When a child is anxious about getting into the swimming pool, getting on a bus, starting to learn to drive or is hyper anxious about tests at school, sentences such as ‘there’s nothing to worry about’ or ‘this is not scary at all’ are not going to make any difference.
How can we help our children to cope with their fears and when is professional help required?
It’s been over a year since Danny (real name withheld) aged 13 started being anxious about taking the bus. Because it’s too far to walk to school, his parents end up having to drive him every day. He avoided going to summer camp and the school’s annual without being able to explain any of this. He is able to communicate, however, that he suffers from constant fear that the bus will run out of air and that will not be possible to open the windows or that the driver will not stop and he won’t be able to disembark at his stop.
Fears for children are as normal as for adults. It’s possible to live and cope with them. The problem starts when they start interfering with normal life and the sufferer refrains from places and activities which would otherwise be considered normal to most people.
Danny’s fear of riding the bus and the anxiety it creates is not uncommon. Anxiety can manifest itself in different forms, and Danny’s fear of riding the bus, like other fears such as blood, dark and enclosed spaces comes from build-up of fears, worries and anxieties which are difficult to trace to their roots and show up in different ways.
Giving children a sense of security
Certain phobias can be considered weird to most people but obviously those who suffer from them experience them differently. Some of the more ‘special’ phobias include fear of clowns (coulrophobia), fear of certain colours, fear of mirrors (catoptrophobia) and fear of the number eight (octophobia). Phobias involve a huge world of fears which is scary and mysterious where almost everything can become petrifying and paralysing. Here’s a list of the top 100 phobias.
Often the root cause of the fear inducing anxiety is known, but the purpose of treatment is not necessarily to find the root cause but to treat the anxiety itself. Research shows that treating anxiety brings about feelings of safety and assertiveness which inspires the child to progress in other parts of his/her life.
Rachel (real name withheld) is 17 years old and of age to learn to drive. Driving anxiety is in the way. The source of her anxiety has to do with a friend who got her licence and was involved in a car accident and ended up disabled. Treating Rachel was based on gradual exposure and teaching her several tools to reduce her anxiety. Initially in a virtual manner followed by actual controlled exposure when already in possession of the ‘tools’ learned. We started by actual meetings in the car, followed later by starting the engine and later on short drives through familiar places.
Danny, similarly to others who suffer from anxiety, was fearful not only from taking the bus but also of the fear of the anxiety caused by the fear of taking the bus. This is because anxiety often has a physical manifestation in symptoms such as overwhelm, freezing, rapid pulse, sweating etc. Our mission was to teach how to deal with type of anxiety, to know what to expect from the body in case of severe anxiety or panic attack, learn how to relax and clam down, and how to leave with the fear.
Scripts and departure points
It’s possible, for instance, to stand at the bus stop and check out the bus schedule, it’s possible to try and get on the bus when it’s parked and walk up and down the aisle. It’s important to ensure that there’s always a ‘partial retreat’ available. Just in case it’s necessary to take a step back. Another strategy would be to get on the bus, ask the driver a question and get off the bus at the next stop. Or if it’s too much, just ask the question, say ‘thanks’ and get off. I always recommend that before you venture out on any ‘intervention’ you have two possible scenarios scripted at the ready. One ‘ideal’ scenario such as: get on the bus, ask the driver what’s the destination and if I’m feeling well get of the bus at the next stop. Another ‘less adventurous’ script would be, for example: get on the bus, ask for the final destination, and if I don’t feel comfortable, I’ll say it’s not my destination and get off the bus.
In any event, never push the child. We need to be sensitive and patient, otherwise we’ll get stuck or lose everything we’ve achieved so far. The most important thing is the trust between the therapist and the child. When we push for ‘quick success’ or try to get ahead to rapidly, we can lose this trust followed by the failure of the therapy. It’s always important to leave the option of ‘partial retreat’.
