Dawn Friedman MSEd, Author at Child Anxiety Support

What causes child anxiety and how do you fix it?

This week’s question isn’t one that has been sent my way. It’s one I’ve ginned up to give me an excuse to address a bunch of smaller questions.

I’m using this question to explain that there are a lot of reasons why your child might have a brain that is more prone to anxiety and so there are a lot of ways to address is.

Anxiety is a helpful, healthy part of being human but some of us, as you know, are more prone to dysfunctional anxiety than others and that might be because of genetics. We can inherit the shape of our brains from our parents.

It also can be learned. We may learn how to be anxious by watching our caregivers.

There might be a trauma history and not just big T trauma — like a cataclysmic event or an act of violence — but also little t trauma, which might be harder to identify or not generally recognized as a trauma. This might be something like a difficult birth or an early separation.

Anxiety can also be part of another diagnosis such as ADHD or autism.

It might be caused by other health issues. For example, sometimes children with gut issues or celiac are more anxious and that can be a chicken and egg scenario where it’s difficult to tell if anxiety caused the stomach problems or the stomach problems caused anxiety.

Children may have allergies or sensory issues that make their bodies feel more anxious. It’s hard to feel calm if we’re itchy or if we’re struggling to know where our body is in space or if our vision or hearing is overwhelmed.

The reason this is so complicated is that we complicated. We are mind and body and spirit and we are also our relationships. We exist in community and this is especially true for children who spend their growing up leaning on us — asking their parents to complete them — until they are old enough to stand on their own. And that takes longer than you think, especially for anxious kids.

The many different treatments for child anxiety depend on how the professional is conceptualize what’s going on, which depends on their training and their theoretical mindset.

As someone trained in child development and clinical mental health, I see things through the lens of mind and relationships. More specifically the family system and the relationship between parent and child. That is my go to, that is where my research and understanding is, and that is where my skills lie.

But what I do is not the singular answer. It can be. For some families that’s where the healing begins and end but for other families — in fact I’d say for most families — it’s just part of the puzzle.

This is one reason why I host Eve Hermann, of Source Embodiment. Eve is a licensed massage therapist, cranial sacral practitioner and somatic experiencing professional in my Child Anxiety Support membership each month. She understands the body and the brain from a perspective that is different than my own. Her training is different, her background is different, and the solutions she offers are complementary because they are different. There’s tremendous value in having more than one way of considering your experience and your child’s experience with anxiety.

Your family’s healing — and your child’s journey — might include working with someone like her. It might include medication, working with an allopathic doctor. It might mean working with an occupational therapist or a pediatric chiropractor. It might mean examining your child’s physical surroundings whether that’s school or your home to see if there are things you can do to make it a better fit. You might bring in an executive functioning coach or a professional organizer to create a more supportive environment.

I don’t want this to seem overwhelming. Instead I want you to understand that helping your child, helping your family, and helping your self is an opportunity to explore what works. It’s not just about some magical fix; it’s about finding opportunities to grow and learn about what we need and how we can flourish.

Often what families need is a mix of services or supports. For example, a child with an auditory processing disorder needs this identified and addressed as part of anxiety treatment. Or a parent who is completely stressed out can’t focus on the kind of intervention we plan in the program. They may benefit from starting an exercise routine or learning to meditate or getting a weekly massage. When we are anxious we can’t access that higher order brain that lets us plan, that lets us follow through, that lets us offer our children the regulation they may need to borrow to get through their anxious challenges. Again, that’s why I’m so grateful that Eve is in our site. She offers a monthly exercise to guide us towards calm.

I think it’s important to understand that no single professional, no particular modality is a silver bullet. Child anxiety can’t be cured in one session with any particular expert or healer; It’s more of a long commitment to healing and growth and every family has their own particular pathway.

I met with a pediatric chiropractor here in town the other day. Her name is Dr. Gabby and she’s at the inside space here in Columbus. I’ll link to both her and Eve in my show notes. Anyway, Dr. Gabby says that working with her families is like a dance where she is participating in the experience with her clients, trusting them to show her what they need. She observes and listens and brings her expertise in choosing how to respond. I totally get what she means here. We meet our clients wherever they are at, we trust who they are in the moment and are curious about how they will show us what they need.

We don’t see our clients as broken. That’s not helpful and it’s not true. We all have specific challenges but there isn’t a perfect version of ourselves or of our children that we need to chase. Perfection is not the goal. Right here, in this moment, you are who you are. Your child is who they are. That’s enough and it’s always the right place to start.

I think about this because I can remember introducing my newborn son to a relative who gazed into his eyes and said, “It’s a shame that someone so perfect is going to be messed up by the world.” My gosh, I was devastated. And that’s how I parented for the first few years, from this place of fear. Everything felt like a threat to his perfection and I felt like I was in a losing battle to protect him from harm. I know that some of you are having that experience, too.

Let me tell you, now that my kids are grown I see how wrong I was and how much that point of view caused me unnecessary sorrow and insecurity. We are meant to experience the world and we are built to withstand it especially when we have the loving support of committed, attentive and attuned parents.

None of us are projects to be fixed or perfected; we are here to grow, learn, and discover.

One of the ways I approach anxious kids is to talk about the great adventure that is life. We talk about their heroes — fictional or not — and how those heroes go through difficult times. That’s what makes them heroes, right? I tell those kids, This is your adventure tale. You are facing dragons. You will have stories of survival to tell and to inspire people. It’s hard work. That’s why we write books about it.

If you are parenting an anxious child know that you are writing your own story. Parenting this child at this time is part of it. I am here to help you with the mind part, the relationship part. I am here to address the family systems part. There are other wonderful practitioners who can be a part of your journey, too.

If I had my way, I’d assign every family a whole team of supporters, and cheerleaders, and educators, and service providers. But you only need to start with one. Just start at the start that is most accessible to you and through that particular path, you will find other helpers, too. Remember, no silver bullets but with those people who come alongside you, you — and your child — can overcome anything.

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Why does my child’s anxiety make my anxiety worse?

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This is such a good question and gives us the opportunity to do a deep dive into anxiety in general and child anxiety in particular so let’s go ahead and do that, let’s dive in.

