May 2022

Why do gifted children have anxiety disorders?

Why do gifted children have anxiety disorders?

gifted children

Why do gifted children have anxiety disorders?

gifted children

Are you ready to bring calm to yourself so that you can bring calm to your family? Subscribe to my newsletter and you’ll get my FREE 7-day Get Yourself Grounded course!

Are you ready to bring calm to yourself so that you can bring calm to your family? Subscribe to my newsletter and you’ll get my FREE 7-day Get Yourself Grounded course!

What do parents get wrong about child anxiety counseling?

This question is a bit of a trick because no one’s actually asked it but I wanted to answer it anyway because I want to help families get help. 

The biggest misconception that parents have about any kind of child counseling is that the counselor is going to fix things. What things? Well, that depends on why the parent has brought their child to counseling. Maybe it’s the child’s behavior, or the relationship the parent has with the child, or the child themselves. But this is not how counseling works.

Counseling works by creating a relationship between the therapist and the client — in this case the child — and then leaning into that relationship to explore and guide. By explore I mean learning who that client is. What motivates them? What are their strengths and challenges? What beliefs are holding them back? What beliefs are serving them well? Who is in their support system? How can they tune into that or how can their support them get better at helping?

By guide I mean giving information and teaching skills. Counseling works by metaphor. Therapists are trying to find a way to explain ideas and concepts in a way that makes sense to the client and gives them greater insight into themselves and into how things work. And they are working to connect the client with skills to make their efforts more effective.

Counselors generally don’t tell people what to do. Ok, sometimes they do. Sometimes they say, “You need to quit drinking” but that’s not very useful if they haven’t done a good job of connecting with the client, given them insight into how their drinking is impacting their functioning and relationships, and helped them identify the resources that are available to them. 

There is a lot of repetition in the therapeutic relationship. People need to hear the same things over and over again, often in new ways and in a new context because what doesn’t have an impact one day might have an impact on another day because the client is finally ready to hear it.

With children it’s even more complicated and the younger they are, the more complicated it is. So let’s talk about some of those challenges.

Generally it’s not the child who has decided that they need counseling; It’s the parent. Therefore the counselor needs to work a little harder to get the child’s buy in. The child doesn’t necessarily think anything needs to change. If a parent brings their 7 year old to counseling because they want the 7 year old to start sleeping alone, the 7 year old probably doesn’t agree that this needs to happen. So they’re not even interested in the goal of their treatment plan. 

Instead the counselor needs to work in a round about way to discover more about how the child’s functioning not just at bedtime but at other times, and figure out what skills are lacking. The counselor needs to understand child development in general and this child’s development in particular. This might mean a lot of ruling out. What else is going on for the child? What’s the family’s sleep hygiene like? What’s the child’s physical health like? 

At the same time, the counselor is trying different metaphors to help the child learn skills that the child may not be interested in. The younger the child is, the more likely this is going to be done through play. Therapeutic play is sometimes directive, in which the therapist is doing an activity with the child with a specific intent to pass on skills or information. Or it may be non-directive where the child is choosing and managing the play and the therapist is either observing or joining in to better understand the child and to connect and build rapport. There are benefits to both kinds of play and different scenarios and relationships require different interventions.

Very often the issue will not be with the child, it will be with the parent because the child isn’t the one making the decisions. For example, perhaps the bedtime routine is inconsistent or disruptive. Well, the person who’s going to need to change that is not the kid; it’s the parents. So the therapist needs to also get the parents’ buy in.

Now this isn’t the same thing as blaming parents. This is not about blaming parents. This is about recognizing that in the family system the parent who is bringing their child to counseling has demonstrated that they want things to change and so they are really the ones who are going to have to change. When the parents change, the child will be required to change.

Let’s go back to that 7 year old. Let’s say the child is very sensitive to light and the parents leave the blinds open. I’m deliberately choosing something very obvious and clear to make this point. The 7 year old is not going to be able to go to Target and get black out curtains and then install them. That’s up to the parents. If the parents don’t do that then the light-sensitive 7 year old is likely to continue struggling no matter how often they go to the therapist.

