March 1, 2023 | Child Anxiety Support

What derails child anxiety treatment?

This week’s question comes out of several different versions of people who contact me and say they’ve tried to get their child help and it isn’t working or it hasn’t worked and they’re asking me what to do next. So I’m squishing all of these questions together into one to talk about the things that get in the way of child anxiety treatment.

There are five things we’re going to talk about. OK? Are you ready? Here they are: The five things that get in the way of child anxiety treatment are:

Information

Time

Trust

Fear

Bandwidth

Let’s go through these one by one.

The first is information or lack thereof. And that speaks to the misunderstanding that the child should be the target of anxiety treatment. There are lots of studies about child anxiety because it is one of the most common if not the most common reason why parents seek out mental health help for their kids. And those studies tell us that we should be targeting the parents because, as you know, if you are a listener to this podcast, the parents are the ones who are capable of shifting the way the family is supporting the child. The parents are the ones who can create exposures, which is to say can find ways to help their child face their fears. The parents are the ones who will be passing on and encouraging skill acquisition on the part of the kids. And parents generally are more motivated. When we target children, we are expecting them to be able to interrupt the patterns that we know become ingrained in families with anxious kids. That’s not realistic. And we’re expecting them to remember and use pretty complicated skills. But these skills are ones that they not only need to learn but they need to practice and relearn over time. If we teach those skills to the parents, they can remind their children and reteach them at each new developmental stage. Finally anxiety is a tricky beast that teaches us that to be safe, we need to listen to it. While parents may be ready for the child to do things on their own, the child may be perfect happy with the status quo. That doesn’t mean that kids like being anxious but it does mean they may be less motivated to deal with their anxiety and more interested in continuing to avoid the things that scare them. Parents on the other hand, are more likely to want the children to gain more independence and so are better placed to encourage their children towards that goal.

The second reason child anxiety treatment gets derailed is time. It does take time to unpack and examine family patterns and create a plan to address those patterns. It takes time to follow through with that plan. Anxiety treatment is not a one and done intervention, it’s something that unfolds over weeks. So there’s learning how to make the plan, making the plan, and executing the plan. A way to cut back on the time needed for this, is to get direction. A program like mine, where I’m available to answer your questions and give you feedback, can cut back on the time it takes to figure things out and then get the things done.

Third reason why child anxiety treatment can get derailed is Trust. Namely parents need to trust the plan, children need to trust their parents. The parents I work with tend to be gentle parents, supportive parents, parents who are in tune with their kids. It’s their super power and also the thing that gets them stuck. I know this because we didn’t call it gentle parenting back when I was raising my kids — we called it attachment parenting — but when you are so close to your children, it can be difficult to trust anxiety treatment because it does require us to put our kids in uncomfortable situations. So if we have an anxious child who is struggling to order for themselves in a restaurant and we see their tears and know they’re hungry and scared and here’s this nice evening out with the family and they are suffering instead of enjoying being at their favorite restaurant, we may so identify with them that we just go ahead and order. It’s hard to trust that making them do it is good for them when they’re telling us it’s not. Like, who do we trust? Our child who is telling us they’re not capable? Or this plan? No matter how much research is behind it, in the moment it can be hard to follow. This is why I think ongoing support is so important, which the research bears out. Parents do better when they have someone to help guide them, reassure them, remind them of the plan and help them figure out how to dial it back if needed or when to push even though it’s hard.

Ok, next barrier, next thing that can derail treatment is Fear. Not the child’s fear but the parents’. Lots of parents have tried to manage the anxiety and then have pulled back because they’re concerned that they are further harming their child. This is another reason why I like working directly with parents. I have found that if we expect parents to be the target of the intervention then we have a terrific opportunity to work with their parent on their own anxiety about their child’s anxiety. Just as we’re working with the child on exposures, on helping them confront the things they’ve been avoiding, so we need to do that with parents. And I think this is really exciting — this is the part of the work that I love the most, I think — because there is so much healing to be had in supporting parents who are anxious about their kids. Processing their own worries has such great lessons in figuring out how to help their children process their worries. I know that’s been incredibly helpful for me as a formerly anxious child who has an anxious kid. Anyway, our fear can derail child anxiety treatment but it can also be such an important key to progress.