Ok first of all, anxiety is catching and it’s meant to be. We are meant to live in community and if something is threatening the community — like if we are all sitting around together, around the fire, relaxing after a long day hunting and gathering — and a lion creeps up on us and one of us hears a sound and sits up all alert, the rest of us are supposed to catch their tension so we get on high alert, too. It’s a safety issue.

You know how sometimes you’re sitting in your car at a red light and you turn to look at the person in the car next to you and they feel you looking and stare right back at you? We are all attuned to each other. We are sensitive to the people around us and most sensitive to the people to whom we are closest.

I thought about this a lot over the past few years when things have been scary for a lot of people. Our society is more anxious right now and has been for some time. We catch anxiety from each other and even if we’re having a particular experience that isn’t very anxious for whatever reason, we might find ourselves feeling on higher alert, a little more tense, a bit more irritable when we go out around other people.

This is another reason why I expect to field more phone calls from parents about their anxious kids during back to school time. It’s not just the transition, although there’s that. It’s not just the greater demands of school, although there’s that, too. But there is also the fact that anxiety is catching and kids catch it from each other and we catch it from them.

Anxiety, in other words, begets anxiety.

So that’s one reason why your child’s anxiety makes you anxious is that it’s supposed to.

Beyond that there are a couple of other reasons why your child’s anxiety might make you anxious and these are super important to unpack when we’re planning how we want to address their anxiety.

The first is that maybe you’re anxious about the same things. So say your child is really worried about passing their test. Maybe you worry about grades, too. Maybe you worry about their ability to pass the test. Maybe when they say, “I think my teacher doesn’t like me and is going to be extra hard when they grade my essay responses” we start to worry that this might happen.

We might know we’re worried about the same things they are but we might not know it. We might be so caught up in their worry and whining or tears or asking for help that we don’t notice that we share their worry. That can make it difficult to address it. We might start problem solving, like encouraging them to study harder when studying harder isn’t actually the issue. The issue is the worry. This can be especially true for perfectionist parents — because perfectionism is a symptom of anxiety — whose response to their own triggered worry is to run from that worry. That is to say, your child is afraid of failing, we are also afraid of their failing, and so we run from the idea of failure whether or not that is a realistic fear.

Our anxiety may make it difficult for us to recognize it as an unrealistic fear.

Ok, so that’s two reasons.

Now there’s another one and this one is the most common reason parents reach out to me for help. And that is that their child’s anxiety triggers their own anxiety not about the fears the child has but about their fear that their child can’t handle it.

Parents don’t always recognize this as anxiety. They experience it as frustration, anger, overwhelm, or discouragement. They tell me things like, “I’m afraid that my child can’t handle their anxiety” or “I’m afraid my child’s anxiety will derail them” or “I’m afraid my child will be traumatized if I I make them do the thing they’re scared of” or even “I’m afraid of my child’s behavior when I push them about the thing that makes them anxious.”

In those cases it’s our worry — the “I’m afraid …” part that we need to address first.

What we know about anxiety is that it’s a family systems issue. The child does have anxiety, that is not the family’s fault, it’s not the parents’ fault, it’s not the child’s fault. It’s a fact and what happens is that the system of the family starts to shape itself around the child’s anxiety. This is normal and generally speaking it is healthy for systems to shape themselves to support its members. It’s only an issue when the system is supporting dysfunction and we don’t always know that this is happening until we look around and say, Shoot, our family is really stuck.

Starting with the parent doesn’t mean we’re blaming the parent, it means that we’re acknowledging that the parent has the position and the power to adjust their own reactions and behaviors in order to adjust the system, which shifts to support the child in growing instead of keeping the child stuck.

It’s big work, I won’t lie. It’s not easy and it’s important that the parent takes care of themselves while they’re doing it. To take care of your child’s anxiety means understanding where your anxiety has become part of the issue so that you can address it and so address your child’s. It’s one of those things where when you start to see it, you can really see it. And that makes it much easier to address it.

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What should we do about our anxious child’s negative self talk?

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Negative self talk looks like, “I’m terrible, I’m stupid, I’m the worst player ever, etc.” My child is incredibly talented and none of what he says is true, but no amount of positive reinforcement seems to help.

This is a great question because it’s really common. I often get calls from parents looking for help because this kind of negative self talk is getting more and more worrisome.

The first thing I ask parents to consider when they contact me about this behavior is when its occurring. Anxious children will often say these kinds of things when they are trying to confront their anxiety in some ways but are failing. For example, a child who is worried about failing a spelling test might say this when they try to study. Or a child who is struggling to go into school alone is sitting in the car unable to get out and go in. They may also say it when they realize their parent is frustrated or unhappy with how things are going or if they think their parent is frustrated or unhappy with how things are going. And many many kids who are on the fight end of fight/flight and freeze say it after their meltdown. They look around at their trashed room or at their unhappy family and feel pretty terrible about it and then say, “I’m the worst. I’m a bad kid.”

If your child is saying these statements in the context of their anxiety then this is part of their anxiety.

Anxious kids are anxious, right? And one of the things they’re anxious about is being able to measure up. They are worried that they are not good enough, not strong enough, and not capable enough.

They are anxious about their anxiety. And they are confusing their anxiety with themselves. Because of course they are. The more anxious a child is, the more their anxiety is ruling their lives and may feel like the most central, most important thing about themselves.

Anxiety tells us lies. It tells us that all the dogs will bite, and that thunder storms will turn into tornadoes and whirl us away, and that our friends are just waiting to laugh at us and that we aren’t good enough. That’s a pervasive lie of anxiety.

Anxiety robs us of our self esteem. The more that we are limited by our anxiety — the more that we are avoiding or limiting ourselves and our loved ones — the worse we feel about ourselves. Other kids can spend the night places. Other kids can speak up in class. Other kids —maybe even our siblings — aren’t driving our parents crazy. No wonder anxious kids often feel bad about themselves.

And this is true, even for the kids who are successful. Perfectionist, anxious kids may be performing at a very high level of functioning, but they still feel bad about themselves. That’s because their best is never good enough and they always feel one mistake away from everything falling apart. Perfectionist, anxious, kids are all or nothing kids. That means that they’re absolutely 100% fantastic or they are abject failures.

And this is why it’s so important that we and our children get support around anxiety. Anxiety tends to go hand in hand with depression in large part because anxiety does such a number on our sense of self. It tells us the lies that we are not good enough. That we must remain small to stay safe. It tells us that we have to avoid adventure in order to stay protected. Or that we must be perfect in order to deserve love.

