At the age of three, Jan was frightened by a burst balloon and became afraid of balloons, and at the same time firecrackers and thunderstorms. Then he began to avoid playgrounds and any noisy places in the city, for fear of «going crazy.» What can psychologist Sylvia Schneider advise parents of anxious children?
Anxiety disorder is diagnosed in 10% of children aged 5 to 18 years — that is, one in ten children! “This is not written in textbooks, but we know from experience: this is the most common of all types of mental disorders in children,” says clinical psychologist Sylvia Schneider, child and adolescent psychologist, psychiatrist, professor at the Department of Psychology at the Ruhr University in Bochum (Germany) , a specialist in mental disorders in children and adolescents. She came to Moscow to give a seminar on cognitive behavioral therapy for children and adolescents, where we asked her a few questions.
Psychologies: Parents often notice deviations in the child’s behavior when it comes to autism or, for example, hyperactivity syndrome, and immediately turn to specialists. But anxiety disorders are not so noticeable. Anxiety seems to be dissolved in our environment, and its manifestations do not attract the attention of adults. How do you know if a child needs help?
Sylvia Schneider: The reason for the lack of attention to anxiety disorders in children is partly that the problem is experienced by the child inside, it is not as noticeable in his interaction with the outside world as in autism spectrum disorders or hyperactivity syndrome. And therefore, an anxiety disorder is more difficult to recognize and diagnose.
Often it grows out of the most ordinary, natural fears. For example, the fear of being separated from the mother and the fear of strangers are completely normal for a child from 8-9 months to 2-3 years. But by the age of 3-4, 95% of children overcome this anxiety. And then they calmly go to kindergarten, communicate with other children and stay overnight with their grandparents without scandals.
But if a child experiences this anxiety even after 4-5 years, then it can be called pathological. In addition to being inappropriate for the age of the child, unhealthy anxiety lasts for a long time — from a month to several months or years.
What fears of the child clearly do not correspond to his age?
Parents should be wary of the reluctance of a child of five years and older to sleep in his bed. And we are not talking about those two or three days when something happens in the family (moving or quarrel) and the child is afraid to go to his room, because he is very excited. No, I’m talking about a long period of time when the parents themselves would like to send the child to sleep separately, but they can’t do anything. Or when a child over five years old is afraid of loud noises for a long time. This is a typical phobia.
Children often report experiencing strange, uncomfortable sensations in their stomachs — this is the most common complaint.
I had a clinical case when a three-year-old child, being at a children’s party, was frightened by a burst balloon and has since become afraid of loud sounds. And then crackers, fireworks, thunderstorms and many other situations that are associated with harsh noise. He began to refuse to go outside to play with the children.
His family lives in Switzerland, where August 1 is a national holiday. So, they began to leave for Germany every year on this day in order to save the child from the noise and fireworks. The whole family was involved in this situation. In a word, unhealthy anxiety is pronounced and interferes with the child and his family in everyday life.
How does such a child feel? And what is he really afraid of?
Children often report experiencing strange, uncomfortable sensations in their stomachs — this is the most common complaint. Their heartbeat quickens, they feel weakness in the knees — their legs become as if they were cotton. And most of all, at such a moment, they want to run away to their mother or another loved one, next to whom they feel safe.
And the object of fear depends on the type of anxiety disorder. With separation anxiety—we call it separation anxiety disorder—the child is afraid that his mother will leave and not come back to him. A child with a social phobia cannot speak loudly in the presence of strangers and answer in class when the teacher asks him. At this moment, he may think: «I’m going to say something stupid, the whole class will laugh at me, and I won’t be able to come here anymore.»
It is important not to encourage avoidant behavior and in every possible way to show that the child is strong, that he can handle it, that parents believe in him.
And the child who avoided loud sounds was afraid that because of them he might go crazy, and it would be terrible, because the boy could not afford to show such weakness. In any case, anxiety disorders interfere with harmonious development. After all, a child who experiences such strong fear tries to avoid those situations in which this anxiety can arise. Therefore, he stops going to kindergarten or school, does not communicate with peers, and generally does not do what children of his age usually do.
What do parents need to know to help their children? Or at least not harm them?
First of all, it is important to show the child that they really understand how difficult it is for him to live in such a situation. And then — to encourage and support all the ways that their son or daughter chooses to cope with the situation.
For example, when a child with social phobia is asked what his name is and he answers in a very quiet, timid voice, you should praise and support him (“well done for answering!”), Instead of forcing him to repeat louder! And parents usually do exactly the opposite: they are ready for hours to discuss and criticize the avoidant behavior of the child, to force him to be bolder, but just not to support his slightest attempts to be bolder.
So, the family of the Swiss boy should not have followed the child’s fears and left for Germany?
The mistake of these parents was that from the very beginning they supported the tactics of avoiding the child: they stopped buying balloons for him, they took him away from loud sounds. Instead, they had to talk to the child and patiently, persistently, calmly offer: let’s try to inflate the balloon a little and burst, check what the sound will be … Try step by step.
And this is the general principle of the behavior of parents with such children: do not encourage avoidant behavior and in every possible way show that the child is strong, that he will cope, that parents believe in him.