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May 2023

What do I need to teach my child about anxiety?

Podcast

Last week’s podcast episode, that’s number 60, how do I find time to work on my child’s anxiety, I talked about anti-anxiety skills and techniques and how it’s important that we learn them so we can teach them to our child and a listener wrote me after to ask more about this. They wanted to know what I meant by skills and techniques.

Ok, so tackling child anxiety has two basic pieces. The first piece is about confronting the anxiety itself. And that’s the Parenting Pitfall piece. That’s where we need to learn how to parent our specific child to help us stop avoiding the things that make them anxious. I’ve talked a lot about that.

The second piece is learning the cognitive behavioral tools so your child understands and learns how to manage their anxiety.

Anxious people, anxious kids are gonna be anxious. If we are sensitive, a bit more negative — you know, like we can spot potential problems before they even show up. This would be someone who always has a Plan B because they’re worried Plan A might work, or someone who tells you all of the reasons why things are likely to go badly. Anyway, if we have a brain that’s prone to anxiety then anxiety is going to be part of how we operate. Instead of trying to eliminate anxiety, we need to understand it — understand how it works, how it shows up for us — and we need to know what to do when we’re feeling it.

Both of these things — not avoiding anxiety, also called exposure and managing anxiety — are necessary. Learning one without the other is incomplete but that doesn’t mean you have to be learning both simultaneously. It’s more like you start chipping away at it wherever it feels most accessible. Which is what I was talking about last week.

We need to learn them first and figure out how to make sense of them so that we can interpret them for our children. And they also need to become sort of embedded in our thinking and in the way our family operates. We often segregate big discussions but I want you to understand that anxiety is a way we operate and so we can’t segregate anxiety work to a once a week thing. Anxiety is not a Topic with a capital t; it’s a way of functioning and that’s how anti-anxiety needs to be, too.

Think about other values that are automatically practiced in your family like living out kindness by saying please and thank you or living out responsibility by prioritizing homework or whatever. These value practices might be so automatic that you don’t notice them unless you visit someone else and you realize, oh so not every family greets each other when they get home. Or not every family has a chore list. A value of anti-anxiety needs to be practiced. It needs to become a way of functioning. First we learn it, we learn how to enact it in our family, and then we practice it.

Let’s discuss more what those skills, those cognitive behavioral tools, look like.

I’m going to use the section headings from my CBT Family course in the membership to illustrate this. It’s important to know that in real life these skills aren’t so neatly classified. They overlap each other and they build on each other. But this will give you a general ideas.

Section 1 Understanding Anxiety

We need to know how anxiety shows up for us. How does it show up in our bodies, how does it work. We need to be able to spot and label it. Remember anxiety is not danger but it can feel and look like danger. Understanding the difference is a big part of learning to overcome it. 

Section 2 Feelings Literacy 

I meet lost of people — kids and adults — who struggle with knowing how they feel. But recognizing, labeling and learning to handle our emotions is an essential part of resilient functioning. This is also important as part of that first bit of understanding anxiety. Because anxiety can sometimes feel like anger — anxiety can make us irritable and it can also make us meltdown and it can also feel like sadness — we may feel anxious that no one likes us or that we are failing, which can make us sad.

Section 3 Self Esteem/Self Concept 

Self esteem is what we think other people think of us and self concept is what we think of ourselves. Lots of anxious kids struggle with self esteem as just part of that anxious functioning. They may worry excessively about what other people think or their negative emotional bias may make them assume they know that other people don’t think well of them. And with self concept, the anxious child needs to start believing in their ability to face and deal with their anxiety. This can be a chicken and egg thing. They may need to feel strong to face anxiety but they may need to face anxiety to feel strong.
Section 4 Calm Down Tools 

Lots of families start here. Most families I talk to have done some calm down practice, especially deep breathing. But starting here is putting the cart before the horse. These are important skills for sure but they are absolutely not the be all end all of anxiety. Just calming down is not enough to bring to the anxious table.

Section 5 Understanding Thinking 

This section is meta cognition, which is thinking about thinking and this is some big philosophical work. Little kids aren’t going to be able to do this, they’re just not going to have the developmental capacity. But that doesn’t mean you can’t get ahead of that. This is hard work even for adults and it can bring up a lot of different feelings, which takes us back to emotional literacy. See what I mean about how this builds on itself? Don’t let that discourage you though because Understanding thinking is a lot of fun, too. Or at least it can be and it’s definitely something we relearn in new contexts.