If you have a child who is saying rotten things about themselves there are a couple of things to know.

The first is that reassuring them that they are wonderful is unlikely to help in the moment. If you’ve taken the Parenting Pitfalls quiz, which you can find at my site child anxiety support dot com, just look in the menu at the top then you know that reassurance is one of those pitfalls. That means that reassuring our children when they are anxious actually makes them more anxious. That reassurance feels good for a minute but then our children acclimate to it and need more of it. Yes, it’s good to tell our kids how great they are but when they are feeling anxious and beating themselves up, we can remind them that this is their anxiety talking. We can say things like,

“Your anxiety is is trying to keep you small right now.” Or even, “Your anxiety is not being very nice to you right now.” When they are not feeling anxious, we can explain how this all works. The first part of helping our anxious kids is teaching them how anxiety functions. We should explain that anxiety is our safety system working over time. It’s good to be concerned about our safety but it’s not good to be so concerned that we’re missing out or beating ourselves up.

We should teach our kids to talk back to their anxiety. Your child says, “I’m stupid” and we can say, “That’s your anxiety talking. What would you like to say back to it.”

Sometimes this is no good in the moment. When our kids are at their most anxious they are in survival mode and can’t access the higher order thinking that logical reasoning requires. In those cases we should wait until their calm and process the negative self talk later.

Again, negative self talk is in itself a form of anxiety in anxious kids and reassurance is going to make things worse.

Which brings us to our own anxiety. It’s really really difficult to hear our kids trash talk themselves. It is painful and it can be scary. Of course we feel anxious when we hear their anxiety coming out this way.

So how do we handle that? In much the same way. First we learn about how anxiety works — ours and our child’s. Second, we learn how to manage anxiety — ours and our child’s. We learn to think in two modes — in the moment, dealing with what’s right in front of us and big picture, dealing with anxiety as a whole. That means having a plan for in the specific anxious moment that feeds the larger plan of helping our anxious child long-term.

In short, if your child is full of negative self talk then:

Educate them about anxiety and how it shows up including making us think mean things about ourselves that are supposed to keep us small and safe but really end up keeping us small and unhappy;
Make a plan for what we’ll say to them in the moment, which might be something like, “Your anxiety has its mean voice on today.” Or “Sounds like your anxiety is really trying to keep you small.”
Create a long-term family plan to support your child in dealing with and facing they anxiety.
Create a long-term plan to support you in dealing with any anxiety you have in parenting an anxious child.

Have questions about this topic or something else you want to ask? Let me know.

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Why is that parents get blamed for their child’s anxiety?

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Well, frankly I think parents get blamed for everything when it comes to their kids. It’s not just anxiety it’s everything else. Parents get blamed for their kids who tantrum, or their kids who whine, or their kids who struggle in school, or their kids who struggle in life.

Parents just get blamed period.

It’s tricky because our parenting does have a big impact on our children and our choices do shape who they are — I mean, I think it’s a lot of nature but that nature is shaped by the nurture. Basically I believe we are born with personalities and tendencies and preferences and strengths and those things are impacted by our environment, including our parents.

That makes us awfully powerful but that doesn’t mean that there isn’t a lot that’s out of our control.

I think it’s important, too, to recognize the two-way street of parenting. We do shape our kids but they shape us as well.

There’s a lot of research about this but the information hasn’t really drifted down to commonsense understanding of the reality of parenting.

Some children are more difficult, more sensitive, more reactive than others and we have kids like that, we learn to handle them more gently, which can look like enabling them.

For example, lots of us rock our babies to sleep for a long time. Some babies grow out of it, some babies don’t. And some of us get trapped into remaining part of our child’s sleep routine — like laying down with them or staying in the room with them — until they’re ten or even older. If you talk to somebody about that, they might say it’s your fault for always staying with them. That you shouldn’t have started that so-called bad habit of laying down with them. But if you’ve got a toddler or a preschooler who desperately needs sleep and who falls apart if you’re not with them then of course you’re going to stay with them. It works until it doesn’t.

It’s not the parents fault that there is now a 10-year old who can’t sleep alone. I think we have to stop thinking about blame and fault and instead say, “Is that still working?” Does the parent still want to lay down with them? Is it preventing the 10-year old from gaining some new skills that they’re going to need? Are they missing out on slumber parties? Is the parent missing out on adult time?

Basically it worked and now it doesn’t. It’s not helpful to say, “You shouldn’t have done it in the first place” because that’s not even true. You do what works until it doesn’t and then you do something different.

That’s why I say it’s not your fault but it is your responsibility. As parents, when we need or want change, we will have to upend our routines in order to create change.

It’s not our fault if a ten year old still can’t sleep alone but we will need to take action if our child is stuck and we or they are suffering for it.

I know parents feel guilty when they realize that they are responsible for changing things up because they look back and say, “I should have done it differently.” But that’s not helpful. You did it that way — whatever way it was — because it worked or else you thought it would work. I mean, it made sense for you to do it that way. Now it doesn’t make sense. So now you get to reassess and do things differently. That’s all. No blame. It’s not your fault but it is your responsibility.

There are lots of things like that. Maybe we used to play tennis but now our knees hurt so we start taking swimming instead. Tennis was great until it wasn’t. It’s not our fault we have bad knees and it wasn’t a bad idea to play tennis. It was a good idea until swimming became a better idea. You wouldn’t beat yourself up for playing tennis? Or at least I hope you wouldn’t. So I hope you can find a way to not beat yourself up if you realize your parenting needs to change, too.

When it comes to anxiety it’s super easy to get stuck in patterns and routines that make things worse. Remember 94 to 99% of all parents with anxious kids and teens get stuck, which means you are NOT alone. But you have the opportunity to learn from these stats, to learn from the research and figure out what you’re going to do to change things up.

When we know better we get the opportunity to DO better.

And if we know better and choose NOT to do better? Well, then we need to take a long hard look at what’s stopping us.

In my work with parents I can say that the common barriers to upending anxious patterns are:

Lack of information, parents don’t know what to do or how to do it even if they know that something has to change;
Lack of support, all that blame they get isn’t helpful and is often hurtful;
Their child’s behavior, which tends to get worse when parents try to shift things up.

