Anxiety in Children
Promoting the social and emotional well being of children and young people
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Understanding Anxiety in Children
By Dr Rob Long
Some understanding of how our brain works will help us un-derstand how best to support our children in these unusual times; a bit like having some knowledge of ‘what’s under the bonnet’ of your car.
Our jungle brain and emotions
There is within every brain an ‘old brain’ often referred to as the ‘animal brain’. This is where our emotions come from. We can think of emotions as providing the energy to take action and help us to survive. That is their function. The emotions we all have are anger, anxiety, sadness, disgust and joy. Each of these evolved to help us survive. They evolved when we lived in the jungle and we faced dangers such as lions, snakes and food shortages.
So the emotion ‘anxiety’ signals potential danger and helps us escape from harmful situations. Our muscles tense, we breathe faster and our heart rate increases. Our body is put on a state of red alert, we are ready for action - the flight response. So as a result of the biology we have inherited we are all prone to anxiety. However, for a child these internal sensations can be distressing when they have no idea “why” their body is reacting like this.
The modern world and anxiety
We still have a brain that evolved to survive in the jungle, not in our modern world. If you like, we have not adapted fast enough. In the modern world we are not faced with lions, but terrorists, and in our present time, coronavirus. For all that we may be told that there is every chance that we, our children and our loved ones will not contract the virus, we are naturally and understandably in a state of some anxiety. This is a normal response to such conditions.
Children and anxiety
As children mature their use of language and ability to control how they feel increases, i.e. they develop self-regulation. For example we are not surprised that a two year old has a tan-trum when they are not allowed a treat. But by the time they are four years old, they are able to accept and wait for the treat. They now have language to understand and manage how they feel. With anxiety, language can be both a help and a hinderance. A child of seven or eight can now imagine ‘bad’ things happening to those who care for them, or themselves. They will have a very self-centred view of what is happening around them. Any threat or danger will be experienced as directed at them. So what is an abstract fear will be responded to in their bodies as a real fear. So hearing the news or listening in on adult conversations or trying to make sense of the changes taking place will result in a range of feelings, such as being scared, fearful, terrified and tense, which can all be seen as the surface symptoms of anxiety.
Why are some children more anxious than others?
We all inherit from our parents a unique nervous system. The ‘animal’ part of the brain triggers anxiety whenever there seems to be a threat, real or imagined. A false alarm is better than no alarm. Better to be safe than sorry. Think of it like a smoke detector. It is better to have nine false alarms and one for real—the benefits out way the costs. So some children will have inherited an over sensitive smoke alarm.
What ever happens to children becomes the norm; it is what they have learnt to expect. Getting up each day, getting ready for school and seeing your friends is part of the normal pattern of daily life. Routines make life predictable. “I know what will happen next so I do not need to think or worry about it.” Suddenly children find themselves being kept at home. They do not have a routine for how they are to be taught at home. A parent/carer trying to teach might hear their child say, “we don’t do it like that”.
Our children will need time, patience and support to adapt to these changes. So the question is, are there guidelines or ideas that can help.? If only there was a manual to solve this problem. However children are unique, each are at their own developmental stage, families are unique. So what might work in one family will not in another. The ideas presented here might work for you or suggest something that could. Use those that are helpful and leave and ignore those that do not seem to fit with your child or you.
So as we have seen, anxiety is a general feeling of apprehension or worry and is a normal reaction to stressful situations. The need to seek professional advice/support is when the feelings become excessive, thoughts become irrational and everyday functioning is debilitated.
12 PRACTICAL IDEAS FOR HOME
1. Talking About Coronavirus
There are many good resources to help guide you to-wards sensitive conversations. Here are a few key ones.
• Try to use words that you know your child knows and understands.
• Ask open ended questions. “Tell me what you know about this virus.”
• Be guided by their questions.
• Tell them not to worry.
• Ask too many questions.
• Listen when you are stressed/anxious
• Answer questions that are not asked.
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• Teach children deep breathing. Put their hand on their tummy and breath in through the nose to the count of 7. Then exhale through the mouth to the count of 10. Let them see their tummy rise and fall.
