Dr Martine Prunty
Taming the toddler worries – a crash course in managing anxiety
Think about any situation that you may feel anxious about – needles? planes? heights? spiders? closed spaces? These are common fears adults face. If you said yes to any of these, you would understand the lengths you take to avoid these situations. Children do the same and no amount of coaxing, reassuring or accommodating from their parents will ease their distress the next time this situation pops up.
Children tend to grow into their fears unless they are taught how to manage their worries and outsmart the tricks the brain can play. Before long, anxiety can become a family affair as it limits the activities everyone can participate in.
Nature and nurture both play a role in the appearance of anxiety in children. There is a genetic component that may be passed on, or a pregnancy full of constant stress, which can trigger anxiety in children. There is also a component of anxiety that is learned and inadvertently taught by parents who are prone to anxiety and who model this behaviour to their children.
Anxiety and fear are the body’s way of alerting us to danger. So it’s very important that we have this response, when we are in actual DANGER. However, if your child is being alerted whenever a light gets switched off and it’s dark, or when you leave the room, or if they see an animal in a petting zoo (just a few common examples), these children are experiencing a perception of threat and danger when there really isn’t one. In order to cope kids start avoiding whatever provokes the anxiety response; e.g. the child who is afraid of the dark only sleeping with the lights on. Understandably, being the exhausted parents that we are, we think, “whatever! Sleep with the light on! Just sleep!”. Most of the time this is fine and the phase will pass. However, in those children that are overly anxious, when children are allowed to avoid feared situations they never learn to tolerate what their anxiety feels like and they become fearful of fear itself. Over time as anxiety takes its hold, it can lead to not trying new things or not being willing to experience new situations.
Assisting your child to overcome their worries takes time and requires effort on your part to remain consistent with your approach in helping them. The first thing I would recommend is to develop a language to talk about worries. This helps everyone understand what is happening and gives you a chance to explain that having worries is a normal thing to experience. Help them to describe what it feels like when they get worried – it might feel like a fluttery, sick feeling in their stomach, they might get headaches, feel dizzy or tingly in their hands or notice that their breathing has gotten faster.
A second step is to try and elicit what the fear actually is, because it helps to guide you in what you do next. For example, one child might be afraid of the dark because they believe in monsters, whereas another child might be afraid of the dark because they think you have left. Both very distressing thoughts - if they were true (could you imagine?? Monsters??? Awful!) but the motive is different. When a child imagines something scary, they can’t tell if the threat is real or imaginary. That is the magic of anxiety; it contains a high degree of irrationality.
The key to helping your child overcome their worries is helping them to recognize when a fear is healthy and truthful - when a dog is barking viciously at them - or unrealistic and imaginary, like the mere sight of a dog.
Encourage your children to face their fears, starting with small goals and building up to more anxiety-provoking situations. In the fear of the dark example, you might start with staying with them in the semi-dark, then slowly moving away until they can tolerate you being by the door in the semi-dark, and building right up to standing in pitch black, alone for 1 minute. These fear ladders take time and moving up a rung in the ladder is more important than the time taken to get to the top. Having small goals is key because you want them to succeed so they are more willing to climb their worry ladder.
Your end goal as your child grows up is not for them to never feel anxious, but to recognize when they are experiencing anxiety, to stay in the feared situation so that they can experience their symptoms slowly subside, and see that they can cope. A healthy way to think about it is that while anxiety feels terribly unpleasant, it is not dangerous.
That goes for you too parents! Except for when it comes to spiders, right??