What happens is the family continues to struggle, everyone and their brother has advice to give, which only makes things more confusing, and the parents feel worse, which makes change that much harder.

I will tell you right now, that anyone with solid training on supporting anxious kids and their families knows that you got here not because you care too little but because you care, period. You care about your kids, you’re trying to do right by them, and parenting an anxious child is confusing and exhausting. It’s hard to make the right decisions when those decisions aren’t always clear and you’re ground down by the reality of parenting an anxious child.

But I want you to remember that you did not create your child’s anxiety, that the patterns that we fall into are ones that are common and understandable, and you can do things differently when you’re ready. Note I said when you’re ready, which might be before your child is ready but we can plan for that, too.

Just because what you’re doing is no longer working doesn’t mean you’re not doing a good job. It means that you and your child are growing and your parenting needs to grow, too. That’s all. No shame. No blame. Just the facts

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Am I being protective or over protective?

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This week’s question came from a parent who is trying to figure out how to support their anxious child and reached out to me with a more complex and personal version of the question, “am I being protective or over protective when I try to support my anxious child.”

Here’s the thing, one family’s protective is another family’s over protective because we can’t take a particular behavior out of the context of a particular family and say, “That is always right” or “that is always wrong.”

Anxious children come in all shapes, sizes, ages, and developmental needs. Families, too, have different expectations and values. In one family, choosing to homeschool due to a child’s anxiety is overprotection and in another family it’s a great idea. So how do we know the difference for ourselves? Or at least how can we start figuring it out?

Ok first we have to back up and remember what this whole parenting gig is all about and that’s raising humans to grow up and live their own best lives, right? That’s parenting in a nutshell. And we know, from just looking around us, that there are a whole lot of versions of best lives out there. So part of this parenting and growing up is figuring that out — what version? What are our children’s strengths that we can play to? What are their challenges that we can help them confront and overcome or learn to work with them?

As they grow, we continuously reassess. Our children change, our values as a family sometimes change, and certainly circumstances can change. Any of that means we go back to the drawing board and say, “Is this still working? Are we still moving forward? Is my child still making progress however that’s meant to look?”

Back to protections, protect should protect; not limit. Overprotections limit. Overprotections keep kids stagnant and stuck whileProtections keep them safe and encourage growth.

A general example would be making your typically developing preschooler hold your hand when you cross the street is protection. Making your typically developing 12-year old hold your hand when you cross the street is overprotection. That’s easy, right? That’s very clear. We know what to expect from preschoolers and we know what to expect from 12-year olds and we understand the mechanics of crossing the street.

Things get trickier when we’re talking about expectations that are more complicated or nuanced such as managing social media, or navigating romantic relationships, or figuring out how to deal with anxiety.

In cases like that, where it feels more complicated, I encourage you to step back and ask yourself these questions:

What are my goals for my child around this topic?
What skills around this topic will they need when they’re adults?
How can I help them to begin to build those skills now in ways that are developmentally appropriate?

If what we’re doing is not building those the skills that we know they need, then it might be overprotection. Remember, protections protect but leave room for skill building and over protection limits, it doesn’t find ways to give kids the opportunity to learn the skills they will need as adults.

This is so hard when we’ve got anxious kids who don’t want to learn those skills. Who are perfectly happy with you managing things for them. Again, step back and think about your child as an adult. Think about what they need now to get them there, to adulthood with the skills that they need whether they like it or not.

This doesn’t mean that you let an 8-year old fend for themselves when they’re scared anymore then you’d let a preschooler cross a busy street without teaching them how traffic works. But it does mean that at a certain point you’re going to ask them to do the things they need to do, knowing that you’ve given them the support and information that will allow them to do it.

For example, if you’ve got a 12 year old who reasonably knows how to cross the street but doesn’t want to, then you might insist. You might say something like, “I don’t have time to walk you to the ice cream shop to get you that milkshake so if you want to get a milkshake you’ll need to get there on your own.” And we’d say that with the full confidence that we’ve given them the knowledge and skills to accomplish that safely.

They might be scared. They might insist they don’t know how to do it. But a milkshake might be just the incentive they need to find out they can.

When it comes to anxiety, we might need help drilling down to the small steps and small skills they need. We might need help understanding what’s protective and what’s over protective because some anxious kids are pretty dramatic. I don’t mean this in a dismissive way at all. I mean that their fight, flight or freeze is so big or so consuming that it’s hard for us to get perspective and know whether or not what we’re asking of them is reasonable. That’s all part of the planning and work of supporting and raising anxious kids.

If you are feeling stuck or your child is feeling stuck, know that this is part of the anxiety process. Feeling stuck just comes with the territory and usually means we need to stop and reassess what we’re doing and whether or not we’re off track in helping our child acquire those skills they’re going to need. If you need help with that. Let me know.

Am I being protective or over protective? Read More »

Is my child manipulating me?

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This week’s question is, “Is my child really anxious? Or are they just manipulating me?” This is one of the questions I ask in the Parenting Pitfalls quiz because it’s one way I assess for patterns of anxiety in a family — that is whether or not people tell you that your child is manipulating you or if you wonder if they’re manipulating you. So let’s talk about that a little bit.

First of all, when people use the word manipulation to talk about a child’s behavior, what I know for certain is that family is struggling. Manipulation is another word for “doing things to get what we want” but it’s a really negative word. The truth is, we all do things to get what we want. We may be extra nice to our boss even if we’re annoyed by them because we want to get a raise. Or we might pretend to like a book we dislike so that other people in our bookclub will think we’re smart.

According to Kohlberg’s moral development, children tend to behave selfishly until around the age of 7. They are reward oriented — behaving in ways that serve them rather than because it’s the right thing to do and they are selfish — looking out for their own self interest rather than ways to serve others. Now I know you’re going to give me examples of your child’s selflessness at younger than seven. It’s not that they don’t do lovely things like give a toy to their sibling, or bring you flowers, or give up the last cookie because their friend is crying — it’s that they do those things because they want to. They want your praise, they want your approval, they want their friend to play instead of cry. This again, is developmentally appropriate. And we help them learn our moral code with that praise and approval. That’s part of the teaching we do.

