Dawn Friedman MSEd

How do I support the siblings of an anxious child?

Recently a reader wrote to me with this question, “How do I effectively meet the needs of my oldest child who is anxious without my middle child getting lost between her older siblings and her toddler, sibling. The guilt is real.”

Reader, let me just say, I hear you. And I understand what a big challenge this is. I’m sorry that you’re feeling guilty about it, but I get it — to be a parent is to feel guilty. We’re always really struggling to do the best that we can and frankly, sometimes we’re going to feel like we’re not measuring up.

When we’re feeling guilty. I think we can use this as a reflection. What do I want to be different? What would I like to change? Guilt can be a good tool. It can be a good motivator if it’s well-placed and if the guilt is warranted.

Now I’m a middle child so I know what it is to be the kid that sort of caught between the oldest kid and the youngest kid and it’s not uncommon for middle children to be lost in every family although I will tell you, the research shows that us middle kids were really good at handling things on our own; we tend to be pretty independent and capable. That’s the plus side of it, but let’s go back to what can you perhaps do differently?

When you’ve got an anxious child, it stands to reason that siblings are impacted by the anxiety and even though anxiety can run in families, if you’ve listened tuned in to other posts, you know that people with anxious brains tend to have children who have anxious brains. And that anxiety is also learned behavior. When kids see us be anxious, they learn to be anxious.

So anxiety can run in families, but it doesn’t mean that every child in the family is going to have anxiety. Let’s be really clear about that.

Before we get into the specifics of the anxious family, I do want to say that sometimes in families things are not going to be even. You say you have a toddler and toddlers take up more time. That’s just going to happen when a new baby arrives, right? New babies, take up more time.

In other words, it is natural and it is appropriate that in seasons of a family life, one child will be taken up more of the oxygen than the other children. That is going to happen.

Now back to anxious kids. What we do know from looking at the research is that when it comes to the parenting pitfalls — the things that parents unintentionally do that trap their child and the family and anxiety — are things that impact siblings as well. Siblings usually become part of the pitfalls. If you want to take my Parenting Pitfalls quiz, just go here. This quiz is based on the research that looks at the ways families get stuck. So when you take the quiz, Hopefully, this will give you some insight and understanding that the ways that families get stuck are very predictable and very understandable and not a sign that the family is doing things wrong, but are a sign that the family needs help.

That anxiety gets people stuck so the child is stuck, the family is stuck, and the siblings are stuck too. What the pitfalls are all about is when we do things to avoid upsetting the anxious child. Parents do this and siblings do this. This could be something like limiting family movie night. Say one child really wants to watch a new superhero movie or something like that and the parents say, no, that’s going to upset your sibling. We can’t watch that. Or that one has a giant spider in it and your sibling is afraid of spiders.

It can also mean skipping events that the family maybe is going to go to an event, a party or something, and they need to leave early because the anxious child is getting upset. It may mean when the family is trying to cajole the anxious child, get them out the door, get them to do something and the other children are left waiting.

It can also be times where if everybody is used to the anxious child, getting upset and being a little more sensitive that we’re asking other children to make way for that. A classic example would be, you know, that your sibling gets very upset when this thing is happening. So can you just give them the iPad? I know you were playing it, but your sibling is really upset. Can you just give it to them? So we need to notice when we’re doing these things and taking the quiz can help you identify ways you might be doing this, but let’s talk a little bit about why that happens.

When the child acts up and gets really upset. The family tends to do more avoiding and caretaking. That means the anxious child learns that avoidance and caretaking is necessary. For example, if you felt like, “I don’t know how to walk upstairs, I can’t walk upstairs.” And so I carried you up the stairs every time you would learn that you really can’t walk upstairs. You would never get the chance to try.

If you did try and you fell apart and begin to weep, I might carry you up the stairs. You’re not learning the skills to get up the stairs. You’re not learning how to tolerate the discomfort of getting up the stairs. My carrying you seems helpful, but it’s actually holding you back. The more adverse a child is to face in their discomfort the more they may act up or act out or break down.

If a child screams every time they see a dog and we hustled the dog away, they learn that dogs are scary. And they also learn that the way to let us know that dogs are scary is by screaming. We may say, “Don’t scream, use your words” but our actions show otherwise.

When I was a toddler teacher and sooner or later in every class that I had with toddlers, there would be a toddler who would bite. I’m going to call him Hank, (which was not his name). And Hank was a very bright child in the toddler room who learned that biting was a really good way to get things done. So if another child was holding a toy and Hank, wanted the toy Hank would bite. And the whole room would explode with action and excitement!

Hank would get hustled away by us. There was lots of screaming and crying and action, and the other child would drop the toy. So biting worked. It didn’t mean that Hank necessarily got the toy because usually the toy was a casualty in the whole big excitement of biting. But Hank did learn that biting made things happen.

So unintentionally by reacting the way that we did when Hank would bite, which was to get involved and to get involved specifically with, “Hey Hank, no biting you know better, blah, blah, blah.” What we were doing was teaching Hank that biting was a means of getting control. Even though it was creating chaos, it was creating chaos on Hanks terms. What we learned to do instead is that when Hank bit we immediately put all our attention on the bitten child.

Now before it would be, somebody would go to the bitten child. Somebody would go with Hank, but in this case, xomebody would be guarding Hank because we didn’t want him to buy it again. But we were focusing our attention on the child who was bitten. One teacher would go towards the child who is bitten. I was in charge of Hank.

I will add here that the reason I would be in charge of Hank is that I have always really liked to work with the kids that are a little more explosive and difficult. So guaranteed if there was a biting kid in the classroom I was usually the teacher assigned to manage and work with that biting kid; i’ve just always liked difficult kids.

Anyway instead of immediately engaging with Hank, I would move Hank and use my body to protect other students from Hank. And model attention and concern being on the child who was hurt.

Once we were clear, the child was not hurt or caring for their bitten self. Then we would turn our attention to Hank. Now this doesn’t mean we were ignoring Hank. It means that we were shifting our attention in such a way that Hank was learning that biting did not actually give him control over the classroom.

Is this making sense? I hope this is making sense. So this is what we need to do with the anxious child.

Please notice that where we give our attention then we can see things increase. When we give our attention to the child’s anxiety, the anxiety will increase. I understand why we do it just like I understood why we would immediately go towards Hank who was biting, but it’s not helpful.

We need to step back and reassess and say, who is getting short shrift in this situation? And where are we giving attention?

Now it’s going to be a very specific plan for the anxious child. I can’t give you all of the details here, because it would be very specific to the anxious situation. It would be very specific to how entrenched the family is in the parenting pitfalls. It would depend on the child who is maybe needing more attention, what that looks like. But I will say that I think a good thing is to take the pitfalls quiz cause that’s gonna help you see, first of all, where you might be stuck, that you didn’t know you were stuck and also how stuck you are, like, are you super, super stuck or are you medium stuck or are you. Just starting to get a little bit sticky understanding that will help you be more realistic about where you need to go.

So let’s go back to Hank again. If we had let it go on for a long while, the whole classroom may be organized around how to keep Hank from biting other children. And so we would have a longer ways to untangle that focus.

So it’s the same way with child anxiety. The more your family is entrenched in the anxious, stickiness, those parenting pitfalls, the harder it is going to be to pull yourself out of it. But that’s okay. You’re going to start with baby steps and the first. Baby step you can take is to notice what’s happening to the child who is not getting attention when the anxiety happens.

