick at your scabs, bite your nails and pull your hair, eyebrows and eyelashes out. I always tell people to rule out any possible medical origin before thinking it is anxiety – but it is helpful to know that these physical symptoms can be linked to anxiety.
Page 137 4. Giving in to your child’s anxiety will make their anxiety grow over time.
Some well intentioned parents cater to their children’s anxiety. It’s hard not to! This is tricky – because there is a ne line between giving in to your child’s anxiety versus being aware of when your child has reached their limit. There is a ne line between pushing your child too hard and empowering your child. Children need to be given tools to learn how to ght their anxiety. They need to be empowered. They need to be supported. At times – they need to be challenged. Having said that – they also need to be understood. They need to not be pushed beyond their limits. The balance can be hard to find! 5. The earlier a child can get help for anxiety – the better the long-term prognosis.
Often as parents –we take a wait and see approach. Parents might think – this is a stage or maybe they’ll outgrow this behavior. The earlier a child can learn coping mechanisms – the better. You can help by reading books on anxiety with your children or reading parenting books on anxiety. Addressing anxiety head on gives your child the best odds for less anxiety in the future.
Page 138 Some children bene t from some sessions with a child therapist. Parents can also bene t from learning parental approaches from a child therapist. Just remember – it doesn’t have to be extreme for you to start helping your child. Young children who show signs of anxiety are less likely to have developed unhealthy coping mechanisms and are often more open to learning new skills. ***
For more on this topic click here to listen to the AT Parenting Survival Podcast episode on Missed Signs of Child Anxiety.
Page 139 My Stomach Hurts! I Can't Go to School.
My Stomach hurts. I can’t go to school. It starts o with stomach complaints. I feel sick. I feel like I am going to throw up. I can’t go to school. You take them to the doctor. You give them antacid medication. Nothing seems to help. This happens every year.
Not again – you think! When will this stop? How can I help them? Sound familiar? No, I am not stalking your family. I just hear this time and time again every school year. I am ooded at the beginning of each new school year with a sea of children that have mysterious “week-day” stomach issues. Often – it is school anxiety.
Page 140 They will tell you they love school. That they have friends. That they are not bullied – and that is all true. And yet – the same resistance to going to school happens every year. Welcome to the mysterious world of school anxiety. Unfortunately anxiety often makes itself cozy in the pit of our stomach. Sometimes anxiety will skip the brain altogether and make a beeline to the stomach. If you nd your child in this di cult predicament here is some guidance to help them:
1. Go to the doctor.
Say, what? She just got through telling us it is anxiety, why should we go to the doctor? For two reasons, 1) It is good to be over-cautious. You don’t want to second guess yourself or miss a true medical condition. 2) If the doctor can rule-out any medical origin this will help your child (and you) buy into the correlation between anxiety and stomach issues.
2. Tell your children that you understand their pain is real.
Even if it is anxiety wreaking havoc on their stomach – the pain is real. The pain is the same. So, when your children are doubled over on the toilet – they are really feeling that pain. When they say they feel like throwing up – they really feel like throwing up. Explain to your children that you know that they are hurting and you want to help them.
Page 141 3. Explain how anxiety works.
Help your children understand how anxiety works. I sometimes explain it to kids this way (depending on their age): Sometimes worries will make our stomach hurt. Sometimes we may not even know we are worried until we feel our stomach hurt. That can be really confusing. Worries create acid in our stomach that can make us feel sick. Worries want to boss us around and want us to avoid things. When we avoid what it wants – it will grow bigger. So, when your worries make your stomach hurt it wants you to avoid going to school. If you avoid school – guess what will happen? Your worries will grow bigger and your stomach will hurt every school day. You can’t cave and do what your worry wants – you have to shrink it by ghting back and going to school. The more you ght back, the less power it will have over you. Now, although that is a helpful story…prepare for a long battle with your child. There will be much resistance and many tears before this issue gets better. Sorry. But hang in there.
Page 142 4. Avoid the knee-jerk reaction to keep them home.
And now for the tip that makes you scream at your computer. Try, try, try to get them to school as much as possible. I know – trust me – I know that at times this will be an impossible feat. Separate from literally carrying your children into school – this may not be possible at times. I get that – and I don’t suggest carrying them in their PJs. You want to just mentally know that your ultimate goal is to get them to attend school as much as you can. Some parents feel like they are being cold and cruel by sending their children to school when they feel sick. Remind yourself that the doctor cleared your children of any medical condition outside of anxiety. If it is purely anxiety – letting their anxiety win will only make this problem grow bigger. You are helping them – by encouraging them to go to school and by keeping them at school when possible. Their pain is real and their worries are real. Using brute force or punitive methods won’t work. You children need help and so do you. Get support from the school counselor as soon as possible (if you have one) or the school administration. The school can work with you to develop a plan on how to help your children work through their anxiety. I have worked with families where the children meet with the counselor in the mornings or goes to the nurse during the day when they feel sick. The trick is to keep them at school – even if they are in the nurse’s o ce some of the day.
Page 143 .
I have worked with children who are allowed to stay home or even switch to home-schooling due to their anxiety problems. Unfortunately anxiety can grow after this happens – and some children’s anxiety will make them fearful of leaving their house in general. 5. Get your children into therapy.
Ahhh spoken like a true therapist – right? Not really. I don’t think therapy is the answer to everything – even though I am a therapist. This particular issue though – can go downhill fast. It is one of the most debilitating issues I deal with in my therapy sessions. Often when I dig deep enough there is an anxiety below all that stomach pain. The 5 most common worries I see related to this problem are: Afraid to be away from their mom – (I only feel okay when I am with her) Worried about their safety Worried about their mom’s safety Afraid they are going to throw up at school Worried they are going to do poorly on assignments (even though most of these children are academically advanced)
I know that this can be one of the most exhausting struggles as a parent. Get support so you do not have to fight this alone! *** For more support click here to listen to the AT Parenting Survival Podcast episode on school refusal.
Page 144 20 Tell-Tale Signs You Parent an Anxious Kid
Parenting an anxious kid is like parenting a di erent species. Those of you who have anxious kids know what I mean. When you are in the trenches with an anxious kid – you better learn to laugh.
Page 145 Not sure you have an anxious kid? Here are some tell-tale signs! If my references are lost on you – do a happy dance – ignorance is bliss. If they ring true – don’t worry – you are not alone! 1. your purse is armed with a full medical kit, a complete change of clothes and a portal to escape any unbearable situation. 2. Your heart starts to palpitate and your hands get clammy when you have to tell your child it is time to go. 3. Taking a dump in the bathroom is a family a air – if you don’t know what that means – give yourself a high five – this isn’t about you! 4. You have eighty di erent styles of ice packs in your freezer and fteen different boxes of cartoon bandaids. 5. Sleeping in your bed is a full contact family sport. Confused? I envy you! 6. You never worry about whether you are going the wrong way or have a full tank of gas because your kid will alert you to all those little details. 7. You hold your breath and quietly reach for your camera when your child spontaneously approaches another child. 8. You screen movies like Nemo for disturbing themes that will cause your child nightmares for weeks. 9. Your bedtime routine is longer than some novels. 10. Your child is more worried about being on time than you are. 11. When you serve dinner, your meal is inspected, smelled and licked before ingestion. 12. The idea of changing your child’s daily routine gives you heart palpitations.
Page 146 13. Questions like, “When will I die?” are just part of casual conversation at your house. 14. Going to the doctor or dentist is like preparing for war. 15. You know what Miralax is and you have needed to use it. 16. Your child owns several belongings that – if lost – would cause them to hyperventilate. 17. You have never said something like, “get down from there you might get hurt.” 18. You have no use for child nail clippers – nails are miraculously kept low all on their own. 19. Phrases like, “Come with me!” and “Stay with me!” are theme songs in your house. 20. Your child gets Post-Traumatic Stress Syndrome after Halloween – and they didn’t go trick or treating. How many did you get? 20 out of 20? 15 out of 20? Do you have some signs you’d like to add to my list? ***
Page 147 5 Tips on How to Parent a Child with OCD
Watching your child su er from irrational beliefs and partaking in bizarre rituals is heartbreaking. The parenting handbook left out the chapter on how to parent a child with OCD. How are you supposed to react? How can you help them stop their compulsive behavior? Should you be stern? Should you ignore it?
Parenting a child with OCD is one of the hardest jobs a parent will ever have to face.
Page 148 These are the questions I typically get when working with parents in my practice. Here are ve basic tips I have learned from working with children with OCD:
1) Educate you and your child on Obsessive- Compulsive Disorder
Time and time again I sit on the opposite side of the couch talking to a nervous and uncomfortable child. They whisper to me how they have silly beliefs. I o er them reassurance and they reluctantly tell me more. They sheepishly tell me how they have to touch corners, or count in their head, or wash their hands every time they have a bad thought. They apologize for their bizarre thoughts and stare at me – waiting for me to o cially declare them “crazy.” No matter how often this happens – it breaks my heart. I tell the child that I have heard this before. That they are not alone. That there is a name for this. That it is common. And that there is help. Their eyes open wide and they say, “there is?!” with palpable relief. You can help your child by explaining to them what OCD is and how it a ects their thinking. If you don’t understand OCD yourself – it is helpful to acquire this knowledge so you are better prepared to help your child. You can read my other article – OCD in Children: Are you Missing the Signs or watch my video on the same topic. There are some great books that help children understand OCD on their level. Some parents shy away from using the word OCD, but I have found that children nd great comfort in knowing that their issue has a name and that they are not alone. My favorite books on OCD are:
Page 149 2) Give the OCD a name like Mr. Bossy Often children don’t know how to talk about their OCD. They are embarrassed by their thoughts. They are dependent on their rituals. When you tell them to stop doing ritualistic behavior they may feel like you are attacking them – not their OCD. They sometimes feel angry. Why would you tell me to stop doing something that is keeping me “safe.” Help your child externalize their OCD by giving it a name. You can call it Mr. Worry or Mr. Bossy. Some kids like to get creative and come up with their own names. I have had kids call it Mr. Germs or Mr. Numbers – depending on their OCD theme.
Page 150 One approach is to tell your child something like: Mr. Bossy is a trickster and he likes to boss you around and make you feel worried. He wants you to avoid stu and follow his silly rules. When you do what he wants – he grows bigger. When he grows bigger – he can bother you more. When you turn into Super (insert your child’s name here) – you can ght Mr. Bossy and beat him. When you ignore him or argue about his silly rules you shrink him and make him smaller – less powerful. Books on OCD can help you reiterate this message – or help you create one of your own if this approach doesn’t resonate with you or your child. 3) Do not get overzealous and point out all of your child’s rituals When your child has a problem you want to x it as soon as you can. This can make parents overzealous with their e orts to beat their child’s OCD for them. Unfortunately this is your child’s battle. You can o er your help and guidance, but you can’t x this for your child. In fact, if you point out every ritualistic behavior you see – you may unintentionally cause your child to become more secretive about their OCD issues. Stopping ritualistic behavior does not happen overnight. Initial success may be as simple as them just recognizing it is an OCD thought or being able to briefly delay a ritual. 4) Don’t be part of their rituals One area you do have control over is your participation in rituals. Some children involve their parents in their ritualistic behavior. If possible, you do not want to enable or participate in rituals. You can tell your child, “I am not helping Mr. Bossy boss you around. You can listen to him, but I won’t!”
Page 151 5) keep an eye out for new rituals so you can work together as a team
Children can get defensive about their rules and rituals and they may not want you to recognize any new rules or behaviors. Even though children do not want to have OCD, they are often slaves to the rituals that provide them with brief relief from their worrying. Therefore it is important to keep an eye out for odd or irrational behavior. Often when one type of OCD behavior has been eliminated – another rule or behavior replaces it. That is why it is important to give your child the skills to beat OCD and not just the speci c behavior or rule they are currently doing. When you discover your child is doing a new ritual – gently address this with them and let them know you are here to help them beat Mr. Bossy. OCD can be a challenging issue! It can consume little minds and impede their social and emotional growth. The sooner children are given the skills to overcome their OCD – the better the long term prognosis will be. I encourage you to follow these tips, educate yourself by reading books on OCD and seek out professional guidance and support for you and your child as needed. For more information and resources on OCD you can visit iocdf.org or take this quick 8 minute Video Lesson on how to parent a child with OCD here. ***
Page 152 5 Ways to Help Separation Anxiety and Finally Pee in Peace
separation anxiety is a normal stage of development. Knowing that doesn’t make this phase that much easier to stomach!
Page 153 1) Play games that encourage healthy separation. Toddlers who are in the throes of separation anxiety feel they are not completely safe if they are not in direct contact with their parent (most often the mother). You can encourage brief periods of small separations by playing games that naturally incorporate distance. Start off with small baby steps. These positive experiences will help your children realize that they are still safe when they are not within eyesight. Hide and Go Seek Hide and go seek is an easy game to encourage separation. Start o in the same room and pick very very easy hiding spots. Let your children do the same. As your children get more empowered include more rooms. Scavenger hunt around the house
Set up a scavenger hunt around the house. The treasures could be dollar store toys, gold coins, chocolate coins…whatever excites and motivates your children. The more exciting the treasure – the more distracted they will be from being separated from you. Place the treasure in easy places around the house (in eyesight). Position yourself in one central location and tell your children to bring their treasure to you as they nd it. This serves as a check-in for them as they roam around the house alone. If you feel your children can’t handle roaming all around the house, start off in one room and expand over time.