Very often it’s very difficult for parents to help children with their fears and anxieties. There are too many emotions at play. Therefore, it’s better to use the services of a professional therapist or coach. However, when the child is, for example, a 2.5-year-old who started refusing to use the toilet and things got as far as having to use enemas, the therapist needs to teach the parents how to work with the child, for example by going back to using diapers before completely weaning off diapers.
Don’t prolong therapy longer than necessary
Very often, despite the fact that the objective of the therapy has been achieved, some parents prefer to extend the period of therapy. Some parents sometimes find it difficult to believe that their child overcame his/her fears and for that reason they believe that extended therapy is likely to reduce the chances of fears reoccurring. When this happens, I find it best to guide the parent on how to cope. They need to understand that an important part of the therapy is acquiring competences. After treatment, children know how to calm themselves down, and are equipped with coping tools and techniques.
When I’m talking about this kind of treatment, I’m not talking about overcoming fears and anxieties. I’m talking about teaching the kids tools that will help them cope with these issues and situations. Equipping these children with a ‘chest of tools’ which will help kids like Danny and Rachel not only take the bus and stop being anxious about car rides but also hop on a space shuttle or drive a formula 1 car in the Monte Carlo Grand Prix. Even if we didn’t manage to get down to the root of the anxiety that prevented Danny from riding the bus, the fact that he managed to overcome this fear will bestow a sense of self-worth and confidence that will help overcome almost any future challenge and very likely will take care of the roots of the original challenge.
Important tips for parents
Don’t’ underrate your kids’ anxieties. Don’t say things such as ‘it’s nonsense’ or ‘don’t worry about it’ or ‘let me show you how I’m not scared of it’. Because such comments and attitudes will only make the child think that he’s misunderstood, induce shame and introversion and also sadness and insistence.
Parents should acknowledge their kids’ anxieties. Instead of making fun of it or berating it, say ‘I’ve notice that you too are feeling uncomfortable by this’ or ‘I can see this is difficult for you’. Acknowledging the challenge, encourages the child to cooperate since he can sense that the parents understands and supports and wishes to help find a solution.
Don’t push or force the child to confront their fears. Forcing Danny onto a bus is something we refer to as ‘flooding’. Flooding can lead to loss of trust in you as a parent or in him/herself. The sense of security that most kids have with their parents can be lost. In extreme cases this can lead to panic attacks.
Don’t contribute to the problem by avoiding the challenge. For example, if your child is afraid of water because of fear of drowning, don’t cancel the family outing to the swimming pool. Let the kid play around the pool. The message you’ll be giving him is we respect your discomfort but we don’t all share it. More importantly, he’ll get a chance to confront his fears at his own level of comfort and tolerance.
Never punish a child because of his fears of anxieties. Punishing your child for avoiding facing a fear is like punishing them for a tummy ache. The message you’ll be giving if you punish is that ‘you’re are not ok’, which is likely to reduce self-worth and confidence. Obviously, this is counterproductive as confidence is essential for recovery.
Always complement your child on any effort to confront or challenge their fear.
However, if the child is panicking, crying and screaming and refusing to cooperate, for example getting into a car for a family trip, try not to create a situation that will reward the avoidance attempt. For example, letting him/her play with your mobile phone.
Demonstrate how you deal with your own fears. This can be anything from telling ‘hero tales’ to physical demonstration of facing your fears. For example, how you pick up a spider despite your fears.
Don’t put words in their mouths. Don’t give them ideas they never thought of. Telling a child that is afraid of mice, “don’t worry, they won’t bite you”, can only increase the anxiety and add insult to injury.
Let them lead. Instead of telling your kids what to do or not to do, what’s right and what’s wrong (in your opinion) just ask them. Something along the line of: “how may I help you feel more comfortable on the bus” is much better than saying: “ try to overcome your fear, be strong or close your eyes”.
If you have any questions or need help with coping with fears and anxieties, feel free to contact me.