Just notice it. I know that there is a poll to immediately pay attention and take care of the anxious child in the moment. But give yourself a minute, just give yourself a minute and say what’s going on here? Is this pull I’m having towards the anxious child my anxiety? Am I anxious about their anxiety? And that is a big part of Child Anxiety Support membership — untangling our anxiety from our child’s anxiety.

Then we figure out where we can start pulling some of that attention away. Where we can start focusing on the child who is not anxious and is getting a little bit left behind. Once you have a picture of that, which again, starts with noticing what you’re already doing and really noticing in the moment.

Then figure out where can you give that non-anxious child a little more attention? What can you do in the moment? So for example, If you have an anxious child that melts down and kicks and screams, and it’s pretty dramatic. And, you know, you can let them melt down and kick and scream for a minute. You can just stop and turn and look into the child’s eyes, the middle child and say, are you okay? Is everything good? Are you all right? Just give them even that sort of touchstone attention before you turn to their sibling.

You can let them know, “I’m concerned that we’re getting stuck and the whole family is going to need to work on it.”

It’s not just on the anxious child to work on it. In fact, they can’t work on it unless we’re all working on. It. And then we are asking the siblings to also help us in getting this unstuck.

One thing to know when we start pulling attention away from our anxious child, when we stop being stuck, when we stop doing the things that get us stuck, we can expect things to get worse before they get better.

Let’s go back to that child who screams when they see a dog. They have learned that screaming is what they do. If we have decided we’re no longer going to respond to their screaming then they are going to scream more.

Because they’ve learned that screaming works so they’ll think, “I must not be doing it loud enough. I must not be doing it long enough because it works. I’m going to go past the time when it usually works and amp up more than the limit of where it usually works because I’m expecting it to work.”

So you can expect things to get worse, which is another reason to start with baby steps. You don’t want to start way at the end where things are already difficult and challenging. You’re going to start and really tiny baby steps, making slight changes. And that again starts with understanding where you’re getting stuck. All right. So that’s the answer to this week’s question. And if you have other questions I’d love for you to reach out to me.

What can I do about my anxious child’s temper?

We have a terrific question today and that’s what can I do about my anxious child’s temper? This is a really common problem and a typical reason that parents reach out to me. An anxious child often has really difficult behavior, like temper tantrums, meltdowns, and flip outs.

Sometimes this includes screaming at their parents or saying really mean things like, “I hate you. You’re stupid. I wish you’d die.” Sometimes these children are hurting other people, siblings, or pets, or they’re hurting themselves, hitting their own head. Sometimes they’re hurting parents — pushing their parents, or hitting their parents.

Very often, these kids are also trashing rooms. Their parents will send them to their room for some reason, or send them up to bed and the child will tear up their room, break toys, tear up mattresses. Sometimes they’re tearing up other people’s property.

Understandably, parents reach out to me saying, “How do I deal with my anxious child’s temper? They’re out of control. I need help with this behavior!”

But when we’re starting with the behavior, we’re actually starting backwards. One of the very first things that parents do when they join the Child Anxiety Support membership is take a child anxiety assessment so they can get an idea of the shape of their child’s anxious behavior,

Where is it showing up? Are we seeing general anxiety or are we seeing separation anxiety? Are they having somatic symptoms like stomach aches and headaches? Basically how anxious are they? And if we find out they indeed are pretty anxious then we can understand the why behind their behavior, which is that it’s anxiety.

We have to address the anxiety before we can get to the behavior. Now, I’m not saying that angry outbursts or hurting people is acceptable. Of course it’s not, but in order to deal with it, we need to see it through the lens of anxiety and see it through the lens of fight, flight, or freeze and what we’ve got here is kids who are fighting.

Now I absolutely get that parents want to start with behavior. Behavior like this — behavior that’s hurting people — is disruptive. It can be scary. It can be getting the child in trouble at school or with friends. Other family members may be alarmed and telling you’ve got to do something. And you, of course may feel really urgently that something needs to happen, but you need to understand that starting with anxiety is doing something. No, it’s not addressing that big angry behavior. But it’s starting at the front at the tip of that angry iceberg.

One of the resources that I have is a bill of rights for anxious kids. This is based on Ross Green‘s work. He’s the author of the Explosive Child, and he wrote a bill of rights for behaviorally challenged kids that I used as a model for my bill of rights for anxious kids. The gist of it is that when we understand anxieties behind the behavior, we acknowledge that we need to start with anxiety. We need to start with all the anxiety work. That means starting with educating our kids about their anxiety. Building their coping tools and importantly, seeing this as a developmental challenge for our child.

I encourage you to check this out because it’s a paradigm shift, seeing your child as someone who is having a big developmental struggle and not a child who just needs to be parented towards a fix. It’s a lot more complicated than that. Developmental challenges are not the kind of thing that you just start using a different tone or using a specific behavior modification program and it goes away.

Developmental challenges like being an anxious child whose anxiety comes out as anger is a big picture, long range, ongoing pursuit. Now. This does not mean that we give up and let our child’s anger run rampant. No, absolutely not. Reasons are not excuses and being anxious may be a reason, but it does not excuse behavior that hurts people.

However we do need to be realistic. For example, I get lots of calls from parents, with kids who are trashing their rooms. So the first step in that is accepting the fact that you have a child who trashes their room. That’s a fact. And something we’re going to work on, but while we’re working on it, we need to accept that the room is going to get trashed.

So we remove things we don’t want broken. Ideally, we would do this with our child while they are calm and we would talk about it without judgment. It wouldn’t be a punishment or shaming. We might say something like, “I notice that when you’re upset, you really struggle and sometimes that means in your struggle, you are trashing your room. So I need to remove things that we can’t afford to replace, or that might hurt you if they’re broken. Now I know you’re growing and you won’t always be trashing your room.”

You need to say that part because you need to give them hope. You need to show them that you believe in them, even if they don’t believe in themselves and that you believe in their ability to outgrow and get a handle on this behavior.

Now it’s okay to fake it. You may worry that they are going to do this forever, but for now give them hope. Say to them, “I know you won’t always trash your room.” So you remove the things that you need to remove, and then you ask them, “Is there anything that you want to remove?”

The challenge here is it can feel like giving in. It feels like letting them get away with it. If you just accept this behavior as a reality, does that mean you’re condoning? It. No, no, no, no. But in reality, it’s accepting that controlling one’s temper has lots of developmental challenges. These kids have growing frontal lobes growing impulse control and of course, growing in learning to manage anxiety. They’re growing.

Meanwhile, we’re going to work on their anxiety. Not because their behavior is bad. Not because we’re trying to fix the behavior. But because anxiety is difficult and painful. And as our child learns to manage their anxiety, we will see changes in their angry outbursts.

In anxiety we’re working on lots of things.

We’re working on their coping tools, their ability to handle this regulation and discomfort. And the big one is their sense of self. And that’s why hope is so important. If your child sees themselves as someone who is out of control, of course they will act out of control. This is what I mean by accepting that your child is going to act out of control until they don’t. That’s where the hope comes in.

So you say to your child, “You are struggling with this but you will not always struggle. You’re going to get better at it until you get better at it. I need to protect you. I need to protect your siblings, myself, the household, whatever it is.”

Now I want you to think, how would your management of this situation change if you gave up on the idea that your child. Is capable of handling their temper right now. And that is at the heart of Ross Green‘s work, which is kids do well, if they can and is at the heart of the bill of rights for anxious kids.