Page 154 Walkie talkie fun Give your children easy to use walkie talkies. You keep one. Depending on their skill level they may not have the dexterity and maturity to click back and talk to you. Regardless, it still makes a fun, silly game to try. Tell them you are going to talk to them through the walkie talkie in the other room. This encourages separation, while instilling the idea that you are still close – even when they cannot see you. 2) Set up activities for your children in the room right next to you. Once your children have mastered some of the games above, move on to a more challenging step. Set up an activity (such as arts & crafts, trains, legos – whatever your children like) and tell your children that you will be doing a task (cooking, laundry, paperwork etc.) right in the next room. If they are resistant, tell them that they can come and check on you from time to time, but it is important that they sometimes do activities on their own. Try to do one activity a day in this fashion as you work on their separation anxiety. The activity can be as long or as short as you think your children can handle. 3) Tell your children when you are leaving the room they are in. Okay, I know you are thinking this step does not make sense – but it does. Children who are nervous about being separated are hyper-vigilant. That means they are watching your every move. When you sneak o , your toddlers eventually becomes aware and start to panic. This panic makes them even more vigilant moving forward.
Page 155 If you tell your children where you are going, you are dealing with the issue upfront and not perpetuating the problem. You might have a shadow for a little while, but if you tell them you will be right back – they might eventually stay where they are and trust that you will return. 4) Do not cave and bring them into the toilet with you! I know this is tempting and what mother hasn’t done this – but when trying to help your children with separation anxiety – don’t bring them into the toilet with you! For goodness sake – you need to at least pee in peace! It is also helpful to have a built-in, natural time when your little ones are separated from you. This will give your toddlers a natural way to practice separation throughout the day for very brief periods of time. They will hover and stick little ngers under the cracks, but that my friend – is par for the course. 5) Don’t sneak out when leaving them with others! If your children are su ering from separation anxiety – do not make it a habit to sneak out when leaving them with another caregiver. This will only heighten their fears and they will be less likely to recover from your sudden departure. Instead, give your children a quick and non-emotional good-bye. Do not show hesitation when they cry or worse, come back and try to soothe them. They are upset because you are leaving – so you cannot successfully comfort them during this process – the caregiver will have to do the comforting.
Page 156 Let them know that the caregiver is there for them and that you will return by a speci c activity such as bed time or dinner time. Avoid using time references, as young children do not get the concept of time. If you say you will be home before bed time – be home before bed time! Trust is key in building your children’s con dence and decreasing their separation anxiety. ***
Page 157 Teach Kids to Fight Fears
Teach your Child How to Fight Anxiety….and be a Super Hero!
Teaching your child how to ght anxiety can start at a very young age. I have worked with children as young as two and three that were able to learn skills on how to face their fears. So, roll up your sleeves and start arming your child with skills to overcome their anxiety. It is never too early to turn your little one into a superhero!
Page 158 Episode 1: Develop Your Superhero Set the Battle Ground Have your child name their worries. Sometimes this will just be Mr. Worry, but you can pick something more speci c based on your child’s fears (Mr. Bossy, Mr. Bugs, Mr. Scared, Mr. Sick etc.). Tell them that Mr. Scared likes to boss kids around and make them fearful. Have them create a worthy superhero to ght o Mr. Scared. I like to use the child’s name with Super in front of it (Super John, Super Amber, etc.). Have them draw a picture of Mr. Scared and of their superhero. Prompt them to make the superhero look like them in some way. Dress the Superhero
Children love dress up and there is something transforming when one is dressed as a superhero. Have your child pick out a superhero costume that they can wear when they are a ghting Mr. Scared. A cape and a mask are always good places to start. If they have a particular superhero that they love – have them dress up as that instead. Give them the back story Set the stage for your child by giving them their superhero story. Incorporate your child’s fears into the story. Their story might go something like: There once was a mean, bossy guy named Mr. Scared. Mr. Scared liked to go around bullying kids and making them feel scared. Every time Mr. Scared was able to make a kid feel scared, he would grow bigger. Super John wasn’t going to let Mr. Scared grow any bigger! When Mr. Scared started telling him to be scared of the dark, Super John didn’t listen to him! He knew he could turn on the lights.
Page 159 Put on Your Game Face In my house we have a “Brave Face” pose. Whenever anyone is scared to do something – we say, “Brave face!” and we all put our heads up high and proud. Sometimes duck lips are included. Sometimes it is a full superhero pose – arms on hips, chest pushed out. It is a nice way to empower each other and it encourages us to ght through our fears. At the very least, it lightens the mood and makes us all laugh. Episode 2: SEND YOUR SUPERHERO OUT TO BATTLE Verbally encourage your superhero Having your child dressed and feeling empowered is only half the battle. Now they will need actual experiences to challenge and fight Mr. Scared. You want to encourage your child’s independence by giving them the least amount of assistance they need during these challenges. First start by giving them verbal support. You can say things like, “Don’t let Mr. Scared win this battle! Where is Super John? Do you need to get your cape on? Show me the Brave face!!” Give suggestions to your superhero Give your superhero some suggestions. You can say, “I know it seems dark upstairs, but there is a light switch right there you can turn on.” Or another suggestion might be something like, “We can sing together as you go upstairs so you know I am still right here.”
Page 160 Offer limited support to your superhero When your superhero is lacking some any superpowers – it may be time to call in for back up. The main goal is for your child to feel success, so if you have come to the conclusion that Mr. Scared is de nitely going to win the battle, get your kiddo’s back! O er the least amount of intervention as possible. This might be turning the light on for them or walking half way up the stairs with them. Always premise your assistance with something like, “Okay Super John I will make you a deal. I will turn on the light for you if you do the rest” or “I will go up the rst ight of stairs, if you go up the rest.” Getting your child to agree on a plan makes it more likely that they will stick with it…sometimes. If that doesn’t work – pleading helps – “Don’t let Mr. Scared win! I know you can beat him!” Okay, if all else fails, bribe your superhero!
I know that if someone told me to jump o a high dive there would very little that anyone could say to get me to do it. However, if the price was right – I might be encouraged to face my fears and try to do it. When all else fails o er a “challenge prize.” I will often have families set up a “challenge treasure box ” that is lled with dollar store toys and prizes. When your child is faced with a particularly hard challenge, you can o er a challenge prize if they try to do it. You want your child to push themselves just slightly out of their comfort zone. If they are able to do this, but don’t fully complete the challenge you can say, “You were amazing! I know that was scary for you, but you went ahead anyway and tried to do it! You get a challenge prize for being so brave!” Children don’t turn into superheroes overnight, but if you don’t give your child the skills to ght their fears, they have lost the battle before it has even begun. *** Page 161 10 Strange Reasons Why Kids Hate Bath Time & 6 Ways to Fix it.
Although bath time may be relaxing for some children – there are many kids who go running in the opposite direction when they hear the word “bath.” Kids fight bath time for many different reasons. If your little ones have to be chased down for their bath, it is possible there is something behind their opposition.
I often work with families in my therapy practice who misinterpret their children’s intense avoidance of bath time as “bad behavior” – when in fact there is often a fear or discomfort driving their behavior. Besides the obvious reason: I am doing something and I don’t want to take a bath!
Page 162 There are other reasons that are often missed. Here are a few of them: Hard time with transition/change of activity Afraid of bed time – which often occurs right after bath time Fear of bugs in the bath (even those small, microscopic mysterious black dots) Sensory issues related to the feeling of water on their body Sensory issues related to the temperature of the water Sensory issues related to the sound of the water pouring into the bath Fear of getting soap in their eyes Aversion to getting water on their face Fear of slipping in the tub Fear of getting sucked into the drain This is not an exhaustive list, but it addresses the most common reasons why kids may want to avoid bath time. With that being said, how do you get your little ones from being scared to loving their bath? As with many kid issues, it is not e ective to get into a power struggle and out-power your child. Getting to the source of your child’s fear will get you much farther in the long run! Below are some approaches to help get your kids back to loving bath time:
Page 163 Avoid sensory overload in order to get your child IN the bath.
If your children are sensitive to noise or temperature – there are many triggers around bath time that might overwhelm them. Parents do not always realize that their children may have some sensory issues. If children hold their ears around loud noises they might have some auditory sensitivities. If your children have noise sensitivities, it might be helpful to ll up the bath prior to bringing them into the bathroom. A nice quiet bath might be more inviting than the roar of rushing water. Some children have issues with temperature or with the feeling of water around their body. A possible indicator of this would be if your child stands and refuses to sit in the water through the entire bath. To help alleviate this sensitivity – have your children sit in the bath tub as you ll up the water. This will help them acclimate to the water as it envelopes and tickles their little body. It will also help them adapt to the temperature and allow you time to make adjustments if the water gets too hot or too cold. Avoid soapy eye disasters! The most common bath time issue is the fear of getting soap in one’s eyes. Kids have a good memory for pain and it only takes one soapy, teary experience for them to want to avoid bath time all together. Besides soapy eyes, many kids don’t like water on their face. Take precautions to avoid both of these nightmares! Use a bath visor to help prevent water from trickling down their face.
Page 164 Also, I always recommend keeping a dry wash cloth right next to the bath. This instills con dence in your children that if they were to get their face wet, you got it covered! Put stars or a mobile above the tub so your little ones will look up for a longer period of time when you are rinsing their hair. Use washcloth puppets to get their hair wet if they refuse to let you pour water on their head. A very soaked monkey may want to pat your kids on their dry head during a fun puppet show. Help associate bath time with fun time! This point may be obvious – but if your children are having fun, they are less likely to focus on their worries.
Adding bath toys, bath paint or bath crayons can turn your bath time into a fun play time. I discovered the world of fun themed baths through the website Growing a Jeweled Rose. She has amazing ideas for fun baths (plus lots of other great ideas)! Conceal those little black specks that freak your child out! Trust me, this is a bigger problem than you think. Younger kids get very paranoid about little black specks that they view as large, scary bugs that can eat them. As irrational as this might sound, the x can be quite easy. Bubble bath. A beautiful sea of white bubbles that consume and conceal anything that might possibly be analyzed and deemed as a threat to your kid. You can also add color to your child’s bath. There are bath drops that don’t stain your bath and make beautiful, colorful baths.
Page 165 Don’t drain the bath with your child still in it. If your child is sensitive to noise or just tends to be on the nervous side – the obnoxious, aggressive sucking sound your drain makes might be pretty unsettling for your kid. This nervousness about drains sucking them to their death will pass – thank goodness – but in the meanwhile why have all that drama? Take your children out of the bath without pulling the drain. As they are drying o you can pull the drain as you distract them or as you are leaving the bathroom. Their fear of the drain will most likely naturally go away as they develop. Give plenty of warnings about when bath time will start and finish. Ironically the biggest complaint I hear from parents is something like, “He ghts us tooth and nail not to take a bath and then weirdly he refuses to get out of the bath!” This isn’t really that big of a surprise. Many kids don’t do well with transitions. Also, once your children are having fun in a warm, soapy oasis – who can blame them for not wanting to get out! Before bath time is going to begin, give your children a ten minute warning. For younger kids, anchor your warning around an activity not a time. You can tell them something like, “After you are done drawing that picture it will be bath time.”
Page 166 I have transitional theme songs with my children that I have made up. My bath time rendition is “bath time is fun time…bath time is fun time….who wants to take a bath?” luckily you are not hearing me sing it – it gets worse. But…my children know what is coming when they hear the bath time jingle. I also have a bath time jingle to end the bath – I won’t subject you to that one. Anyway, my point is – let your children know what is coming before it comes. Have a fuzzy towel ready for your little ones so you can wrap them up as soon as they hit that cool air. My parenting motto – whether to myself or to the families I work with is “this too shall pass.” I have whispered that many times under my breath as I have endured hardship after hardship with my kids. My rst child actually had occupational therapy to address her fear of bathing. My third child had a month long aversion to the bath – where she cried and screamed every time it was bath time. I am happy to report that my oldest child is now eleven and laughs when I tell her she needed therapy to eat and take a bath (we’ll talk about the eating issue some other time)! My little one is still a toddler and now she loves her bath! On to the next phase and struggle… ***
Page 167 End Your Child's Fear of the Dark with These 9 Sure Fire Tips!
Fear of the dark is a common and typical fear for most children. Fear of the dark usually starts to crop up in toddlerhood. When children’s cognitive abilities expand – so does their imagination! For some kids, this fear never goes away.
Page 168 Some kids are more seriously a ected by their fear of the dark. Children who tend to have an anxious personality can be more debilitated by these fears. They might follow you from room to room and might refuse to go into any dark room alone – even during the day! Bedtime can be a complete nightmare – no pun intended! Kids can take hours to go to sleep and can wake up throughout the night due to their fears. In general, it is never too early to start empowering kids to ght their fears. You can even start teaching your toddler how to fight their fears. Arming your kids with coping mechanisms to ght their fears will give them a jump start in facing challenges and will reduce their level of anxiety in the future.
Validate your children’s fears – don’t discount them.
One of the most important ways to help your children is to first validate their fear of the dark. This may sound like some sort of psycho babble, but it actually has some merit. All too often, we as parents tell our children that their ne – when they are not feeling ne. Let your children know that you understand that they are scared and that it is normal to have a fear of the dark. Explain to your children that the dark is scary only because we can’t see what is around us. When we can’t see what is around us – our imagination can make us worry about things that aren’t there. You can tell your children, “When your imagination tries to trick you, turn the light on and you will see that you are alright.”
Page 169 Have light switches accessible for your children.
In order to help your kids feel empowered, make light switches more accessible to them. Some toddlers are taller than others and for some this may not be an issue, but for those that are on the lower end of the growth chart (like all three of my children), this can be a major challenge for the rst few years!
