Anxiety is usually thought to have two components: 1) emotional; and 2) physical.
The emotional component is fear. Although fear is a normal emotion experienced by children and adults as well, the fears of the anxious child become greatly intensified. The child feels controlled by the fear, threatened and “trapped” by the experience of one’s own emotion. This can sometimes make it difficult for a child to be consoled by a parent because the fear overshadows the child’s ability to think rationally at the time or to accept simple supportive input. Inadvertently, a parent (out of frustration) might try to talk the child “out of the fear” or tell the child “to stop carrying on” or punish the child for being so unreasonable. These responses, of course, fuel the fear even more making for quite an impasse between child and parent. The child feels judged, criticized and alone and the parent(s) feels helpless and inadequate. Not a good combination for building a healthy relationship between the two!
Again, the fears involved are typical of childhood, but they become unmanageable, and are to a certain extent not rational when they take over. Such fears include: fear of the dark, making a mistake and disappointing a parent/authority figure, being perfect, getting perfect grades, being left, being alone, not having friends, fear of burglars, monsters, water, new situations, leaving one’s parents, insects, apparent “bullies” at school, going to the bathroom, talking in front of others, etc. It is important for parents to remember, in order to help the child, that the fear is not something out in the world; the fear comes from a way the child is thinking about a situation or experience. The fear is within the child and cannot be pointed to.
The second component — the physical — relates to the sensation a child feels when experiencing anxiety. This is a very real bodily reaction which might include: a racing heart, agitation (difficulty sitting or remaining in one place), nervousness, biting of the lip or finger nails, stomach aches, headaches, diarrhea, crying, insomnia, difficulty separating, problems with focus/concentration, moodiness, irritability, etc. These reactions can be signals to parents that their child is experiencing an underlying fear that is, or is beginning to be, out of control. These signals need to be taken very seriously and not dismissed as indications that the child is just trying to get attention or avoiding responsibility.
The impact of anxiety on children can be far-reaching. The socially anxious child tends to have fewer friends because of being shy, guarded, careful in interacting with peers. As a way to overcome the anxious feelings this child might become very bossy and controlling of others in an attempt to control what is happening inside. Because of this, however, other children do not want to play with this bossy and controlling child and so, the cycle of anxiety is fueled by feelings of rejection.
Teachers are many times stymied by the student who does not turn in homework, but declares having done it. Academically, this is a child who is so anxious about doing well that the ability to perform and follow through is diminished. This child fears making mistakes so does not try as hard, does not study or prepare as well, and over time becomes labeled as “lazy” or a “goof off.” Not only is this child in the grips of performance anxiety, but is on a downward spiral of defeat which, again, perpetuates the cycle of anxiety and intensifies the internal experience of fear.
Many mental health practitioners know well the incredibly complicated story of the child who is referred because of being “oppositional,” “a discipline problem,” “defiant and talking back,” “disruptive in class, rude to the teacher and bullying classmates.” Complaints about adolescents include, but are not limited to: “cutting school,” “failing grades,” “refusal to accept limits,” “drug/alcohol use, running away from home, stealing,” “cutting and other self-destructive behaviors.” Once again, the list seems endless. The exasperated parents drag the child/adolescent in to the therapist’s office and want only one thing: STOP THIS CRAZY BEHAVIOR…FAST! Chances are, if the behaviors ONLY are the focus of attention, and the goal is to eliminate them, the child/adolescent might well show improvement only to return to these behaviors (or others) in a relatively brief period of time. Why is that? Because the underlying anxiety has not been identified and treated along with modifying the behaviors. Thus, the untreated anxiety, under stress especially, builds up within the child and fuels the “out of control” behaviors.
Understandably, parents want to know what causes anxiety. There are several sources to consider:
1) Genetics: Anxiety is a condition inherited from the parents through the child’s DNA. How refreshing it is when, getting to this point in an evaluation, one or both parents, sheepishly raises a hand and says: “ok, it’s me…I’m the one!!”