Final barrier! That would be bandwidth. Parents are by definition busy and often overwhelmed with lots on their plates and I can appreciate that even if anxiety treatment feels urgent that it’s also difficult to find the bandwidth or the spoons or the mindspace to devote to addressing it. Am I going to explain how my program address this? I sure am. Let me explain how it works. The central workshop is Strong Kids, Strong families and that’s based on the Supportive Parenting for Anxious Childhood Emotions or SPACE program developed by Dr. Eli Lebowitz of the Yale Child Study Center. That’s a six week program — one lesson drops each week. SPACE is fairly straightforward. You do the things and you get results. That’s the information piece, the first barrier in this list is addressed via Strong Kids, Strong Families. The rest are addressed by the other parts of the Child anxiety Support membership. Now you can get in there, do your six weeks, solve the anxiety issue. But most of us have other barriers. I address the Time by making the site so accessible. It’s better than a weekly group because it happens on your time, at your convenience. You can get to the site on your computer’s browser but it’s even better in the phone app so it’s easy to find time to take the lessons, check in, talk to me, etc. The Trust piece and the Fear piece, those are addressed through the live components. Whether that’s watching the live webinars, or by coming to the live chats or office hours to speak directly to me in real time, or by private messaging me because I answer really quickly. Again, better than a weekly support group because the virtual piece of it means you can reach out to me whenever and I’m super available. The app makes that easy for me, too. I get a notification on my phone and check in to respond.

But bandwidth, how do I address that in the program? Well, I’ll tell you, it’s by using a membership model so that people can drop in, can go at whatever speed they want. You can rush through, you can go slow. You can start slow and speed up or vice versa. You can take a break and process what you’re learning, you can dip into other courses or resources that can help you figure out what you need to do next. You can tread water for awhile and then dive back in. You can hang in there and lean on the community supports. I’m there to encourage you even when you need to take a step back. You can drop in to Eve Hermann’s Stress Reset practices to give yourself some bandwidth, that’s why she’s there, to help parents take care of themselves so they can do this big work.

Yes, I’m obviously a fan of my program. And remember, if you’re listening to this in the last week of March 2023, we will be starting our spring cohort next week on April 3rd. If you join that week, you will join me in walking through the program. Child Anxiety Support is always available — you can enroll at any time — and the Strong Kids Strong Families piece is asynchronous. But twice a year — spring and fall — I’ll be offering it cohort style, meaning if you join then you’ll get the first week lesson at the same time as I go offer extra supports around that lesson, and the second week I’ll be talking about the second week and so on and so forth.

Just head to my site to join me and know that I’m here and the program is here whenever you need it.

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Does social media cause teen anxiety?

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The answer to this one is easy. Yes! Yes, social media can cause teen anxiety and adult anxiety, too, which I’m sure you already know personally. Ok I’ve answered that question but how helpful is my answer? Not very so let’s talk instead about what you, as a parent, are supposed to do about it.

It’d be easy to say, “Just don’t let your child have social media” but I don’t think that’s entirely realistic and I don’t think it gives your child the tools they’ll need to exist in a world where social media is a thing. Even if we choose to opt out of social media, depending on what your child ends up doing, they may need to have it.

An example of this would be professional networking. They might need to have LinkedIn. And socializing. I know that for my generation, there is an expectation that you’ll be on Facebook and that’s where some of my social groups do all of their event planning. If you’re not on FB, you’re going to miss the potluck invite.

And I’m sure there are ways social media will continue to embed itself in our lives that I can’t even imagine because I’m as, the kids say, an old and as an old my imagination is limited.

Also I can tell you now, as a therapist who has works with lots of teens, many of them who are not allowed to have social media have it anyway. They may download it to their phones and delete it so that they can have it sometimes but get rid of it before you catch them. They may create accounts on friends’ phones (I’ve known a lot of teens who do this) or they may find ways to access accounts on their Chromebooks or laptops. Which is to say, very often taking a zero tolerance policy is just going to push your teen to be secretive when what they’re really going to need is your help and guidance.

Besides even if your child doesn’t have social media, absolutely 100% agrees with you about it and it’s accessing it behind your back, the same isn’t true of their friends. According to the Common Sense Census put out by Northwestern University’s Center on Media and Human Development in 2016 (I will link to this PDF report in the show notes) 80% of teens have their own social media account and 23% of tweens — that’s kids 8 to 12 — have one. I’d be curious how those numbers changed over covid because I bet they went up. I know a whole bunch of little kids I know got that Facebook kid messenger during lockdown. Also this doesn’t take into account the risk of TikTok.