Fortunately, the world of innovative toddler products has not failed us! You can nd various brands of light switch extenders on Amazon that make light switches reachable for all!
Page 170 Have battery operated press lights strategically placed around your house.
Keeping on the theme of accessible light sources, purchase a few battery- operated stick-on tap push lights. You can buy these at most major stores like Walmart or on Amazon. Place the small lights in strategic places that tend to scare your kids. You might want to place one right by their bed or in their closet. You can place one at their level, in the hall.
You can buy those Velcro mounting strips if you do not want to damage your walls – as this is a temporary approach. When you are teaching your children to ght their fear of the dark, the rst step is empowerment. If your kids can feel like they are in control of the dark, they will become less fearful. It is okay for your children to not like the dark, what you are trying to teach them is how to develop independent ways of coping with this fear. One coping mechanism will be their ability to independently turn on the light and check their environment themselves when they are scared. Don’t assume you know why the dark scares your children!
Page 171 kids are strange little people, with their own unique and unpredictable fears. Recently my kid was scared of french fries and was having nightmares of french fries chasing her – no joke! So, even though your children might give you an obvious answer to the question “What do you think is in the dark?” such as –monsters or creatures – it is better to not to assume – it might be something like french fries! Addressing the dark, without the fear associated with the dark- is like putting on a band aid without knowing what you are covering. Sometimes we are unaware that some kid-friendly TV shows can have scary themes for kids. My children get particularly scared of Peter Rabbit – who is always being chased by the scary wolf. Octonauts have also contributed to a few nightmares about sea creatures eating them. We can’t shelter our kids from all that they will see and observe, but we can have discussions about what they see and make some of those images and stories less scary for them.
Put fun light sources in your children’s rooms.
Although this recommendation sounds pretty simplistic – it can actually be a bit of a struggle. Too much light during sleep can a ect your children’s sleep cycle. So keeping your children’s main light on is not ideal. Not enough light can cause your children to panic and can keep them up all night. A dim nightlight can cause more shadows and make your children’s fears increase. A bright nightlight can cast sharp shadows in the room.
Page 172 Finding the right light source that meets your children’s standards, but doesn’t affect their sleep can be a daunting task.
Luckily there are many creative nightlight options on the market. My current favorite night lights are the Glow Buddies (people or animal shapes that glow at night).
There are also glow balls that can be held or carried by your children when they move around the room or get up.
There are also projection nightlights that project various images on the ceiling (stars, ocean scene).
Page 173 There is no right answer to nightlights – just what is right for your children.
Eliminate the scary shadows in your children’s room.
When I have worked with children in my child therapy practice, they often tell me about a particular shadow in their room that scares them and keeps them up at night. When I ask them if they told their parents, they almost always say, “No.” Usually it is an object that children can identify in their room that is causing the shadow. I have advised many families to move dolls, hat racks and puppets out of their children’s room. Sit with your children in their bed when their nightlight is on. Ask them to show you what areas of the room scare them at night. If there is an obvious shadow, nd the source of the shadow and show it to your children. You can say something like, “See, it was your doll making that shadow on the wall. We can move your doll into the closet and the shadow will be gone.”
Teach your children how to have fun with shadows.
One way to desensitize your children to shadows – is to have shadow puppet fun . Have shadow puppet shows with your hands. Teach your children how to manipulate their hands to look like different things on their wall.
Page 174 You can get shadow ashlights that have plastic covers that go over the ashlight and shine images that project on the wall. During the holidays you can often nd these type of ashlights at the dollar store. Teaching your children how to play with shadows will demystify the concept of shadows and will make them less scary in the future.
Celebrate the dark by having glow parties! Another way to help your children acclimate to the dark is by having what I like to call – glow parties! These have become a popular activity in my home and can be at yours as well. Find a room that has no windows – this might be a closet, laundry room or bathroom. Buy glow in the dark bracelets and necklaces. You can buy glow in the dark balloons or just put a glow stick in a regular balloon to make it glow. Page 175 If you want to splash out – you can buy a blacklight for under $20 at stores like Amazon. If you have a black light you can add white and neon shirts. If a mess doesn’t bother you, you can paint with shaving cream (which will glow in the black light) or you can buy glow in the dark silly string. The whole purpose of the glow party is to help your children make a connection between the dark and fun. Most often this association doesn’t exist and it has to be established. Give your children challenges where they can earn a reward for facing their fears. This is an approach that I utilize quite often in my therapy practice and I encourage parents to use this approach at home to address many fears. When your children are afraid to go into another room because it is dark, tell them something like, “I can go with you or you can face your fears and take a challenge. If you go by yourself you can earn a prize?” Some families I have worked with have created treasure boxes with little trinkets their children can earn when challenges are accepted. Always let your children decide if they want to take a challenge or not. Forcing your children to face their fears is ine ective and will actually exacerbate the problem in the future. A prize box encourages children to push through their fears and utilize coping mechanisms that you have been teaching them. You can verbally support your children by reminding them of their coping mechanisms – such as “You can do it. Just go in and turn the light on right away. You can sing to me as you go or we can sing together so you know that I am near by.” Remember – you are planting seeds that may not blossom for a little while. Just keep on planting and watering and you will eventually see all your e ort sprout!
Page 176 Section 2
UNDERSTANDING ANXIETY
Page 177 Signs of Selective Mutism: When it is Beyond Shyness
A day in the life of Selective Mutism
The lady at the cash register smiles at your daughter. You think to yourself, “please don’t try to talk to her. Please just scan the next item.” But all your internal pleading falls on deaf ears.
“What’s your name sweetie?” the checker asks in your daughter’s direction. Your daughter stares at the lady with big brown eyes. She blinks once, she blinks twice. There is a visual stare down that seems to last forever. And then there is the awkward silence that always follows. You’ve been here before. Maybe not in line 3 at the local grocery store, but yes, you know exactly how this is going to play out before it even begins. The cashier will experience the awkward silence. She will have a sick awareness that something is wrong. Perhaps she’ll think your child is delayed, on the spectrum, hearing impaired or worse – disrespectful. On a good day, she’ll glance in your direction and give you a sympathetic smile. On a bad day, she’ll scowl at you with judgmental eyes. Today was a good day. You got a “sympathetic look” and moved on.
Page 178 As you place the groceries into the car your daughter is talking up a storm. She is safe now. Out of earshot of any listening ears. Your daughter is not shy. Your daughter is not rude. Your daughter has Selective Mutism. Selective Mutism can be overwhelming not only for the child but for the family as well.
Page 179 Signs of Selective Mutism can show up subtly when kids are very young. Perhaps you had a toddler who hid behind you when you talked to others or hid their face when people spoke to them. You might’ve chocked it up to “shyness” and for most toddlers, you’d probably be right. But then you may have noticed something weird. Whenever your child was around other people they became unnervingly silent. I mean no sounds. Eerily quiet. Maybe at rst, you thought your child was just uncomfortable in new situations or around people they didn’t know. Maybe you started to feel like your child was rude, and grew embarrassed by her refusal to say thank you and please. Perhaps it was only in kindergarten that you really started to put the pieces together. After all, it was mid-year and your child had yet to speak to their teacher or peers. Maybe your child found one special friend who she was able to share her thoughts with, one soft whisper at a time. A friend who became her lifeline and translator to the outside world around her. Perhaps whispers began and rumbles of “what’s wrong with her” started to emerge. But she looked like your run of the mill, free-spirited child at home. You stared at her playing in the backyard, laughing and singing with her brother. Why couldn’t she be like that anywhere else?
Page 180 Selective Mutism can debilitate kids and puzzle parents. Many parents will tell themselves… She’s just shy. She’s just overwhelmed. She’ll grow out of it. She’ll adapt. She’ll be fine when she is a bit older. Unfortunately, Selective Mutism is an anxiety disorder and it knows no age limit. Do you worry your child has Selective Mutism? A child may have Selective Mutism if: [this is not meant to be used to diagnose and is written for informational purposes only. Seek out the guidance of a mental health professional if you are concerned about your child having Selective Mutism]. -They consistently do not speak in certain situations where they are expected to speak [like school], even though there is nothing wrong with their ability to communicate or their understanding of the English language. -The issue has been happening for over a month and it is beyond a reaction to just new situations (i.e. beginning of school etc.).
Page 181 How is Selective Mutism Treated? Selective Mutism is treated through cognitive behavioral therapy. It is important to work with someone who understands the disorder and the treatment approaches that are the most effective. Click here to watch a helpful video from the Child Mind Institute on Selective Mutism: As parents, you can help or hurt the situation. Don’t shame your children for not talking. Having Selective Mutism can be extremely frustrating and overwhelming for the child. No one wants to feel like they can’t talk to people. Kids with this disorder often beat themselves up about it and don’t need any additional help in that area! The earlier kids get treatment for Selective Mutism, the better. Left untreated, this anxiety disorder can get much worse and can impact all areas of a child’s life. Let your child know about the condition. Demystifying this issue can help your child feel less alone and reduce self-blame.
Page 182 There are many great books on this topic that are written for children. Here are just a few:
Page 183 Don’t put your child on the spot. Kids with this disorder don’t do well under pressure. Putting them on the spot to talk to others will most likely back re. The more a child experiences negative situations around talking, the bigger their anxiety and fear will grow. Slow and steady wins the race. You want your child to feel success, not failure. Putting them on the spot will most likely end in failure. Set up one-on-one interaction. Kids with Selective Mutism are much less likely to talk when there are too many people around. Their anxiety will create irrational rules in their brain: I can’t talk to adults And/or I can’t talk to kids I can talk to her, but no one else Typically, if a child with Selective Mutism starts talking to you, they’ve broken their “rule” and can, therefore, continue talking to you. Kids will tell me that once someone hears their voice, their anxiety around talking to that person dissipates. Getting them to that point, however, can be an uphill battle. As a parent, you can stack the deck in your favor by orchestrating ongoing contact with an outside adult or child to interact with your child one-on-one. This will foster a relationship and will give your child an opportunity to practice the skills they might be learning in therapy.
Page 184 Be creative with communication. Just because your child has Selective Mutism, doesn’t mean they can’t have a relationship with relatives outside the home. Many parents I’ve worked with are heartbroken that their child won’t talk to extended family. You can help with this by recording an audio or video message from your child. Many kids are comfortable creating messages for extended family to be listened to later. As you progress through therapy, your child might get comfortable with you playing the message in front of the relative or friend. At times this can help them overcome the anxiety of talking in front of that person. Get yourself support. Having a child with Selective Mutism can feel very isolating. You are not alone. Find support and guidance. Below are some places to start: List of Selective Mutism Support Groups Selective Mutism Association Other Books on Selective Mutism:
Page 185
Page 186 Do Your Kids Hate the Sound of People Eating? It Could Be Misophonia.
What do a bag of chips and loud crunching do to your kids? If you said throw them into a rage, we should talk. Did you know that some of us are triggered by noises? I am not talking about being slightly annoyed, I am talking about an urge to go completely ballistic when hearing these sounds. Let me introduce you to the world of sound rage, better known as Misophonia. Don’t know what that is? Take the Misophonia quiz below to see if it sounds familiar.
Page 187 Misophonia literally means “hatred of sounds.” Misophonia has many names including Select Sound Sensitivity Syndrome and Sound-Rage. There has been very little research on Misophonia, but there is speculation that it may be caused by a dysfunction of the central auditory system in the brain and not a dysfunction of the ears. Early data is showing a possible hyperconnectivity between the auditory system and the limbic system, a part of the brain responsible for generating emotion. That would explain the irrational anger and strong hatred these sounds illicit. Unfortunately, Researchers are in the early stages of understanding this phenomenon. It will be some time before we have a clear picture about this condition and what treatments will be truly effective.
Take this Misophonia Quiz to nd out if your child is struggling with this issue:
[This list is not meant to be used to diagnose and is for informational purposes only.] #1. They have an irrational reaction to certain sounds. #2. They get angry when someone makes noises while eating. #3. They verbally attack the person who is making the noise. #4. They are bothered by other sounds as well such as breathing, sni ing and gum chewing. #5. They have a hard time sitting at the dinner table without getting enraged. #6. Other noises bother them as well such as someone on a keyboard, the tapping of fingers/pencils or the clicking of a pen.
Page 188 #7. People are afraid to eat in front of them. #8. The sound of water dripping upsets them. #9. They are aware that they have an irrational reaction to noise. #10. They show some level of anxiety when they know they are in a situation where they will be triggered. How did your kids do on the Misophonia Quiz? Did you nd yourself saying “Yes” to many of these? Younger kids might only exhibit a few of these symptoms and may develop further symptoms as they get older. Sensitivity to these sounds can cause an array of emotional reactions ranging from mild to the extreme.
Some kids might have mild reactions to noise sensitivity that might include: Anxiety Discomfort Panic Annoyance Disgust
Page 189 Other kids might have severe reactions to annoying sounds that might include:
Verbal aggression towards the person making the sound Attempt to physically harm the person making the sound Fleeing from the sound Crying and having a meltdown A feeling of strong hatred toward the person making the sound
Types of sounds that trigger Select Sound Sensitivity Syndrome: Noises that revolve around the mouth: -chewing -chomping -slurping -lip smacking -crunching -silverware on teeth or clanking plates -kissing -breathing
Page 190 Other bodily noises: -sniffling -snoring
Repetitive high pitched noises: -keyboard tapping -clicking buttons on remote or game controller -tapping fingers -clicking pen -tapping pencil on the desk -water dripping You might think, “What is the big deal? We all get annoyed by irritating noises. These kids just need to learn how to deal with it!” But your thought process would be all wrong. This is an issue that goes beyond irritation. These sounds are triggering intense emotions that are out of the child’s control. It is as if these sounds have a direct switch to their anger, a switch they have no ability to turn off. The di erence between general sensitivity to sound and Misophonia: It is important to di erentiate the experience of general sensitivity to sound to those su ering from Misophonia. Many of us have kids who have sensory issues. They might have an acute sense of hearing or might be disturbed by loud, overwhelming noises. That is not Misophonia.