When we see them as growing individuals who are struggling, then we are working with them with an acknowledgement they’re not ready yet. This is your anxious child with a temper, just like having a toddler who’s a messy eater. Toddlers are going to be messy eaters until they have the skills to eat neatly. Kids who are struggling with their tempers because of anxiety are going to continue to lash out until they have the skills not to. Meanwhile, we work on the anxiety with the understanding that as they get better control over their anxiety, as they grow in those developmental skills — the impulse control, the handling dysregulation, the concept of themselves as someone who can handle things well — we will see changes.

Now it can feel really slow going for the parent and this is why I think it’s so important to have helpers. Whether that’s a therapist, an understanding family member, a group of friends who also have kids with big behaviors. Maybe it’s a support program like mine, but basically people who can help you see the growth, even when you feel stuck in it.

I can remember working with a family who had a child who used to be really destructive — punching holes in walls — and things got better and they got better. Then one day the child slipped because we’re going to slip as we’re growing and punched a hole in the wall again. the parents said, “Oh my gosh, are we right back at the beginning? Are we starting over?”

We were able to look together and say, this is the first time in a long time that my child has done this. They are growing and getting better. Sure, they had a slip, but the work that we’ve done is making a difference. Look at how well they’re doing, let’s look at all of their successes. Then that family was able to share that with the child because they get discouraged, too. They think of themselves as people who are problems, who are upsetting, the family who are destructive, it takes time to change that mindset.

So the answer is what can you do about your anxious child’s temper is accept that the temper is an issue and start making plans to protect the people and things, the household, the other family members and meanwhile, get to work on the anxiety. Accept that your child is going to lash out. Figure out how you would like to keep everybody safe and focus on the anxiety. Usually that means starting with baby steps.  

If you’re struggling with this if you’re not sure how to do it please reach out to me and let’s see if child anxiety support could be a help.

 

 

How do I stop getting angry with my anxious child?

Our very first question for this year is: “How do I stop getting angry with my anxious child?” This is a really good question. I wouldn’t be surprised if the person asking this question is feeling guilty about getting angry with their anxious child so the first thing I want to do is assure you that getting angry with your kids is normal.

Anger is just a feeling and feelings are neutral. It’s okay if you get angry with your kids; it’s how we express the anger that matters. So when you say, how do I stop getting angry with my anxious child? My answer would first be it’s okay that you’re getting angry. Now, if you’re yelling or if your anger is making things more difficult, if you’re snapping at them or if anger is motivating how you care for them when they’re anxious that can certainly be an issue.

And again, I want you to stop feeling guilty about this and just recognize that. Anger is normal. So let’s talk a little bit about why anger is normal being around anxious people makes us anxious. If our kids are anxious, we’re going to catch their anxiety and anxiety can feel like irritability and tension, right? Because anxiety sends us to fight or flight or freeze and fight looks angry, right?

Fllight can also look like anger. It can look like impatience. It can look like wanting to get away from the child, wanting to push the child away. And freeze can look like shutting down, ignoring them, turning away from them. 

These are all things that we may interpret as anger and actually it’s that fight, flight or freeze we’re catching from our anxious child.

Now the fact that we’re catching it again is totally neutral. We’re catching it. Anxiety is meant to be caught. We are meant to catch each other’s fears so that we can do things to protect ourselves. Let’s just forgive ourselves about that. Instead let’s talk about what we can do to take care of our anger, our irritability, our want to ignore them.

So the first step is understanding that anger is normal. And the next thing is to look at what might be underneath the anger. So we talked a little bit about fight, flight or freeze, but here I want to share an activity that is in the Child Anxiety Support membership site. There’s a part of the site that’s called CBT Family. I describe this as a recipe box of ideas, activities and things you can do to teach your child cognitive behavioral tools as they continue to learn how to cope with their anxiety. CBT Family has a series of categories so that you can think about which tools your child might need as they deal with their anxiety. Those categories include things like understanding anxiety, self-esteem and self-concept, calm down tools and feelings literacy. And this activity that I’m going to share with you is under feelings literacy, and it’s called angry sandwiches.

I used to use a card game called Schmear, which is with bagels because you can buy that really easily on Amazon or any store that sells games. And this Schmear has pictures of bagels. And then the kinds of things you might put on a bagel like Nova lox and cucumber and cream cheese, these basic things you might put on a bagel. And what I did was take the bagels and write ANGER. That’s the basic emotion, the essential ingredient to our Angry Sandwiches. And then on each of the different kinds of toppings, I put different emotions that anger covers up. Anger is a secondary emotion. It covers up the primary emotion in other words, anger is always fueled by other feelings. 

Not all kids are familiar with bagels or the kinds of things we put on bagels so I also made sandwiches by just cutting out pieces of paper in the shape of bread, writing ANGER on it, laminating it, and then things like lettuce and cheese and tomatoes, onions, different things to make angry sandwiches.

First, I’m going to tell you what the other emotions are that we might put on our angry bread or angry bagel. And that would be, are you ready? Sadness. Guilt. Frustration. Disappointment. Embarrassment. Jealousy. Hurt. Shame and fear. So when a child is feeling angry, I would say to them, What’s on your angry sandwich? Let’s build your angry sandwich and they would identify these other emotions and put them on the sandwich. And then we would pretend to eat the sandwich. Or I have the little angry guy from Inside Out, the little red guy, and he would eat the sandwich. And it was a really good activity for kids to explore what other feelings were inside their anger.

We would do this for their own experience and then we also might talk about other people. I might say, “When your parent got angry with you what do you think was on their angry sandwich?” Then we would bring the parent into session and have them talk together about what was in my angry sandwich to also help kids understand that parental anger is complicated too. Their own anger is complicated. Parental anger is complicated.

We, as parents, can benefit from doing this activity as well. What’s on your angry sandwich when your child is anxious. Let’s go back through those again. It’s sadness, guilt, frustration, disappointment, embarrassment, jealousy, hurt, shame or fear.

When you get angry with your anxious child, what’s happening? Part of it is you’re catching their anxiety. So that would be fear. Fear would be on your sandwich. Maybe you’re catching their anxiety and you yourself are just feeling some fear. But what often happens is we’re feeling afraid of what their anxiety is going to do.

We’re afraid that they are going to continue to struggle with anxiety. That their anxiety is going to be out of control, that their behavior is going to be out of control that people are going to judge them. That they are never going to learn how to cope with it, all these things we might be afraid of, but other things might be on our angry sandwich too. So let’s run through the list. It could be sadness because it’s hard to watch our children suffer. And that makes us sad. It could be guilt. We may feel like a bad parent for having an anxious child or feel guilty.

We don’t know how to handle it or feel guilty that we are getting angry. We might be frustrated. And in fact, every angry sandwich I have ever made. For myself with a child. With a parent in session. Frustration is always there. There can be disappointment. We may feel disappointed that our children are not handling this better. We’re disappointed in ourselves for not handling it better.

We can certainly be embarrassed. If there are other people around, we may feel embarrassed by our child’s behavior or our own behavior. Jealousy can come up to if we have friends or family who seem to have an easier time parenting. We may feel jealous about that. And so some of our anger might have jealousy or resentment.

We may be hurt by the things that our anxious child says to us like you’re the worst parent ever. You just want me to do badly, or we feel hurt because. We are struggling with their pain and that’s causing us pain. And we may have shame at our inability to cope with their anxiety or shame that we have a child that has such a difficult time.

In short, there are many reasons why you might feel angry with your anxious child. 

So back to the question. Can you stop being angry with your anxious child? I would say worry less about stopping it. And learn more about caring for it, which is what we’re working on with our child as well. 

We are not going to be able to stop our anxious child from being anxious. We want them to learn how to cope with their anxiety. 