This means your child may not have accounts but is likely to see things on friends’ phones or tablets.

This is is all to say that instead of doing a hard core, “No social media for you!” And thinking that’s solved our problems, we need to recognize that social media is a part of our kids’ lives whether we like it or not and help them build literacy around it.

This is what we know, social media can be fun, it can be educational and it can support relationships but it can also be harmful. It’s meant to be addictive. TikTok for example, is well known for serving its viewers exactly what they want to see when they want to see it. The algorithm is set up to keep you on there; it’s notoriously sticky that way. There are some studies that show the more attached we are to our screens, the more trouble we have being mindful. That is being present in the moment. When we struggle with even short experiences of boredom — for example, if we struggle to wait in line or wait for the kettle to boil without looking at our phones — we are training our brains to need constant new stimulation.

To tie this back to anxiety, anxiety requires being able to sit with discomfort. Boredom is a form of discomfort. If we’re always avoiding boredom, then we’re not practicing that distress tolerance.

Kids need to know this and need to know how it works. But we can’t expect them to make great decisions about that. Heck, we struggle to make good decisions and our brains are fully developed. So we need to educate them but we also need to do things to protect them.

That can mean learning how to use the parental controls on our phones or on our home networks. It can mean blocking certain sites or social media. It can mean setting up screen limits. And these things take ongoing attention because our phone set ups change, because our kids get older and need different access, and also because our teens tend to be more tech savvy than we are. I know lots of teens who make it a sport to figure out how to undo their family or school internet limits and they’re awfully good at going on Reddit to figure out work arounds. Which is again, why we can’t just count on external controls. They are tools but we do need to keep talking.

Because we want to grow children who have the skills to navigate the realities of social media, we should be talking to them about how it makes them feel. They need to notice when going on Instagram brings up their fear of missing out or worries of not being included. They need to understand how filters work and how people curate their lives and how knowing that doesn’t always help us feel better looking at other people’s projected perfection.

We need to teach them practical things like how to block certain hashtags, how to handle it when they inevitably see something upsetting. We need to talk to them about ambivalence, which is when we know that looking at some accounts is. Upsetting and yet we want to look at them anyway. I’ve talked to so many kids who feel guilty for wanting to look at social media that they know is not good for them, particularly around disordered eating, for example. That’s a particular danger of social media.

One of the other concerns for children and teens who are ons social media a lot is that they tend to be driven by emotional-focused coping, which is, “I need to feel better” instead of problem-solving focused coping, which is, “I need to address the problem that’s causing me trouble.” A simplification of this, would be someone who is worried about an exam and goes on TikTok to forget about it versus someone who is worried about an exam so makes time to study.

This is a special concern for our anxious kids. Kids who are anxious are already trying to manage their anxious feelings by avoiding the things that make them anxious.Social media can exacerbate this tendency.

And social media encourages this by prioritizing the accounts of influencers who tell us that if we follow their lead that we will feel better.

This is why your children need you to be involved. I know it’s exhausting. Please remember there is not a one right way to handle this. We need to hold social media loosely. We need to stay on top of what our kids are using, keep the conversation open, do our research about what is good about the accounts and what is not. We need to educate our children to be good media consumers. We need to share with them what the research says and not condemn them for quote “giving in” to social media’s siren call.

It is not immoral to like social media but lots of kids — like lots of adults — feel guilty about it. That’s not helpful. It’s fine to like social media but we need to remember that it belongs to us and we do not belong to it.

We should talk to them about not using their phones in the evening or at night but we might also need to help them with this by not allowing them to have their phones in their room or turning them off after a certain time and using screen time limits.

I think for some children, especially kids who are interested in social justice, explaining how social media makes money off our free labor whether that’s making media or viewing it, might help them to get annoyed enough to limit their viewing.

I mean it’s an ongoing conversation.

Back to those kids using TikTok to avoid their feelings, we can also do our part by continuing to challenge the Parenting Pitfalls and helping our teens connect what they learn in those contexts — whether that’s pulling back on reassurance or not helping them to avoid — so that they can figure out how to apply that in other areas of their lives, including social media.

Well that’s a lot. That’s a big topic and impossible to do justice in such a short podcast but I do hope that you’ll go check out the Commonsense Media report because that also shares information about managing social media and our kids and I think you’ll find it helpful.