Page 191 Kids su ering from Misophonia aren’t bothered in general by loud, startling noises. They are disturbed by the speci c types of sounds we have already outlined. The other di erence is the intense level of anxiety and anger that comes with the sound. Misophonia can cause intense rage. Rage that is targeted at the person making the noise. This rage can cause kids to verbally and physically attack the person making the sound. It can make it di cult for kids to eat meals with their family or their friends. Kids can have a hard time focusing in school, due to the built-up rage of classroom sounds. It can make kids want to avoid eating out, going to the movies (popcorn eaters are the worst) or hanging out with friends. Not every child is going to have these severe reactions, but some do. My personal experience with Misophonia I have a confession to make. Misophonia is true to my heart, not only because I see kids in my practice su ering from it, but I su er from it as well. I didn’t know it had a name until a few years ago. In fact, it didn’t even have a name until 2000 when audiologists Pawel and Margaret Jastrebo gave it one. But since then people all around the world are reporting the same symptoms, making researchers scramble for answers. When I was a child our dinner table conversation often centered around who is “chomping” and how to eat with your mouth closed. As I got older these sounds started to enrage me. I realized as an adult how debilitating this issue could be. As I breastfed I would grow increasingly agitated at the sound of my baby sucking on my nipple. As my children grew older I would have them move away from me when they ate a snack. Later I would privately beat myself up for my behavior and would question what kind of mother would get angry at their kids for such normal sounds.
Page 192 When you are triggered by these sounds, you have very little control over your strong emotional reactions. The sound of my husband channel sur ng would generate such hatred and disgust towards him, I would literally be crawling out of my skin waiting for him to stop. These emotions can be confusing, as he is the last person on the planet I would ever feel hatred or disgust towards. That is what Misophonia does to you. Not only do the sounds drive you completely crazy, but the aftermath of guilt and shame are not fun either. If your child scored high on the Misophonia quiz, how do you help your child?
There is no treatment for Misophonia but there are things that can help: At this time, there are no evidenced-based treatment approaches yet for Misophonia. But there are two things I have found very effective:
Knowing about Misophonia helps Believe it or not, the knowledge that this nasty thing has a name can help. Once I discovered that this was not my fault, the blame stopped. Once I discovered that my limbic system is possibly being triggering by these sounds, the guilt stopped. And once I understood the list of triggers that can cause me to go into a tailspin, the hurt stopped. I informed my children about my issue. I let them know it wasn’t them, it was me. I explained in simple terms what the issue is and how it a ects me. We all joked about it, but I know they were relieved to hear they weren’t doing anything to cause my irrational grumpiness.
Page 193 Take precautions against triggering We developed new rules out of love, not out of anger. We no longer eat on the couch. Yes, it is an added bonus that my couch stays clean, but the rule has a dual purpose. If little people want to snack, they need to be at the table. A place I stay far from when I see little mouths smacking, I mean snacking. When I hear people on keyboards, game controllers or using the remote, I take a deep breath and get up if I need to. I tell myself it is not their fault. If I need to say something I start with, “It’s not your fault, but that sound is driving me crazy can you…” This helps remove blame and hurt from the issue. You can help your kids by… #1. Teach your kids about Misophonia. They will be relieved that this issue has a name and that they are not alone. Siblings will be relieved that their brother or sister doesn’t truly hate them. #2. Have your kids make a list of sounds that trigger their anxiety and/or anger. This will help them know what sounds are triggering their sound-rage. If they are unsure, have them look at the Misophonia quiz. #3. Teach your kids how to use coping mechanisms to deal with sounds they nd unbearable. Let them know they can only control themselves not those around them. Teach them to use ear plugs, headphones and music to tune out irritating noises. Teach them to get up and move to another room when initially triggered. #4. If mealtime is an issue, play music or use a sound screen to drown out the noise of everyone eating. Let your kids know that they can leave the table if the sounds get unbearable, but it is not okay to lash out at others who are eating.
Page 194 Misophonia can be a slight annoyance or a serious issue. I hope that with this new information you are in a better position to help your kids and their little ears tolerate these irrationally enraging sounds. Other resources on Misophonia: What is Misophonia http://www.misophonia.com
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Page 195 13 Signs of Health Anxiety in Children
She mentioned her stomach hurts for the hundredth time today. Her face lights up when I tell her I am going to take her to the doctor. “When!” She beams, her little body covered in band-aids. I am concerned. My ve-year- old is consumed with her health. “Do I have a fever?” She asks. “Do you think I am sick?” She questions. Unfortunately, I have seen this behavior before. As a child therapist, I know exactly where we are headed. We are entering the world of health anxiety. Health anxiety, also known as Hypochondria is a condition where people xate and obsess over their health. Many people don’t realize that health anxiety can start in children. Unfortunately, it is alive and kicking in little anxious minds.
Page 196 Do your kids suffer from Health Anxiety?
Do you have your pediatrician on speed dial? When you visit the pediatrician does he normally tell you there is nothing to worry about? Does your child ask to go to the doctor often? If so, you might be dealing with Health Anxiety. Below are 13 signs of Health Anxiety I see in my child therapy practice.
Obviously, children can have several of these signs without having Health Anxiety (especially #5), but if most of the signs sound familiar, Health Anxiety might be the issue at hand. [This list is not meant to diagnose and is for informational purposes only. If you have concerns about your child’s anxiety, please seek out the guidance of a local mental health professional]. #1. Your child has a new physical complaint almost every week and the doctor has concluded your child is healthy. #2. Your child brings up a concern about their health every single day. #3. Your child frequently asks you to take their temperature. #4. Your child worries about things like cancer, brain tumors and heart disease. #5. Your child is permanently wearing a band aid. #6. Your child nds mysterious lumps on their body that no one else can feel.
Page 197 #7. Your child researches ailments on the internet. #8. Your child knows more about germs and diseases than the average child. #9. Your child is frequently absent from school (or would be if you let them). #10. Your child frequently has sharp pains that cannot be identified. #11. Your child takes a long time to recover after an illness. #12. Your child has anxiety attacks when they think they are sick. #13. Your child gets very concerned when they are around someone who is sick. Helping Children with Health Anxiety Does this sound like your child? If so, what can you do to help? The earlier children with this type of anxiety get help, the better. Here is what you can do: Do not feed into your child’s worries. If you start to have concerns about your child’s health do not vocalize them to your child, monitor them silently.
Explain Health Anxiety to your child. Let them know that some children worry too much about their health. Let them know that sometimes anxiety can make you hyper-focus on every ache and pain. When anxiety hyper focuses on these aches and pains, those sensations can get more intense. Anxiety will tell you it is something horrible and deadly like a tumor. Your anxiety will tell you that if you don’t get help right away you might get very, very sick. These thoughts increase your worries and your panic.
Explain to them that although the feelings are real, the situation is not serious. Anxiety is a trickster who likes to make us worry.
Page 198 Teach your child to beat anxiety and defeat anxious thoughts.
Do not discuss your own aches and pains in front of your child. You want to minimize the focus of health issues in your home.
If your child continually complains about aches and pains throughout the day, have them write it down and give you the list once a day. This helps de ect the focus on physical ailments, while still helping your child feel heard.
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Page 199 The Link Between Sensory Processing Disorder and Anxiety
Does your child have Sensory Processing Disorder and anxiety? Have you ever wondered why?
My initial therapy sessions with parents often start out the same. I can almost guess what parents are going to say before they say it. “He’s just so sensitive.” “He’s always been a cautious kid.” “Everything bothers him, even his clothes.” “We have to lie down with her at night.” “She is such a picky eater. Always has been.” “She is terrified something bad is going to happen.” Does he refuse to wear jeans? Does she hate socks? I start to ask the usual questions.
Page 200 “Yes! Yes! How did you know?” I know because I have had this conversation a thousand times before. I know because they are describing a sensitive child. A child who is sensitive to the core, both inside and out. Time and time again parents come to therapy for anxiety and walk in with a child with Sensory Processing Disorder (SPD). Anxious kids are sensitive kids inside and out. It is not surprising then that a good portion of those anxious kids have Sensory Processing Disorder (SPD) as well. Sensory Processing Disorder and Anxiety go hand in hand. SPD is often missed. Anxiety is not. That is why I am often the initial introduction to the letters SPD and not an Occupational Therapist. The connection between Sensory Processing Disorder and Anxiety Parents struggle. Is it the SPD causing the anxiety? Feeling your world so deeply is sure to make anyone feel overwhelmed and anxious. Is it two separate issues? Who do they see? A Child Therapist? An Occupational Therapist? Unfortunately, the answers are a bit blurred. Sensory Processing Disorder and Anxiety are simpatico. They are best buddies. They like to hang out and wreak havoc together. Not every child with Anxiety has SPD and not every child with SPD has anxiety, but a large proportion do. SPD can cause a child to feel overwhelmed. They might have anxiety about situations that trigger their sensitivities, like crowds or new foods. They might wake up in a rage because they have to put on clothes. They might worry about fire drills because they are so loud.
Page 201 But unfortunately, those same children might meet SPD’s cousin, anxiety. They might worry about bad guys. They might be consumed with their health. They might be paralyzed with fear around peers. They might strive to be so perfect, that they feel they can’t do anything right. How to help kids with both Sensory Processing Disorder and Anxiety These kids need help in both directions. They are equally important and they are equally destructive. Parents need support on how to navigate through the maze of sensory meltdowns, as well as how to help empower their children to face their anxieties. Kids need help understanding their sensory “super powers” as well as how to boss back their anxiety bully. The good news is both can get better. Much better. I know this professionally and I know this personally. I have watched kids develop an understanding of their own sensory needs. And I have watched kids crush their anxiety. Both are doable. I have had shoes chucked at my head. I have spent hundreds of dollars on clothes that have never been worn. I have had moments when I just gave up. Like the time I brought my child to a wedding wearing a casual cotton dress and flip flops. An SPD uniform of sorts. We had many anxiety rules at my house. The highway was o limits. Elevators, escalator and closed doors were a no-no. A small bit of food had to be left on the plate. We conquered these fears. We crushed these rules.
Page 202 There is help With help and support, these children can blossom. My oldest no longer chucks shoes at my head (bonus). But, I still see piles of rejected clothes on her closet oor every morning. She has learned to be more in tune with her skin. With all her sensitivities. She no longer takes her struggles out on the rest of us. We go on highways. We use elevators and escalators. We face fears, we don’t avoid them anymore. SPD and anxiety can bring any family to their knees. But with help, support and determination things can get better. Once small victory at a time.
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Page 203 30 Signs of Social Anxiety
Do your kids have a hard time warming up to people? Are they slow to make friends? Are they silent at family gatherings? When does shyness turn into social anxiety in children? It can be a challenge to tell what the signs of social anxiety are and what is just shyness?
Page 204 Here are 30 signs of social anxiety in children. Each sign individually is normal and many kids will have these thoughts and struggles. But if the whole list starts to sound very much like your kid, you might want to take a closer look at social anxiety. This list is not meant to diagnose and is for informational purposes only. If you are worried about your child having signs of social anxiety, please consult a mental health professional. 1. Has a hard time talking to other kids and/or adults. 2. Excessively worries about their appearance. 3. Worries they might say something or do something embarrassing. 4. Struggles with ordering their own food at restaurants. 5. Is consumed with what other people think of them. 6. Has a hard time eating in front of other people when they are not at home. 7. Prefers to stay at home most of the time. 8. Feels overwhelmed in large social gatherings.
Page 205 9. Worries parents are going to embarrass them in front of their friends. 10. Doesn’t like anyone to focus on them. 11. Is too anxious to raise their hand in class. 12. Overanalyzes social situations. 13. Often feels friends don’t really like them. 14. Has a hard time talking to people on the phone. 15. When they were very little they had a hard time separating. 16. When they were little they didn’t talk to anyone except family. 17. They have a hard time using the bathroom when they are not at home. 18. Refuses to poop anywhere, but home.
Page 206 19. Feels like their friends don’t really care about them.
20. Is too anxious to do school presentations. 21. Is too anxious to read out loud in class. 22. Excessively worries that other people are judging them. 23. Is mortified if a teacher corrects them in front of other students. 24. Speaks softly to those they don’t know. 25. Fears new social situations. 26. Plays alone at school. 27. Has limited friends.
Page 207 28. Teachers describe a completely di erent child than the one you see at home. 29. Gets self-conscious when their appearance changes (haircut, braces etc.). 30. Is overly afraid that kids will be mean to them. This list is by no means comprehensive. These are just some of the most common signs of social anxiety I see in my practice. ***
Page 208 Why Anxious Kids are Often Misdiagnosed with ADHD
Some kids have anxiety. Some kids have ADHD. Some kids have both. And some anxious kids are misdiagnosed with ADHD. Unfortunately there is some overlap between the signs of ADHD and anxiety.
How can this happen you ask?