• Exercise: Anxiety will put tension into muscles ready for action. So some form of daily ‘work out’ is essential. Try an obstacle course.
• Muscle tension: Tense your toes as tight as you can, and then relax them. Feel the difference. Now tense the muscles in your legs, hold it to the count of 5. And relax. Feel the difference. Work through the different muscle groups in the body.
• Guided imagery: Ask your child to relax into a comfortable position and close their eyes. Now ask them to imagine themselves some-where where they feel really calm and happy. Ask them to describe where they are. What can they see? What sounds can they hear? Are they on their own? What are they wearing? What sounds can they hear? How do they feel inside? What does it feel like to be calm, relaxed and happy?
• Now ask them to cross their fingers and imagine themselves in their ”happy place”. The idea is that crossing the fingers becomes an anchor, so that when they do this they will be reminded of a good place with good feelings.
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3. Basic Needs
What makes a home a safe place for children?
Children feel safe when there are firm but fair boundaries. Naturally they need to be appropriate for the developmental stage of the child. There is a saying, ‘children without boundaries, go in search of them.’
• Showing you are in control and can manage difficult situations will help your children feel secure. If you panic they will also.
• Let them know that it is okay to be angry, and you will not let them hurt themselves or others.
• Being available is an important message, especially after a conflict.
• Help them understand that making mistakes is not a problem, it is often how we learn how to get it right.
• Let them know that they know best what they need, and you will help them achieve this.
Children need to know that they belong in your family, and that you are glad they are here.
• Leave unexpected messages under their pillow saying just this. For example: “I like you the way you are.”
• A practical idea is to wake them up in the morning showing your love and affection for them. This is a great start to any day.
• Being interested in their pastimes and hobbies, and spending time supporting them and encouraging them will help them feel happy to be with you.
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4. Being in control
At times of stress and anxiety having some degree of control can be a definite way of coping.
• The reason for hand wash frequently needs to be clearly explained and understood so that children see it as a way of taking control over the situation. Modelling it frequently and making it fun will help.
• Develop set responsibilities that they are in charge of on a daily basis.
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5. Information limitation
Children are exposed to a constant flood of information from numerous sources. With so much information linked to the coronavirus spread children are in danger of being over exposed as well as having difficulties making sense of all that they hear or see.
• As parents/carers we each have a responsibility to protect our children from information that is not suitable for them. The United Nations General
Assembly (1989) defined childhood as “ a separate space from adulthood” and recognised that what is appropriate for an adult may not be suitable for a child.
• So we have a duty of care to limit the amount of in-formation children receive on the coronavirus. Fam-ily limits on news reports and the like will be
needed. We will all benefit from this.
Children and parents:
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Routines are important as they make the day predictable. Knowing what will happen at different times removes a source of anxiety. This is especially true of children with additional needs. A good routine is a way of communicating to children that they are in a safe place and being cared for. It is also how children learn about the nature and function of different activities. Some tasks are for fun and play while others are for specific reasons, for example brushing your teeth. Good routines also teach children:
• Self-discipline, learning to wait.
• Time management - different activities have set times.
• Focus and concentration - set tasks are given priority at set times.
Involving your children in working out a time-table of routines will develop shared responsibility.
• If you are teaching your children it could be that learning tasks are interspersed through out the day.
• It is better to have a short learning activity that works than a longer stressful one. A guideline is two to three minutes per year of their age. That is the length of time a typical child can maintain focus. But remember, which child is ‘typical’?!
How to Set Up a Family Routine That Works
Normal Attention Span by Age
It is too easy for these difficult times to be remembered only for negative reasons. And we are over biased to remember bad news. So it would be good to acknowledge and record positive events. During this time your children will be developing, learning new skills and changing. Recording the positive things you do will capture these changes.
• Keep a diary or make a scrap book with your children. Take some photos to include. Keep their drawings/paintings or things they made.
When we reflect on these times it will be really good to be able to say to your children, “yes it was a difficult time, but look at some of the good things we achieved, what happy memories we made together as a family ‘in lockdown’.”
