Dawn Friedman MSEd

How can I tell the difference between an accommodation and a support for my child’s anxiety?

Before I answer this week’s question, I want to define accommodation and support. I think it’s confusing because when we talk about children who have 504 plans or an IEP for school, accommodations are a good thing. And when we’re looking at the research on child anxiety or OCD, accommodations are a negative thing. This is why I use the term Pitfalls as in parenting pitfalls instead of accommodations when I talk about them on my podcast and in my program. 

For the purposes of this particular episode, I’m going to use accommodation because that’s what the person who asked the question used and again, because that’s what the literature uses. All right? So just to be crystal clear, we are NOT talking about the accommodations your child might have in their 504 or IEP program. 

I am going to use the definition offered in the 2014 study Parental Accommodation of Child Anxiety and Related Symptoms from the Journal of Anxiety Disorders, which is “changes in parents’ behavior in attempts to prevent or reduce child distress.” That sums it up. It’s parent behavior (as an aside, siblings and grandparents and other caregivers might get pulled in) but it’s parent behavior and it’s meant to prevent or reduce distress for the anxious child.

I want you to really focus in on the “prevent or reduce” part of the definition. Accommodations are all about AVOIDANCE. They’re about avoiding the feelings that come with being anxious, that feeling of distress.

Common accommodations include:

–reassuring children repeatedly, trying to help them feel better about their worries

–intervening on a child’s behalf with others such as ordering at a restaurant, speaking for them when they are questioned

–Minimizing separation such as staying with them at night (and I’ve addressed co-sleeping several times on this podcast if you want to talk more about that, I encourage you to look at previous episodes), picking them up from school when they’re upset, or even showering with the door open because they get upset if they can’t see you

You can see that these are about helping a child NOT feel worried. And it’s natural that we would want to do this. You know why a baby’s cries are so upsetting right? Because we are meant to respond and stop it. Same with whining. We have a primal urge to prevent tears and upset in our kids. Very often we are responding before we’ve even thought about it. Our child is upset, and we immediately do what we can to minimize the upset.

Accommodations can work for non-anxious children. A child says, “what if my teacher gets mad” and we say, “Oh they’re not gonna be mad” and a non-anxious child says, Great! And moves on. An anxious child needs more reassurance. They get hooked on it because they are unable to tolerate the distress of their anxiety.

We all experience an anxiety but a child with an anxiety issue, feels it more often, feels it more deeply, and finds it more distressing. Which is to say, they have good reason to want to avoid their anxiety. They are not weaker than other kids, they are not unreasonable — they are truly feeling that anxiety more intensely. It’s a bigger deal for them. And avoidance is understandable. That said, it does not help.

Accommodations allow them to avoid and avoidance does not help.

Now. Supports. Supports help them tolerate. They encourage their ability to stick with the thing that scares or worries them. They help them acclimate to their feelings of distress so they are able to increase their distress tolerance.

All right? So that’s the major difference and it’s easy to remember: Accommodations allow avoidance, Supports Help them Stick with it. See? Alliteration for the win!

Ok, so we’re all on the same page here and we understand what we’re talking about but now things are going to get tricky because a support can become an accommodation or rather we may need to accommodate a bit as we move to support. 

What I mean is, on our way to decrease accommodations and increase supports, we may need to move down the accommodation scale. 

Let me give you an example. Let’s say we have a child who is afraid of dogs and so they won’t go in the backyard because the next door neighbors have a beagles who barks its head off whenever someone goes outside. A support to help them face their fears might be that a parent goes out with them. That helps them face the barking dog.

After awhile, the presence of a parent ceases to be a support and becomes an accommodation because as they acclimate to the barking dog, they need to face their anxiety about doing it alone. 

When we’re planning to reduce accommodations and increase supports, we use a scale that helps us map levels of anxiety and we work to move the child from the bottom of the scale, where there is the lease anxiety, towards the top where there is more anxiety.

We do this in a systematic way, step by step so that we’re not overwhelming the child but also not overwhelming ourselves. This is especially important if we have kids who demonstrate their anxiety with meltdowns or other big behaviors. 