Page 209 Easily. Many of the symptoms that will get you a guaranteed diagnosis of ADHD are behaviors anxious kids have as well. Now I am not saying that anxious kids can’t have ADHD and anxiety. In fact, many kids have both. But some kids look like they have ADHD when in fact, it is pure anxiety in disguise. These kids are often misdiagnosed with ADHD. This is a dangerous mistake, as many ADHD medications actually exacerbate anxiety symptoms. Let’s break it down. Symptoms that overlap in ADHD and Anxiety: When anxious kids are nervous they can act HYPER. That’s right. When they are scared, they might be bouncing o the walls. You might wonder what has gotten into them. They are rocking, bouncing and can’t sit still. They are literally a ball of nervous energy. When anxious kids are consumed with worry, they can be UNFOCUSED. Anxious kids are constantly consumed with thoughts – and they are not fun thoughts. When everyone is paying attention to math, they might be worried about who will play with them at recess. They might be sitting there worried about whether or not you are safe. The teacher might call on them, but they can’t hear her. They are too busy worrying.
Page 210 When anxious kids are overwhelmed they can look DISORGANIZED. Anxious kids spend much of their time worrying. They don’t often tell anyone they are having these thoughts. They might wonder if they will have enough time to play when they get home. They might wonder if their homework will be too hard. They might shove their school work into their backpack. They might not write their homework down. They hope you are outside waiting to pick them up. What if you are late? Where will they go? Their focus is on their worries, not their organization. When anxious kids are nervous they often FIDGET. When anxious kids are nervous they squirm. When they are at school and are stressed, they might shred paper or poke holes in their jeans. They might pick at their eraser until a sea of pink lls their desk. They are unsettled because of their thoughts, not because of their body. Ask yourself these questions if you are concerned your child has been misdiagnosed with ADHD: When your kids are hyper is it right before or after something that made them nervous? Before or after school? Before an activity? Before bedtime? When your kids are unfocused are they daydreaming about Minecraft and Legos or are they battling worries? When your kids are disorganized are they incapable of organization or are they feeling overwhelmed? When your child fidgets are they bored or are they nervous?
Page 211 Unfortunately, it is often hard to discern what is anxiety, ADHD or both. Sometimes kids look hyper or angry when they are really anxious. This happens more often in boys than in girls, but it can happen in girls as well.
If kids have experienced abuse or trauma, Post-Traumatic Stress Disorder (PTSD) can highly mimic symptoms of ADHD as well. Kids with PTSD are often hyper-vigilant and unfocused due to ashbacks and fears. If you have a child with an abuse history who has been diagnosed with ADHD, you want to look at those ADHD symptoms very carefully. If you have concerns about your child being misdiagnosed with ADHD talk to your pediatrician, therapist or psychiatrist for a full evaluation. This article is for information purposes only and I encourage you to have a dialogue with your providers. It is helpful to understand what is driving kids to become hyper, unfocused, disorganized and dgety. Once you know what is at the root of these behaviors, you’ll be much more e ective at helping your child with these issues. ***
Page 212 Are You Missing These 5 Uncommon Signs of Child Anxiety?
Parents would know if their child is anxious, right? You would see obvious signs? Your child would express all their fear and worries. They would be afraid all the time.
Unfortunately, anxiety isn’t always that obvious. Some children don’t vocalize their worries. They don’t show their fears. And anxiety isn’t on their parents’ radar.
Page 213 In my child therapy practice parents often bring their children in for other reasons, only to discover that the problem is actually anxiety. Here are five missed signs of child anxiety: PHYSICAL SYMPTOMS: Anxiety isn’t just in our minds, it is in our body as well. Here are just a few examples- Your child won’t poop. They have been constipated for weeks. You’ve been to the doctor and there is no medical origin. Your child’s stomach hurts. They feel like throwing up. They are having gastrointestinal problems. You brought them to the pediatrician. You went to the gastrointestinal specialist. Your child has been poked, prodded and maybe even scoped. No medical origin has been found. Anxiety isn’t just in the mind, it can be felt in the body as well. SCHOOL REFUSAL: Your child used to love school. They’ve always had friends and they have always gotten good grades. Now it is a battle just to get them in the car. They tell you they don’t feel well. Their stomach hurts. They say they are going to throw up. You keep them home – only to feel bamboozled because they seem fine shortly thereafter. You talk to the teacher and the counselor. Everyone swears up and down that your child has friends. That they are not being bullied. That they enjoy school. Weekends are pain-free. Your child seems completely healthy – and then Sunday rolls around. The cycle begins again.
Page 214 ANGER: Anger can be tricky. Kids can be angry for so many reasons. They might have di culty self-regulating. They might have a mood issue. They might have a hard time accepting no. But along with the usual contenders, anxiety can be the underlining cause of anger too. If your child stu s their worries way down deep – the only thing to bubble to the surface might be their anger. They come home from school ready to explode. Bedtime brings with it rage and resistance. New situations cause unusual hostility and defiance. Pay attention to when and why your child gets angry – as it could be the key to unearthing the true cause. AVOIDANCE OF ACTIVITIES: Your child used to love soccer practice and now they are refusing to go. Your child said they wanted to take swim lessons, but after the rst lesson you can’t get them back to class. Your child always wants to stay home and refuses to go to restaurants and stores with you. When a child starts avoiding situations they used to enjoy – it is time to take a second look at why. It might be that they simply no longer like soccer or swim class – but it might be something more significant. The #1 unhealthiest, go-to coping mechanism for anxiety is AVOIDANCE. Avoid at all costs. If I don’t go to soccer, then I won’t have to worry about the ball hitting my face.
Page 215 If I say I don’t want to go to swim, then I won’t have to worry about sinking to the bottom of the pool. If I put up a big ght – then I won’t have to go to the restaurant and worry about throwing up in public. ROUTINES VERSUS RITUALS: Your child has to line up all their stuffed animals in a perfect row before they go to bed. You have to say “I love you” in a certain way – for a certain number of times – before your child will go to bed. Parents often mistake ritualistic behavior for routines. Routines are comforting and predicable. Rituals are rigid and need to be redone if not done “correctly.” Routines are a healthy part of childhood – rituals are an indication of anxiety. Anxiety is a very treatable condition. The earlier children get help – the better the prognosis in the long run. If you feel like your child is having some signs of anxiety, seek out the advice of a mental health professional. It can never hurt to get some professional input and guidance. ***
Page 216 Is My Angry Boy Really an Anxious boy?
He is like a powder keg ready to explode. No one knows what will set him o or when. But, when he does – watch out and brace yourself. Because once he’s in a mood, it will take a miracle to get him out of it.
Sound familiar?
I meet hundreds of angry boys a year in my child therapy practice. Some have self-regulation issues. Some have family issues. Some have school issues. But some – have anxiety. You might think what does anxiety have to do with anger? But they have much to do with each other. Some children are uncomfortable expressing emotions – especially fear and anxiety. They ll up to the brim with anxiety until they can’t stu anymore emotions inside.
Instead of imploding (like most anxious kids) they EXPLODE. Leaving everyone in their wake ba ed and confused. Why did he explode? What just happened?
Page 217 You might be thinking, why is this lady only talking about boys? Don’t worry I haven’t forgotten the girls. But, in my practice boys struggle with this issue twice as often. It doesn’t mean that there aren’t angry girls out there stu ng their anxiety – it is just less common. So how can you tell if your angry boy (or angry girl) is actually an anxious kid in disguise? Here are some possible signs:
LOOK FOR PHYSICAL SIGNS
Anxiety doesn’t only impact the mind – it takes a toll on the body as well. Often this is the only indicator that something is amiss. Below are some ways anxiety can manifest into physical symptoms. For more on this topic you can read Are Your Child’s Worries Making Them Sick?
IS THEIR ANGER SEEMINGLY RANDOM
Look at when your child gets upset. Does the situation warrant such a reaction? Is their anger out of the blue? Do they lash out at everybody indiscriminately? When anxious children are in need of exploding – it doesn’t take much to set that in motion. They just need one small spark to ignite the tinderbox of emotions they have stored up. The more anxious they have been – the larger the explosion.
Page 218 RESISTANCE AND ANGER TOWARDS NEW SITUATIONS
Are you met with an angry little face every time you sign your kid up for something new? Are you dragging him to soccer practice? To parties? Even to school – sometimes?
Page 219 I can’t tell you how many times parents have told me, “He ghts so hard to avoid new things, but once he goes he really likes it.” Anxious kids often have a hard time with new situations. With a worried mind, the unknown can be scary. Unfortunately angry boys don’t typically vocalize their fears. Anxiety is usually the last thing anyone suspects.
SLEEP PROBLEMS
Sleep issues is one of the core indicators of anxiety in children. Not all anxious kids have sleep problems – but most do at some point. If your child is giving you a hard time going to sleep or staying asleep – read the next article Bed Time Battles or Bed Time Fears to decipher if your child’s sleep issues sound anxiety related. For tips on how to help your child get to sleep click here.
YOUR CHILD IS AN ANGEL EVERYWHERE ELSE BUT HOME
I frequently hear, “Everyone tells me how sweet and well behaved my son is with them. I wish we saw that kid more often at home.” Typically this isn’t because home life is horrible. Rather, anxious children store up their anxiety throughout the day. They work so hard at keeping it together – that they come unglued as soon as they walk through the door (lucky you). Parenting an angry child isn’t easy. If the underlining issue is anxiety – the anger won’t go away until the anxiety is addressed. If you recognize your child in this article – seek out some further guidance. This is just a broad description of some potential indicators of anxiety and is not meant to be used to diagnose.
Page 220 These signs can also be indicators of other issues, so get a full assessment by a child therapist.
They make some great kid books on anger! Read Anger Books For Kids: Anger Management for Kids of All Ages for a great collection. ***
Page 221 Bedtime Battles or Bedtime Fears: Are You Missing the Signs?
Bedtime arrives and so do bedtime battles. Your child kicks into high gear. Instead of winding down – they are winding up. Gearing up for bedtime battles.
Page 222 They come out of their bedroom repeatedly. They need to pee. They need to get a drink (so they can pee some more)! They need one extra hug. They need you to fix their blanket. Sound familiar? Bedtime battles happen for a zillion reasons. They aren’t tired. They want to play longer. They don’t want to miss out on the fun (Net x and a tub of ice cream anyone)? But, sometimes, this annoying, tiring behavior is an indication of something more. Of a nervous child. A child with racing thoughts and a worried mind. A child that may never mention that they are scared. Never mention that they have worries. A child that has been labeled difficult. You yell, scream and threaten your child to go to bed – but nothing works. Worries are often immune to punishment. When parents come to my child therapy practice for bedtime battles – the rst thing I rule out are bedtime fears. Why? Because if your child won’t go to bed because they are scared, no amount of typical parenting is going to make that go away. You need to fix the fear – not the bedtime refusal. So how do you differentiate what is causing the behavior?
Page 223 Here are the questions I ask kids when trying to figure out the difference.
As I talked about in my article How to Get Your Kids to Talk , you want to avoid asking closed ended questions or questions that lead your child. Under each question I provide examples of how children with and without worries typically answer these questions. This is by far not an exhaustive list of questions or responses and should only serve as a guide. Please note – these questions are only for informational purposes and are not intended to be used to diagnose children. If your child has sleep concerns, please seek out the guidance of your pediatrician and/or a local child therapist. What is the worst part about going to bed? Without worries: I am not tired. It is boring. Why do I have to go to bed when they [siblings] don’t have to? I go to bed so early, it’s not fair. With worries: It is so dark. I can’t shut my mind o . I’m scared. I just can’t sleep. I hear noises. I don’t know when you guys are going to bed [kids with worries at night are more likely to have a preference about when their parents go to sleep].
Page 224 If you could change one thing about bedtime what would it be? Without worries: I would get to stay up longer. I could watch TV in my bedroom. With worries: You would lie down with me. You would stay with me until I fall asleep. My room would be brighter. I can sleep with you. What do you think about when you are trying to fall asleep? Without worries: Nothing, I am just trying to go to bed. My day tomorrow. What happened today. With worries: What if a bad guy breaks in? What if there is something in my closet? What if there is something under my bed? What if someone will break through my window? What if a ghost wants to hurt me? What if an alien abducts me? What if someone is outside my door? I feel like I am being watched. I worry about the noises I am hearing. I worry about tests and school the next day.
Page 225 I feel like my heart is pounding. I worry I might be sick. I worry I might die if I go to sleep. I worry something bad will happen to you when I go to sleep. I worry you might leave the house when I am sleeping and I will be all alone. What keeps you up the most when trying to sleep? Without worries: I am just not tired. I hear you guys watching TV. With worries: I think I see things in the shadows. I hear noises that scare me. I wonder when you guys are going to go to bed. I wonder when you are going to leave (if you lie with them at night). I worry someone might try to kidnap me. I feel like I am having a hard time breathing. What makes it hard to go to bed? Without worries: I am not tired. I don’t like sleeping. I am not ready for bedtime. With worries: I am scared at night. I feel like something bad might happen. It is so dark in my room. The shadows look like people. Sometimes I hear things in the house and I think someone is breaking in.
Page 226 If you could change one thing in your room when going to bed – what would it be?
Without worries: I don’t know? With worries: It is too dark. Certain objects/toys look scary in the dark. I don’t like my closet. I don’t like my bed by the window [children with worries often believe someone is watching them through the window or will break their window. It doesn’t matter if they have blinds or if their room is on the second oor – worries don’t always make sense]. If you could change your bedtime routine what would it look like? Without worries: You would let me stay up later! I can play on my computer/iPad/phone in my bed. With worries: You would lie down with me as I go to sleep. I could fall asleep in your bed. I could keep my light on. I can move my bed. You wouldn’t leave me.
Page 227 How do you feel when I tell you it is time to go to bed?
