Monsters and mid-terms: Helping your child cope with anxiety

For adults, stress is an inescapable fact of life. Jesus Himself acknowledged this reality over 2,000 years ago when He said, "In this world you will have trouble . . ." Nowadays, however, it’s not only adults who are beset by worries: stress is also exacting a heavy toll on our kids.

At Halifax’s Dalhousie University, psychologists estimate that 8 to 10 per cent of Canadian children (ages 2-12) already have a diagnosable anxiety disorder. Among adolescents, the estimates are similar: 8 to 10 per cent qualify for treatment.¹

What’s particularly troubling about anxiety in children is that it often goes undetected. Parents – and often even the anxious child too – may not recognize the symptoms of growing angst. The child’s frequent tummy aches remain a mystery. Or the child simply complains I don't like school, because they have no words to describe the "weird" feelings they experience in the classroom.

Other children and teens deliberately hide their distress. A straight-A student may never reveal their gnawing dread of getting a low mark on their next assignment.

Children plagued by uncontrollable worries, and who soldier on in secret, carry a heavy burden all alone. In addition to the anguish of living with persistent fear, anxious children often have difficulty making friends, are more likely to be targeted by bullies, and tend to underachieve in school. Without help, an anxious child has a 50-50 chance of spiralling into depression. Especially chilling are studies conducted in multiple countries that have all come to the same conclusion: a long-term anxiety disorder is the number one predictor of adolescent suicide.²

As parents, we need to be proactive. Whether we detect unusual anxiousness in our children or not, we need to teach our kids how to recognize and discuss anxiety, and how to manage stress well.

Here’s a look at some practical ways we can guide our kids into the second half of John 16:33: "In this world you will have trouble. But take heart! I have overcome the world."

Managing feelings of anxiety

On their website at AnxietyCanada.com, the Anxiety Disorders Association of British Columbia provides comprehensive guidelines to help parents educate their children about anxiety. These are some of the basic steps they recommend (and discuss in detail on their website):

Help your child recognize the feelings that accompany anxiety. Help them correctly name those sensations as worry, nervousness or anxiety. (Even teens may falsely conclude there’s something wrong with their heart, when they are merely experiencing their body’s perfectly normal response to stress.) Commonplace symptoms to point out include:

• A feeling of light-headedness (parents will notice dilated pupils, face goes pale)
• Breathing becomes fast and shallow; heart rate increases dramatically
• Muscles tighten (and sometimes cramp)
• Sweating increases; stomach acids increase, often causing stomach aches
• Child loses ability to think clearly; experiences compulsions to flee or fight

Emphasize that anxiety is normal – that it’s something everybody experiences. Share your own experiences with anxiety, and how you deal with it. 

Emphasize that anxiety is good – that God designed this "early warning system" to keep us safe: to motivate us to do the things we should do, and avoid things that could be harmful.

Help your child recognize pessimistic thoughts and replace them with realistic or optimistic thoughts. Show your child how to become their own "coach," cheering themself on with positive self-talk. Help them memorize some of the many promises from God about trusting Him. Here are just a few ideas:

• Deuteronomy 31:8; Isaiah 41:13; Psalm 56:3; Hebrews 13:6
• This is hard, but I can do it.
• I can do this. I just need to try. And Jesus is here to help me.
• I'm not giving up. I will get through this.

Teach self-calming skills such as slow breathing and relaxation strategies. 

Recognizing causes of anxiety

Vancouver-based developmental psychologist Dr. Gordon Neufeld has developed some compelling theories about causes of anxiety in children, and how to deal with anxiety constructively. Based on a 40-year career working with children and youth, Neufeld has concluded that intense anxiety in children is very often rooted in what he calls attachment alarm.³

Attachment alarm arises when a child fears physical or emotional separation from someone very important to them. By way of example, here are a few common fears often rooted in attachment anxiety:

• fear of sleeping alone – often coinciding with a fear of the dark
  (the real issue is physical separation from mom and dad)
• fear of a first sleep-over
  (real issue: separation from one or both parents)
• fearful after a rebuke from a teacher
  (real issue: the child concludes My teacher no longer likes me / never did like me)
• school performance anxiety
  (real issue: the child concludes To maintain my parents' love / my peers' respect / my own self-respect, I must continue to get good grades. I only matter if I do well.)
• fear of not appearing "cool" or of being humiliated in class
  (real issue: potential rejection by peers – a particularly intense fear for tweens and teens)
• concern over parents’ separation or divorce
  (real issue: separation from at least one parent)
• fear of death
  (the ultimate separation from those we love)
• fear of illness, or even germs
  (real issue: the possibility that illness will lead to death)

It’s important to note that a threat need not actually exist to spark attachment alarm in a child. If the child believes they are in danger of losing a significant relationship, the threat becomes real to the child.