I’ll tell a story about my daughter here with her permission to illustrate this. When she was about five she figured out that if I said no to something like a popsicle just before dinner, she could get a popsicle by going to her dad and looking very sad and saying, “Gee, I sure wish I could have a popsicle” and he’d say, “Well, go have one then.” Of course she was manipulating him because she wasn’t telling him the whole truth by explaining why she didn’t have one. But that’s typical manipulation. She didn’t know that lying by omission was a thing. We had to tell her that. If anything she was showing some good problem solving and people skills.

From 8 to 13, their moral code is still about meeting rules and getting praise. Kids want approval. They are growing into the idea that morality can be more personal and that the greater good may sometimes mean they will miss out but they definitely haven’t mastered it. Heck, we adults struggle with this so of course we can expect children to still be learning and exploring what it means to behave in a moral manner.

Back to manipulation. Manipulation, as in manipulating people to get your own way, isn’t a moral issue for kids the way it is for us. A child who is anxious and who is avoiding through fight or flight or freeze, is definitely trying to get their own way. If they don’t want to do the scary thing like sleep alone, or talk in class, or go to the baseball game then they may meltdown, cry they may threaten to hurt themselves, they may punch someone or punch a wall and then parents often give in. Is the child being manipulative? Is the child really that scared? That in danger? Or are they pretending to be to get their way?

My take is it kind of doesn’t matter. We need to take threats seriously, always, especially when there is threat of harm. They might be exaggerating their threats but exaggerated threats have resulted in real harm when we don’t take them seriously. They are trying to get us to take their fears seriously and yes, they may blow those fears up so that we will.

That doesn’t mean we help them avoid. It may mean we need to start smaller in addressing their anxiety because the big stuff is too big at the moment. Or it may mean that we need to create a plan that keeps kids and other people and things safe even as we continue to challenge their avoidance. (I will add that when a child blows up their fears so we take it seriously, they are also blowing those fears up for themselves. I don’t know how many of you read Anne of Green Gables. But there’s a chapter where she’s imagined a haunted forest and she’s done such a good job of imagining it that she is terrified to walk through the woods. Her imagination has run away with her. Our anxious kids do this, too. And sometimes that manipulative behavior may raise things to another level not just for us but for them.)

So I guess what I’m saying is that the question isn’t helpful because a child can be both anxious and manipulative and being manipulative doesn’t mean that your child’s struggle isn’t real.

When things get to this level of crisis, it’s time to get help. This is just such a difficult place to be as a parent and as the child or teen whose behaviors have become so damaging.

If you’re curious where your family falls in the Parenting Pitfall quiz, which is about the family patterns that keeps us stuck in child or teen anxiety, I’d love for you to come by the site and take the quiz. If you have questions about your results, let me know. You’ll also have the opportunity to sign up for the free Get Yourself Grounded email course when you complete the quiz but you don’t have to fill anything out — like your name or email — just to take it or to get the results.

Is my child manipulating me? Read More »

Is it ok if I miss school because of anxiety?

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This is from a message I received on the podcast page from a young teen, facing down the start of school and feeling overwhelmed. I don’t have more info from this person about their anxiety like how it started or the shape of it or how they’ve dealt with it so far. I do know that they’re going to be a sophomore this upcoming year and that they are looking for support to tell their parents that it’s ok for them to take a break when they need it.

First, young friend, I’m sorry that you’re struggling. I also struggled with going to school at around your age and used to beg my mom to let me stay home. I want you to know that I hear you and I support you in figuring this out. I hope that you will continue to talk to your parents and I encourage you to think about getting counseling. If your parents aren’t willing or able to help you connect with a counselor, I hope you will reach out to your guidance counselor at school. And if that doesn’t feel accessible or appropriate to you, there are lots of great workbooks about anxiety and you can look on Amazon at reviews or go to the library to check them out.

The important thing for you to know is that ultimately anxiety needs to be faced. I don’t mean in a pull yourself up by your bootstraps kind of way or a tough love kind of way, I mean that the cure for anxiety is learning to deal with your anxiety. That’s the crux of it. How you do that is very personal and doesn’t need to be all or nothing. Just hold it in your mind that facing your anxiety is going to ultimately help and then you can think about how best to do it.

Some of us face anxiety in the same way we get into a cold pool — we just jump right in. We let ourselves get kind of smacked in the face with the discomfort and hang in there until we acclimate.

That is not me. That’s not generally how I do it. I’m a slow to warm person and when I get in a pool, I get in at the shallow end and creep my way towards the deep end slowly, slowly getting used to the water until it feels comfortable.

Both ways are totally legit. Both ways end up with us fully in the pool. So you get to think about the way you want to acclimate to anxiety. Most of us who are anxious are shallow end people. Our anxiety is so big and can feel so overwhelming that we need to start small. That’s just fine.

Which leads me to school. Again, I don’t know the details of your specific anxiety experience so I’m going to take about school refusal in a general way and I hope that you can make sense of it in the context of your unique experience.

Generally school refusal in the teen years is about social anxiety. For me there was some of that and also just a general disillusionment about school. It was hard to feel motivated to go when I wasn’t getting what I wanted out of it. Looking back, I wish I had reached out to the guidance counselor more and talked to them about what I needed to see if they could help me figure it out. That’s why I mention that as a first step.

But the social anxiety piece, that was complicated by some bullying I experienced in seventh and eighth grade that colored the way I saw my peers. That may be part of your experience, too, and if so my heart goes out to you. I want you to hear and to know that school is NOT representative of the so-called real world it’s preparing you for. School is school. Yes, there may always be mean people you’ll have to deal with but you’ll have more freedom to figure out HOW you want to deal with it when you’re an adult. OK? It really does get better and the people who say that your teen years are the best years of your life, well, I feel bad for them because their best years are behind them. For most of us, the teen years are tough years and life gets better as we get older. Truly. I’m telling you being a grown up isn’t as scary as you might think and actually is a lot of fun.

All right, back to anxiety.

Here’s the deal about missing school because of anxiety. When we avoid things because we are anxious about them, we are rewarding that avoidance so it gets harder and harder to face the scary thing. Avoidance begets avoidance. So I’m not able to advocate that as a coping mechanism.