Without worries: Annoyed – I don’t want to go to sleep. I don’t like having to stop watching TV or playing. With worries: Scared. Fearful. Worried that it will soon be pitch black and everyone in the house will be sleeping, but me. My stomach feels weird. I feel nervous. If your child answered with worry-based responses, it is likely their bedtime battles have more to do with fear than with anything else. Helping your child ght their fears will eventually end the bedtime battles. You can read books that address their worries and teach them how to work through their fears of the dark. ***
Page 228 Childhood OCD: Are You Missing the Signs?
If you or someone in your family has OCD (Obsessive-Compulsive Disorder) – your child is more at risk of getting OCD. OCD is believed to be inherited. So, along with eye color and hair color – your child can get OCD and Anxiety.
Page 229 I have seen OCD symptoms in very young children in my therapy practice. Often children su er with symptoms for years before parents or teachers recognize the issue as OCD. The earlier a child can get help for OCD – the better the prognosis is long-term. I am going to give you a simple break down of what OCD is and what behaviors to watch for. So let’s arm you with some facts:
OCD has two parts – obsessions (unwanted thoughts that cause distress) and compulsions (acts or behaviors that are meant to reduce the distress). Obsessive thoughts can be centered around safety or health – or it can be an unwanted, inappropriate thought that makes the child feel bad. OCD goes way beyond germs and hand washing – and that might be a big part of why parents miss these early signs. OCD has many faces and at times it can disguise itself pretty well. I have picked out the most common types of OCD along with possible warning signs. This list is not exhaustive and it is meant to be a brief introduction to OCD in children. Typically children have symptoms in only one or two categories. Having some of these symptoms does not mean your child has OCD – but may indicate a need for further assessment by a pediatrician or child therapist. Rituals: It is easy to mistake early ritualistic behavior for routines. There is a di erence between a routine and a ritual. Routines are comforting, but if you veer from your routine – your child doesn’t go into a panic. If it is a ritual – your child will panic and will insist you “redo” the ritual correctly. Children often require these rituals to ensure nothing “bad” will happen to them or those they love. Ritualistic behavior may rst start around the bedtime “routine.”
Page 230 Example of possible Early Signs: -Having to do the same exact behavior when tucking your child into bed (e.g. flatten out sheets, check for bugs). -Having to say an exact phrase back to your child (e.g. saying I love you in a particular way) -Having to tell your child an exact phrase at bedtime or before you leave the house -Your child has to do things in a certain way and will start over if interrupted Movements or Gestures: Children who are bombarded with distressing thoughts, will often make up a gesture or a movement to counteract these thoughts. They believe that if they do these movements – it will stop the OCD thought from happening. Example of possible Early Signs: -Movements that look like tics, but are done on purpose (e.g. blowing air into their hands) -a series of body movements that are non-sensical and can be controlled (e.g. shoulder shrugs) -Head nodding in a pattern that can be controlled -purposeful eye movement in a pattern that can be controlled (e.g. moving eyes up and down or left to right) -constant throat clearing -constant nose sniffing (without a cold) -Having to tap or touch things for no reason Special Numbers: Some children with OCD develop a special number that helps ward o negative thoughts. They may favor odd or even numbers to counteract their OCD thoughts.
Page 231 Example of possible Early Signs: -Things have to be done a certain amount of times (either a special number or an even or odd amount of times) -Avoiding even or odd numbers (on the TV, on the radio) -Counting their steps or skipping steps on the stairs -Having to say or repeat things a certain amount of times
Order: A child’s predisposition to being neat or messy is no indication of whether they have OCD or not. Order in OCD does not have to do with cleanliness. Some children with OCD place their toys, stu ed animals and other belongings in a certain way and feel considerable distress if someone moves it out of its designated spot. Example of possible Early Signs: -Having stu ed animals in a particular order that cannot be altered (especially around the bed) -They get very upset when objects are touched or moved in their room -If something is moved or placed in a di erent position they will put it back to its original position Contamination: Contamination thoughts go way beyond germs though…items can get contaminated due to other themes as well. Some children have a fear of urine, bird poop or even just bad thoughts they are having while touching or wearing something. The common denominator in this category is avoidance of an object, toy, room etc. due to the belief that they can no longer touch it.
Page 232 Example of possible Early Signs:
-Avoiding certain objects, toys, rooms or areas -Asking you to do something for them (touch the remote, open the garbage can lid etc.) -Rigidity in routine (has to have the same exact seat in the car [because other seats are contaminated], won’t touch certain door handles) -Walks in strange patterns to avoid certain areas of tile or floor Confessional Thoughts: This category is a bit tricky to detect. OCD can make children second guess their actions, behavior and thoughts. They might feel guilty about thoughts that are inconsistent with how they actually feel (e.g. I think I called you stupid in my head). They might worry they did something that in reality – they did not do (I think I might have cheated on my test). Relief is only achieved when the child “confesses” these thoughts to a parent. The confessing behavior is the compulsion component of the OCD. Possible Early Signs: -Tells you things they thought in their head (e.g. I thought I hated you just now) -Tells you they are having bad thoughts (e.g. I am thinking she is fat) -Is embarrassed to tell you what type of thoughts they are having (older children may have inappropriate sexual thoughts) -Confesses to behaviors that are small or inconsequential (e.g. I think I bumped someone at school) -Confesses to behaviors that they do not do or can’t remember doing (e.g. I think I cheated on test)
Page 233 OCD can be a complicated and confusing disorder. It can look di erent in each child. This list is not exhaustive and it is not meant to diagnose your child. If you are seeing some of the early signs listed here, consult with a child therapist who specializes in childhood OCD and Anxiety. Young children are very resilient and adaptive. Once your child is armed with tools on how to ght their OCD – they will have much more success decreasing and possibly eliminating their symptoms. For further information on OCD you can visit the International OCD Foundation http://kids.iocdf.org. ***
Page 234 10 Signs of an Anxious Toddler
Common anxiety symptoms often do not show up until a child is school aged. But -why wait? What if you could detect those early signs and get your child help when they are very young? There are the obvious signs of toddler anxiety such as excessive fears and phobias, but there are also more subtle signs that indicate an anxious and sensitive temperament.
Page 235 Some early precursors to anxiety are not fear related issues, but rather behavioral and sensory processing issues. Children with sensory processing issues (SPD) are much more prone to having issues with anxiety as well. Many children will have sensory issues as toddlers and will be diagnosed with anxiety when they are school aged. Early intervention is key for both issues – therefore it is important to get an evaluation from a mental health professional who specializes in toddler mental health along with a Pediatric Occupational Therapist if you have any concerns. What are the signs of an anxious toddler? Many parents and even mental health professionals will miss the early signs of toddler anxiety, as it can often look vastly different than what we might expect.
Below are 10 common signs of an anxious toddler: 1) Fears and Phobias First, let’s address the most obvious sign of toddler anxiety – fears and phobias. Toddlers with an anxious personality tend to be more fearful than the average toddler. Typical toddlers can also exhibit some of these fears, but it is the level of fear that sometimes di erentiates the anxious toddler from the non-anxious toddler. The most common toddler fears are centered around a few basic themes: Bugs, birds, animals, shadows, the dark, monsters, creatures and dinosaurs. Bathroom fears include: Fear of getting ushed down the toilet, of bugs or of the ush. Bathtub fears include: Fear of getting swallowed by the drain, bugs in bath or of water.
Page 236 This is not an exhaustive list, but highlights the most common toddler fears you might encounter with your little one. 2) Rigidity in Routine All toddlers love routine and structure, but anxious toddlers cannot survive without it! Anxious toddlers need to have their day planned out in a very predictable fashion. If plans suddenly change, these children become completely unglued. Anxious children cannot handle change or transitions and they will often become unraveled when simple changes are made to their daily routine. 3) Sensitivity to Noises Anxious toddlers are more likely to have heightened sensitivities. They are often more startled by noises in their environment. They might be afraid of loud sounds such as the vacuum, garbage disposal, garbage truck, automatic toilet flushers and loud music. 4) Sensitivity to Clothes Besides noises, anxious children might start to have issues with their clothes. Often anxious toddlers have trouble with seams on their socks and tags on their clothes. Some children prefer to wear crocs or ip ops. Some anxious toddlers refuse to wear jeans or clothes that feel restricting on their body. 5) Doesn’t like to get Hands Dirty Some anxious toddlers are very concerned with getting dirty – especially their hands. Anxious toddlers often avoid messy play and they may have a mini-meltdown if their hands get overly dirty. They will often insist on washing their hands when their hands have anything on them.
Page 237 6) Has Many Rituals Anxious toddlers have many routines, that border on ritualistic behavior. They may only want to use certain dishes or they may insist that you serve food to them in a certain way (cut it in triangles). They might have bedtime routines that require you to line up their stu ed animals in a certain way or require you to say good night to them in a certain way. They might have you re-do things because it wasn’t done in the correct order or in the correct way. 7) Picky Eater Most toddlers are picky eaters. Food is a common toddler battle. The anxious toddler takes picky eating to another level! Anxious children are less likely to try any new foods at all. They may not want their food touching on their plate. Some anxious toddlers gag when their food has textures they are not expecting. Anxious toddlers might have less than a handful of foods that they will eat. 8) Toddler Follows you From Room to Room The anxious toddler is a parent’s shadow. Many toddlers will follow their parent around the house, but the anxious toddler will have a complete meltdown if they cannot see their parent. These children are right under their parent’s feet and cry and hover around the door when their parent’s in the bathroom. Any type of separation is a cause for panic for the anxious toddler. 9) Slow to Warm Anxious toddlers are less likely to be friendly to strangers. They are more likely to be leg huggers and may take some time to warm up to new people in their life. Some anxious toddlers might be overwhelmed in crowds or at busy birthday parties where there are many children around. 10) Sleep Issues Page 238 Anxious toddlers almost always have sleep issues. They have a hard time sleeping on their own and want their parent to lie down with them or sleep with them at night. They might get up several times a night because they are scared or had a bad dream. Some anxious toddlers might have all ten of these qualities and others might only have a few. Every child is unique and anxiety can manifest in different ways for different children. The good news is the earlier you detect anxiety in your child, the quicker you can learn approaches to help build their level of resiliency and teach them coping mechanisms to overcome these challenges. If you are concerned about your toddler’s behavior, consult a child therapist who specializes in infant and toddler mental health along with a pediatric occupational therapist for an evaluation. Anxious children often tend to be some of the most kind-hearted children I have ever met! Having a sensitive temperament brings many great strengths. It is important to arm our young children with tools to overcome their anxiety, so their full potential can achieved. Do you have an anxious toddler? For a complete guide get the book How to Parent Your Anxious Toddler .
Page 239 SECTION 3
ANXIETY & HOLIDAYS
Page 240 5 Ways to Prevent Your Kids from Having Holiday Meltdowns
It is that time of year again – frenzied shopping, experimental baking and party after party. Holidays are many people’s favorite time of year. I love everything about the holidays, except the over stimulation and pace that turns my otherwise well-behaved little children into gremlins, causing truly ugly holiday meltdowns.
Page 241 If you want to see a gremlin for yourself just nd a young child at a holiday party three hours after it started or for even more fun go visit the end of the Meet Santa line. To avoid holiday meltdowns start by following these five tips: Avoid over scheduling and allow for some down time. It is tempting to cram every festive activity into your schedule. I know I am guilty of this! With so many cute holiday-themed activities, it is hard to decide which ones to let go. If you are like me, you want to soak up the holidays. Unfortunately some kids can’t handle the pace and stimulation this might bring. This could be a quick trigger for holiday meltdowns. Be aware of your child’s limits. If your child gets tired and overwhelmed after activities, be sure to arrange for some down time at home after a fun event (That is of course unless you just love holiday meltdowns).
Holidays with kids are full of treats. Keep an eye on your children’s sugar intake. I must gain at least 10 pounds in the month of December. It seems like no matter where you turn, a cute holiday treat is being shoved (albeit by your own hands) into your mouth. Your kids are stuffing their faces too! For two of my three children this does not alter their mood or behavior too much. For one child it is a scary transformation. I swear if you look close enough you could probably see his head spinning. Know how sugar alters your child’s mood and behavior. Some children get more emotional, hyper and quick to anger when on sugar overload. A recipe for a delicious disaster (and a guarantee for holiday meltdowns)!
Page 242 Family holidays are fun, but be a buffer for overzealous relatives.
You might love your Great Aunt Margaret from Idaho – but your kids probably don’t. Some children are slow to warm and can be uncomfortable hugging and chatting with people they don’t see often. You can help your children by not insisting that they go up and hug every distant relative and friend. Teach your children to be polite and smile or say hello, but do not force your children to hug or entertain those they do not know well. Spread out the gift giving. Sometimes marathon gift giving can overwhelm children and lessen the appreciation for the gifts they are being given. One way to help with this issue is to spread out gift giving. We have a tradition where our children can open a few gifts on Christmas Eve. Our Christmas Eve gifts always require more assembly and keep our children’s attention for hours. Hmm – coincidence, I think not! I also like the concept of hiding a few gifts that are “found” by the children a day or two later. Have something your children can look forward to after the holidays. The holiday season is like a huge wave that is building momentum from Halloween to New Years Day and then crashes January 1st. You have one more week o with the kids and all the holiday fun is over. This can cause holiday withdrawals for not only you, but for your kids. Having something fun planned for after the holidays can help with the anticlimax of the season’s end. Have a special get together, hike or outing for the week after Christmas. This will help with the holiday detox process and give the kids something to look forward to while on break.
Page 243 Holidays should be magical and screaming children who have lost the ability to use their legs is not what I call fun! Hopefully with some of these tips you will be able to truly enjoy the holidays – and your children will remain children and will not morph into seasonal gremlins!