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Do you recommend any supplements for child anxiety?

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The question that showed up in my inbox this week is “Do you recommend any supplements for child anxiety?” The author of the question goes on to say, “Also is there a relationship between vitamin D and anxiety? I have read too little and too much vitamin D can make anxiety worse?”

First off I cannot make any recommendations about supplements because that’s out of my scope. My masters is in clinical mental health and I do not have additional training in nutrition. That said, I can report what studies have said. And for this I’m relying on a lit review published in Nutrients, an academic journal, in March 2021. The title of this lit review and I’ll post it in the show notes as well, is The Influence of Vitamin D Intake and Status on Mental Health in Children: A Systematic Review

Their findings were that the studies, and I quote, “supported potential positive influence of vitamin D on mental health in children.” They go on to recommend, again, I quote, “Vitamin D intake within a properly balanced diet or as a supplementation, except for safe sun exposure, should be indicated as an element supporting mental health in children.”

I couldn’t find any research specifically about having too much vitamin d and child anxiety although a google search on the popular web Brough tup results. But nothing in the scientific literature. That doesn’t mean it’s not an issue so I’d say that your best bet is to talk to your cild’s healthcare provider to get a better understanding of how to know what’s right for your child.

My take on this overall is that good nutrition is good for our mental health but it’s not a cure all and more does not mean better. In other words, when we’re looking at our anxious child’s functioning, we can look at basic nutrition, sleep, physical exercise as part of the big picture. We know, for example, that anxiety gets worse without sleep and that physical exercise can alleviate some of its symptoms but as the study says, this is “an element supporting mental health.”

Our physical and mental functioning are tied together for sure but sometimes it’s a chicken and egg kind of thing. I work with a lot of families whose children have gastric issues like celiac or IBS or allergies and it can be difficult to tease out which came first. Did the gastric issues contribute to the anxiety? Because our gut is very tuned into our thinking. Lots of us call the stomach our second brain. If you have an upset tummy, you may interpret that as anxiety even though ti might be caused bye omethign you ate.

On the other hand, anxiety can cause upset tummies. It’s one of the most common symptoms of child anxiety.

This is why it’s so important to get a medical workup for your child when they are dealing with anxiety. And if there are gut issues or their headaches are because they need glasses, we need to address that.

So vitamin D might be part of the picture. And I’d say considering this study, it’s a good idea to talk to your child’s healthcare provider to get more information about how to test their levels and whether or not supplementation is necessary. I wouldn’t just start with supplements for child anxiety and assume all is well.

Now as I said, my masters is in clinical mental health counseling and so I work through that lens. That’s my bias, that’s what the research says. A two-pronged approach — taking good care of our bodies and also working on our minds — is in my opinion, our best bet.

What this means is even if there are physical issues present that need to be addressed we also need to work on our mental functioning.

Anxiety can become something of a habit. That’s not to say that it’s a habit like smoking or biting your nails, it’s more a habit of thinking and processing. If we have a child who has gut issues and they develop anxiety either due to those gut issues or due to something else that is exacerbated by the gut issues or whose gut issues are caused by anxiety and we take care of their belly we still need to take care of their anxiety and vice versa.

Even when their belly feels better, they have learned to expect the world to be anxiety producing. They’ve gotten so used to feeling uneasy in the world — of expecting that stomachache, of expecting the social anxiety that can come when you might have to run to the bathroom, of associating certain public spaces with nervous feelings — they will need to address that. That takes practice and it takes exposure.

The next question might be where to start first and I’d say wherever feels most available to you. If your child is due for a well child visit soon, it’s easy enough to talk to their provider then. If you’re going to have to wait a bit to get in there, you can start working on the education and coping piece. You can’t get it wrong as long as you’re moving forward and are open to finding answers where you find them.

There is no silver bullet for anxiety. Sometimes I’ll see folks on social media saying, “Do this one thing, get this one treatment, learn this one technique” and that’ll cure anxiety but that’s not been my experience and observation in working with hundreds of families. Anxiety is more complicated than that. There are things you can do to support growth and coping but there is an element of learning that is unavoidable.