This is how anxiety treatment works, too. In lots of ways parents act like training wheels on a bike. They are there to support their child while their child builds new skills. Eventually the parents need to remove their support and let their child learn to ride on their own. 

Anxious children will not necessarily want the parent to stop being training wheels and yet the parent needs to stop anyway. This is often the point where the parent will bring the child into counseling, which is wonderful, but they will continue acting like training wheels. What they want — and I understand this — is for the therapist to talk their child into wanting to change. The parents are waiting for the child to say, “Please stop being my training wheels.” 

This may not ever happen. There is a large body of research that says that when we do it this way — waiting for the child to ask for the training wheels to come off — that we’re doing it backwards. 

And if the parent doesn’t understand that things work this way, they may continue to be training wheels even when the child HAS asked them to stop because the parent doesn’t realize that’s what they’re doing. 

It’s common in families with anxious children for the parents to have anxiety, too. And as the child begins to grow and stretch and confront their anxiety, this might trigger the parents anxiety. Then we have a child who is ready to go without training wheels and a parent inadvertently getting in their way by checking in repeatedly. “Are you sure?” “Are you sure you’re ready?” “Do you have a plan if you fail?” “Do you want to go over the plan again?”

This is another reason why parents must understand how anxiety works and be a part of the intervention even if the child is the one asking for change.

So in a nutshell what parents get wrong about child anxiety counseling is believing that it’s up to and the responsibility of the child to do the learning and do the changing. No, it’s a family affair. 

Parents need to understand anxiety — how it works, how it’s perpetuated, the different ways it shows up

Parents need to identify their own anxiety — knowing when they are projecting, knowing when their worry is interfering with the intervention, and learn how to care for it. Child anxiety treatment is for the whole family.

And this ultimately is why I built Child Anxiety Support. Because even if the child is in counseling, the parents need to do their own work. As a counselor, I would only see a child once a week or once every two weeks but parents, of course, are with their children every day and so the parent can effect real change in the family and in the child’s functioning. As studies show, empowering parents to support their children is what makes a real different in anxiety treatment. Child Anxiety Support is my effort to make that more accessible, less expensive, and more convenient. I hope you’ll check it out.

Does reassuring my anxious child help?

“Does reassuring my anxious child help?”

The answer to that is no, not in the long term and rarely in the short term.

But this is actually a longer question so I’m going to share the whole version now and of course the much longer answer, too. Here we go: “My son has severe anxiety that manifests in needing constant reassurance that his every ache or stitch is not life threatening. My question is am I making it worse by reassuring him or would it be better to not feed into the OCDness of his questions?”

[Have your own question? Go here to submit it to the podcast!]

First of all, let me say my heart goes out to you and your son because I know how challenging and heart breaking and frustrating this can be. Thank you for asking it and I hope my answer will be helpful.

Reassurance is a great example of how parenting an anxious child is different than parenting a child who is not prone to anxiety.

In a non-anxious child — or rather a child who has a typical level of anxiety — reassurance can be helpful. They come to us and say, “My leg hurts, do you think I’m ok?” And we can answer, “Yup, that sounds like growing pains” and they will feel reassured and be able to move on. End of story.

But a child who has more functional impairment, which is to say, whose anxiety gets in the way of their ability to do things, will get stuck. That reassurance only helps for a minute but the anxiety comes back, the distressed feeling continues and so they return for that quick hit of relief that your reassurance offers. 

That’s because the issue is NOT the aching leg, it’s the anxiety itself. 

One of the things we know about anxious people is that they have an information processing bias, which means that anxious people more likely to see danger in otherwise neutral situations. This can be a very useful trait under some circumstances. If you’re going on a long camping trip, for example, the person with some anxiety is more likely to pack bug repellant, to check that the tent is still waterproof, and to remember to charge the GPS tracker. Being able to scan for potential dangers or roadblocks or problems helps us prepare for them and that’s great.

When the anxiety causes functional interference, that is to say, it stops us from going camping altogether, it’s a sign that the issue is not the camping trip, it’s the anxiety itself.  

That anxious person —avoiding the camping trip — hasn’t learned to tolerate the discomfort of not being able to control what might happen. We can pack the bug repellant, we can check that the tent is waterproof, we can charge the GPS tracker but we can’t control every little thing that might go wrong. We need to live with a certain level of unknowingness. We have to give up on being able to control and address every possible outcome.