If you are curious if your supports look more like accommodations, I encourage you to take my Parenting Pitfalls quiz, which is based on the Family Accommodations Scale assessment. Have questions? Let me know!

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Does mindfulness help child anxiety?

Mindfulness is a big buzz word these days especially around anxiety and I appreciate the opportunity to talk about it here so thank you to the listener who sent this question my way. They asked not only “does mindfulness help child anxiety” they also asked, “And if so, how?” 

All right, first let’s define mindfulness and for this I’m going to head to the Oxford Language dictionary and share the second definition, which describes mindfulness as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.”

I’d say that’s pretty dang accurate so that’s the definition we’re going to go ahead and use for this episode. 

Now let’s go back to the question. Does that help child anxiety? Does achieving a mental state by focusing one’s awareness not etheh present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations” help child anxiety?

Well, that depends on how you’re going to define help.

Lots of people when they first begin working on child anxiety are focusing on stopping the anxiety. They call me and say, “My child is anxious and I’d like to help them learn how not to be anxious.” Or they say, “I want them to learn how to cope” but as we dig into their situation it’s clear that the proof of coping will be the eradication of anxiety.

I get that. That’s the way I thought about anxiety, too, before I had my clinical training. That’s why we say things to our kids like, “You don’t have to be nervous” or “there’s nothing to be afraid of.”

We see tears or tantrums or meltdowns and we think, “Oh gosh, this is failing. My child is feeling their anxiety and something has to change.”

Mindfulness doesn’t mean not feeling. It’s right there in the definition. It means feeling and being aware of the feeling. It means noticing thoughts. It means noticing that your stomach hurts with worry. It means noticing that and accepting that, not necessarily fighting it.

When I say that, I’m curious. What’s your reaction? When I say, your child is just going to have to sit with that tummy ache. Or just sit with that feeling of wanting to run away. Or just sit with their anger that you’re not helping them. I imagine you’re feeling a lot of yuck. Noticing that yuck, noticing that perhaps you feel resistance to allowing your child to suffer, that’s mindfulness.

I think paying attention to the similarities of our experience with our child’s experience is incredibly helpful when it comes to child anxiety. So when I talk about mindfulness and child anxiety, first I want the parents to explore their anxiety. I want them to work on their own mindfulness skills because through that they will be able to help their child. 

Let’s say our child is anxious about a new babysitter. You have plans to go out to dinner with your partner and you know you’ll be back kinda late. There’s a new baby sitter, you know them and you trust them — let’s say they’re your neighbor’s niece who is getting her degree in early childhood education. You trust your neighbor, you’ve talked to this young woman on the phone and you really like her, but you haven’t met her yet and neither has your child. You also know your child doesn’t like anyone else around at bedtime so you’re nervous. 

You want to go out, you have special tickets to a big thing, a big show that you’ve been looking forward to. You’re excited to put on grown up clothes and eat at a grown up restaurant and see this show but you’re nervous. 

You’re nervous that your child won’t talk to the babysitter. You’re nervous that they’ll meltdown when you try to leave. You’re nervous that the babysitter won’t be able to build any kind of rapport. You’re nervous that your child will be constantly texting you during dinner and during the show and if you turn your phone off or on airplane mode during the performance that you’ll miss an emergency call. 

So you’re just kind of a mess about it.

Your mess about it mirrors your child’s mess about it. Your worry about your child’s worry is a helpful lens into what’s happening for your child. 

If you can take care of your worry, you will be helping your child to find a way out of their worry.

Let’s bring mindfulness into it.

Mindfulness doesn’t mean that you ignore your worry or distract yourself away from it. It means you sit and you notice it. You don’t do anything else. You don’t try to talk yourself out of it or try to manage it, you just notice it. 

Noticing helps you step outside of yourself. You can try narrating what you observe, doing this literally can really help. 

That might sound like saying out loud to yourself, “Wow, when I think about walking out the door, I can feel my breath get more shallow. I think my heart rate goes up. I catch myself trying to talk myself out of going or into going. I feel like my mind races.”