A basic example of this is learning that story The Blind Men and the Elephant. There are picture book versions of this so I’m hoping it’s familiar but the gist is several blind men come across an elephant and they all experience the elephant differently. One gets a hold of the trunk and thinks an elephant is like a snake, one gets a hold of the ear and thinks the elephant is like a fan. One gets a hold of the leg and thinks an elephant is like a column. Anyway, That’s thinking about thinking, understanding that our perspective defines our reality and not always accurately.

Section 6 Shifting Attention 

This is about learning how to distract ourselves when anxiety threatens to take over. These are mindfulness tools, giving ourselves space to appreciate anxiety from a distance. This has overlap with calm down tools, it has overlap with meta cognition. And of course feeling literacy and understanding anxiety. These are powerful skills and again, take practice.

Section 7 Exposure Tasks

Eventually as we get better at staying out of the parenting pitfalls, our children will be able to take over designing exposure tasks or recognizing opportunities to confront their anxiety. This is also a skill and it’s based on all of the other skills. At the beginning exposure tasks may be fairly formal — if you join and take the Strong Kids Strong Families course you’ll see how confronting pitfalls is at first organized and formal — but as we get better at spotting them and confronting them, it can become second nature. That’s what those tasks are about.

You of course can find ways to teach these skills to yourself. You can buy some of the anxiety workbooks and looks hem over — they’re generally organized like this but might use different names or break things up a different way. These are also the kinds of things you’re likely to learn in therapy. 

And there is CBT Family inside my membership.

I hope this has given you some ideas about building those anti anxiety values and practices into your family. I welcome any specific questions you. Might have. 



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How do I find time to work on my child’s anxiety?

Podcast

This is a question that every busy parent has to ask themselves and thinking back to my most intense parenting years, I hear your screams, friends. Oh boy do I appreciate how many plates you’re already spinning and how fast they have to spin especially when you’re parenting an anxious child.

Let’s be frank, you’re not going to be able to find time because most of you are already over scheduled, over booked and over whelmed. It’s the nature of the parenting beast. So the answer to this question is more complicated than just revisiting your schedule.

When we think about working on our child’s anxiety, it’s easy to think about it as a separate curriculum. A thing you make time for, an event you schedule. But the most effective work is one that you integrate into your day to day life. Yes, most of us will eventually need to have a plan — a concrete step by step of figuring out what to do next — but that’s a lot easier when you have things already in place.

Think of it like cooking. Cooking is easier by a lot when you do the preparation.

     

      • You go to your recipe box or click to your favorite cooking site

      • You choose what you want to make

      • You make a list of the ingredients

      • You go to the store and get them

      • You prepare everything — chop the onions, wash the greens, debone the chicken — and get out all of the equipment

    Oh yes, we forgot about the equipment because you also need to have the appropriate pan and knives, etc.

    Then you cook. And when you’re first learning to cook, you make mistakes. You don’t know what medium heat means on your stovetop of you are still working on your knife skills.

    Once you’ve been cooking for awhile you can wing it. You know how to make last minute substitutes or how to throw together a dinner based only what’s in your pantry. You may not need recipes or you may have figured out how to adjust the recipes you have to suit your family’s tastes and budgets. You know which meals you can make quickly and which are the ones to save for special events.

    You get better at it by learning and by practicing.

    Most of us don’t have time to take cooking lessons — formal once a week events that we block out on our calendar — instead we kind of learn as we go. And we have to learn if we want to be able to expand our palates beyond whatever uber eats or Lean Cusine has for us. Not that there’s anything wrong with take out because sometimes that’s all we have time or space for but if we want to save money or eat in ways that serve us body and soul more or just more to our preference.

    Managing child anxiety is like that, too. Right now you might be spending more energy on NOT managing the anxiety — or more specifically managing it in ways that don’t serve you or your child or your family as well — and you’re going to have to make a shift in how you think about it.

    Now, you can take cooking lessons for anxiety. You can join a program like mine or grab a book or workbook and you can do the things. You can devote an hour each week or even more time and work your way through it. And that’s great. That’s a great way to do it. 

    But most of us are going to do it in more messy ways, which is why I designed my program the way I did. Most of us are going to dip in and out. We’re going to join the program or grab the book and we’re going to dive in and then we’re going to set it aside. We’re going to forget about it a little bit. We’re going to feel overwhelmed and guilty about not tuning in more and that will make it even harder to return to it.

