Getting to the root cause of a child’s anxiety

Last week I explored the nature of anxiety. I discussed the amygdala and how we are hardwired to experience a bout of anxiety from time to time. In this week’s column I am going to outline how parents can support their child suffering with anxiety.

If we step back from the disorder it does seem like we are in the middle of an epidemic. It is by far the most recurring issue I see in my own clinic. 

Parents often come to me exhausted and worried because they really do not know what to do about the child in the family that is anxious all the time.

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And it can be very unsettling, as a parent, to watch your child struggle with basic everyday activities like going to school or meeting friends at the weekend.

I find more and more students are finding school extremely challenging. And it can be quite difficult when you hear a young teenager describe their absolute opposition to the routine of the school day.

What do you say to a teenager who describes how they feel sick at the thought of being stuck in school for eight hours a day without any possibility of escape and where they have to ask permission

to go to the toilet? I know I find it challenging myself, hearing a young boy delineate feelings of confinement and banal regularity, where they feel straightjacketed and stuck on a conveyor belt. Is my job to convince them that their feelings are not valid, when I agree with them?

But they have to go to school and they have to get used to the day-in and day-out routine of life, because as we all know that is a considerable part of the adult world. 

So why are they struggling more than ever with going to school today?

A lot of the issues with school refusal are rooted in the child’s reluctance to separate from a parent, in particular the mother.

This idea of separation is an important one when looking at anxiety. When you think of the child in your house experiencing anxiety, are they connected more to one parent? A significant psychological idea to think about is that of enmeshment. This can form when an unhealthy relationship develops between child and parent. When boundaries are ambiguous between parent and child, the child can find it difficult to form its own identity free from a parent.

Therefore the idea of leaving home provokes incredible anxiety. It is so important in the formative years that parents begin to allow the child to experience, something I like to call ‘a held autonomy’.

You don’t want to give the child too much autonomy because they don’t have the skills yet to manage that but it is very desirable to give them the confidence to explore their own merging identity. Being in a healthy family system is about allowing space for your child to be a part of and separate from that system.

When this doesn’t occur, separation becomes incredibly problematic for the child. So thinking about who your child is more attached to and slowly changing the dynamic of that relationship can significantly alleviate the anxiety they are experiencing.

There is no doubt about it, separating from parents is probably one of the most difficult and stress inducing life events a child goes through in their journey to adulthood. And I think that is one of the most salient reasons we have so many children refusing to go to school at the moment.

Three important ideas to think about for supporting your child with anxiety:

1. Is your child trying to prove something to someone? I have heard, over the years, so many young adults describing how they desperately want to prove themselves to their parents. This pursuit causes them such anxiety and ultimately ends in the child becoming further frustrated because they never receive the reward they are after. A question I often ask a teenager is; when you come first, or get that top grade who is it you want to be the first person to tell? The answer to this will generally reveal the source of their anxiety.

2. Perfectionism: Often children get caught trying to be perfect because they fundamentally believe something negative about themselves. The pursuit of perfectionism is a way of elevating that negative held belief. They mistakenly come to think that if every aspect of their life is perfect and in order it will ameliorate the part that causes them anxiety.

3. Your reaction to your child’s fear or anxiety is incredibly important. If you are anxiously walking your child up to the school gates because you fear they will become anxious you are analogically (body language) giving your child the message that they are right to be fearful.

I tell parents they must not let all conversations be consumed with whatever it is their child is struggling with. Restrict the amount of time given to talking about the anxiety.

It is not going to leave your child forever. You cannot defeat it, but it is important that you help your child to learn to live with it. And, as I said last week, when you view it as something that is transient and non fatal you can turn it into a source of power.

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