That’s the same thing for us. We may or may not be able to stop feeling angry with our anxious child. Sometimes going through the angry sandwich activity will help us deal with that anger and magically, it goes away when we recognize it as these other feelings, but if you continue to get angry with your anxious child, just notice that’s happening.

It does not have to drive your behavior. 

I often got angry when my kids were anxious because I was catching their anxiety. I recognized that and learned that before I deal with them, I need to deal with myself. Whether that means taking a deep breath and shaking off these feelings I’m having, whether it means removing myself from the situation until I can get some perspective. 

Usually what happens for me when I get angry is that I try to remind myself not to do anything, not to do anything yet, not to knee jerk my way into a reaction and instead recognize I am really feeling this. I’m really feeling this anger. I need to stretch out my shoulders. I need to get some physical distance. And then I’m able to respond and sometimes my response is: “I can’t help yet. I can’t help right now. I need you to give me a minute.”

That’s perfectly fine because anger is not driving my behavior. I hope that’s helpful. I hope that maybe you’ll think about trying the angry sandwich activity.

And let me know how it goes for you. Let me know what your thoughts are. What is underneath your anger, what is on your angry sandwich? And this is an activity you might do with your child sometime when they’re calm to revisit a situation. You could share with them. This is what’s on my angry sandwich. This is why I was having a hard time helping you when you wanted my help.

What was on your angry sandwich when you realized I wasn’t going to be able to help. If you have other questions that you’d like me to address on the show, you know what you need to do. Go here to ask your question.

Why isn’t therapy working for my anxious child?

This is such a useful question and I’m really glad that a listener submitted it. Now the poster didn’t say what they meant by “working” so I’m going to assume that their anxious child is still anxious even though they’re in therapy and that’s how I’m going to answer it. So. Why isn’t the therapy working? Why is your child still anxious?

There could be several reasons. Let’s walk through them.

First of all, it may be the wrong therapist for your child. The greatest predictor of therapeutic success, meaning the client makes progress towards their goals, is a good fit therapist and that means different things for different people. Same goes for kids. Think about all the teachers you had growing up. I’m sure you liked some of them more than others. Just being a teacher doesn’t make you the best teacher for every student. My very most favorite teacher, Mrs. Schwartz, made my third grade an absolute dream. Then when my little brother got her, his third grade didn’t go as well. She just wasn’t the same personality fit for him that she was for me.

If you’re not sure if the therapist is a good fit, ask your child and ask the therapist. How do they think things are going? Is the child participating? Are they sharing in session? Does the therapist feel like they have a handle on what’s going on? 

A wrong therapy fit may also be that the therapist doesn’t see things in the same way that the family does — whether that’s the parent or the child. Let’s pretend a therapist is working with the Ingall’s family, you know from Little House on the PrairieCarrie was always kind of nervous in those books, right? So maybe the family brings Carrie to therapy and the therapist says, “Your family needs to quit moving around all of the time. This constant traveling around the country is a covered wagon is too disruptive for a child like Carrie.” And the family’s like, “Hey, listen, that’s how we do things. Telling us to just stop isn’t helpful or realistic.” See, that might be a poor fit. They might do better with a therapist who’s like, “Yeah, my dad moved us a lot, too, I get it. I know how it is. I can totally address this with Carrie in session.” 

It may be that therapy isn’t working because the therapist has a different conceptualization of what’s going on. So make sure you know what the treatment plan is — what are the goals? Maybe your child isn’t reaching them because you and the therapist have totally different ideas about what should be happening next. Maybe you’re hoping they deal with your child’s sleep problems and they’re working on test anxiety. Keep those lines of communication open so that  you’re sharing and collaborating.   

Sometimes, especially with younger children, the therapist isn’t offering developmentally appropriate interventions. Working with kids is a specialized skill that requires specialized training. I remember talking to one family who took their kindergartener to someone who said they worked with younger kids but had no toys in their office other than an antique tin ferris wheel that the child wasn’t allowed to touch. The younger the child is, the more therapy should be play-focused.

Another reason that your child’s therapy may not be working is because your child isn’t interesting in changing. Now there are ways to work on motivating an unmotivated child or teen for sure but ultimately we cannot force ANYONE to behave differently if they don’t want to. Some children resent being in therapy and won’t participate. Some children will perform well in therapy — doing what the therapist asks, answering questions — but it’s all surface-level and the child is unwilling or unable to bring that work out into the real world. 

Lots of times kids are coming to therapy not because they want to be there but because their parents have decided they need to be there. Or the child is willing to come but that doesn’t mean they’re ready to really participate. The anxious child might not be interested in learning new skills or facing their fears. They might not care whether or not their parents stop nagging because their fear is greater than their discomfort with their parents’ reactions.

I’ll tell you that my bias is not to send kids to therapy against their will. Especially if they’re anxious children. That’s because therapy is likely to be something they will want or need later on in their life and I think it’s important that they have a good feeling about it. I have a strong pro-therapy bias, obviously, and I don’t think anyone especially kids should be coerced into going because it’s likely to give them a bad feeling about counseling and make it more difficult for them to reach out when they’re ready.

Another reason therapy might not be working is that the parent isn’t doing their part in creating change. I’m not blaming the parent here. Sometimes this is because they don’t even know they’re supposed to be doing anything. If the therapist isn’t sharing that with them, how would they? 

Even if an anxious child is in therapy, if their environment isn’t shifting to supporting instead of accommodating their anxiety, then the anxiety will continue. And even if the child is making progress in session if they aren’t getting the opportunity to practice coping, to confront their anxiety, and deal with their discomfort then the progress will only exist in session.

In my own clinical practice a frequent challenge would be that I would work with a child on an anti-anxiety plan that was clear, that the child agreed to, and was committed to, and was ready to implement and then they would take that plan home with the parent and the parent would unintentionally undermine it. The child would be ready to do the difficult thing — whether that was to confront the challenge at school or socially — and the parent in an effort to be helpful would undo that child’s hard work and preparation by questioning them or reassuring them or interrupting the process.

This could look like a child about to step on stage and the parent says, “Are you sure you’re ready?”

Or the child is trying to sleep alone and becomes tearful and the parent says, “Do you just want to try tomorrow?”

Basically the child may be doing the prep work but still needs their parent to hold the boundaries and to remind them of their skills.

No matter how often I was telling the parent they needed to do this part, for some parents it was just really hard. They needed more direction and more encouragement which is why ultimately I shifted to working directly with parents. As I dug into the research, it became clear that the real key to change for anxious children and teens is their parents. If the parents can do their part, then the children — even without therapy — are able to do theirs. 

I personally think an ideal situation is the anxious child would be in therapy with a good fit therapist and the child’s parents would be working in or with a program like mine. That one-two punch is the best bet to learning to deal with child anxiety. If a therapist isn’t available for the child — and I know there’s a shortage right now — or the child is unwilling to go, that doesn’t have to stop the parents from doing their own learning and shifting the way they deal with anxiety in their home. 

I’m curious, if therapy hasn’t worked for your child, which of these issues do you think was contributing to that? Or was it something I didn’t mention here? Feel free to let me know and reach out if you have any questions or thoughts. 

 

 

How do I change my anxious child?

Our question this week is simplified for the podcast title but it’s part of a longer question. The asker described their situation — they have an anxious child, the child is older elementary age, and the child isn’t interested in dealing with their anxiety often melting down when the parent attempts to talk to them about it. And the parent wants to know, how do I get my child’s buy in. How do I talk them into dealing with their anxiety. How do I make them change.