• For example: Following the birth of a younger sibling, the older child may begin to fear that they no longer matter to Mommy and Daddy. In reality, this is not true at all, but it’s what the child perceives that matters.

If you notice a sudden upswing in anxiety in your child, consider any recent changes that impact your child’s relationships. Attachment alarm may well be the real source of your child’s concern. (Keep in mind though that your child – or even your teen – may not recognize that an attachment issue is the true root cause of their anxiety.)

Healing (and protecting against) severe attachment anxiety is a sizeable topic in and of itself. Here are a few fundamentals:

• Frequently reassure your child that you will always love them.
• Deal with bedtime issues by choosing strategies that help your child feel that they are still connected to you when they’re sleeping in their own room. Perhaps place a baby monitor beside their bed and reassure your child that you can hear them, even if they can’t hear you.
• Be sure to continue to show love and appreciation for your child throughout their teen years. Your reassurance of your child’s worth will make them much more resilient to rejection by peers.
• Never discipline your child by threatening (or implying) long-term separation from you or withdrawal of your love.
• If dwelling on the possibility of your death becomes a major source of anxiety for your child, reassure them that you would continue to love them from heaven. Consider discussing with your child who would care for them in the event of your death. Stress to your child how much that designated caregiver loves them, and how well they would look after your child.

Taking action in response to anxiety

In addition to helping your child manage feelings of anxiety, and determining the true nature of your child’s anxiety, it’s also important to help children choose the right response to anxiety. Anxiety is meant to motivate us to action – to make us move out of danger or take another wise course of action – so that we again find peace and calm.

According to Dr. Neufeld, we should ideally respond to anxiety in one of three ways, depending on the circumstances:

When facing anxiety we should either

• exercise caution, or
• grieve what we cannot change (so we can adapt and move on), or
• summon courage and face the thing we fear.
  
  

Exercising caution: The first option, exercising caution, isn’t difficult to understand. It simply means taking appropriate action to get out of trouble or danger.

• For example: A parent might shout sternly when witnessing their child jabbing a knife into the kitchen table. The child is initially startled and alarmed, but quickly decides to avoid similar unpleasantness in the future by never cutting the table again.
• To use another example, a child may feel growing alarm about a looming exam. She decides to start studying right away, and that sensible choice helps allay most of her anxiety.

Grieving what cannot change: This second potential response to anxiety is much less obvious, yet it has profound implications for parents. When a child is excessively worried about something inevitable and outside the child’s control, Neufeld emphasizes that parents should help the child fully grieve any unavoidable disappointments:

"We are meant to come to terms with those things we cannot change, and so the sadness and disappointment is actually an end point to alarm. . . . Resilience is built through those tears, and a child begins to be more resourceful. He’s moved to find other ways of dealing with the situation."

You’ll recall (from the earlier discussion about attachment alarm) that many of our deepest fears, as well as our most profound sorrows, centre around the loss of significant relationships. These types of losses almost always need to be grieved before we can accept, and adapt to, our "new normal." Never minimize this type of loss, but "make room" for your child to grieve.

• Examples of unavoidable stresses that may need to be grieved deeply before the child can move on:
  • moving home and/or school (loss of friends)
  • rejection by a long-time boyfriend or girlfriend
  • death of a close relative or friend
  • child’s parents separating

Finding courage: This third potential response to anxiety comes into play when fear prevents your child from reaching a desirable goal.

• For example, your child may want to attend summer camp with a friend, but at the same time, is desperately afraid of being away from home for so long.

To help your child find courage, advises Neufeld, help them focus on the reward, rather than the fear. Begin early, so you can have multiple leisurely discussions about the rewards of facing the challenge, while the challenge still lies in the not-too-distant future. Acknowledge to your child that yes, they will be a little afraid, but convince your child that the rewards of following through will be more than worth it. Show confidence in your child – that you believe they’re up to the challenge.

One important point to remember, however, is that finding courage in the face of fear requires a child to keep two thoughts in mind at once: the fear and the desire. Neufeld warns that for many children under seven years old, their brain is simply not yet mature enough for this feat.

1. Bagnell, A., Kutcher, S. and Garcia-Ortega, I.: Identification, Diagnosis & Treatment of Childhood Anxiety Disorders: A Package for First Contact Health Providers. General Practices Services Committee Report, 2011.

2. Miller, Lynn D: Worries and Woes: Identifying and Preventing Anxiety in Children. Presentation for the F.O.R.C.E. Society for Kids’ Mental Health monthly networking and information sharing session "in the know," 2013.

3. Neufeld, G.: Making Sense of Anxiety in Children and Youth. DVD seminar produced by the Neufeld Institute, 2012.

For a much more in-depth understanding of your anxious child, we recommend Dr. Gordon Neufeld’s DVD seminar entitled Making Sense of Anxiety in Children and Youth, available at Neufeldinstitute.com.