You could journal your way through it. 

You could talk it out with someone who is willing to listen and not try to solve things. 

In mindfulness, you allow yourself to be in two places at once. You have the experience and you NOTICE you’re having the experience.

You might feel yourself drawn to look back — like at the last time you tried to go out. Or you might feel yourself drawn to look forward — projecting into how the night might go. And when you notice that, you can bring yourself back.

You can say, “Ok, I’m having all of these feelings. I notice all of these sensations in my body AND I notice the feeling of the sofa cushion I’m sitting on, the rough fabric of my couch. I notice that I can hear the wind chimes outside or the traffic. I am aware that the light in this room dims when the sun goes behind a cloud.”

That brings us back to the present. We notice the pull away, and we notice that things here that bring us back.

So how does mindfulness help? It helps by letting us sit with the feelings until they pass. 

There are different ways to be mindful. IT doesn’t have to be sitting quietly; it can be walking and tuning into the walking. 

You know how some people think more clearly when they listen to background music? It’s the same kind of thing. You’re not doing mindfulness wrong if you do it differently than someone else. The goal is to be with feelings. 

Movement can help us be in two places at once. It can help us look at our experience more objectively. 

For some kids, especially anxious kids, it might be easier to be with a feeling when they’re moving. I used movement a lot in my clinical work with children. Asking them to sit with their feeling might be overwhelming but we could pace around my playroom or play toss or they could even cartwheel and then come back to whatever they were feeling.

Again, there’s no wrong way to learn how to engage with our feelings. Remember anxiety is about avoidance and the avoidance is focused on helping us NOT feel uncomfortable. But we do need to feel uncomfortable to overcome our anxiety and mindfulness is a tool to do this. It gives us the opportunity to step into being anxious, being uncomfortable and not running from those anxious, uncomfortable feelings. It’s fine to dip in and dip out. It’s fine to build up our tolerance a little bit at a time. Mindfulness does not have goal posts. It’s a practice, which means we practice it. 

By the way, if you’d like some help in bringing mindfulness to your day to day, you can head to my site and take the Parenting Pitfalls quiz. AT the end you’ll have the opportunity to sign up for my free 7-day Get Yourself Grounded email course. Just go to Child Anxiety Support.com/quiz

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How do I address child anxiety that’s the result of trauma?

I recently had a question from a listener whose child has separation anxiety after the death of a caregiver. I did reach out to this family privately but I wanted to cover this on the podcast as well.

Before the most recent DSM update, PTSD was listed as an anxiety disorder but as the field has become more trauma informed, it is now listed as a trauma and stress-related disorder and anxiety is recognized as one of the symptoms. 

This shift recognizes that PTSD is not just a subset of anxiety and in fact anxiety is an adjunct of PTSD. The new diagnosis recognizes that the most pressing concern is to address the trauma. The anxiety may drive the behavior that inspires the intervention, That is, the child may be displaying separation anxiety and that’s the reason the family is seeking help but the underlying reason behind the anxiety is the trauma of losing a family member.

Let’s talk a little bit about trauma. It’s a word we use a lot and not always correctly. The DSM defines trauma as “actual or threatened death, serious injury or sexual violence.” You can see that’s extremely limited and doesn’t include the way we use trauma even in the therapy field. In the therapy field, we include broader upsetting or disturbing events so we might call a divorce a trauma or being fired from a job. Technically, per the DSM diagnosis, these would not be trauma although they would certainly be upsetting and deserve attention and care.

Now I personally have no interest in gatekeeping the word “trauma.” If someone tells me an experience was traumatizing for them, I’m not going to say, “Well, technically I don’t think you can claim that term” instead I’m going to offer support, right? But when it comes to figuring out what to do next and how to treat or address a situation, we do need to be clear about what is traumatic and what is not.

I mention this because I’ve talked to many parents of anxious children who are using the term “traumatized” to describe their child’s experience and this is making it difficult for the parents to address the anxiety. They are understandably concerned that pulling back from the Parenting Pitfalls and exposing their child to the things that make them anxious will further traumatize their child. They are confusing upset with trauma. And I think we need to be very clear that being upset is very different than being traumatized.