The short answer is you can’t. We can’t make anyone change. If you get into a power struggle with your child, you have already lost. They are better rested than you and they aren’t going to get distracted by things like needing to pay the mortgage or laundry. So before you try to change your child, give up on changing your child.

But just because you can’t win a power struggle doesn’t mean that you’re not powerful because you are. You are in charge of the environment and you are in charge of yourself and what you choose to do. So those are things you can and you should focus on changing.

At the heart of child anxiety is their relationship with you. That’s where we find the answers in treating their anxiety. You hold the key. And all of the hard work that you’ve done to build a loving, respectful, and responsive relationship is going to pay off when you turn your attention to helping your child meet the challenges of their anxiety. 

This is true for all facets of parenting and there’s a paradox at play here and in fact at play in all of parenting. That is that you are deeply essentially part of your child and they are entirely their own person having their own experience. It’s within this paradox that change happens.

Let me explain.

In parenting, especially in highly attuned and connected parenting, we and our children are sharing experiences. We are catching each other’s moods. We are impacting each other’s functioning. If your child is in a bad mood, you might feel bad and vice versa. If you are worried about something, your child might catch your worry. We are living in the same space. You are choosing fundamental experiences for them like the food they put in their bodies and the clothes they put on their backs. You are choosing where you both live. Whether or not details like open windows, colors of carpet, the presence of pets. You share relationships with other family members and other people outside the family. 

At the same time, you are having entirely separate experiences. You may love the open window and your child might find the sounds coming in from the street annoying or upsetting. You may be struggling with your child’s other parent and they are full of adoration for that other parent. You may serve oatmeal for breakfast and buy them a cozy sweater for chilly days and they may insist on Lucky Charms and choose to wear their favorite tee shirt no matter how cold it is that day.

And you may want them to deal with their anxiety and they are strongly committed to the avoidance that makes their anxiety worse. You can’t change that for them. You can’t change their commitment. You can’t talk them into it. So you will have to change yourself.

One of the most important things you can and should do is realize that your child’s anxiety belongs to them. It is part of their journey as a human being. Your anxiety — even if your anxiety is about them — belongs to you, not them. You have to figure that piece out. I talk to parents who get confused — where does their anxiety leave off and their child’s begin? Or they don’t know how to tease out the differences between them.

This essential separation is at the heart of parenting. It’s the work we’re doing for 18 plus years with an emphasis on the plus. We are dancing the weaning dance all of our parenting careers — figuring out when to step in, when to step away, when to offer support or advice, and when to let it go. Very often any conflict we are feeling in our relationship with our child goes back to this essential work. Either they are wanting more separation or we are wanting more separation and we are constantly pushing and pulling to figure it out.

It’s inevitable that we’re going to make some mistakes and step on each other’s toes. I think there is so much learning in these conflicts. Anytime you’re hitting a point where you are fed up with parenting in general or your child in particular, you can look to see at it’s roots there is this push/pull happening.

This is especially true with anxiety. 

You cannot make your child learn the skills they need to handle their anxious emotions but you can offer them. You can make them part of your family culture in the same way that you have shared your other beliefs, your other expectations, and your other everyday routines. You can show them by internalizing and practicing these skills yourself. You can use them to deal with any anxiety you have about your child’s anxiety. Children learn directly but also through observation. A child who is reluctant or resistant to learning is not going to be happy when you tell them to learn anyway. But if you do the learning yourself, they’re going to pick up on it. 

You can also decide your boundaries. Remember that your child’s experience of anxiety is theirs. But your experience of raising an anxious child is yours and you get to decide how you’d like to manage that. If you are experiencing frustration or unhappiness because your child’s anxiety seems to be demanding particular behavior from you, you can choose whether or not to continue with that behavior, to cease it altogether, or to change it. When you change things — whether it’s your behavior, or the environment — that will change things for your child. 

When we recognize and address the parenting pitfalls of anxiety, and change what we do, that’s how our child changes. 

Child anxiety tends to enmesh parents and children. It gets us all tangled up and forgetting or misunderstanding what belongs to us and what belongs to them. It’s the parental dilemma but on steroids. If you are unsure of where to start, I encourage you to go to childanxietysupport.com/pitfalls that will lead you to my quiz based on the research about how parents get stuck in parenting their anxious kids. Once you’ve taken it if you have questions, please reach out to me. 




How do we know when to push our anxious child and when not to push?



How can we tell between a child’s anxiety about an activity and their genuine dislike for an activity? 

This is such a good question but I’m afraid I”m going to disappoint you with not such a great answer and that is, you might not be able to tell. And in fact, your child might not be able to tell.

And part of that is because if you think about it, we’ve got reason to dislike doing things that scare us. It’s why I’m never going to learn to ski. Going down hill fast is my idea of a terrible time because it scares me. I wear the brakes out on my bike because I keep ‘em on when I’m going down hills.

So I dislike going fast downhill and I dislike it because it scares me; it’s not fun. 

But using my brakes on my bike and not learning to ski doesn’t hamper my life in any way. Now someone who loves to ski might say I’m missing out but it’s a choice I’m perfectly content to make. 

On the other hand, there are other ways I’ve confronted my fears like public speaking. It scares the heck out of me but I’ve also learned to enjoy it. The results are worth it to me. So I have had opportunity to face my fears and learn to cope with my anxiety to access the opportunities I want to access.

With kids it’s harder because they don’t really have the far range thinking to figure out what’s worth it and what’s not. So we have to be part of that decision-making with them, which is really difficult. For one thing, we might have strong feelings about what’s worth it and what’s not.

If I’d grown up in a family where skiing was my parents’ favorite winter sport, maybe I would have conquered that fear because it would have been part of the family functioning to go skiing. I don’t know. Maybe it would have been worth it, right? To not miss out with the family. Or maybe I would have thrown such a fuss that I would have stayed at the lodge sipping cocoa. 

It depends on a lot, doesn’t it?

When you’re trying to figure it out, you’re going to have to look at the big picture. Generally anxious kids have anxiety that shows up in many different places. Figuring out where to address it, where to start, is part of figuring out how to parent a child with anxiety. 

How we make decisions in addressing our child’s worry will depend on how we consider a number of things:

  1. How is our family functioning? Where are we — all of us — struggling most? 
  2. How is our child’s functioning? Where are they feeling most limited or unhappy?
  3. How much time and energy do we have to tackle things right now? Are we ready to dive in and do big work? Or do we need to focus on small wins?
  4. How anxious is our child? Are we talking about every day niggling fears or are we talking about great big disruptive meltdowns?
  5. How motivated is our child? How interested are they in change?
  6. Are there skills we need to address first either in ourselves or our child? Are we able to cope when they’re not able to cope?

It’s a long list and we haven’t really dug into the details involved in each of those decisions. They’re all worth a conversation. 

Choosing where to address our child’s anxiety is intensely person. It depends so much on what we value and what we hope our children will value. If we know our child meltdown when we push, we have to know what’s worth pushing and how to do the pushing so there’s growth. 

We need to be realistic about our kids and their capacity

And we also need to be realistic about ourselves. Learning to parent an anxious child means shifting our perspective as well as changing our behavior. That perspective change is critical and that’s a bigger challenge than remembering to respond with this when our child does that. We need to know why we respond that way and we need to buy into it. 

For some kids and families we need to start super small. We need some easy wins before we head to the big targets. This is especially true for very sensitive children and very sensitive parents. We need time to acclimate and experience ourselves as a family that can do this hard work. 

For super motivated kids and families, we can start with the heavy hitters. We can sprint right to the top and dive into bigger exposures.

As an example, we might have two families with 10-year olds who are still asking parents to stay in their room until they fall asleep and that’s where the parents are hoping to see some change.