That said, we can also consider what school is offering you. School is about academics and it’s about socializing. If a particular school experience is a poor fit for someone and that’s causing anxiety — like if the bullying is making school unsafe or a child or teen has learning needs that aren’t being addressed by the school — then pulling that person from school might make sense IF we have a plan for academics and socializing.

In other words, I wouldn’t recommend that a child or teen leave school to do fully online school alone at home without any social opportunities. And I do mean face-to-face opportunities, not just online ones.

Being online is fine, having online friends is great, but we all need the practice of socializing in real life.

We need to figure out how to manage social expectations around eye contact and back and forth conversation. That’s not to say that there is just one way to do that. I often talk to families whose children are neurodiverse and their needs are different and that’s fine. An autistic person shouldn’t be forced to mask but they do need to figure out how they want to support themselves while navigating social life. Like do they want to mask, do they want to work on specific social skills, do they want to figure out how to find a community that doesn’t demand this of them. Which is to say learning how and if you want to fit into the mainstream world is part of the job of growing up but also finding the places in the world that loves and accepts you is important, too. And those places do exist.

For example, sometimes when I’m working with families, we’re talking about ways to find a social support system for their child that will let their child be exactly who they are without demanding that they be different. There are spaces like this. They can be harder to find especially for people who live in small communities, but they’re out there.

Some of us do best with a wide circle of friends but lots of us are happy to have one or two people who really get us and can support us. That might mean finding a tutor who understands how we learn and can help us work with our skills and talents. That might mean finding a mentor who shares our passion for a specific hobby or topic.

If leaving school doesn’t make sense or truly isn’t available and you’re going to have to go, I still think looking outside of school for pro-social opportunities can help us deal with the social demands of school. It’s not as painful to eat alone in the cafeteria if we know that after school we’re going to go to the library and hang with our D&D group or go to choir practice or whatever activity where we can remember that school is not the end all and be all of our experience.

I know that’s big work and we’re talking about the day to day coping in going to school when you are anxious and would rather stay home.

Remember the metaphor of the pool. Think about ways to take baby steps. Again, your guidance counselor can be a help here. I hope they are. And parents can be advocates. And if you have one teacher who seems to get you, reach out to them. Back to baby steps. What do you need to get through your day at school. If you painted your ideal day at school — acknowledging that you’d rather not be at school but let’s just paint your ideal day there — what would help? Is it breaks? Is it being able to listen to your music sometimes? Is it being allowed to wear sunglasses or your hood up? Is there a particular class that is more challenging? Mapping our your day may help you come up with some specific coping tools to ease you into that cold swimming pool.

But full on avoidance isn’t it. Basically you’re going to need to think about how to face your anxiety as best you can.

I wish I could give you more specific advice but obviously that’s beyond the scope of a podcast so I hope that I’ve given you some places to start and some ideas. I’m thinking of you and know that other members of the listening audience are thinking of you, too.

If you need crisis support, please call 988 for local resources and help.

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Is failure to launch caused by anxiety?

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First let’s talk about what failure to launch is. What do we mean when we use that term? Failure to launch is generally used to describe a young adult child who is struggling with the transition to adulthood.

Maybe they’re struggling to get a job, to get their own housing. Maybe they meant to enroll in school and haven’t been able to or have dropped out. Sometimes parents talk about their adult children who have difficult connecting with people their own age or out in the quote real world. Perhaps they aren’t keeping up with their responsibilities at home like cooking for themselves or their family or cleaning up after themselves.

But failure to launch in itself isn’t a diagnosis. It’s more of a cultural description about our social expectations for older teens and young adults and the way that some individuals struggle with these expectations.

And speaking of culture, failure to launch only exists in the context of these expectations. Some families may expect adult children to live at home for some time. Some parents may have different goals for their adult children. But when I hear parents use that term — failure to launch — I understand what they’re describing is their family’s frustration and worry about that adult child’s functioning. And that adult child may share that worry or may not.

So why might an adult child struggle in this way?

Well, we need to acknowledge that there are factors outside of the individual that may create these problems. For example, it’s a lot more difficult to move out on your own then when I was a young adult. Back then minimum wage in Ohio was $3.35 and my share of the rent was $187.50. Now minimum wage here is $9.30 but if I lived in that apartment today my share of the rent would be around $1200. Which is to say it was much easier to launch in the past. So let’s definitely acknowledge that.

Now back to the original question, is failure to launch caused by anxiety? And the answer is maybe. Sure, sometimes. Or anxiety may play a part. Like all things, it’s complicated.

But let’s talk about anxiety, specifically young adult anxiety that keeps that person feeling trapped at home longer than they want or perhaps longer than their parents want. Yes, that’s a thing. Absolutely. And it deserves care and attention.

One of the reasons I don’t like the term “failure to launch” is because of its emphasis on FAILURE. And my experience in working with those families is that everyone is already feeling overwhelmed with the idea of failure. Parents are dealing with criticism — why haven’t you kicked that kid out of there already? Why are you holding them back? And certainly the young adults themselves are facing their own sense of failure in not accessing whatever it is they believe they should be able to access by now. Failure just isn’t really a helpful way to frame it. Instead, like all developmental challenges in growing up, we can consider where and how people are getting stuck.

If we’re talking about anxiety specifically, the idea of failure is going to make everyone much more anxious. I think it’s more helpful to talk about lagging skills. That is to say, that the adult child is needing to work on and improve specific skills that will help them move on and launch.

We’ve said before that anxiety is about avoidance and it’s also about dread. I hear more and more and more from older teens who have very real dread about the future. And it’s no wonder if you glance at the news. They’re worried about being able to handle the demands and some of them become so overwhelmed that they freeze. That’s anxiety. What they need from us is help to face those fears, tolerate the distress of stepping out of their comfort zone, and adults who believe in them.

As parents, when children — even adult children — are struggling or have struggled or have faced very real challenges and setbacks, it’s hard not to steel ourselves for more of that. We may unintentionally send a message that they are not prepared to handle the quote “real world” end quote. We may do this by rescuing them or by second guessing their choices when they do make an attempt to reach out. We may try to take charge by calling their bosses or college instructors or making ourselves necessary when really we’re supposed to be making ourselves obsolete.

These are hard lessons for parents. Again, with anxiety, it makes sense that we fall into these parenting pitfalls where we mean to help and instead perpetuate the anxiety. If we do too much caretaking, too much interfering, too much helping we end up sending the message that they can’t handle things on their own.