Let’s go back to that DSM definition of “actual or threatened death, serious injury or sexual violence.” The key here is threatened, which means that even if we weren’t in danger, we believe we were. Truly believed. This is a big concern about active shooter drills in schools. If children aren’t aware that it’s a drill, this can absolutely be traumatizing. 

Now we’ll talk about the symptoms of PTSD — that is, post traumatic stress disorder — in the current DSM for children 6 and under

For that diagnosis, the child must have been exposed to actual or threatened death, seriously injury or sexual violence either directly experiencing it, witnessing it happening to someone else, or learning that it did happen to a parent or caregiver. The DSM expressly states that this does NOT include media such was watching a violent movie or seeing an upsetting picture. Again, this is the DSM diagnosis and we are not saying that seeing a scary or violent movie would not be upsetting or disturbing. 

If the child has this exposure history, then we look at symptoms. These would include intrusive symptoms like:

—Distressing memories that reoccur (sometimes the child won’t seem upset but will play repetitively about the event). When I worked at a shelter, many of the children would act out the police coming to arrest someone in their house over and over again.

—nightmares or dreams about the event. This could be a child who wakes up crying because they’re dreaming about the person who died.

—Dissociative reactions, also called flashbacks, where children act as if the event is happening again, and again this can be expressed through play. 

—Distress when exposed to things that remind them of the event, like a child who gets upset driving through the intersection where they were in a car wreck,

And it would include symptoms of avoidance such as:

—Refusing to go into the room where that person died;

—Avoiding conversations about the trauma event.

—Disinterest in play or other activities that used to interest them;

—The presence of negative emotional rates like sadness or confusing or fear;

—Withdrawing socially;

—not being able to have fun.

Other symptoms might include:

—sleep disturbances;

—Irritability or anger so tantrums

—difficulty concentrating

—hypervigiliance, which is being super tuned in to the possibility of danger

—exaggerated startle response

You can see how this can be confused with anxiety since anxiety shares many of the symptoms. Sow hat’s the difference? The biggest difference is the presence of the traumatic event. 

There are several treatments with a strong evidence base for young children with a PTSD diagnosis. These include Trauma Focused cognitive behavioral therapy or TF-CBT, Parent-Child Interaction Therapy and Child-Parent Psychotherapy. All three of these treatment modalities include the parents. The younger the child is, the more vital it is that parents are included in the therapy. This is because relationships mitigate trauma. EMDR or eye movement desensitization and reprocessing is also a recognized treatment for trauma and if you’re interested in exploring this, I would recommend that you contact EMDRIA at EMDRIA.org. Doing EMDR with children is a specialized skill and EMDRIA has high standards for the people who can be listed in their directory. Sometimes a clinician will take a weekend class and feel like they are ready to go and I just want to caution you about that. EMDRIA can help you screen for a truly qualified therapist. 

Children heal best in the context of a loving, supportive, relationship with a caregiver who is dependable and trustworthy. If your child has experienced a traumatic event and you are seeking treatment, make sure that you are included in that treatment, whichever you choose.

Trauma treatment is meant to help the person process the traumatic event so they can move through it. Now I’m going to explain this super simplified but trauma glitches our brains. It gets us stuck. Note that the intrusive symptoms are all about the stickiness — nightmares, memories we can’t shake, being triggered back into our trauma response when confronted by a reminder, avoiding things that make us think of the trauma. Treatment helps us unglitch our brains. Children who may repetitively play out the traumatic event are trying to unglitch. They are trying to play through to understanding so they can let it rest. Sometimes they need help pushing through the stuck place in their play. 

It’s important that the therapist a family chooses has specific training in trauma because inappropriate treatment can be retraumatizing. For example, our thinking used to be that people needed to remember the traumatic event. You’ll see that in movies where someone has a blank space in their memory and the big climactic moment in the movie is when they remember what happened. Actually not remembering can be protective and healing doesn’t always require uncovering those distressing memories.