But maybe one child is dealing with the recent death of a beloved pet. Or is having a hard time in school. Or has no interest in sleeping alone. And the other child is more motivated. Or has less pressing worries outside of sleep. 

And we can look at the parents. Maybe the parent of one child has been working overtime. Or is worried about budgeting for the holidays. Or gets completely wound up when their child is crying. On the other hand, the other parent has a good friend who has offered to sit with them while they deal with bedtime. Or has a great meditation practice that helps them stay calm. Or is just fed up enough that they’re clear that this is what they want to do.

Any combination of this — a motivated child but a waffling parent or vice versa — makes it a whole unique proposition.

You know you’re pushing too much when you get overwhelmed either with your own emotional reactions or with your child’s. The people who I work with don’t tend to be people who are unreasonable with their kids. I tend to work with people who identify as gentle parents or respectful parents or attachment parents — there are a lot of terms that basically mean highly attuned, thoughtful, sensitive parents who care deeply about their parenting. These parents tend to go much easier on their kids than on themselves. They tend to sacrifice their own well being for the sake of their children in ways that don’t serve the family well. So I am less concerned that they are being too pushy with their anxious children and more concerned that they are pulling back too soon.

Or they are focusing on one area that is less important than another. So they are putting their energy in an anxious area that doesn’t necessarily align with their family values because they are trying to do what they think they ought to do. Parents of anxious kids — especially the ones who act out — are generally dealing with a lot of criticism and concern from others. Sometimes what we need to do is get really honest about what matters to us most. Maybe we don’t care about sitting with a sleep 10-year old but we do really want them to go to soccer practice.

See, those are very personal decisions. 

When you’re trying to figure out when to push and when not to push, I’d say where are you and your child most unhappy? Where is the easiest win? Start with that easy win and build on it. You both need to start experiencing your child as someone who is capable and brave. That can be very tiny. It can be a child who tolerates being alone on one floor of the house for two minutes longer than they used to tolerate it. Celebrate that success and go a little further. When you’ve got a handle in that area, look for where you’d like to take those skills next.

When it comes to parenting anxious kids, it’s a dance we’ll be doing all of our lives together. We’ll always be learning how to support without creating dependency, how to cheer them up even when we ourselves are scared, how to cope with our anxiety as we continue to celebrate their growth.



What if my child’s anxiety is rooted in real fear?

The example that came in with this question was specifically about a child who was being bullied at school and so was afraid to go to school. Well, that’s not an anxiety disorder, that’s appropriate anxiety. If the situation is not safe then the child’s anxiety is serving its purpose. That is what anxiety is supposed to do. We cannot address anxiety unless things are safe.

So before we can face our anxiety, we need to be clear. Is this appropriate anxiety? Is it keeping us safe from something that is truly dangerous? Or is it dysfunctional anxiety? Is it keeping us from growing through our lives?

Sometimes this is an easy thing to figure out. If you have a child who is afraid of your neighbor’s friendly toothless basset hound, that’s pretty simple. A friendly toothless basset hound is unlikely to be harmful. You can definitely do some exposures to help your child confront their anxiety in that situation.

But sometimes it’s more challenging. If a child is refusing school because they are being bullied as in our questioners situation, then school is not safe. If a child is refusing school because they were once being bullied but now are safe and are protected from the bully or the bully has been removed, that’s a bit more complicated. 

It will take careful planning because we’re not just dealing with the anxiety, the child also needs support in healing from the experience of being bullied.

In other words, if a child’s anxiety is rooted in appropriate fear then we need to get them safe. It is not dysfunctional anxiety; it is protective anxiety. 

Once the child is safe, facing their anxiety in supported ways can be a truly healing experience. This might mean trauma-informed counseling. This might mean helping the child connect to resources that allow them to see themselves as someone who can access supports and advocate for themselves.This also might mean changing the environment entirely, for example, if that particular school is an overall poor fit, changing the school is not avoiding; it’s choosing a better fit. 

I want to stop for a minute and dig into this a bit more from the parents perspective. Because it’s been my experience that we, as parents, often need to address our own neglected experiences of harm in order to take care of our anxious kids. Sometimes we struggle to assess for safety because we ourselves struggle, due to our own anxiety, to know what is safe. 

I’ll use a very clear example from my own life. I have always been afraid of water. I think, as an aside, that this is related to undiagnosed and unaddressed vestibular and proprioceptive sensory issues. In any case, I am very afraid when I am in water over my head. It’s something I avoid. Because of this, it was difficult for me to watch my children swim in deep water. Heck, I can’t even watch the shipwreck scenes in Castaway. I mean it, this is a big fear of mine. Anyway, because of this I was not involved in teaching my kids to swim. I had to farm that out. I also had to sometimes walk away when they were swimming with their dad. I just can’t really assess safety in those situations. I know this about myself and I built supports that allowed my children to grow despite my own anxiety. They both love to swim. I’m never gonna like it but that’s ME. I can’t visit that on them without limiting their lives.

Like I said, that’s a very clear example. 

Other examples from my own life are more challenging. I also struggle with social anxiety and so when my kids had a social challenge it could be difficult for me to assess whether or not the situation was truly safe. I can look objectively at them swimming in a pool with an attentive adult nearby and know it’s ok even if it feels scary to me. That’s not necessarily true with social situations. 

In those cases, it took more effort to figure out what was mine and what was theirs. This became particularly salient when my daughter, who had been homeschooled all through elementary school, decided to attend middle school.

Can we just stop and acknowledge the tremendous bravery of this kid who decided her first introduction to traditional school would be in seventh grade. Needless to say, my own experience of middle school was terrible. I say that it’s needless to say because ain’t that the truth for many of us. In particular I did have a bully in eighth grade so when my daughter dealt with some mean kids, I had to work very hard to recognize that her experience was not my experience. That her school was altogether a safer, more attentive environment than mine was. That she had parents who were involved and able to coach her through difficult social situations, while my parents were simply unable to be there for me in that way. In short, I had to recognize that her anxiety was not my fear and so she could safely confront it.

I didn’t need to pull her out of school. I didn’t need to march to the guidance counselor’s office and demand that they move my child to another classroom. I didn’t need to call up the other kids’ parents and ask for a mediation. In short, while our situations had similarities, my daughter was safe. She was anxious, for sure, but she was safe. And so we were able to come up with a plan that allowed her to confront her anxiety, deal with the bully, and grow stronger through the experience.

SWhen we check for safety around our child’s anxiety — when we stop and assess are they safe? Is their anxiety protective? Or is it limiting? We also need to check in and see if we need to address our own history and take care of some old wounds.

This is all very tricky. I often say that parenting is the most triggering thing you can do. It’s hard work. It’s heavy lifting. But ultimately I believe that our experiences in parenting are opportunities for growth and healing.

I think sometimes in an effort to be clear and concise, I send the message that anxiety is always and easily cured by exposure and that’s definitely an oversimplification. Anxiety is complex, people are complex. Exposures, frankly, are also complex. Addressing anxiety must be personalized and fit not just the individual but also the individual’s family. School refusal is one situation that brings up all of this. The child’s real experience, the child’s perceived experience, the child’s temperament, goodness of fit in the school, the family’s history, the family’s needs, the surrounding culture. And on and on and on. 

There’s not one right way to do this. There’s not a singular best practice. It’s personal. If you need support, you know what to do. Reach out. Let’s talk. 



Why do kids love to play about things that scare them?