    Let me assure you that it’s ok to be messy and in fact I think it HAS to be messy to be effective.

    Learning to manage your child’s anxiety is a lifelong learning. It’s full of paradigm shifts and self growth and you’ll need to become an expert on a lot of different topics like anxiety in general, and your child’s unique development, and specific tools and techniques that you can pull out at different times and in different contexts. 

    I designed my program thinking of this messiness as a feature not a bug. There is the asynchronous step by step course, Strong Kids Strong Families, and it’s asynchronous so you can get it whenever and wherever you need it. But there are other opportunities for learning, too. There is CBT Family, which are the skills and techniques to bring cognitive behavioral tools to your family. Those are things you can dip in and out of. You can bring those in as slowly as you like wherever you might be in the Strong Kids Strong Families process. And then there are some people who basically use the membership in order to contact me and ask me questions and directions about their particular child. They may not use any of the courses at all at first, they’re just messaging me and that’s fine. I will direct them to where I think they might need help.

    In short, I designed this as a membership and not a static course were you pay once and forget about it because I wanted members to start thinking of it as a companion. And as a commitment that is flexible to meet their needs.

    You do not need to have set aside time but you do need to be willing to come by and check things out or check in with me. Then as you grow in your understanding of how anxiety works, it becomes easier to see ways to adjust things.

    It’s a little like one of those meal kits, where you get to ease your way in. A lot of it is done for you, you can give feedback or ask how to make it more personalized and eventually you take the confidence you’ve gained through the meal kit and into your own menu.

    I think this metaphor works. 

    Anyway, if you’re struggling to figure out how to find time to manage your child’s anxiety, I encourage you to consider just starting with learning more about anxiety. This podcast is a good place to start — dive into some of the archives. The more you learn, the more you will know your way to go. So just keep learning. 

     

     

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    What do I do when my child doesn’t want to deal with their anxiety?

    Podcast

    This is a really great question because a whole lot of us — not just children — don’t want to deal with our anxiety. We may not realize our anxiety is even a problem. We might not even know that we HAVE anxiety. We might think that this is just the way that we function.

    That wouldn’t be an issue if our anxiety only impacted us. But what we know from the research is that those of us with anxiety that is left unaddressed or untreated tend to pull on our loved ones in ways that hep us avoid the things that make us anxious.

    In fact, when you dig into the scientific literature around anxiety accommodations, which is the term for the pitfalls we get stuck in with our kids, you’ll see that many of those studies were looking at accommodations within couples particularly around OCD. This is all to say that anxiety is an issue in relationships and child anxiety is always a family systems issue.

    This can be confusing because we are seeing our child struggle with this problem and so of course we say, “I need to intervene with my child. I need my child to change.”

    But actually we need to change.

    That’s good news. It may feel like rotten news like, “I’m screwing up” but you’re not screwing up. It’s just how anxiety plays out. 

    Think of it this way. If you have a child who is allergic to eggs and you’re the person who does the grocery shopping, menu planning, snack providing, you are going to have to figure out eggs. You’re going to not buy eggs, you’re not going to make omelets for your child, you’re going to need to get that recipe for wacky cake, which is the cake that uses vinegar and baking powder for leavening so that you don’t need eggs. That’s because your child may be the one with allergies, but you are the adult who actually controls the general overall function of how the house eats.

    Maybe that’s not such a great example since with allergies avoidance is the right thing to do and in anxiety it is NOT the right thing to do.

    Oh well, I hope you get my point.

    So it doesn’t matter if your child doesn’t want to deal with their anxiety because we are going to focus on our own behavior.

    It is both easy and difficult to make this shift. It’s easy because the only person we have to deal with is ourselves. We get to unpack our often complicated feelings about our child’s anxiety, to address our worries about their worries, and to learn the tools we’d like to pass onto our children. It’s difficult because we care a lot about how our kids are doing. It’s challenging to unhook ourselves from our want for things to be easier for them. And it’s difficult because letting go of attachment to results can feel neglectful. 

    What we need to remember is that over attention to our child’s anxiety is what is keeping us stuck. Wrapping our family functioning around their functioning tends to be insidious. It creeps up on us, it has deep roots. Often I talk to families who say, “No, we are not stuck. We are ok. We are doing the things we need to function and they’ll point to one particular challenge. One particular big emotion behavior.” But it’s’ very much an iceberg kind of thing where that one particular behavior or problem is just the one we’re seeing but there are many more that the family has just become accustomed to.