***
Page 244 What to Do When Your Child is Scared of Halloween
Some of my favorite childhood memories come from Halloween. I love it all! Pumpkins, costumes and the thrill of trick-or-treating. I was so excited to have children - mainly for the excuse to go trick-or-treating again!
Apparently it is frowned upon to go trick-or-treating without a kid in tow. Whatever!
But the universe thought it would be hilarious to give me a child who was deathly afraid of my favorite holiday.
This shouldn’t have come as a shock to me, after all as a child therapist I see kids every October because they are scared of Halloween. But not MY kids! With determination to salvage the best holiday ever for parents everywhere – I offer these 5 ways to help kids who are scared of Halloween:
Page 245 Don’t minimize your child’s fears.
It is helpful to let your kids know that you understand their fears. Halloween can be a scary holiday. Kids are just making sense of their world. We might think decapitated monsters and bloody eye balls are festive – but to some kids it is pure terror. Young kids have a harder time di erentiating between reality and fantasy – making Halloween a real life horror movie. Add masks and costumes to the mix and you’ve got a holiday full of nightmares – literally. Start preparing your child for Halloween early. It is impossible to keep your kids in a bubble for the entire month of October. Instead of avoiding Halloween, help prepare your kids for the holiday. Tell your kids that during Halloween people nd it fun to dress up like scary things. Let them know that the monsters and scary creatures they will see are not real. If you see scary decorations in the shops – demystify them by letting your kids hold them and see how fake they feel. Save the bloody zombies for another year. I love decorating for Halloween. I have two huge cabinets full of Halloween decorations! So there is no way I would tell anyone to not decorate for Halloween! However, to help your kids get acclimated to Halloween – keep your decorations festive and spook-free. Pumpkins, friendly witches and cute ghosts are all kid-friendly decorations.
Page 246 Some of my favorite childhood memories come from Halloween. I love it all! Pumpkins, costumes and the thrill of trick-or-treating. I was so excited to have children – mainly for the excuse to go trick-or-treating again! Don’t get too attached to those cute little costumes. The stores are packed with aisle after aisle of the cutest costumes. Your little one might plead with you to buy that $40 Frozen costume – only to refuse to wear it on Halloween. Kids are moody. What is exciting one week – is boring the next. There is nothing more frustrating than spending lots of money on a costume your child refuses to wear. To spare the frustration – keep your expectations for Halloween low. Be exible with costumes – and have a back up from the dress up bin. Make plans that are fun for your child – not necessarily you. If your child has shown fear throughout the month of October – you might want to skip trick-or-treating this year and do a community event instead. Many communities and shopping centers do Halloween trick-or-treating events. These events are usually family friendly and your child is less likely to be frightened. If you do brave the neighborhood, try and go with an extra adult or an older child. It is helpful if the older child approaches the door rst. This helps weed out the neighbors with spirited teens hiding in the wings. Our neighborhood is full of people who love to scare the trick-or-treaters. My older child loves it – but my littlest one finds it traumatizing. Once your kids moves through their fears – they will see this holiday for what it really is – free candy. And who can be scared of that!
Page 247 Child Therapist's Tips to Help Anxious kids Over the Holidays
What could go wrong with holiday songs, gifts and yummy treats? A lot if you have anxious kids. Anxious kids during the holidays have a tendency to implode. Any deviation from a predictable routine can make anxious children feel on edge. Add a bunch of over-stimulating and socially demanding activities and you might have a child on overload. So should you shrink wrap your anxious child and put her away until after the holidays? No way! Holidays are the best time of the year. With a few minor adjustments and tips – you can make this time of year go much more smoothly for you and your child!
Page 248 1. Give your child plenty of “previewing” of what is happening in the weeks ahead.
For older children you can make a calendar and hang it on their wall. Highlight what activities will be happening each day. The more time children have to prepare for an event or activity the less likely they will become anxious. This can really help anxious kids during the holidays.
2. Pace yourself – you don’t have to attend every holiday event in a 50 mile radius!
If you are like me, you want to soak up the holidays and don’t want to miss out on any special events. Unfortunately our anxious kids do not always feel the same. Too many events can leave our children drained and depleted of energy. They might feel overwhelmed or over stimulated. Make sure to plan some down time between each event you attend. Go home and let your child recharge after holiday parties. 3. Don’t force social interaction on your introverted child. Some anxious children are more socially self-conscious. Having a bunch of friends and distant relatives hug, kiss and interrogate them can be more than some kids can handle. You can help by not forcing your kids to go hug Great Aunt Martha or have them perform for the whole room.
Page 249 Don’t put your kids on the spot if they don’t like the spotlight. You can tell your kids prior to arriving at a social gathering that you expect them to say “hi” and to smile, but you will not force them to hug or interact with people.
4. Watch the sugar and ca eine – unless you want your children to turn into gremlins! Some kids tolerate sugar more than others. To avoid a “sugar high” and the ensuing meltdown – try to limit the half ton of sugar your child will want to digest over the holidays. I was never a major “sugar police” until my anxious child showed me that he becomes a puddle of emotional volatility when he has too much sugar. Now I watch every crumb of sugar he shoves into his mouth – as I know we will all pay for it later. Ca eine is not only in co ee. It is in all those chocolates your children are cramming two at a time in their little mouths. For anxious kids ca eine is their kryptonite. Anxiety already causes kids to feel jittery, add a legitimate stimulant to their body and they might feel like they are having a panic attack. 5. Watch your child’s sleep cycle during the holidays. Most kids don’t want to miss anything, but anxious kids might take that to another level. They might obsessively worry that if they sleep they might miss a spotting of Elf on the Shelf or Santa himself. Parties that run late into the night, might also wreak havoc on your child’s sleep routine. Many kids can function perfectly ne with a disrupted sleep cycle – but anxious children usually don’t fare as well. The more tired an anxious child, the more heightened their level of sensitivity becomes – and trust me – that is not a good thing during the holidays. Try to keep bedtime at a reasonable hour, even during the holiday season. Put your child at ease that they will not miss anything when they are in a deep slumber. Let them know that elves and Santa did not like it when kids try to sneak out and see them – it ruins the magic of Christmas. Holidays are such a magical time for children. Hopefully with these tips – all of your children will be able to enjoy the holidays without turning into a puddle half way through!
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Page 251 SECTION 4
INSIDE THE MIND OF ANXIETY
Page 252 My Double Life as Child Therapist and Mom to Anxious Kids
Parenting can be hard when you know all the signs and symptoms of every childhood mental health disorder. Every behavioral hiccup can be over evaluated and scrutinized. Every developmental struggle can be cause for serious alarm.
Page 253 REALITY HITS My introduction to my own child’s issues came as I sat in a post-graduate class on infant and toddler mental health. I listened as the instructor rattled o signs and symptoms that should trigger a cause for concern. I looked around the room and asked, “Isn’t that normal? Don’t all toddlers do that?” Eventually I stopped asking questions and quietly took notes. I realized that I was not just a student, I was a worried mom. TABLES ARE TURNED I quickly found myself on the opposite end of services. I entered the world of early intervention and in-home services. At times I felt judged. At times I felt demeaned. I vowed to never make any parents feel that way. I stopped services and decided to wing it myself – after all, I was supposed to be a professional. My oldest child’s issues were predominantly sensory in nature. She had her anxieties, but it was her sensory struggles that controlled our life. Luckily with some patience and time – she learned how to adapt and grew out of her debilitating issues. She still buys clothes based on how soft they feel – but shoes are not being flung at me anymore, so I’ll take it. It seemed just as my oldest grew out of some of her more debilitating issues, my middle and youngest children stepped in to take her place. Anxiety is rampant in my family genetics and my kids did not win the genetic lottery. ROUND TWO New struggles popped up before I could catch my breath. One was afraid of the potty and was holding her poop in for days. The other one was crying at night that there are bees in his room. No, it doesn’t make sense, but either does anxiety. I deal with what anxiety wants to dish out – stomach pains, sleepless nights, fear and avoidance.
Page 254 I have practiced what I preach and preach what I practice. It has been eye opening. Sometimes I forget to take my own advice and make mistakes. My husband will ask, “What would you tell your clients?” Duh, I think. I wouldn’t tell them to do this! Sometimes when you are so close to a problem, you are blind. I often feel like the universe is playing a cruel joke on me – making me earn the title of child therapist. Making me live what I teach. THE STRUGGLE IS REAL Just like any parent, I have good days and I have bad days. I have days when I am paralyzed with fear (the apple doesn’t fall far from the genetic tree)! I have nights where I toss and turn wondering if this latest issue is going to debilitate my child forever. If he will have issues as severe as the thousands of anxious kids I have seen in my practice. I quietly make mental notes in my head about how other kid’s struggles mirror his own. A scary checklist starts to pop up in my head. He does that too. Check. Check. Check. Lately, I have been talking myself o the ledge. Partly because my kids are teaching me how strong and resilient they can be. Not in those moments when they are up late into the night calling out my name, but in those brave moments when they walk off the cliff and don’t look back. SMALL VICTORIES My son recently started rst grade. I saw the usual signs revving up. A few days before school was about to begin he started to say, “My stomach hurts” all the time. I have taught him to recognize a worried stomach and so he was able to articulate his fears. “I think I am worried about school because my tummy is nervous.”
Page 255 Knowing that my child has already shown signs of OCD and debilitating anxiety, My mental dictator took advantage of my concerns and ashed scenarios of the hundreds of kids I have treated for anxiety. He won’t be able to go to school. He will throw up and be sent home. He will cling to me and won’t be able to let go. He will get stomach aches every morning. He will start missing school. He will beg to stay home. He will miss so much school he’ll have to repeat 1st grade. He’ll want to be homeschooled. This is not my paranoia (okay maybe a little), but these are true stories being played out in my head. These are real life scenarios that have unfolded in my o ce hundreds of times before. Will he be one of those children? Will his anxiety get as bad as the other kids I see? Sometimes I wish I did not have this inside view. Sometimes I wish I did not have the gift of knowing the signi cance of every small fear, phobia and ritual and what beast it can morph into. This year (so far) my son has surprised me – again. Just as my daughter started to poop and did not need to wear a pull-up at age eight (like other kids I have worked with) – my son’s anxiety did not get the best of him. Yes, he clung to me the rst day. But, then he acted like he didn’t know me as he self-consciously sat himself down. In the afternoon I held my breath as he got into the car. How bad was it going to be? “I had a good day.” He said nonchalantly. And then I exhale, for now.
Page 256 LIFE GOES ON We are still battling a slew of irrational fears and thoughts. I have become part mother, part philosopher as my anxious children ask me about their death, my death and all the many dangers that can bring us both there quicker. Like I teach others, I am taking this whole parenting thing one day at a time. I am no longer going to entertain What if thoughts that want to dominate my mind. I am going to soak up my children as they are and not worry about what’s to come. At least for today. ***
Page 257 Why the World Needs More Anxious Teens
I know what you are thinking. Seriously, how can anyone wish for that?! Who wants a world full of su ering teens who are ridden with irrational worries? A world where teens are paralyzed with fear and avoidance. But if you know teens with anxiety, you also know a different side of them.
Page 258 Along with a heightened sense of awareness, comes a heightened sense of empathy. Along with the burden of being emotionally sensitive, comes the desire to not hurt other people’s feelings. Along with the fear of what other people think, comes the desire to make other people feel good. Along with a tendency to be overly cautious, comes the ability to problem- solve. Along with a keen awareness of others, comes the ability to pick up on other people’s emotions. Along with the impulse to keep life from feeling chaotic, comes great organizational skills. Along with being hurt by other people’s actions, comes a sel ess, giving friend. In my therapy practice, I have sat across teens with all sorts of issues year after year. I have listened to the oppositional teen. I have tried to help the unfocused teen. I have problem-solved with the depressed teen. But it is the anxious teens who remain in my heart and in my memory. They are the ones who always remembered my name and asked how I was doing. They are the ones who refused to say anything mean to bullies – because they didn’t want to hurt their feelings. They are the ones who spent some of their session worried about people other than themselves.
Page 259 They are the ones who offered comfort and advice to their friends. They are the ones who warned their friends when they had unsafe ideas. They are the ones who saved their money to buy their family presents. They are the ones who talked about how to make the world a better place. Yes, the world needs more people like them. You see, despite their anxiety, their inner beauty radiates. The same genetics that causes them to be anxious, helps them to be considerate. The same genetics that causes them to feel self-conscious, gives them the awareness to notice when other people are upset. The world could use more kind, considerate, empathic people. Can you imagine what the world would be like if everyone had the ability to be tuned in to other people’s emotions? If everyone had the awareness of how their behavior a ected those around them? If everyone thought of other people, and not just themselves? I would love that kind of world! Anxiety is a package deal. We cannot separate out those wonderful qualities from the nasty beast of anxiety – I wish we could, but we can’t. But we can teach our teens to crush their anxiety. We can give them the tools to obliterate the dictator in their head, so they have an opportunity to let those wonderful qualities shine. We can teach them that they have much to o er the world. That they are special. That along with their anxiety comes some beautiful qualities. Beautiful qualities that will shine, once the clouds of anxiety are lifted.
Page 260 Dear Mom of the Anxious Child
To the Mother with the Anxious Child, When many others only see your child throwing a t, I see the woman struggling behind the chaos. I see you at the store, at swim class, hovering at the kindergarten fence. I see you – because I have been there. I am there. Having a child with anxiety is a private battle. A battle that plays out at home, late at night, at mealtime and all the times in between. A battle many people don’t understand. A battle people blame on the child, on the parent – or both.
