Despite huge gains in knowledge about the neurophysiological and psychological roots of anxiety, as well as the billions spent each year on psychotropic medications meant to assuage anxiety, Americans are more anxious than ever. Anxiety disorders—OCD, phobias, PTSD, generalized anxiety disorder, social phobia, panic disorder, separation anxiety—are by far the most commonly diagnosed disorders in America, especially among the young. More than 30 percent of children up to age 18 receive one of these diagnoses at some point, and anxiety symptoms are the primary reason parents seek out a mental health professional for their child.
Why are our children so anxious and getting more so? At first, the epidemic of childhood anxiety disorders seems puzzling. After all, we live in the age of “helicopter parents” and ubiquitous child professionals—teachers, counselors, therapists—all trying their best to shield children from feelings of fear, insecurity, uncertainty, or discomfort.
But too often in our anxiety to stop the anxiety, we surround the child with an anxiety-reinforcing system, comprised of family, school personnel, physicians, and even therapists, all fixated on protecting the child from any twinge of the dreaded disease. Imposing this array of deeply caring adults not only rewards the anxiety, but encourages it to consume ever more of the child’s life. In short, by building a systemic protective shield around the anxious child, we make sure that the anxiety remains in charge.
Theresa and her 15-year-old daughter, Grace, came to see me several months ago. Grace had been in therapy off and on since the age of 7, and given various diagnoses and medications over the years. Now she was starting in a new school, which had ramped up her anxiety symptoms again. She was having trouble finishing her homework because of obsessive worrying about getting good grades—her parents were, of course, anxious that she should get into a good college—and she said she felt “paralyzed by the pressure.” I asked Theresa what she’d learned from therapists about managing Grace’s anxiety.
“I’ve learned so much,” Theresa said. “Most importantly, Grace needs to know exactly what’s going to happen during her day. She hates surprises. We got her a cell phone early on, and we text each other throughout the day. The school’s been good about making sure she has all her assignments, and she meets every morning with a tutor who checks all her work. She’s an excellent student, but she needs reassurance.”
In short, kids and parents are often so anxious about anxiety itself that they must prevent even the least anxious twinge—any feelings of uncertainty and discomfort. As anxious parents try to reassure, comfort, explain, argue, punish, and bribe their child out of the anxiety, they grow more and more emotionally reactive, angry, and distraught, even bursting into tears before ultimately capitulating.
Teaching kids to manage anxiety is not about simply teaching them to relax and feel comfortable. It’s the cognitive shift and new perspective that changes things. That said, I want kids to know how to interrupt their physical symptoms, because it gives them a chance to reboot for a moment and immediately shows them how malleable this whole anxiety experience really is. When they learn to slow down and shift their bodies’ reactions, they feel capable of shifting their emotional reactions as well. They feel powerful and autonomous—a huge accomplishment for kids who’ve been bossed around by anxiety for so long.
So in a first session with young, anxious clients, we make a recording together, a self-hypnosis CD that teaches them how to calm their bodies. They learn to send different instructions to their bodies and to override the demanding voice of anxiety. “You’re like a superhero,” I tell them. “Your superpower is your imagination. In comic books, when people discover their superpowers, they must decide whether to use them for good or for evil. Your imagination, your superpower, was making you feel anxious because that evil worry part was in control. Now you’re going to use that power for good, and you’ll be unstoppable!”
Laugh the Uncertainty Out of Power
The leitmotif of anxious families is unalloyed grimness about their situation. Any levity or humor about their truly awful, serious, exhausting, probably unsolvable problem is unthinkable to them. But the little-known secret about anxiety—which it works hard not to reveal—is that it can’t stand being laughed at, and tends to shrivel up at the first giggle or joke at its expense. So I spend much of my time being a comedian, getting kids and parents to see how silly and puny this monster is. Humor and creativity allow us, as Jay Haley said, “to change the framework of the situation in the spirit of play.”
As a society, we’re obsessed with security, safety, and predictability. As good parents, we tend to think that we should keep our children from ever feeling afraid, upset, or vulnerable. After all, we have technology for keeping in constant touch with our kids, reassuring them and ourselves that we always have their backs. It makes us and them feel better, too, so why not use it?
Here’s why not: kids need to be problem solvers. They need to learn how to improvise when things go awry, to take the next step when plans fall apart, in order to grow up. Anxiety will come. So will disappointments, grief, and, occasionally, even disaster. Sometimes our imaginations will be enough to make us panic, but sometimes our imaginations are just practice for the real thing. Children need to learn how to function with anxiety in the passenger seat. When we overprotect them, we deprive them of the practice needed to manage in the world.
Lynn Lyons, LICSW, has a private practice and speaks internationally on the treatment of anxious children and their parents. She’s the author of Using Hypnosis with Children: Creating and Delivering Effective Interventions and coauthor with Reid Wilson of Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children and the companion book, Playing with Anxiety: Casey’s Guide for Teens and Kids.
This blog is excerpted from "Taming the Wild Things" by Lynn Lyons. The full version is available in the January/February 2013 issue, Treating the Anxious Client: New Directions for Psychotherapy's Most Common Problem
Illustration © SIS/Rob Colvin
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