What we’re really talking about here is an existential crisis. How do we tolerate the big endless not knowing of being alive? How do we learn to exist in a world where bad things happen and might happen to us? 

If you’re listening to this, it’s likely you’re a parent so I’m going to share my own experience as a brand new parent and I’m sure that lots of you will be able to relate.

When my son was born I struggled with postpartum anxiety as many, many of us do. I felt undone and overwhelmed by the fact that I was now responsible for this very tiny, very precious being. I had intrusive thoughts — those uninvited, unwelcome thoughts — of harm coming to him and I couldn’t walk into a room without seeing all the potential dangers. I felt like one giant exposed nerve. 

Eventually I learned to live with this reality  — this reality that I had to cede some level of control to the universe — and some of that learning to live has to do with denial. I learned not to harp on the ways my child might get hurt. I learned to let those intrusive thoughts pass without comment or reaction. I learned to ignore the things I couldn’t control. And, as he grew, I learned and relearned to tolerate the discomfort of watching him step out beyond my supervision and care. 

Sometimes this meant literally covering my eyes like at the playground when he would attempt some death defying trick. This kid is now 25, lives in another state where I can’t keep an eye on him, and his hobby is rock climbing. Let me tell you, I still nag him about wearing his helmet but most of the time I just pretend he’s not hanging off of cliffs every weekend. Because that’s what it takes to live my life and to let him live his.

Because I have my own struggles with anxiety, these were skills I needed to learn over and over again in new contexts. But as I learned them in one area of my life I was able to apply them to others.

This is the work that anyone who struggles with anxiety must do.

The anxious child or teen or young adult who is depending on our reassurances is avoiding that existential task of tolerating the unknown.

They ask you to tell them their leg is ok and you do but the question is a cover up for a larger crisis of not knowing. To get deep, and anxiety requires deep work, they are really asking how can I avoid death. How do I live in a world where death and pain and sorrow is unavoidable.

This sounds overdramatic but ultimately an anxiety disorder is learning to live with that reality of death and pain and sorrow.

No wonder it’s so difficult, right?

When we see this big picture, perhaps it will give us permission to stop trying to fix things in the moment. Now I’m not saying to sit your child down and tell them it’s time to face their own mortality. No way. Of course not. Instead we, as parents, can see this big picture struggle so that we are better able to meet the challenges in the moment. 

We must learn to accept that we can’t reassure them out of this. 

What we are meant to do is help them build their tolerance. Life is uncomfortable because it is unpredictable and ultimately out of our control. And yet we must learn to live with that and to be happy in spite of it.

So what do we do instead of reassuring?

We reassure once, “It sounds like growing pains” and then we stop. We tell them, “I’ve answered that question and I’m not going to anymore.” We say it with empathy and compassion and then we hold to it. That’s it. They may beg and plead but remember, you answered the question and it’s not the answer that will fix the anxiety anyway. The child needs to tolerate their distress, which will eventually feel less distressing. They will either acclimate to the feeling of not being sure or it will pass. 

The more we’ve reassured our child, the harder it will be for them to tolerate our unwillingness to answer. This will be hard for us. But I want you to think about how you and your child are having the same experience. They are yearning for you to answer and you are yearning for their calm. Both of you are struggling but both of you can manage this distress. 

You can manage yours by recognizing it as your own. 

You are catching your child’s urgency, for sure, but your feelings belong to you. I know it seems like your child is causing your discomfort but it’s more complicated than that. 

Your feelings are yours — they are your responsibility — and you will need to learn how to manage them. That may be taking your own deep breaths, it may be removing yourself so you can step out of their anxiety loop because again, anxiety is catching. It might be using self-talk — telling yourself it’s ok and that your child will be ok. 

As anxiety is catching, so is calm. As you bring more calm to the family and to the interaction, you’re helping. You’re setting an example. You are showing them that it’s possible to tolerate what feels intolerable.

The work of raising and loving an anxious child is ultimately self-work. But then isn’t that the thing about parenting. As I always say, nothing is more triggering than being a parent but in the context of parenting we have such opportunity to heal ourselves.

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