This is part of a longer question so let me set up the scenario for you. The parent has a 5-year old and this 5-year old saw part of a scary movie when they were visiting cousins. It sounds like it was a horror movie but the parent didn’t give a lot of details about it. In any case, the child is now obsessed with this movie particularly in their play. Like pretending to be the bad guy or pretending to run from the bad guy. But the child is also still clearly scared because they’re having trouble sleeping and say it’s because of the movie.

So why is that? Why do these themes come up in their play? If they find it so scary, then why do they keep coming back to it?

I’ve seen this with other kids around real life scenarios, for example, a child who saw a tree in their yard come down during a storm and becomes obsessed with the weather or makes a point of seeking out big trees on the playground. Or a child is scared of robbers at bedtime but always wants to play robbers at recess. Or you might be seeing this with your own child around Halloween decorations right now, being scared of them and also kind of obsessed with them. 

To understand what’s going on here we need to understand how children process things. We process things by talking, right? If we have a worry we generally want to talk it out. 

Children do this, too, but they also process things through play. The younger they are, the more we’ll see these themes — these anxious themes — show up in play. This is one reason why play therapists keep certain toys around, certain standard toys like a doctor’s kit. Lots of kids worry about the doctor and lots of kids need to process scary parts of it like getting shots and so doctor’s kits give them a way to do that.

I can’t tell you the number of kids who would spend their entire therapeutic hour giving me shots over and over again. They loved it and they would direct me to be scared. They’d say, “You have to get a shot and you should be crying.” 

This is the way they work to make sense of it and also to give themselves some control over it.

Learning that we have control over our lives is one way we learn to manage our anxiety about what is NOT controllable. When children play with things that scare them or make them anxious, it helps them to explore it under their own steam. If a thing has happened TO them that they did not expect or welcome — like a falling tree, or a scary movie, or the sudden appearance of an animatronic witch in the yard of the house next door — talking about it helps them process and move through it.

But just like We may need to talk about it so much that we start to bore our friends or even ourselves children can get stuck in their play and may need our help to move on. They may need us to help solve the problem they’re repeating. 

How can you tell? Given that repetitive play — like giving your therapists a million flu shots — can be part of processing, how can you tell when they’re stuck?

Look for small changes in their play. They may up the ante, like begin to give the shot more ferociously. Or they may start explaining more ahead of time. Or they may offer more comfort after the shot. Even small changes show that they are working with their fear and exploring its limits and its control.

What is their attitude about the play? Do they seem like they’re having fun? Are they gleeful? Or are they worried? Do they seem more upset after playing or do they seem relieved or ready to move on?  Children may become “obsessed” with things that scare them. If they seem controlled by the play rather than controlling it, that’s Alan an indicator that they’re stuck.

If they don’t seem stuck, if their play seems enjoyable, if they’re mostly having fun and if you see changes however small, they likely don’t need our help. 

If your child does seem trapped in their play then you can do things to help them get unstuck. You can show them a way out. IN the therapy room we use a lot of cages or other traps. I had a whole set of toys that represented typical childhood fears like skeletons and mean guys and spiders and zombies — and kids loved to put them in jail or bury them in the sand tray and put the lid on top. 

You can offer that, too. Let your imagination go and think about ways to conquer fear through play.

Now one thing I want to mention is that sometimes anxious play can be upsetting to us. For example, a child may connect more with a bad guy. They may want to be Darth Vader in the big good vs evil battle. We might worry — why are they identifying with the wrong side? Well, the answer to that might be as simple as Darth Vader is kind of cool. He’s got a great voice and a cape. It also might be that pretending to be the thing that kind of scares us is a great way to master that fear. Pretending to be the robber means the robber can’t scare you anymore.

It’s just another way to process things.

This is also why at certain ages kids might be obsessed with fighting or weapons. They’re trying to feel safe. Play is a safe way to practice being safe. And it’s imaginary, remember that. It’s no more an expression of real wants and wishes than our watching Breaking Bad is a sign that we all want to cook meth. Adults play via video games, TV shows, and reading books, right? And kids play by playing. 

Play — as long as no one is getting hurt — should have free range. Again, that means no one has to play when they don’t want to, no one should be forced to play in a way that they don’t like — but if everyone is safe and having fun then it’s fine. We adults sometimes get hung up on play — about what it means, about how it’s happening — but especially if we recognize play as a way to work through tough issues, we need to let kids do the things that they do. 

Now one thing though. When we say “fun” in regards to play, it kind of diminishes the importance of play. Maybe I should use the term “satisfying” instead. Play is truly a child’s work. It is how they process and experience and learn to manage the world. It is vital. And it’s often outside of the understanding of adults who want play to be clean and clear and, I guess, nice. Play is not always nice. It’s serious. It’s important. It matters to children deeply.

If you want to read a good descriptions of play, check out the third chapter of the book Ramona the Brave. It’s a great book about child anxiety (if you haven’t read it or don’t remember, it’s the one where Ramona is afraid of the gorilla without bones) and the description of Ramona and her buddy Howie playing brick factory is a terrific reminder of what play can be. I’ll leave you with this short description of their play,

“Brick Factory, [is] a simple but satisfying game. Each grasped a rock in both hands and with it pounded a brick into pieces and the pieces into smithereens. The pounding was hard, tiring work. Pow! Pow! Pow! Then they reduced the smithereens to dust. Crunch, crunch, crunch. They were no longer six-year-olds. They were the strongest people in the world. They were giants.”

from Ramona the Brave by Beverly Cleary

Is it better to make my anxious child sleep on their own?

Last week we talked about whether or not co-sleeping causes separation anxiety and concluded that no, it’s more complicated than that and this week’s question is related so I scheduled them right next to each other. This one is: Is it better to make my anxious child sleep on their own? Let’s go through the whole question with some details disguised to protect the confidentiality of the family. This family has an older child — older elementary — who wants to sleep with heir parents because when they sleep alone, they wake up afraid and come in. The parents find this disruptive for everyone’s sleep but also want to be supportive. They want to know, is it better to ask their child to sleep on their own even when they’re scared? Or is it better to give in and let them climb into bed with their parents.

As I said last week, this is a super common question so it’s no surprise it came up from two different families in the audience so close together. 

Let’s get away from “better” as an adjective because it implies a “worse.” Instead let’s ask, “Which is more effective in supporting my child in their anxiety.”

Now you might remember last week I said that if a family is happy co-sleeping, then great. Go for it. But this family is not and I totally understand. It’s ok to want to sleep by yourself. Will you be doing your child damage if you insist on it? Even if they’re scared? No.

Let me explain more about that.

Sometimes parents share their concern that asking their child to face their fears will be traumatizing. So let’s talk about it.

First let’s consider the context of the parent-child relationship. Is this a relationship where the child is getting their basic physical and emotional needs met? Like are you supplying food, clothing, shelter, and basic emotional support? Is this relationship a safe place for your child to share their feelings? Is it safe for them to be less than perfect? Is there unconditional positive regard — a general love, respect, and acceptance for the child themselves? And note, this does not mean blanket approval for their behavior or every little thing they do, it means for themselves, who they are. So it’s perfectly ok to grouch about them leaving their dirty dishes in the sink. And it’s ok to not want them to climb into bed with you. 

Rejecting behaviors is not the same thing as rejecting them.

In a generally loving, respectful relationship where children are generally getting their needs met there is not just room to demand more of them — like that they learn to sleep alone — it’s also necessary. 

