Clinical Psychologist Sarb Johal talks about why rates of anxiety in children have gone up so much recently. He answers listeners' questions about children and anxiety during lockdown.
Photo: Copyright: Evgeniya Kramar
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One parent says:
Recently my 12-year-old daughter pulled her eyelashes out, we have talked about different coping strategies and have written a list of ways to cope and distract when she's feeling stressed - is this uncommon behavior or common behavior?
"Certainly hair pulling, I'm not so sure about eyelash specifically, but hair pulling is not that uncommon.
"Often, people find the physical stimulation of something going on in their body more distracting and absorbing than perhaps the emotional experiences that they're going through.
"So often this can result in people doing things to their bodies, that are preferable to experiencing that emotional pain.
"But I would definitely recommend getting professional advice in that particular case.
"We know that one of the things that we try to do as parents is that we don't want to have children in distress. And so, we can do all kinds of things, in order to prevent that from happening. And some of that can sometimes unwittingly create a cycle in which actually, we're not decreasing the likelihood of anxiety, but we're just kind of putting it off in order to get the short-term win, of decreasing what's going on in the moment. But we're maybe putting off for a later date and storing up problems in the future."
Another listener says:
My seven-year-old daughter struggles with perfectionism, with most things that she does, she refuses help, she rejects suggestions or solutions, and her perceived failures seem to affect her self worth, she seems compelled to dwell on negative thoughts about herself, which is now disrupting her ability to self-regulate and to sleep. How do we balance being empathetic, whilst also not encouraging her feeling like she's a victim?
"What we're trying to do here is to not necessarily eliminate anxiety, because actually anxiety is a normal emotion, it's there around all the time.
"But what we don't want to do is to let it spiral up into something that's a disorder. Anxiety is a useful, necessary response to stress and uncertainty.
"So, what we need to do then is if we're starting really upstream, just for a second, let's talk about that what we want to do is when we're talking with our children to try to normalise communication, especially about emotions, so that your child feels comfortable coming to you with problems or for support to start off with.
"If your child does appear anxious, then having a think about what has changed in their lives in recent times. And to a certain extent, parents have to do the thinking for the child at that point.
"Certainly, you know, if you've got that communication with the child, you're getting clues as to what might be going on, what's changed.
"But the goal here is not to eliminate anxiety, but to help the child to manage it. And none of us wants to see a child unhappy. But the best way to help a child to overcome anxiety isn't to try to remove the stresses that trigger it, to help them to learn to tolerate their anxiety and to function as well as they can.
"So being realistic, but also encouraging them that they can still do things even when they're feeling anxious.
"As a byproduct of that, they'll start to learn that the anxiety is number one tolerable and number two starts to decrease or fall away over time, the more they get experience of doing things, whilst the anxiety is still around."
This listener says:
We live in Auckland, what if your child doesn't want to go outside because he thinks he will get Covid and he's scared to get the vaccine and worried about his transition back to school, my son's anxiety has grown a lot this year.
"One of the things that I would add to what I've already said is that we don't want to reinforce the child's fear. So, what we don't want to be saying with our tone of voice or body language is that maybe that this is something that you should be afraid of, given all the protection that we're putting in place.
"We also have to be realistic in that there is a small chance but we're doing everything that we can, and even if we do become ill, then there's a really, really good chance, an excellent chance that we won't become too ill.
"But one of the things that we can do is to try to keep the anticipatory period short. Because when we're afraid of something, the hardest time is just before we do it.
"So, another rule of thumb for parents to really think about is to try to eliminate or to reduce that anticipated period. So don't have a really long ramp up time where you're going to be talking about what it is that's going to be coming up which that child is finding anxiety provoking.
"So, if the child is nervous about going to school and getting ready for that and all the things that they're going to need to do or vaccination, then we don't want to launch into that discussion hours before, because it's likely to get your child more keyed up. Try to shorten that period to the minimum possible."
Alice says: What is a good approach to help our 11-year-old son who seems to be getting more anxious, and now has a near constant sore stomach?
"It's worth getting it checked out by a doctor to make sure that there's nothing else physically going wrong. But I think what you need to do is to, and it's difficult, again, is respecting the feelings of disturbance, however, they show themselves.
"Often children who perhaps don't feel comfortable, or don't have the language to express what's going on emotionally, feel more comfortable with the bodily expression of that, because that's what gets through, and also gets them what they want to do, which is to avoid the anxiety provoking experience.
"So, I guess the thing to remember here is that just because you're validating that they're feeling distressed, or there's something going on for them, which they're finding difficult, it doesn't mean that you agree with what their solution is.
"So if the child's terrified about whatever it is that they're going to do; going to the doctor or going to school, you don't want to belittle their fears, but you also don't want to amplify them.
"You want to listen and be empathetic but you want to encourage them to feel that they can face their fears, the message you want to send is I know you're scared, and that's okay and I'm here, and I'm going to help you to get through this.
"What we want to do here is not to ask leading questions. So not asking things like 'are you feeling anxious about going to school?' Because we want to avoid feeling that cycle of anxiety.
"So asking open-ended questions such as 'how are you feeling today about such and such?' Then it gives you a window as to what the possibilities might be to have different conversations."
This listener says:
My eight-year-old daughter has suffered anxiety in the past, with constantly washing her hands, however, that partially now seems to be having trouble with her vision. It scares her and she thinks that things are very far away.
She was sick with the virus just before lockdown. And I'm thinking it's her anxiety raising its head again, due to being rundown and locked down. She is extremely social and I think lockdown has more effect than we think.
"Kids who are going through particularly that tweens age - 10 11,12 - and a little bit older, where their peer group has now become more important or is starting to become more important in their lives, then being deprived of that relationship, or having that relationship going through the channel of online media, where actually they prefer more face-to-face contact, that's a really big change for children.
"I just want to touch upon this idea I think that might be helpful for parents. Why it is that they find themselves bending over a little bit to kind ease the child's experience?
"If a child's afraid of dogs, what's called an accommodation, might be walking them across the street so that they can avoid one, if the child is scared of the dark it might be letting them sleep in your bed.
"We know that the vast majority of parents of anxious children engage in this kind of accommodation.
"This is trying to make the world easier for that child. But the everyday efforts that we might make to prevent our children's distress, minimising things that worry them, or scare them, assisting them with difficult things, rather than letting them struggle a little bit, may not actually help them to manage it in the long term.
"And one of the big reasons for this is we as parents, and caregivers are really time pressured.
"And so if we're not careful, we're setting up a framework where we're getting short term gains, but we have longer term pain for the child.
"One of the things we need to do is set up a virtuous cycle, where we enable the child to sit with their anxiety, support them and scaffold them through it, so that they can learn to support themselves a little bit with you as a team member, rather than taking over and managing that anxiety for them."