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8. Worry box
Children are still learning how to manage their feelings effectively. This is where language can be as much part of the problem as the solution. Being self-centred children will relate bad news to themselves and those who care for them. Like adults they are likely to fall into the 10 : 90 Rule. That is that 10% of life is what happens to you and 90% of life is decided by how you react to it. So, given the bias we have towards remembering bad things or things that threaten us, children are likely to increase their anxiety level through worrying that the virus will be caught by themselves or family members.
A Worry Box is a metaphor for those thoughts that are worrying a child. It is a way for children to learn that thoughts are just thoughts. Usually worrying thoughts are irrational. A thought that is not based on any evidence or realistic possibility of the thought becoming reality. The time when such thoughts take hold is often at night. When a child is busy engaged in different activities their mind is focussed, but at night worrying thoughts have a chance to preoccupy the mind. A Worry Box is a way of helping a child manage such thoughts.
• The box is a real box, either a tissue box or the like. It is decorated and each evening an adult will talk through any of the worrying thoughts their child has. These are written down on a note and put in the box. Putting it in the box means the child is told they do not need to think about it. In the morning check with them to see if the worry is still a worry, if it is keep it in the box, if not it can be torn up.
The Worry Box
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While opportunities for outside visits are curtailed, this could be an ideal time for families to rediscover ‘board games’. Social media activities can be too individual. Playing simple games together can teach important social skills such as, sharing, cooperating, turn taking, compromising and learning to cope with losing. You can take museum visits from the comfort of your front room as well as explore the natural world of amazing animals.
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10. Positive thinking
When anxiety takes hold of a child their thinking will become more and more negative. Their glass becomes half empty more and more often. But there are definite steps you can take to challenge this.
Positive thinking means that you ‘know’ that things will work out well, you expect you will manage the problems that you face. Positive thinkers, or optimists remember the past differently. Even when something went wrong, for example it rained on the picnic, they will remember the fun they had and the good food, unlike the pessimist who remembers just how wet it was in great detail.
Helping children to see that they have some control about what happens during this time of forced quarantine will help. We all hand wash often as a way of protecting ourselves: A positive thought that supports definite action.
• Teach your children that when they have an anxious thought to link it to a tune/song that makes them smile. It will take practice, but learning new habits will take time.
• Help children make a positive list about themselves.
One thing I like about myself is . . . . . . . .
A favourite family memory I have is when . . . .
I know I can. . . . . . .
One of my best qualities is . . . . . . .
A skill I have mastered is . . . . . . .
My friends like me because . . . . . . .
A recent problem I solved is . . . . .
Add more that apply to your children.
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11. Emergency fire drill
There will no doubt be times when the best laid plans just do not work. And because you can expect this to happen you have prepared for it. A worthwhile mantra to remember is that “if you can predict it, you can prevent it.” You mightn’t be able to prevent the crisis but you are prepared for it.
• So when anxiety seems to be winning and you can see by some of the tell tale signs that you need to do something fast, reach for your emergency pack. This is a pack you have ready. It contains a set of activities that you only use under these circumstances. Tell the child you will have to go and get the CAT.
Coping with Anxiety Tools (CAT)
This box might contain:
A favourite story book, DVD or film
A stress ball
A favourite piece of music
A painting activity
• With your child make your own unique CAT.
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12. Daily plan
• With all of the ideas shared here, and the many you are already using, it might be worth making a wall planner with your children.
• Remember the more they are involved in this project the more successful it will be.
How To Create A Family Calendar | Tips with TRACY
2019 Family Daily Planner
And some bonus ideas…..
• Place objects, pictures, photographs and the like that have positive memories around the home.
• Encourage children at the start of the day to set a positive intention: Perhaps helping someone, painting a picture, sending a ‘thank you’ to someone.
• Have special places allocated for different activities. Have a room or place that is the quiet corner; here reading and more restful activities can be done. Another can be for learning and another for games.
• If possible bring nature in doors. Fresh flowers are preferable but avoid spiky plants. If not prints/photos can be used instead. Nature has been found to have a calming effect.
• Play music that you and your family find uplifting and fun.
• Too much noise can have a negative effect on children’s ability to concentrate and learn, setting quiet times for everyone will help.
And finally in these strange and challenging times: