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Anxiety and Fear

anxiety-man-redThe expression “Time heals all wounds” is nice, but not entirely true.  Specifically, time heals most wounds, but not anxiety.  For example, if you have a fear of flying in an airplane, you will very likely continue to have that fear of flying many years from now.  Of course, to get past the fear, one must “confront” that which is feared.  So, in our example, if you “forced” yourself to take 30 flights, you most likely would eventually get past or “master” your fear of flying.  In psychological terms, this treatment is known as “exposure” or “desensitization.”  There is an irrefutable, extraordinarily large body of peer-reviewed experimental and clinical research that indicates that anxiety is most effectively treated with exposure-based interventions.  Of course, adults also choose to manage their anxiety in several other ways (some of which are safe and legal, and some which are not).  These include the use of prescription medication, “talk” therapy, religion/spirituality, alcohol, illicit drugs, etc.  The effectiveness of any of these may be debated, however, one fact remains clear: to “master” anxiety, we must confront that which we fear.  Simply stated, when thrown from the horse, we must “get right back on the horse” (so as to not let anxiety build and paralyze us).

With our children, though, there is a hesitation to fully embrace this line of thinking because (1) we are wired to protect our children and it is counter-intuitive to expose them to something that causes them distress, and (2) we would like to believe that our children will “grow out of” their fears.  This is where things get tricky, because while it is indeed true that a child may outgrow a fear, there is also the distinct possibility that a child’s fear will become more entrenched/pronounced over time, and, of course, we never know for sure which way things will play out.  That said, parents often need to make a philosophical decision about the way in which they will address/manage their children’s anxieties.  Is the anxiety “developmental” in nature (and therefore, presumably, “just a phase”), or is the anxiety “unusual” or “too much”?  One way to make that decision is to be guided by your heart.  Another way is to be objective/rational and examine the data.  For example, if your child has demonstrated several different fears without improving over time, then it is likely that he will not be “out-growing” his fears anytime soon.  Finally, a decision may be governed by demands of various situations.  For example, you may choose not to address your 2-year-old’s fear of separation (because you deem it normal), but you may choose to proactively address your 5-year-old’s separation anxiety (because it is time to go to kindergarten on the big school bus).

Here are some ideas and guidelines for the management of anxiety and fear:

  • Whatever the fear is, do not too heavily “push” your child into feared situations (e.g., if he fears dogs, it may be too big of a “first step” to go to a house where a large, highly active dog is not restrained).  If forced into feared situations, your child may feel that you are not respecting his feelings and you may inadvertently intensify the fear.
  • When in a situation where your child is fearful, make sure that you remain calm and relaxed to model self-control and confidence.
  • When a child is fearful, sometimes kidding may ease the fear. Be careful, though, and make sure that you simply “joke” about the fear, without inadvertently making fun of your child.
  • Expose your child to feared objects/ situations over and over to help desensitize and build a sense of mastery. For example, to help with a fear of dogs: buy a stuffed dog (similar to one that is feared) that can be played with while controlling the situation, take your child to a pet store where there are puppies in cages (in hopes that he will feel less threatened by a smaller dog who is safely contained), let your child observe a large dog on a leash from a distance, let your child watch while others go up and play with the dog, read books about dogs, and finally, seek opportunities to allow your child to safely approach and interact with dogs.
  • Finally, it is very important to remember that for a child to master a fear, the desensitization process must be given sufficient time.  Specifically, to continue with our example involving a fear of dogs, the child would NOT benefit from being brought to a pet store, and then quickly carried out the instant he begins to cry, because he is has not been given an opportunity to let the anxiety build and then dissipate, while in the presence of the feared stimuli.  In fact, people (adults and children) can often maintain a high level of arousal/resistance/anxiety for lengthy durations (e.g., 45+ minutes).