    It takes time to pull back and fully consider the ways we — the parents — have become trapped in our child’s anxiety. And then when we start to realize it, we may find ourselves feeling defensive and wanting to explain why it’s important that we do those things and why we need our child to change. 

    We might feel we can’t shift until our child agrees to work on their anxiety because we feel so tangled up in it. 

    If you feel like you can’t make a move until you have your child’s buy in, until they are willing to deal with their anxiety, that tells me right there that you’re stuck in Pitfalls. No shame there. 89 to 97% of all parents of anxious kids — depending on which study you read, some say 95 to 99% – are stuck in pitfalls. You’re in good company. But we are the ones who are stuck so we are the ones who will need to get unstuck.

    If you feel super tangled, if you feel super stuck, if you feel like there is no way you can work on this without working on your child, that’s all right. It means that you’ll probably need to go slower as you learn more about child anxiety and more about how to uncover and address the ways you are stuck. This isn’t a one and done deal. This is a process and it takes time. But once you’ve begun it and you really understand it, and you know how to work your way through it, you will never be that stuck again because you’ll be able to apply and reapply what you’ve learned every time you look around and say, Dang, we’re here again.

    It’s not the getting stuck that’s the problem — any of us with anxious loved ones will get stuck now and then — it’s recognizing it and knowing how to get unstuck. When we do that, our loved ones will get unstuck, too. That’s just how it works. That’s just how family systems work. You change and that creates change in the system, which requires change from other members. This is essentially the core of child anxiety treatment. The rest is about learning skills and bringing them to your family. You can do that. Even if your child doesn’t really want you to.



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    Does my child have social anxiety or are they just shy?

    Podcast



    I really like this question because I think it can be confusing. If you listened to the previous episode e about why encouragement doesn’t always work for anxious kids (that was episode # 48), we talked a lot about temperament, particularly about the slow to warm temperament. And temperament is what we’re also talking about here.

    Some kids are more shy than others, meaning that they take more time to warm up in social situations. Some kids are more introverted, too, which means that they don’t need as much social stimulation as other kids. They may find social situations more of a drag on their energy and so these children and teens may have fewer friends.

    And that’s fine.

    It’s fine to like being alone, it’s fine to hang back in social situations until we are comfortable, and it’s fine to enjoy one or two close friends rather than to want to hang out with a crowd.

    It’s all fine.

    Shy children, introverted children are living out a preference. They prefer smaller situations. They prefer to come to things on their own time.

    They may like a big party but want to hang at the edges. Or they may have no interest in a big party but would prefer a celebration with just one good friend.

    Now socially anxious kids are NOT living out a preference. They want to be social — or at least more social than they are being — and are unable to because of their anxiety.

    Socially anxious children and teens may also be shy or may also be introverted and this can make it more difficult to tease things out.

    Let’s compare the two:

    A shy child will eventually warm up in social situations. A socially anxious child will continue to feel distressed and in fact their distress might increase.

    A shy child may prefer one or two close friends over a crowd. A socially anxious child may struggle with friendships, worrying that the friends they have like them or worrying that their friends are secretly upset with them even when they’re not.

    A shy child may be reluctant to attend a large social gathering but they won’t necessarily be avoidant. They may roll their eyes or grouch, but they’ll still be willing to go to the birthday party. The socially anxious child may panic and refuse to go or struggle to sleep the night before or repeatedly ask you if they can stay home.

    A shy child’s functioning is fairly consistent — you know which situations they prefer and which they don’t. A socially anxious child’s functioning likely gets worse over time if there is no intervention. They may be unpredictable, willing to attend a social event one day and then the next bottoming out and unable to get out of the car and head in to the party.

    The shy child would prefer to stay home. The socially anxious child struggles to leave the house. So there’s preference and then there’s ability.

    The shy child can push past their limits when motivated. The socially anxious child is trapped by their limits. It’s the difference between someone saying, “Ok, fine, I’ll do it” and someone melting down or beating themselves up because they can’t do it. 

    Shy child don’t have the performance worries of the socially anxious. 

    Let’s look at some examples and hopefully you’ll be able to recognize your child in one of these if you are wondering about their functioning.

    The first child is socially anxious and outgoing. They want to be part of the crowd. They are sorry to miss out on the school dance or soccer team try outs. They are unhappy not being a part of things but they are excessively worried about failing or about being made fun of or of not getting things right.