It is hard to raise a child that can crack as easily as an egg – that feels they are being judged with every stare. You want to swoop in and shelter your child from a world that is too harsh for their sensitive skin. A world that sometimes feels even too harsh for you. Looking back now – there were early signs. Struggles with new foods, with falling sleep, with potty training. You told yourself she would grow out of this. Her tight grip on your hands would loosen and she would learn to y on her own.
Page 261 But with each new age, came new challenges. Your child’s mind lled with fears of dying, of losing a tooth, of making friends. Questions like, “Will I die?” and “Will you die” make a simple car ride turn into a mine eld of well crafted responses. A woman at swim class turns to you and comments at how carefree your child is – as you both stare at her jumping into the water. You have flashes of your child being so fearful of swim class she would have diarrhea. No, you think, she isn’t carefree – but she is a fighter. She is brave. You think of all the victories she has had. That you have had. Victories that other parents may take for granted. Like the move from her nurturing pre- school to the harsher terrain of kindergarten – with drop o lines and a sea of children. You think about all the victories that trail behind her – like her fear of pooping, of choking, of dogs, of the bath. She is more than her anxiety – she is a warrior. You have gotten used to her loaded questions. Like, “What would happen if our tires fell o as we are driving?” You now recognize these questions as a little peek into her worried mind. A worried mind that is constantly churning. A mind that often needs your help. She is starting to surprise you. Like when she had to give blood – and you were afraid to tell her. You were sure she’d be up half the night – like she had been in the past. You were sure you’d have to entice her with dollar store treasures and ice cream treats. But, after her initial worry – she said she was “good.” You waited for the predictable screams and the call for extra sta . But she was wearing her warrior expression – and you knew she had this. You are raising a ghter, not an anxious kid. Others may not see her battles, but you do. They may not celebrate her victories. But, you do. You no longer worry about her worries because you believe in her, but more importantly – she believes in herself. And that, you realize – is going to get her through this. Going to get you through this – one day at a time.
Page 262 Dear Mom & Dad, It's Me Your Shy Kid
Being born a shy kid is tough at times. Add an outgoing parent to the mix and it might be a squeamish existence. It is like being parented by another species.
Page 263 You don’t get us and we don’t get you. In an e ort to spare other kids the humility I have endured so far – I have made a cheat sheet on how to parent – what you might term –us shy kids. Let me break down the basics free spirited, outgoing parents. You and I feel di erent when we are around other people. When you are around people you get charged up. I have seen your type out there at parent pick-up. Buzzing around like a busy bee. You get back into the car revitalized and full of juicy gossip. You my friend are a battery and you get recharged every time you make contact with other people. We, on the other hand, are charging stations. Every time we are around other people we are giving o energy and getting depleted. Sometimes we like expending our energy – and other times it is frankly –freakin’ exhausting. When you have a limited commodity – you tend to use it sparingly.
So – with that in mind, let us discuss some situations that tend to go down between kids like us and folks like you: The Playground
It is obvious that our solitary existence on the playground upsets you. I know you think you are being helpful when you shout loudly to the kid next to us, “What’s your name? How old are you? Oh, you are the same age as my kid! He likes to play that too? Don’t you? Don’t you? Where did he go?” We are over in the shade, dying a slow death of embarrassment. Seriously, could you guys be any louder. I may be little, but I get embarrassed easily. I mean – really easily. Things that aren’t remotely embarrassing to you – make us want to curl up and die. Seriously. We love your help – really we do – but could you please try to be a little more subtle. Dial it back a notch or two… hundred.
Page 264 The Grocery Store
We can spot the danger all the way across the store. They stare at us. They make eye contact. We will your shopping cart to turn left, but usually you continue right towards the target. It is if a gravitational force pulls you closer and closer. The stranger’s words drip out, “Ahhh he’s so cute. What’s your name honey?” We usually look at the floor, look at the ceiling. Anywhere, but at the stranger who is breathing directly in our face. And then comes your usual cajoling – “Say hello honey.” We ignore you. Wishing we had an invisible cloak. Hoping for an escape hatch. And then come the apologies. “I am sorry. He’s not normally so rude!” As we walk away you give us your predictable scolding. You tell us we were so rude. We embarrassed you. Trust me – it goes both ways Momma. Look, I know we need to learn to interact with people. But, give us time. Don’t put us on the spot. We are not intending to be rude – we are uncomfortable. There is a di erence. You can tell the lady that we are slow to warm to strangers. Maybe teach us to just smile. We might show our teeth if we know it is not an invitation to talk more. Family Gatherings
Ah, the family gatherings. A place full of nightmares. Where else can you have a whole room demanding hugs and kisses and asking you awkward questions. Please, do us a favor and don’t force us to hug and kiss everyone. I know you love your great Aunt and that uncle that pops his teeth out – but we don’t share your fondness. By the time you make us hug everyone, we are completely depleted of energy and we are ready to go. Don’t put us on the spot.
Page 265 I know you love those silly dances we do or those funny jokes we tell you – but we are not trained monkeys. If you ask us to perform we are just going to embarrass you. We will throw a big – and I mean – big t. We’ll give you an opportunity to make more excuses for our behavior – to make lovely family memories. Our Behavior
I have noticed that you often think we are just being di cult kids. We hear you on the phone venting to your friends. Sometimes we throw huge ts when you want to go somewhere. You ground us, send us to our room and give us lectures. But, sometimes you don’t dig deep enough to nd out why we really threw the fit. Maybe we didn’t want to go to karate because the instructor always embarrasses us. Maybe we refused to get our shoes on to go to swim class because all the parents watch us and we feel like an uncomfortable sh at an aquarium. Maybe we loved the idea of a birthday party, but the reality hits us like a ton of bricks right before we had to go. You might see cake and games – but we see thirty loud, unpredictable kids and 120 minutes of no escape. Don’t move into punishment mode until you take time to gure out what is really going on.
Our personality is our personality. Just like you can’t be taught to be an introvert – we can’t be taught to be an extrovert. This is who we are. We are the kids with one best friend – not a zillion super cial friends. We are the kids who sneak o during a play date to play by ourselves. We are the ones that turn a deep shade of red when someone says hi. It is okay.
Page 266 You don’t have to apologize to others for our behavior. We don’t apologize for yours and there have been some cringe-worthy moments. We love that you care and sometimes we do need your help, but sometimes we are just being who we are meant to be. **** Here are some more great books on the topic:
Page 267 Page 268 Dear Mommy & Daddy, It's Me Your Anxious toddler.
Dear Mommy and Daddy, It’s me, your anxious toddler. I know I don’t normally have the words to explain my behavior and at times I probably really frustrated you. I am sorry. I frustrate myself too.
Page 269 I am not trying to be di cult and I am not a bad kid, but sometimes things just get overwhelming. Like in the mornings when you ask me if I want wa es or pancakes. Wa es sound good, but when I see them I know I de nitely made the wrong choice and I cry and say I wanted pancakes. Decisions are hard for me and I am afraid I might make the wrong choice – and I often do. Sometimes I might go back and forth with what I want and confuse us both. Food is scary. You sometimes put things on my plate that look and smell weird. I get upset when I think the food is nice and smooth and then my tongue nds lumps. Sometimes this makes me want to throw up. I might spit my food out or gag. I am not trying to waste food. Sometimes food has a strong taste and I get overwhelmed. To be safe, I try to stick with foods that I have already seen and I already know how they taste in my mouth. You call me “picky” – I don’t know what that means, but if it means not gagging or tasting yucky food – then yes, I am! I like to know where you are. I follow you everywhere. When you leave the room I get scared because I don’t feel safe. I know when you are with me, you’ll keep me safe. Sometimes I don’t play because I want to make sure I know where you are going. I hate it when you go to the bathroom and don’t let me in. Only my little ngers can get under the door. I wish I could squish my whole self under! I stay very close now so you don’t have time to disappear. The toilet is not my friend. I don’t know why you want me to sit on that scary thing with a huge hole. What if I fall. What if it swallows me. What if bugs come out of the toilet. What if water splashes on me. What if I have to wipe and can’t get clean. I am okay with peeing really fast, but I don’t like to sit there and poop.
Page 270 Sometimes it hurts my bottom to poop, so I just hold it in. Sometimes I hold it in for so long, small little poop balls fall out of my pants. I know you think that is gross – but I can’t help it. Sometimes I hold my pee and poop and it starts to hurt. I bounce around and hold my bottom and you tell me to go – but I tell you I don’t have to go. There is no way I am sitting on that scary potty. Night time is the scariest time of day. Everything gets dark and you put me in a room all by myself. I worry there might be bugs in my room. Scary things are in the corners, but you tell me they are “shadows” – whatever that means. You tell me you will keep me safe, but then you leave. Am I safe if you are not with me? Are there scary things that you need to protect me from? I don’t like shutting my eyes – what if something pops out or tries to get me. Sometimes you will lie down with me, but I can’t relax because I know if I close my eyes you will leave! I listen and feel for the bed to move so I can catch you before you leave. Sometimes I see you trying to sneak out, but I cry and get you back in bed! I know dressing me is a hassle. Trust me – it is a hassle for me too. Whose idea was it that we should all wear clothes? I love to just run around naked. You tell me I have to at least wear underwear. Whatever! Socks are the worst. Why should I wear these things that make my feet hot and have big bumps on my toes. I can feel these bumps in my shoes. Shoes! Uggh – don’t get me started on that crazy invention! I hate shoes. Sometimes they feel too loose, sometimes they are too tight. I want my feet to breathe – so ip ops or crocs are good. I wish I could wear those all the time. The things my mom calls “tags” are another huge problem. Who thought it would be a good idea to have an itchy piece of fabric attached to all my clothes. I can feel it scratching my back as I walk. I try to rip at it and nally just rip o the whole shirt. You yell at me to put my clothes back on. I hate clothes.
Page 271 I don’t deal well with change. I have been meaning to talk to you about this. Don’t tell me we are going to the park and then tell me we “ran out of time.” Where did time run off to? Sometimes I am just getting into something and you tell me to clean up. I can’t leave my square half done. My square still needs that pink feather glued to it and I wanted to add the sparkles too. There is no way I am leaving my square! We battle a lot. I win sometimes. I know some of these things can get very annoying. I am new to the world and I am just learning how to adapt and get around. Sometimes the sounds, smells and noises of life scare me. New experiences can be overwhelming and worry me. I see so many things that can hurt me. Things you may not think are scary but are scary to me. Like the ducks at the zoo or the loud garbage truck. I know you tell me it is “just this” or “just that” – but I don’t know that – I am just learning. So be patient with me. Pick your battles. Talk in a calming voice – even when I am screaming at the top of my lungs. You are my anchor in my crazy world – and one day I will really really appreciate it! I promise!
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Page 272 Dear Mom & Dad, It's Me Your Anxious Kid.
I know you don’t say it, but my anxiety is draining us both. It’s okay, you can admit it. I see it on your face. I see it every time I am paralyzed with fear and you need to get to work. You are like a deer caught in headlights, your morning plans falling apart as quickly as I am. I know it is not easy raising an anxious kid. I know you spend many sleepless nights worrying about me. Worrying about how I am going to function when I am older. Worrying about how I am going to weather life’s storms. You beat yourself up, wondering what you did wrong. What you did to cause such a fragile mind. You did not do this to me. You are my biggest support. You are the only one who knows when I am starting to crack. You are the only one who knows when I really need a hug, even though my words and actions would say otherwise. You hold me up when I am falling down and pick me up when I can no longer walk. You translate my struggles to the world when I am not able to, and for that I thank you.
Page 273 I want you to know that I am not as breakable as you might think. Yes, I crumble very easily – but there is a ghter deep inside of me wanting to come out. I am more than this genetic nightmare bestowed upon me. I am stronger than these genes that want to consume my very existence. I can rise above these thoughts. I can overcome these fears that try and hold me down. I am going to need your help, but it won’t be easy. It will be a balancing act. It will require you to read me well and know when to push and when to stop. I am not trying to be di cult, I am trying to win a war that has been raging inside of my mind. A war that I can no longer battle alone. I know you don’t like to see me su er, but I am going to need you to not cave when I crumble. You see, my anxiety takes over when I am overwhelmed. I can’t think straight. I can’t function. All I want to do is avoid the situation. It is what my anxiety wants me to do – it is what anxiety demands I do. Help me take small steps to ght back. Help me build my arsenal of weapons to defeat this dictator inside my thoughts. Encourage me, when I am weak. O er me solutions, when my world is caving in. Small steps lead to big victories over time. Learn to read my panic. There are times when I need encouragement and there are times when I need to retreat. Small wins are better than big losses. You cannot ght this war for me. Trust me, I wish you could at times. This war will take some time, I may not win every challenge. I may not be up to facing every fight. Teach me to dust myself off and try again. I love you. I know I am not always pleasant. I know I can throw daggers when I am in the clutches of anxiety. Please know that is not me. That is not us. We are going to crush this. We are going to no longer allow anxiety to dictate our dance. We are going to dance to our own beat. We are going to dance to a better song. ***
Page 274 About the Author
Natasha Daniels is a Child Therapist and mother to three vibrant, challenging and insightful children who keep her on her toes! She has spent the last twelve years working with children and families in her private practice Hill Child Counseling. Kids are her passion – especially anxious kids. Having been an anxious kid as well as raising three anxious kids, she gets anxiety on a very personal level. She has dedicated her practice and her writing to helping them and their families.
She is the author of How to Parent Your Anxious Toddler and Anxiety Sucks! A Teen Survival Guide. When she isn't in her practice or writing for her website, you can nd her teaching and supporting parents through her online courses, podcast and YouTube channel.
You can reach her at [email protected] or connect with her in her private Facebook group AT Parenting Anxious Kids.
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