What I’ve heard some parents say when we talk about this is, But what if they CAN’T handle things on their own. What if they really can’t? Well, then we work on creating baby steps to move them forward and to put ourselves out of a job. It’s not an easy 1 – 2 – 3 kind of plan. It’s a tricky, sticky, deeply individualized plan.

I’d recommend that the adult child get their own counseling and that the parents get education and support, too, separately but complementary. The adult child has their own work to do but the parents will need to learn and understand how they can best support them in reaching their goals. If the adult child is unwilling to get counseling, the parents can still do their part and get their own help.

The SPACE program, which Child Anxiety Support is partially based on, has been shown to be effective in helping families who are struggling with launching. You can see what I have to offer or go to spacetreatment.net to find other practitioners doing this work.

Is failure to launch caused by anxiety? Read More »

How do you distinguish between ADHD and anxiety in children?

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This is a great question because ADHD — Attention-Deficit/Hyperactivity Disorder — is often co-occuring with anxiety in kids and in adults but they can also look very similar. Let’s dig into that a little bit. Let’s talk about the ways anxiety can look similar to ADD or ADHD? Well, some of the symptoms show up in both diagnosis. Symptoms like:

Fidgeting
Distraction
Difficulty keeping track of things
Do not seem to listen
Problems staying focused
Problems staying organized
Forgetfulness
Impulsivity

These symptoms are present in ADD and ADHD because the child’s brain works differently. They tend to struggle with executive functioning, which basically means the part of their brain that does the planning and organizing works differently than neurotypical people. People with ADD/ADHD may be able to hold a lot of thoughts at once — I tell kids it means they have a busy brain — and tend to struggle with staying on task. This can be confusing since they also are able to hyper focus, which means to put all of their attention on one thing no matter what else is going on. This is the child who can lose themselves in building legos even if there is a literal tornado going on around them.

Ok back to the symptoms that are also present in Anxiety.

Anxious children may also fidget, get distracted, have trouble focusing, listening, being organized and keeping track of things. They may be forgetful. This is because they are on high alert. Anxious children are often keyed up. They may be quick to respond to perceived threats so may seem impulsive. They may also struggle with executive functioning because their planning, organized brain is off-line since they are living in their more reactive brain. Anxious children may spend a lot of time in fight, flight, or freeze mode and so they aren’t thinking with their calm, cool and collected higher order brain.

It gets even more complicated when we consider that about one third of those who are diagnosed with ADD/ADHD also meet criteria for an anxiety diagnosis. There are some studies that indicate that number might be even higher.

Let’s consider why this might be true.

First of all, we live in a world where we expect people to have neurotypical brains. That means our systems — our schools, our workplaces, our childcare centers, our parenting books — assume that we all have brains that function like the average brain. Those children and teens whose brains work differently have to contend with being quote WRONG end quote. They may not get the circle time activities, or appreciate the social nuances of middle school. They may not get why the workplace protocol operates the way it does. They may feel like square pegs getting shoved into round holes and that can create real anxiety. If they feel that they are always missing the point or missing the boat, that’s going to make them feel anxious about their day to day functioning.

Think of a child who struggles with impulsivity. They are the kids who are reaching out to touch the museum display before you can tell them, “Don’t touch!” They are often in trouble and aren’t sure why or how to be different. You can see how it would make a person anxious, right?

The other thing is that this high impulsivity — this immediate jump from a thought to a behavior — can also happen with an immediate jump from a thought to another more anxious thought. If a child has anxiety and has ADD/ADH, they are more likely for feelings to run away with them. If they think about a dinosaur, they may immediately go to thinking about being eaten by a dinosaur. That executive functioning that helps them slow down and be logical isn’t as strong as that impulsivity.

Remember in previous episodes we’ve talked about the information processing bias the comes with anxiety — anxious brains tend to be more negative, spotting potential danger even in neutral situations. As you can imagine, when ADD/ADHD is also present, it’s simply easier to jump to the worst possible conclusion more quickly.

Where it definitely matters is when we’re thinking about medication. Stimulant medication, which we use to treat ADD/ADHD, can make anxiety worse. But that’s a discussion to have with your doctor.

It also matters when we’re talking about school accommodations since your child or teen will need to have an assessment and diagnosis in order to inform the IEP or 504 plans.

But when it comes to treatment, we’re addressing the child and their symptoms and having a clear diagnosis may help with case conceptualization but those of us who work with kids tend to expect things to overlap and be complicated. Knowing if it’s anxiety or if it’s ADD/ADHD may be less important than trying things to see if they’ll work. Sometimes it’s in trying things that we learn what is the most pressing issue. I can think of times when I was working with a child who came to me with an ADD/ADHD diagnosis and as we dove in and made plans with their parents to address their concerns and their child’s challenges, we were able to figure out where anxiety was most present and how to address it with each individual child. In other words, often it is through working with the child that we are able to make recommendations for a better diagnosis and case conceptualization.

How do you distinguish between ADHD and anxiety in children? Read More »

How do I make a decision about anxiety medication for my child?

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This is not a question that I can easily answer for the podcast because not only am I not a prescriber, but I haven’t met your child or teen.

I personally feel very cautious about treating child anxiety with medication andI definitely don’t think you should rely on a podcast for that information. Think of this just as a kind of intro; ultimately you need to reach out to your child’s doctor and talk to them about it.

When you’re thinking about medication for your child, what that means obviously is that you and your child are struggling in some way and you’re wanting to know how best to help.

It’s important to understand that medication is not a cure for anxiety. It’s not like having a headache and taking ibuprofen, and then you feel better. Medication is part of an anxiety treatment plan.

Not every child who meets clinical criteria for an anxiety diagnosis is going to need or benefit from medication. Again, this is very personal. It depends very much on the child and on their environment and on what else might be going on.

The first thing you should do. Is make sure that what you’re dealing with, what your child is dealing with is in fact anxiety.

Anxiety sometimes gets misdiagnosed as other things. Other things sometimes get misdiagnosed as anxiety. So if you’re considering medication, your child is going to need a thorough assessment from someone who is able to do that, and that would be a counselor or a social worker, a psychologist.