2) Personality Trait: It is helpful to ask parents to name a variety of traits of their child and to include “anxious” among them. This seems to make it less frightening and more understandable for parents to have “anxious” among several traits, rather than as an unwanted and negative label.
3) Trauma: A difficult birth or post-birth when there is an absence of a secure attachment.
4) Parents’ Response to Their Child: Being protective of a child is a normal and natural response; being over-protective interferes with the child’s sense of control and ability to be self-reliant and resourceful. Thus, this response can generate deep anxiety within the child. Indifference or treating the child in a dismissive way can also instill significant anxiety and undermine the child’s sense of self and inner strength. This response occurs when parents do not take the child’s experience of stress, upset and vulnerability seriously but rather, communicates to the child to “get over it.”
5) Parental Modeling: Observing and imitating parents who do not adequately or effectively handle their own stress or anxiety; this results in the anxiety seeping over into the child and becoming an identified part of the child.
6) Stressors: Illnesses, relocation, family violence, death of a loved one, being bullied at school, not enough structure or containment in the family so that the child knows that the parents are in charge and taking care of the family and that there is a hierarchy. Without this experience, the world feels too big and overwhelming and dangerous. This can lead to significant anxiety.
How Parents Can Help the Child Deal with Anxiety
1) Ask the child to describe the worry/fear. What color is it? What shape? Big? Little? Name the fear (ex., “wiggly bug”). When does the child feel “wiggly bug”? What does the child want to say to “wiggly bug”? Have the child draw a picture of the fear, the “wiggly bug.” Allow the child to hang up or put the picture where the child is most comfortable with it. Thank the child for sharing something so important with you, something that you really enjoy knowing about and would like to know more sometime.
****The purpose of this exercise is to desensitize the child to the thoughts which produce the fear. Desensitization can result in the fear losing some of its power, reducing the effect of the fear on the child and allowing the child to take control of it. The more control the child has, the less afraid and the more self-confident the child will become; self-esteem will deepen and lead to greater independence and self-reliance.
2) Invite the child to join you in this exercise which can be written or taped. Recognizing with the child the feelings of fear and nervousness and that you want to help with them, say in a very simple way:
“Being worried, frightened makes me feel (sad, lonely, sick, alone, bad, etc.).” “If I did not feel this way, I would feel (happy, good, pretty, like a friend, excited, etc.).”
“When I am frightened/nervous, I don’t want to (play with friends, be nice, go to school, etc.).” “When I am not feeling like that, I could (run around, fly kites, laugh, have fun, be silly.)”
****The purpose of this exercise is to help the child use words to express the internal experience, to put it on the outside so another safe person can hear it and hold it also. This sharing lets the child know that the parent(s) is present, is listening, is protective without being intrusive and that the child is not alone in what feels like impending danger.
3) When children have difficulty separating from the parent(s) to go to school or for a play date, it can be comforting and helpful to the child to have a “token” of the parent to carry along in a pocket. This might be a piece of handkerchief/scarf, or it could be a small rock/pebble that both of you found together. Touching this “token” during the time of separation brings the loved object to mind, thus diminishing any anxiety that is present and threatening a take-over.
4) When children are worried/afraid/anxious, they are usually “stuck” in unwanted thoughts they cannot stop. When this repetitive thinking occurs, ask the child to picture the mind as a TV with 4 channels. Only 1 channel has “bad, frightening, scary, dark, sometimes violent, hurtful” pictures on it. Explain to the child that the mind is “stuck” on this channel and that together you are going to change to one of the other 3 channels that have soothing, fun, playful, colorful stories that make for laughter, smiles, enjoyment and good feelings. Ask the child to describe out loud what the mind sees on the other 3 channels, one at a time.
****The purpose of this exercise is to diminish the impact of the fear, to help the child feel a sense of power of the mind and control over thoughts that are threatening. Having a parent join in is a big part of the healing.
Gail Carney-Carder is a parenting counselor in San Jose, where she specializes in providing child counseling.