The world can feel like a scary place, full of new, difficult and strange experiences. As adults, we learn to manage our anxiety through knowledge and experience that tell us which situations, things and people are to be avoided versus those that just feel scary, but do not pose any real danger.
Your children, however, need help to understand the difference between safe things that should be experienced — despite the anxiety they provoke — and things that are truly dangerous. When your child experiences fear and anxiety more frequently or intensely than other youth, helping them can be confusing or challenging. For example, you may know that petting a dog or talking to a teacher is not dangerous, but if your child is acting as though these situations are frightening, what should you do? The answer may not be simple, but the following steps can help you better understand your child’s fears and help them cope more effectively:
▪ Encourage your child to discuss their fears. Fear and anxiety often seem hidden from others, as suffering children don’t always demonstrate obvious problem behaviors. Once recognized, it is important to have a discussion with your child about anxiety.
To begin, describe a recent time when you saw your child feeling anxious. For children sensitive to this topic, you can start by describing times when other people experience fear or anxiety. Try to lead this discussion to clarify what the child’s main fears could be. You may not like all the answers you get, especially if your child is avoiding things, such as friends or activities that are important or usually enjoyable, because of their fears. Listen calmly, and express empathy and gratitude that your child shared their experiences.
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▪ Teach your child about anxiety and fear. These are normal emotions experienced by all people. They can be enjoyable feelings for some people, like those who like watching a scary movie. So, how does a very common emotion become problematic for your child?
Share with your child that fear feels unpleasant because it serves a purpose — to motivate us to get to safety quickly. When nothing truly dangerous is occurring, these anxious feelings can lead your child astray by suggesting to them that something is wrong when it’s not. It takes time and practice to notice that everything is okay under these circumstances. The true problem your child is experiencing is their strong reaction to fear in a safe situation, not fear itself.
▪ Recognize anxiety-related thoughts, feelings and behaviors. Help your child notice what is referred to as the “three parts” of their fear or anxiety — what they are thinking, what they are feeling in their body, and what they do. By observing the parts of these emotions, it will become clearer how worry and strong reactions to fear in your child’s body may lead them to avoid situations over time. Unfortunately, while avoiding is helpful in the short term to relieve distress, over the long term it teaches your child very little about how to effectively deal with the thing bothering them.
▪ Adjust your parenting when you notice child anxiety. Effective therapies for child anxiety involve gradually approaching, rather than avoiding, feared situations. But it can be very difficult to watch your upset, distressed child. In fact, the normal thing to do when you see an upset child is to soothe them and remove the source of their distress.
This backfires with chronic anxiety, because by allowing a child to, for example, avoid a dance class because they are afraid of separating from you, you inadvertently send a message that the dance class is, in fact, dangerous. By allowing your child to experience their fear and problem-solve how to approach and stay in that class, you are actually helping your distressed child cope with such situations more helpfully over the long term.
▪ Get professional help as needed. The good news about child anxiety is that effective therapies exist. Cognitive behavior therapy, provided at the Child and Adolescent Mood and Anxiety Treatment Program at the University of Miami, is one of the best treatment for child anxiety. Most youth who receive CBT improve after a brief course of treatment (often 12-16 sessions or less). If you have tried the steps outlined above, and are still noticing significant distress in your child, it may be time to reach out for effective help.
If you suspect your child is suffering from anxiety, visit miami.edu/childanxiety for more information. To schedule an appointment with a medical expert, call 305-284-9852.
Jill Ehrenreich-May, Ph.D., is the director of the Child and Adolescent Mood and Anxiety Treatment (CAMAT) Program at the University of Miami. For more information, visit UHealthSystem.com/patients/pediatrics.