Ok, back to the question that inspired this episode, How do I address anxiety that’s the result of trauma? And the answer is first address the trauma. 

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What can I do when I feel like I’ve failed my anxious child?

You know, when I started this podcast I figured I’d do it for one year — 52 episodes and that would be it. But this is Episode 54 so I’ve officially gone past my goal and the questions that are coming in are more complex. Like this one. And of course the actual question has a lot more backstory, which I won’t share given that it is very personal, and I’ve tried to distill it into this one simple but complex question, which is What can I do when I feel like I’ve failed my anxious child.

Oh listener who posted this and who did not leave their email so I couldn’t respond personally, I hope you are listening now. 

I’m sorry that you’re struggling right now and that you are hurting. Being a parent can be so painful especially when we are watching our children have a hard time. AS writer Sarah Payne Stuart: said, You’re only as happy as your least happy child. 

I’m going to try to address this very big, very important topic in this extremely short podcast and I hope that I’m able to do it enough justice that you will feel comforted and more confident at the end of it.

First off, you have not failed your anxious child. The relationship between parent and child is one that is forever changing. It changes as they change, as we change, as life changes. And sometimes we are a step or so behind the changes that need to come.

I learned this for the first time when my son, my oldest child who is now 26, was two. This is when he entered what I call the bent banana stage. You know the one, the one where your toddler asks for a banana dn if you give to them and they fall on the floor wailing because the banana is the wrong shape or size or you started peeling it for them or you didn’t start peeling it for them. When my son hit that age I was totally unprepared and our days bounced from tantrum to tantrum. This beautiful relationship I’d built with him came apart like wet tissue paper. The worst day was when he had a meltdown in public and another person intervened and told me I was handling it wrong. That’s a whole story about a bagel and one day if we ever met in person, ask me and I’ll tell you the whole sordid tale .But as I left that shop in tears, totally ashamed, I felt like a terrible mother and I felt like a fraud because I’d been working with kids for about a decade and yet here I was undone by my toddler. I can close my eyes and put myself right back there and remember exactly how it felt to carry my screaming child to the car while this woman watched, my face hot with guilt and anger and grief and fear thinking, I’ve broken my kid. 

Then my friend called, my friend with a child exactly one month older than my son, and said, “What in the heck is going on, my daughter has lost her mind.” And when we compared notes I realized, oh, he’s just 2 now and he needs a different kind of parenting than I’d been offering. I was still parenting him like a baby and he was letting me know that he was ready to be parented like a toddler. I had to learn a whole new set of skills.

This was a lesson I learned over and over again and every time we hit a snag — whether it was with my son or later with my daughter — and I started having that overwhelming feeling of frustration and guilt and failure I’d stop and say, “Wait, maybe it just means something needs to change.”

So I will ask you dear parent, who is feeling like a failure, I think it’s far more likely that you’re NOT a failure, that you’re a good parent in a relationship that needs to change. The pain and frustration you have, the struggle between you, is a sign that your child is demanding something different from you and you can do something about that. You have it within your power to go and figure out what to do next.

Do you get that reframe?

So many of the parents I talk to who are committed to parenting differently than they were parented — and there are a lot of us in the respectful parenting, gentle parenting, attachment parenting, conscious parenting, etc. community — Are super afraid of getting it wrong. In fact, so afraid that we might be causing harm that we are all too ready to beat ourselves up when we are unhappy or when our child is having a difficult time. 

Parenting guilt goes with the territory, I don’t know any parent who’s going to feel like they’re 100% nailing this parenting gig all of the time. And when we slip and yell or read a parenting book that highlights our mistakes or see another parent handling a challenge with grace that we screwed up, we’re probably going to feel guilt.

But guilt is only useful when it helps drive change. Guilt that just makes us feel bad about ourselves is useless at best and harmful at worst. It’s ok to say, “all right, guilt, I’m going to do things differently so you can stand down now.” It’s ok to say, “I regret those mistakes but I’m going to forgive myself and honor my intention to do better next time.”