It is not traumatizing to be reminded that children are separate from their parents. They are meant to grow and to outgrow us. If they rely on us too much — beyond what is developmentally appropriate — that is more likely to be damage them than if we push. Gently but firmly pushing our kids is part of parenting. It’s a tricky balance. We want to push enough that the reluctant growers learn to grow but not so much that we push them beyond that which they are capable. And that’s where parents of anxious kids get stuck. But I want you to lean on that loving, respectful relationship. When they’re toddlers we stop them from running into the street even if they really want to, even if it makes them really mad. Right? We protect them and ask them to learn the rules by reminding them and they grow. They grow and learn the rules and learn not to run into the street and they might hate us in the moment but they don’t hate us. It doesn’t hurt the relationship.

Likewise, an anxious child who wants to co-sleep isn’t going to like it if their parents say no. But that doesn’t mean the parents should automatically say yes. Instead the parents can set those boundaries. When we say no to the anxious child, we are saying, “I believe you have the capacity to handle this. I believe you have the capacity to grow through it.”

Now some kids need more support. They need us to help them make a plan. This is what the child Anxiety Support program is all about. It’s about making that plan — with all the information and research we have about anxiety, with all the lessons I offer to better understand your child — and then executing that plan. With lots of help and opportunities to share anti-anxiety skills with your child. So. Jus know that if you’re struggling with that whole making a plan thing.

Back to trusting your relationship with your child

What we know is that connection mitigates trauma. This is something Bruce Perry teaches about in his neurosequential model. I’m going to simplify it by a lot with this example. Imagine you have two young children who both lost their homes in a fire. One child has been in and out of foster care, does not have a strong relationship with a caregiver and the other child is in a home with a loving, supportive and consistent good enough caregiver. We know that the child without strong relationships is going to struggle more with the trauma of the fire than the child who does have those safe, consistent caregivers. That’s because we are built to withstand trauma in the context of appropriate community. It doesn’t mean we won’t have trauma — it doesn’t mean that losing your house in a fire won’t bother you — but it means that this child will have greater capacity to heal.

Your child — in that generally loving, respectful relationship — can handle hard things like facing their anxiety. It doesn’t mean they’ll like it. It doesn’t mean they’ll be thrilled when you push them but it does mean that with a developmentally appropriate clear plan, strong supports, and realistic expectations they can indeed handle it.

When we don’t make a plan. When we continue to let their anxiety guide the family decision making, we are far more likely to be causing harm because what we’re doing is telling them that they’re right. They can’t handle it. They aren’t strong enough. It is too dangerous. 

Now this doesn’t mean just kicking them out of the bedroom and telling them they’re on their own. Remember, I’m talking about making a plan. The plan says, I know it’ll be tough but you can handle it. Here’s what you can do instead. The plan says, You are strong enough. Here are some of the skills you can draw on. The plan says, you are safe and protected.

Again, if you’re having a hard time creating and sticking with a plan, that’s what my membership is all about. 

 

 

Does co-sleeping make separation anxiety worse?

Co-sleeping for anyone not in the know is also called bed sharing or family bed and basically it describes parents who sleep with their kids. That’s it. That can mean anything from kids who climb into their parents bed after an nightmare to kids who start out in their parents’ bed or whose families have one big bed made up of a lot of mattresses and everybody piles in.

How we sleep is a cultural decision. Not just the whole broad culture, although obviously we are impacted by our social mores, but also a family culture decision. Lots of families co-sleep and have no opinion whatsoever about that as long as everyone is more or less happy and is getting enough sleep. This is one of those parenting decisions that I don’t think you can take out of context of the family functioning and say it is GOOD or BAD. It’s neutral. It’s good if your family likes it and it works and it’s bad if your family doesn’t like it and it doesn’t work. OK? So just to be clear about that. I have no bias about whether or not you should co-sleep with your kids, it’s a personal decision.

But. Does it cause separation anxiety? Well, there I have some thoughts and I’m gonna share them.

Let’s talk about what separation anxiety is. It describes kids who struggle to separate from their parents beyond when it is developmentally appropriate. We except kids to go through periods of separation anxiety. We know that older infants — around 8 months or so — start to cling to the parents. This is the age where babies that were perfectly happy to get passed around stop liking it. The rise in separation anxiety in infants goes along with their developing object permanence, which means that your baby is learning that things continue to exist even after they can’t see them. That gives them the ability to hold their parent in their mind even after that parent has left, which gives them the ability to miss you thus separation anxiety.

This continues into toddlerhood but we’ shouldn’t be surprised when it crops up later when kids are challenged in new ways. For example, it’s not atypical for a preschooler or even a kindergartener to cry when they’re left at school for the first time. Generally they’re growing out of it so even if they are upset, they’ve learned how to tolerate their discomfort long enough to acclimate to their new environment. 

Separation anxiety disorder is when the child is not able to acclimate. A 4-year old who is a little tearful and doesn’t want their parent to leave that first week of school may be typical but a 6-year old who is struggling might need some extra consideration. Or a 4-year old who doesn’t eventually get comfortable but stays distressed. We’d also want to make a note of that. That’s a sign of true anxiety, not just a developmentally appropriate reaction.

And yes, we see separation anxiety at bedtime when those kids need to separate from their caregivers. It’s one reason some children struggle to go to bed. Not always, of course, some kids just want to stay up where the action is but children who insist on parents lying down with them or who won’t stay in bed unless their parents do, that can be a sign of separation anxiety.

Now let’s be clear, co-sleeping doesn’t cause this. Co-sleeping may happen in reaction to it. If a parent feels unable to leave their upset child or gives in to tears and let’s them sleep in the big bed, that’s a reaction. The parent is reacting to the child’s distress. 

So co-sleeping doesn’t cause it but you can see that it can perpetuate it.

Again, if the whole family is happy with this scenario then there are no worries. But if the family is unhappy with the scenario then something needs to change.

That’s the thing about anxiety. Some of it is situationally dependent. For example, it’s common in other countries for adult children to continue to live with their parents. This doesn’t cause separation anxiety but some adult children live with their parents because of their anxiety.

Or think about a city like New York City. Lots of people there don’t have driver’s licenses because they don’t need them. It’s got nothing to do with anxiety about driving a car. That said, sometimes not having a driver’s license as an adult may be an anxiety symptom. How do we know the difference? It’s about how people feel about it. If someone wants more independence but is afraid to drive that’s an anxiety issue. 

If an adult child wants to move out of their parents’ house but is afraid they aren’t capable, that’s an anxiety issue. Or if a parent wants an adult child to move out of the house but the child is afraid that they aren’t capable, that’s an anxiety issue AND it’s a boundary issue for the parents.

Likewise, if you don’t want to co-sleep and your child is insisting on it, that may be an anxiety issue and it’s definitely a boundary issue for the parents. In other words, the parents are going to have to figure out how to set and hold boundaries in ways that are appropriate for themselves, for their child, and for the family as a whole. Which is, as I said, very personal.

Sometimes I work with families where there is definitely separation anxiety present particularly around bedtime, which is what brings the family in to the program. I also work with families where there is definitely anxiety present including around bedtime, but they’re not concerned about that and are more concerned about the presentation elsewhere like getting the child off to school or going to playdates or letting mom pee with the door shut. That’s fine. We can focus on the issue that is causing the family grief. We do not need to start with areas where the family has not identified a problem. I do think it makes sense to consider it — are we ok with the co-sleeping? is there a point when we might want it to shift? — but ultimately the family gets to decide what works best for them.

What I have found is that when we’re doing good work around separation anxiety that the family is able to make appropriate individualized decisions about things like co-sleeping and babysitters and homeschooling. Every family has different expectations and limits around those things but when things are generally becoming more healthy, it becomes easier to know what to do in those situations.




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