Here’s a metaphor that might help explain this. Let’s say I have a penchant for bad boys. I’m basing this on my young adult self who had terrible taste in boyfriends. I thought the problem was I kept dating not great guys. But actually the problem was that I kept choosing to date not great guys. I mean, that’s not saying I deserved poor treatment — of course not — or that I was causing it. Again, absolutely not. But until I did the work I needed to do with a therapist, I kept dating rotten guys. I needed to learn more about healthy relationships, about setting boundaries. I needed to work on my self-concept.

That’s how anxiety is, too. I can have enough vitamin D in my body, I can be physically centered and calm, I can be exercising and that’s all wonderful and will definitely help but I still need to work on my thinking.

And sometimes working on my thinking, will help me access tools like getting a good night’s sleep and hitting the gym on the regular.

I love when parents are open to a multiprong approach so I’m very glad this person asked the question so that we could talk more about this and it gave me the chance to do the research, which I always appreciate.

A reminder that April 3rd we’ll be starting the spring cohort. If your’e listening to this after April 2023 please know that the Child Anxiety Support program is always open and I tag the recorded live events so that you can find the topics your’e most interested in and revisit them. But if it’s before April 2023 or during, I’d love for you to joint he site and come along as we go through he program together. If you have questions, please reach out to me. You get 14 days free to try it out so you have nothing to lose except the grip that anxiety has on your family.

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How do I explain to my anxious child that they don’t need to be scared?

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This is such an interesting question because it assumes that this is one of our jobs as a parent. That we are supposed to tell kids not to be scared and sometimes that’s true. Sometimes our job is to be reassuring. Like when a child is afraid of going to the doctors, and we sit down and explain what’s going to happen and maybe buy them a toy doctor’s kit so they can process their emotions through play. But does that mean that if they’re still scared that we’ve somehow failed them? Or that they’ve failed to process their experience correctly?

I mean this question really gets at the nature of fear and how we feel about fear and how we feel about our kids feeling fear.

Ok, let’s back up.

First, fear is not a bad emotion to have. Fear is supposed to keep us safe. Fear is a warning signal to be careful, to keep your eyes open. Fear is ok. It’s not comfortable but it serves a purpose.

We are going to be afraid sometimes. We are going to be afraid of new experiences sometimes just because they’re new. We’re going to be afraid of situations like going to the doctor’s if last time we got a shot. It makes sense that we would be nervous about going again even if we’re not going to get a shot this time.

What I’m getting at is that the issue isn’t fear really. The issue is letting fear get the best of us. Fear is a tool and we need that tool but we need to be discerning about using it.

Being afraid is ok. Sometimes it’s even more than ok, it’s super smart. We need to learn when our fear is helpful — like when it’s telling us to back away from the cliff or not go into that dark attic in the haunted house or study for the test in order to get a good grade.

And we also need to learn when it is NOT helpful like when it’s telling us not to ever go on the hike or that every house is haunted or that we shouldn’t even bother to take the class because it will be too hard.

We need to learn when our fear is protective and when it is avoidant. Or more to the point, we need our children to learn when fear is protective and when it is avoidant.

The question, “How do I explain to my anxious child that they don’t need to be scared?” Might be better asked this way, “How do I support my anxious child when they are scared.” And you’ll see we’ve shifted from trying to FIX what’s happening or our child and moved to helping them learn the skills to manage the experience themselves.

When our children are afraid, we can validate the feeling without validating the fearful thing or event itself. By this I mean, we can say, “I know you feel scared,” which is validating without rushing to reassurance or to avoidance. So we don’t have to say, “I know you feel scared but there are no monsters under the bed” or “I know you feel scared so why don’t I sleep in here with you.” What we could say is something like, “I know you feel scared, what do you think would help you know that you are safe.”

It doesn’t have to be these exact words and it doesn’t have to be handled this way every time, I’m just using this as an example to start shifting the conversation and shift to honoring and supporting your child’s agency.

Anxiety offers an invitation to be curious. What might happen? What could we do to explore that? We could invite our child to look under the bed with us. We could give our child a flashlight and invite them to look for monsters. I’ve had lots of kids who have found it helpful to create a sign for their bedroom doors that says, “No monsters allowed.”

When we do the reassuring, we create a dependency on being the source of reassurance. When we give them the means to explore and confront and cope with their fears, we are giving them opportunity to be brave.

Let’s try another scenario.

Let’s say an older child is anxious about a big paper that’s due and they are coming to us for reassurance that it’s good, that they’ve written a great paper. Now there’s nothing wrong with telling them, “You’ve done an excellent job on this paper” or “You can really see your hard work in this paper.” But when they start saying, “But will my teacher like it?” No amount of our reassuring them is going to be enough. So instead we can say, “You worked really hard on this; no wonder you’re anxious to know what your teacher will think of it.” And then we can invite curiosity. “What would happen if your teacher didn’t like it? What would you do? Would that change the way you felt about it?” There’s no right answer there, it’s just a chance to be curious. It’s just the chance to be curious about problem solving, like would you ask for extra credit work? Would you ask for a meeting to argue for a better grade? Or it might be an opportunity to talk about evaluation and what it means to be evaluated and explore our philosophies. Like does someone else’s judgment negate our own? Like can we separate our pride in our work from grades, which can sometimes be so subjective? Again, no right answer. But we’re building up critical thinking, the ability to problem solve, and reiterating our family values around work and judgment and the ways we interact with the great big wide world.

I think this question helps us, too, to see that parenting an anxious child is not just about parenting an anxious child. It’s about parenting, period. It’s about learning and growing and coping with who we are and what we want from the world and how to operate even when things are uncertain or unpredictable or outright scary.

If you are thinking of joining Child Anxiety Support for more specific concrete answers — ones that apply to your unique family and go beyond what we can do in these short podcasts, please know that starting in April we will be going through the 6-week Strong Kids, Strong Families program together. My membership is always open, which means you can join at any time and take the course at your leisure. But if you join by April 3, 2023, then we will all be doing the lessons at the same time. Each of our weekly live events will be focused on that week’s lesson so that we can dive in deep. I am always available to give you personalized support, so that together we design a concrete, step-by-step plan to address your child’s particular anxiety. Whether that’s sleep or behavior or separation or school, this evidence-based program will give you the information and tools you need to address your child’s anxiety across a lifetime.

Just head to childanxietysupport.com and remember that you get the first 14 days free. Have questions? Reach out to me at [email protected] or through instagram where I’m at dawnfriedmanmsed. I look forward to hearing from you.

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How do I get my anxious child to sleep alone?

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This week we’re answering a super common question that I get in different forms and this is: How do I get my anxious child to sleep alone?

The person who asked this question has a 10-year old who still needs their parent to stay with them at night. We’re going to call this 10-year old Francine because that is nothing like her real name. Francine is 10 going on 11. She has a younger siblings who is five. The way the family works bedtime is one parent help the five year old get to sleep and the other parent stays with Francine.

The family has a good bedtime routine — they start getting everyone pajamas and teeth brushed and settled in at around 8:30 and then theoretically lights out at 9. However Francine struggles to fall asleep and has been saying up later and later. Her parents are getting increasingly frustrated because they want to spend time together in the evening and they have things they’d like to get done, too, after the kids are in bed.

The family has tried leaving Francine alone but she will come out of her room and interrupt them repeatedly or if she does fall asleep, she will wake up several times at night and demand to either sleep with them or that they come back into her room to sit with her until she falls back asleep.

No wonder they’re frustrated. And I’m sure Francine is frustrated, too, because I’m sure she doesn’t want to create so much fuss.

The family has tried a lot of things. They’ve tried rewards, they’ve tried charts, they’ve tried sound machines. They’ve tried melatonin. They’ve met with their doctor to see if Francine has any health issues. They’ve tried getting angry and just refusing but that just drags out the inevitable and of course at night everyone is exhausted and so the parents end up giving in.

Again, this is a super common scenario. The details may be different but if you’ve got a bigger kid who still needs this much support to fall asleep, you are not alone.

First let’s talk about this issue in the context of anxiety.

There are two common reasons why anxious children might be struggling with sleep. The first is generalized anxiety, which is being worried. AS I’m sure all of you know, the deep dark quiet at night is prime worrying time. If I could see you I’d ask for a show of hands for how many of you have ever dealt with insomnia where you’re staring at the ceiling, yearning to go to sleep while your brain churns through every potential disaster and every past mistake. Well that happens to kids and teens, too. A child who is prone to worrying in the day is just as prone to worrying at night. Maybe even more prone because at night our defenses are low. We’re tired and our brains are less guarded so all of those worries we’ve been pushing aside show up and disrupt our sleep.

If you have a child who worries about worrying then they may be using you for a distraction from that worrying. Or they may find you a calming presence, someone who keeps the worry monsters at bay.

The second reason a child might struggle to sleep alone is separation anxiety. This would be a child who doesn’t want to be away from you during the day either. They may follow you from room to room, or insist on coming upstairs with you or will call to you if you go to the bathroom without letting them know you’re leaving the space. They might also have trouble separating from you for school or other activities.

These children might feel vulnerable when they’re alone or they may worry about you. They may worry about how you’re doing. Separation anxiety may be a part of their functioning long term but it can also crop up after a traumatic event. So for example, if you were recently ill if there’s been a death in the family or a neighbor was robbed, they might need you close to know that they and you are safe.

Of course both elements of anxiety might be present in one child. Francine may feel safer when a parent is with her because she worries about someone breaking in through her window and she may also find that she has more intrusive worrying thoughts that come to her at night.

In fact, one thing Francine’s parents told me in their email to me is Francine also worries about not getting enough sleep. I know how that feels and I’m sure you do, too. The later it gets, the more aware we are that morning is coming in fast, the harder it is to fall asleep.

All right. Now we have a picture of what’s happening and we can talk about what to do.

Sleep issues are often deeply entrenched. They’ve usually been going on for awhile. It’s a Parenting Pitfall that creeps up on us. We create a routine to help everyone get to sleep and then the routine gets more complicated, it gets more demanding and we get more stuck. That’s because parents tend to start trying to deal with it and then give up because they’re exhausted. What happens is that we are actually training our kids to push more and more and more.

Let me explain this by giving a fake example. Let’s say you have a child who, like Francine, wants you to stay in the room with them. You tell them you will stay for ten minutes, that’s it. They start crying when you get up to leave at ten minutes. They beg and beg and you stand there arguing with them. Finally you leave the room and then they start screaming. You come back and tell them to settle down and try to leave again. They get out of bed following you, still crying. You take them by the hand and bring them back but they leap from the bed sobbing and race out the door. You go after them. This goes on for so long that you give in and stay with them until they finally cry themselves to sleep.

Or some version of that.

That parent may feel heartbroken, or manipulated, or trapped, or angry, or embarrassed, or defensive. I’ve heard from parents who feel all kinds of ways about it. And let me add that it is absolutely ok to not want to co-sleep with your anxious child. And if that’s you, then you’re going to need a structured plan.

Parents are going to have to make the break for sure, which means they’re going to need to push things with their child and it’s likely their child isn’t going to be happy about that. But with a structured plan, clear communication with the child so they’re not surprised, and graduated exposure — which means taking things step by little step — they will see results. And they will be able to build on small results to get to big results.

One of the most challenging things about making this shift is helping parents understand that teasing it out, teasing apart the problem and creating a plan isn’t going to be a quick fix. The longer it’s been going on, the longer it will likely take to get unstuck. Also the more intense the child is in general, the more intense we can expect the process to be. But when we have realistic expectations then we won’t be disappointed or discouraged.

What we know is that parents hold the key to making a difference in these kinds of sleep issues. If you want help with your anxious child’s sleep issues, you can find it in my Child Anxiety Support program. The Strong Kids, Strong Families walks you through how to make a plan and I am available to answer your questions and help you personalize the plan. I’m there via private message, community posts, and in our live events, which include chats, workshops and drop in office hours.

And I also want you to know that in April we’ll be doing our first cohort in the program. What this means is that in the first week of April we’ll be doing the first lesson in Strong Kids, Strong Families together. All of the live events will be about that first lesson — other resources, more supports and information. The program is alway open — I don’t do launches because I want it to be available to anyone who needs it whenever they need it. But I will be walking through the program with all members, six weeks, one lesson each week so that we can be doing it together as a community. To get in on that, join today and we’ll be getting started together April 3rd 2023. If you have questions let me know.

You do not have to deal with this struggle alone and I promise you that things can improve.

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94 to 99% of families are stuck in patterns that make their child's anxiety worse.

Are you?

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March 2023

What derails child anxiety treatment?

Does social media cause teen anxiety?

Do you recommend any supplements for child anxiety?

How do I explain to my anxious child that they don’t need to be scared?

How do I get my anxious child to sleep alone?

94 to 99% of families are stuck in patterns that make their child's anxiety worse.Are you?

Follow Me

94 to 99% of families are stuck in patterns that make their child's anxiety worse.

Are you?