And then we can start putting the supports in place that will allow us to do that. That’s what I mean about finding the motivation to drive change.

A lot of parents I talk to feel guilty not just because of what they’ve done or haven’t done but because of how they feel. They feel guilty for not enjoying their child or not enjoying parenthood and let me just say, that you can love your children very very very much, you can be willing to lay down your life for them AND you can also not enjoy them because kids aren’t always enjoyable.

 you can also not always enjoy parenting because the work of parenting — the day to day work of it — is not always enjoyable.

Parenting anxious kids is really hard. It’s hard to worry so much about them, it’s hard to feel derailed by them. It’s hard to have kids who demand so much. It’s hard to feel like you’re constantly failing. It’s hard to get whined at. It’s hard to deal with meltdowns. I mean, it’s not fun. It’s perfectly ok to want to run away from home sometimes.

I tell parents this all of the time — if you’ve worked with me before you’ve probably heard me say it — but there’s a whole genre of novels about moms who leave their families and there’s a reason for that, which is many of us have days when we’d like to run away from home. It’s ok to fantasize about running away and joining a circus instead of being a parent. Sometimes fantasizing about it is just the break you need to help you come back and face your tantruming child and your overbooked calendar and your messy kitchen and your endless to-do list once again.

I bring all of this up because sometimes the guilt about failing (I’m using air quotes here) is covering up a guilt we have about wishing we didn’t have these demands on us at all. And sometimes all of that guilt — all of that messy shame and worry and regret and fear — makes it really hard to know what to do next.

I meet a lot of parents who are overcompensating — like really getting entrenched in the parenting pitfalls — because they aren’t liking their kids very much and they feel bad about it.

So for example, a parent who goes out of their way to be gracious when their child is whining and dragging at them because they feel guilty for wanting to lose it. And I tell those parents, it’s ok to be human in the relationship. You don’t always have to be an instagram worthy parenting whisperer with your kids. If the relationship between you and your child is generally healthy, is generally loving, is generally strong then there is room for your imperfection.

There is room to get it wrong, realize it, and course correct.

There is room for you to go back and say, “I didn’t know and now I do and so I’m going to do it different from here on out.”

Getting it wrong, getting stuck in parenting pitfalls, feeling unhappy —  is a sign NOT that you’re a bad parent or that you have a bad kid or that you’ve been doing a bad job, the sign is that something needs to change.

That’s it. 

Just that something needs to change. And how else are you going to know that something needs to change except by becoming dissatisfied about the way things are right now. In other words, being unhappy in your parenting relationship or with your child is healthy and appropriate and NOT a sign of failure. 

When I am working with parents, I start with the assumption that they are doing a good job. Because most parents are. And when I start with that assumption, I am looking for confirmation so I’m making a point of noticing that parents’ strengths and skills. Those are the things we want to tap into as we make change. I don’t start with what they’re doing quote unquote wrong because I don’t think in terms of wrong. I think in terms of, What’s working and what’s NOT working.

This is why I say that your parenting isn’t the problem; it’s the solution.

IF I went back in time to meet myself as the unhappy mother of an unhappy 2-year old, I wouldn’t say, “Wow, what a screw up. What a bad mom. What a mess!!” I’d say, “Oh wow, there’s a mom tuned in enough to know that this isn’t working and just needs some help in figuring out what to do next.” 

I’d look at the good relationship we had up until that developmental turning point and know that the relationship was demanding change. My son was one of those kids who hit every developmental milestone like the Wile E Coyote running into a wall. Just slammed into it and every time I’d forget and think oh my gosh, I’m failing. I think I didn’t figure it out until he was about 10. I’m hoping you get to figure it out sooner. That change is hard, that change sometimes — well often, requires some measure if discomfort. It requires us to be uncomfortable enough to change. 

So my dear listener who posted this question to me and anyone else who is feeling this way, you have NOT failed your anxious child. You are realizing that what you’re doing isn’t working and how wonderful that you’ve realized this because now you can look for supports and information to help you create change. That doesn’t mean your struggle is over but it does mean that you have begun the journey to better functioning and understanding. 

True failure would be in denying your unhappiness or denying your child’s struggle and continuing to do the things that are not working. It would be continuing to treat a toddler like a baby when they are begging for help in growing up. 

We growing parents, instead of seeing ourselves as doing things wrong, I wish we could reframe this as the inevitable course of changing parenthood. What you did and what you do works until it doesn’t and then you might be unhappy and your child might be unhappy. But you can change things. Let me know if I can help. 

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What derails child anxiety treatment?

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

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

  • Information
  • Time
  • Trust
  • Fear
  • And
  • Bandwidth

Let’s go through these one by one.

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

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

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

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

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

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

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

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

What derails child anxiety treatment? Read More »

Does social media cause teen anxiety?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I mean it’s an ongoing conversation.

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

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

Does social media cause teen anxiety? Read More »

Do you recommend any supplements for child anxiety?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Do you recommend any supplements for child anxiety? Read More »

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

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

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

Ok, let’s back up.

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

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

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

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

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

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

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

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

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

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

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

Let’s try another scenario. 

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

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

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

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

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

How do I get my anxious child to sleep alone?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Or some version of that.

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

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

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

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

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

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

How do I get my anxious child to sleep alone? Read More »

Why doesn’t encouragement help my anxious child?

The question this week is “Why doesn’t encouragement help my anxious child” but I think it will be illuminating if I give you more information about the question I received that inspired this episode..

I’m not going to read the whole thing since there are some private identifying details in it but the parent shared that they have a child who tends to be pretty negative, which is not uncommon in anxious kids. This child is particularly pessimistic about their ability to overcome their anxiety and the parent feels like the more they try to encourage them, the more discouraged the child gets. So for example, the parent will say, “I know you can do it” and the child will say, “No I can’t.” And the parent will say, “You’ve done it before so I know you can do it again” and the child will give a lot of reasons why they could do it that time but that they won’t be able to do it this time. So they’ll say things like, “Last time the situation was different” or “last time I didn’t know any better” or “last time was just good luck.”

This is a situation I come across a lot in my work and I know how frustrating it is for parents.

So first, why are some kids so resistant to encouragement?

The answer here is that encouragement can feel like pressure. We’ve talked about slow to warm temperaments on this show before but I’m going to go over it again since some of you might be new to the podcast.

Temperament traits are aspects of our personality that are more or less stable. These are nature not nurture qualities although obviously they can be impacted by the environment. A slow to warm person is someone who takes their time coming to new experiences. This is someone who might show up at a networking event, and stay on the sides checking it out for awhile first. You know, seeing how the room is flowing, who’s there and who isn’t. A child who is slow to warm might want to watch other children go down the slide before attempting it themselves. They might not want to eat a new food the first time it is served and need to see it repeatedly before they’re willing to give it a try. 

Slow to warm temperaments can be frustrating for adults who don’t understand it. They might see the child’s initial refusal as a barrier or a hurdle when really that child just needs time to take it all in and make their own decision.

Not all slow to warm kids are anxious but some anxious kids are slow to warm. They might feel anxious as part of that temperament, as part of experiencing something new for the first time but they might also NOT have anxiety about the event but have anxiety about the perceived pressure.

So a child who needs to hang back and watch other people try the slide, might not be feeling worried about the slide but they might start feeling worried if their caregiver interprets their caution as a problem and starts trying to talk them into it.

They’ll be hanging on the sidelines, maybe with an intense look on their face, and if left alone will eventually make an attempt but adults — misinterpreting their slow to warm temperament as an anxiety problem — might start saying, “You can do it, those other kids are doing it, why don’t you try, here I’ll take you over there” and that makes them dig in their heels because they’re feeling rushed.

This is very tricky because sometimes kids do need our encouragement but sometimes they don’t. And figuring our who your child is  and who they are in the context of holding back is part of the parenting puzzle.

Ok, back to encouragement.

The opposite of the slow to warm temperament, which by the way is also called high withdrawal — is a high approach person. The high approach person likes new experiences, is interested in trying out new things. They’re the ones who see a slide and go right up that ladder. Those are kids who are willing to try every new food, who leap into new social experiences. And those children can also have anxiety but it’s not necessarily expressed through this side of their temperament. And we as a culture love these high approach kids.

They can be easier to parent because they are willing to give things a go. And when they’re reluctant encouragement can be just the thing to get them over that hump. They might hang back for a minute and you say, “You can do it” and they say, “Yes I can, let’s go.”

Most of us parent to a high approach temperament because it makes sense. We interpret a child who holds back as a child who is nervous and yes, sometimes that’s true. But as I’ve said, it can also be an expression of this particular personality trait.

Picture the slow to warm child at the slide, not necessarily reluctant but wanting to take their time. And now the parent starts encouraging them with that “you can do it” etc. The child still needs time to figure it out but now they’re feeling pushed. Because they’re feeling pushed beyond what they’re ready to do, they push back. You say, “you can do it” and they say, “no I can’t.” They’re doing this because they are not experiencing the good will you are intending to give them. They are experiencing it as “You’re doing this wrong.”

The slow to warm child, doesn’t actually need encouragement. They need space.

So that’s the slow to warm child and encouragement. Again, they may experience this as pressure. And I think, from what the person who posted this question shared, this is what’s going on for them.

But there’s another reason why encouragement may not work and that’s because encouragement is another form of reassurance.

Reassurance is the most common parenting pitfall that gets families stuck in child anxiety. Anxious kids ask us to reassure them that it will all be all right. With non-anxious kids — children who have a typical amount of developmentally appropriate anxiety — get reassured and move on. Anxious kids — children who have an atypical amount of anxiety or who have anxiety that is more than we would expect for them developmentally — get reassured and then acclimate to that reassurance and want more.

This is a child who keeps coming back asking you to tell them that it’s safe or that they’re ok or that nothing bad will happen or that they can do the hard thing — and you find yourself having to answer them over and over and you start feeling like you need to talk them into new experiences every time. Or that any anxiety provoking event ends up in a meltdown. That’s the way we get trapped in reassurance, that’s what makes it a parenting pitfall.

When that’s happening, we may really struggle because it feels bad not to reassure our child. So I want you to think about describing instead of reassuring. Validing the feeling if not the facts.

A child says, “Will I be ok if I go down the slide” and you can say, “You feel worried about that slide, I can appreciate that.” You could also say, “Why don’t you watch those kids go down and see what you think.” Or you could say, “You can only know if you try.”

What we’re trying to do is build in curiosity about the event rather than a blanket reassurance. They might fall off the ladder going up. They might bump on their bottom at the end of the slide. They might climb up there and decide it’s too high. Who knows. There are no guarantees in life. That’s part of what’s so hard about anxiety is that it wants certainty and anxious people — including kids — need to learn how to manage that feeling of uncertainty. 

There are lots of places to learn how to confront anxiety and going up or down a slide is not a mark of success or failure; it’s an opportunity to explore. Families who are learning how to unstick themselves from the sticky parts of anxiety, who are learning how to climb out of parenting pitfalls and not fall back in, can use everyday events like slides as opportunities to manage their own responses. In other words, save the big confrontations for the things that really have you trapped. If your anxious child doesn’t go down the slide, I wouldn’t worry but I would be working on the things that are getting in the way of functioning like sleep routines, separating from caregivers, dealing with social relationships, struggling with perfectionism, etc. 

When they’re having some success in those areas, you can bring the learning to things like slides.

For example, if you have a child who struggles with separating from you, you can be working on that with a specific plan and then when they experience some success there, if they come to you and say, “I don’t know if I can go down the slide” you get to say something like, “You can only know if you try but I do know that a kid who can stay downstairs on their own while I”m upstairs putting laundry away is plenty brave.” 

How do I motivate my anxious child to deal with their anxiety?
The question, “How do I motivate my anxious child?” is more complicated than it first seems because

Why doesn’t encouragement help my anxious child? Read More »

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