If you wanted to a full neuro psych workup, that would be someone who is sitting with your child and doing a full assessment of how their brain works, how they might be struggling, what their strengths are. Honestly, I think that is really your best bet when you’re thinking about medication, because a neuro psych is going to be qualified to also diagnose ADHD and autism spectrum disorders. Counselors, and social workers are able to do some of that depending on their training, but a neuro psych has that background and the ability to do the full workup. If your child is seeing a counselor, obviously that counselor will know them really well but a neuro-psych is doing a more formal assessment.

Before you go to medication, it’s important that you try other avenues first. Having your child meet with a counselor for treatment would be a great thing to do.

Talk therapy, play therapy, basically cognitive behavioral therapy in whatever form is most accessible for your child is a first step in treatment. Also, and you know that I’m going to mention this, you getting your support in order to make sure that your family is creating the healthiest systems for your anxious child is also a first course of treatment.

A program like mine or another kind of support group, working with your own counselor, family therapy — these are all things to do to make sure that your child is getting the skills that they need. Those are the first steps before you look at medication.

If it does turn out that it is an appropriate treatment for your child, there is no one who will say, just give your kids the meds and don’t do anything else because meds are only part of it. our child is also going to need to learn their skills. You are going to have to need to learn your skills. And then together with the people who are helping your family, you can start thinking about medication.

I’m going to link here to a PDF made available by the American academy of child and adolescent psychiatry. That is their specific guide on treating anxiety disorders with medication, and they’re going to give you information about what medications are available and how they work and how to get access to them.

A really important thing to know is that there aren’t really a lot of medications that are FDA approved for children, particularly younger children. Now that said there are medications that people use off-label that means it hasn’t specifically been approved for the treatment of kids by the FDA. But there are studies that show that they can be effective and the physician prescribing it believes they can be effective. They are using evidence-based information to make that decision. But you do need to know that because as you’re making your decisions, you should have all the facts right in front of you.

If the child or teenoes meet criteria for medication to be part of their treatment plan the goal is the calm down the anxiety enough for them to access their other treatment, their counseling, their cognitive behavioral therapy and the skills that you’re working at at home,

That is to say that medication alone is not the recommended form of treatment for kids; it’s medication, along with something else.

You need to have a plan for who else is going to be supporting your child. What is the plan to get them off medication eventually? Is that going to be part of the plan? Maybe it is, maybe it isn’t — that’s between you and your child’s prescribe and of course your child, as they get older and have more decision-making about their medication. But sometimes we’re going to use medication or a shorter time so the child can access those skills with the hope to eventually take them off their medication.

Sometimes we’re doing medication for a very short time over specific anxious periods, such as the child who needs to get on a plane or is dealing with short term things that are really difficult.

Generally when children are prescribed for anxiety, they are given antidepressants and those are the SSRI. Or the SNRI and those change the chemical neurotransmitters in their brain to help regulate anxiety, mood, and social behavior.

Children who are on SSR eyes, sometimes show an increase of suicidal ideation. Don’t be so alarmed by that, that you say, absolutely I am not going to allow my child to get on medication. No, it just means that if medication is appropriate for your child, you need to have a plan about that and in that case, I do strongly recommend counseling.

If the child is on SSRI, I think that it is just that much more important to make sure they’re in counseling. So there’s someone else’s eyes on them, someone who is trained to assess for suicidality and who can support your family in just keeping an eye on your child.

Another medication that sometimes children are prescribed are Benzodiazepines, we sometimes call those benzos. Those are used for short-term treatment because they can be addictive. And also sometimes the prescriber will say we’re just going to use Benadryl. So if the child is scared of flying and they need to take a flight, That the doctor may say, we’re just going to do some Benadryl or we’re going to do some beta blockers or something like that.

Those are short term solutions, the SSRI. And SNR eyes tend to be longer-term solution. Benzos, benadryl things like that are kind of one-off medications that might be used in specific circumstances.

Again, these are things you need to talk about with doctor with because treating anxiety is complicated, which goes to, how do you find someone to prescribe this for your kids?

If your child is going to get medication for mental health then that prescribers should be someone with a psychiatric background, whether that’s an actual child psychiatrist, or a psychiatric nurse practitioner. I think it’s best to go with those kinds of doctors because they do get more training about psychiatric medication and specifically how to prescribe those for growing kids and how to change things up as the child continues to grow.

I know it can be hard to find a prescriber and sometimes the wait lists are really long so first I encourage you to go to your child’s general practitioner or pediatrician and start the conversation. They may be able to get you in somewhere more quickly. They may feel comfortable making those prescriptions themselves and supervising them and then that’s a conversation to have with them. Why they feel comfortable doing that, how they would know if they weren’t comfortable doing that, what are special things you need to look for?

I think it’s also important to know that all of us who work with anxious kids, anxious families. We are seeing them through the lens of our background. Because I have a clinical, mental health counseling background, I see it through the lens of counseling. How can I support families in shifting those patterns? What kind of psycho-education can I offer what is the longterm treatment plan and bringing those skills to kids?

However, when you talk to a medical prescriber, they’re going to see it through the context of their medical training and background. So they may recommend meds and maybe that’s the right choice, maybe it isn’t, but that is how they’re going to see it. They’re going to see it from a medication standpoint.

You get to ultimately make the decision for your kid. You can talk to a therapist and you should, you can talk to a doctor and you should, you can talk to your child’s teacher, their school counselor, but ultimately you’re going to make the decision. So ask yourself, What is the information I am missing that will help me make that decision. What are the questions I have that need to be answered? What are the concerns that I need to have addressed? And I think it’s really important when we’re talking about meds to say. How will we know if it’s not working? What will our plan B be? And how will we get the child off them? If this is going to be a temporary plan?

I hope this was helpful if you have other questions please post them and I’ll be happy to answer them on a future podcast

How do I make a decision about anxiety medication for my child? Read More »

Dawn Friedman MSEd

What causes child anxiety and how do you fix it?

Why does my child’s anxiety make my anxiety worse?

What should we do about our anxious child’s negative self talk?

Why is that parents get blamed for their child’s anxiety?

Am I being protective or over protective?

Is my child manipulating me?

Is failure to launch caused by anxiety?

How do you distinguish between ADHD and anxiety in children?

How do I make a decision about anxiety medication for my child?

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

Are you?

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Dawn Friedman MSEd

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

Follow Me

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

Are you?