Books To help kids Understand Anxiety, Worries, Fears
Children can be expected to experience situations causing some anxiety, fear, or worry during the natural course of their development. However, some young children have excessive anxiety about separation from their home or a parent. They experience intense distress in anticipation of, for example, going to daycare or school, or visiting a friend. They may even be anxious about being in a different room from the parent during the day or at bedtime. Their anxious thoughts as associated with unpleasant sensations – such as stomachaches, nausea, headaches, and rapid heartbeat – which in itself can be frightening for the child.
Children’s anxiety is related to their understanding of and thoughts about a situation, as well as their sense of competence to deal with it. Sometimes it appears to coincide with a specific event, such as an accident. Or the fear of separation may be a deflection of general distress relating to school, peer conflict, family stress, moving, loss of a pet, or any other significant even that makes the child feel an urgent need for reassurance and support.
Worry thoughts – “What if I get lost?” “What if you have an accident?” – increase the child’s distress. The thoughts and images in the mind become the child’s focus. At their young age, it’s hard for them to filter out fears that are improbable.
Parents may understandably become upset, fatigued, and frustrated while attempting to understand, reason, and negotiate with the clinging child. Unfortunately, expressing anger or attempting to set strict limits only raises the child’s distress. Also, a reward system featuring sticker charts and prizes for compliance may work for mild levels of anxiety but is often not helpful when the child is in a state of panic.
An alternate approach emphasizes correcting the worry thoughts and images that cause the anxiety. With this approach, parents help their children practice “realistic thoughts” that decrease rather than increase anxiety. Calming imagery, relaxation exercises such as deep breathing, and self comforting activities such as drawing or hugging a blanket are also helpful. And finally, the child is encouraged to gather evidence against the worry thoughts.
The ideas and strategies suggested in the book “When Fuzzy was Afraid of Losing His Mother,” are based on a cognitive behavioral approach, which is frequently used in the treatment of anxiety. The basic principles are that thoughts, feelings, and behaviors are casually interrelated, and that new learning experiences with positive outcomes can be designated to change these thoughts, feelings, and behaviors in a healthy manner.
Ideas and Guidelines for Parents:
- Listen to your child’s thoughts with respect. Help him label his feelings and describe physical sensations. Give reassurances: “I’m sorry you feel so upset. We can find ways to make you feel better.”
- Rule out potential medical problems with the pediatrician, and think about what could be happening at home or school. Attempt to reduce stressors at home, and work with the school or daycare as needed. Talk with your child about any identified causes for the anxiety in simple terms.
- Correct your child’s misconceptions by giving evidence. If she asks, “What if you don’y come home? you can respond with “I have come home (multiply 365 days by her age) days. So, it is likely I’ll come home today.”
- Play the “Likely or unlikely” game, taking turns asking silly questions. Focus on fantasy versus probability. For example: “Is it likely that an elephant will come into the kitchen?” “Is it likely you will brush your teeth today?”
- Because anxious children may hyperventilate or hold their breath, it’s important to practice relaxed breathing. Say: “Keep your eyes open. Now breathe in s-l-o-w-l-y and catch your breath in your tummy. Slowly breathe out again and feel your tummy muscles move.” Breathe with your child to demonstrate.
- Encourage your child to practice saying short “scripts” that are comforting to her, such as, “I only cried a little. I will be OK” or “Mom is thinking about me” or “My teacher looks after me.”
- Use humor to help your child relax, but avoid ridicule or sarcasm.
- Practice imagining simple, pleasing images, such as a puppy, balloon, flower, or stuffed toy. Think of these as calming photographs that can take the place of the scary photographs in the child’s mind.
- Provide objects that your child finds comforting, such as stuffed animals, a blanket, or something belonging to you. Provide comforting activities as well, such as playing with a pet, reading books, listening to story tapes, or working on a craft project.
- Notice healthy changes in your child and talk about them. “Did you notice that you managed?” or “Did you notice that your tummy is much calmer?” or “I noticed that you had fun playing with your friend today,” or “I noticed that you cried less when I needed to go out today. Didn’t that feel better?” These are questions that make the child aware of positive outcomes, which will help alter thoughts about the situation.
- Remember that progress seldom happens immediately, and that small setbacks are likely. There will be times when you and your child will feel frustrated and will need space and some time off.
- Create step-by-step challenges designed for success: for example, playing independently in different rooms in the home for gradually longer but realistic periods, or gradually introducing play-dates and activities outside of the home with increasing time and distance. Reassure your child about safe places and caregivers.
- Expand activities suited to her development stage, giving her an increased sense of competence and confidence.
- Occasionally review different coping tools with your child: comforting “self-talk” scripts, tummy breathing, imagery, evidence collecting, comforting articles, and so forth. Talk with him about ways he is managing to cope with anxiety and short periods of separation, and how much you are enjoying hearing about your child’s day.