    The second child is socially anxious and more introverted. They may express that they are lonely. They may say that they worry that something is quote “wrong with me” end quote because they don’t know how to fit in. You may look back and see that they tended to smaller groups or just one friend at a time but now you are seeing them become more isolated.

    Now the child who is introverted but does not have social anxiety does not express unhappiness with their social life. I mean, they might complain now and then — we all sometimes feel left out — but generally speaking they have a solid friend or two, they are able to participate in things, they may not be joiners but if they want to do a thing with someone like go to the movies or have someone over — they’re able to do this.

    If you’re not sure, just think about how your child communicates about social events. Are they like, “ugh, fine, I’ll go but I won’t like it” or are they excessively worried, asking for reassurance, telling you how everyone is dumb or mean or will judge them. Is there an emotional component that you’re seeing, a digging in of their heels. Are things getting worse, is their social life getting smaller. Are they fretting about friend drama to the point that the drama is bigger than their friendships.

    You can also look at their functioning across their lifetime. Introverted babies may make less eye contact or be less interested in engaging with strangers. You know how babies often go through a period of flirting and being adorable with cashiers, shy babies aren’t interested in this. One of my children was shy but not socially anxious and as a preschooler when people would try to engage with him he would just point at me. He didn’t have trouble doing this — he didn’t cry or hide his face — he’d just point at me to answer. My other child was extremely outgoing but struggled with some social anxiety and this appeared later in life. The fact that it was different than her functioning at other ages pointed to it being an anxiety issue and not a preference.

    We see social anxiety crop up in kids when social demands increase. I see it around 8 or 9 especially for girls and I see it a whole lot in middle school. No wonder, right, because these are socially anxious times. Just because it’s developmentally typical doesn’t mean we should ignore it or assume they’ll outgrow it. Untreated anxiety tends to get worse and Kids who are prone to anxiety in one area are more likely to have anxiety in other areas, too. There are no downsides to learning anxiety coping tools.



    Does my child have social anxiety or are they just shy? Read More »

    Good kids are sometimes bad

    Parenting

    Young children, bless their little hearts, think their parents are perfect. It takes them awhile to realize what messes we really are but at the beginning, they think we’re All Good and so when they do things that are Not So Good they sometimes think it means they are in some way defective. After all, the adults who they love and look up to don’t seem to have trouble not spilling the milk or wetting the bed or remembering how to tie shoes. Kids are usually under the false impression that grownups are never deliberately bad. (As grownups ourselves we know that deliberately misbehaving is actually quite the grown up kind of thing — witness insider trading and and people who double park — but when our children are only noticing our stellar milk pouring skills, it’s easy to impress them.)

    When you’re little and you sneak a cookie or lie about brushing your teeth, it changes how you feel about yourself. You don’t have a broad enough worldview to know that being bad is part of being human and that misbehavior is something most of us struggle with on some level for our entire lives. Little kids tend to think very black and white, “I have done this bad thing therefore I am a bad person.” When parents react with shock or dismay when they discover a child’s transgressions, it solidifies that child’s self concept as “bad person.” That’s why it’s so important to reflect back the unconditional acceptance of the small person before us even when we need to condemn that same small person’s behavior.

    Keeping the focus on the bike left in the middle of the driveway (“Michael! Your bike!”) and not on Michael himself (“What is wrong with you? Do you ever think about anyone else? Do you think I like getting out of my car in the rain to move your bike?”) will perhaps help grown up Michael not cheat on his taxes. Grown up Michael will think, “I’m a pretty good person. I try hard to take responsibility for my mistakes and do the right thing. I think I’ll ignore my brother-in-law’s advice to claim the kid’s play room as my home office.”

    Positive discipline: Saving your child from future IRS audits!

    One thing I encourage parents to do is to make a point of reconnecting with children after particularly bad days — the days when you feel like all you did was holler at them — by talking to them about the predictable developmental challenges that kids face. Little children are encouraged to hear that it will become easier to get things “right” as their maturity levels increase. It’s terrific when parents can say to a 3-year old, “I know it’s hard to remember to use your words when you are three, but someday soon it will be easier for you. Until then, I will help you remember.”

    Even teenagers are reassured to hear that their displeasure with the family is developmentally appropriate and that someday everyone will likely be good friends again.

    Knowing that your parents can see the good in you when you are having trouble seeing the good in yourself is a very big deal for growing kids.

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

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