In article 3, we looked at the importance of helping children to problem solve and to take action to address the issues that cause them to be anxious. In this article we discuss how you can get them to scrutinise and examine the anxiety itself. The goal is to get them to to question the utility of their worry and to challenge the circular thoughts that make up their anxiety.
Learning what anxiety is
It is important to take time to help children understand what anxiety is and how it affects them. As discussed in article 3, when having these conversations with children you want to engage their problem-solving and thinking abilities. While a little bit of anxiety is a good thing (getting children motivated and concerned), too much is overwhelming and causes the rational part of their brain to be taken over. There are lots of good child-centred pictorial explanations about this that can help children understand. My favourite is the notion when overwhelmed by anxiety the “lizard” part of the brain (ie the primitive emotional centre) has taken over the “wizard” part (ie the thinking rationale part). The goal is “tame the lizard” and to “activate the wizard” to solve the problems that are really there.
Externalising worry
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Frequently, children over-identify with their anxiety, which makes them defensive about talking about it and getting blamed when their parents try to question them. A useful strategy is to externalise the worry whereby you talk about the anxiety as something that is separate and external to them. For example, if your child is having tummy pains because of anxiety, you might say, “that Anxiety is bothering you again in your tummy”. Or if your teen is reluctant to go to a party because of social anxiety you might say, ‘the Anxiety is trying to stop you from doing something you love – that is a pain”.
A first step in externalising anxiety is to ask the children to name it and to even give it a personality. The can be simply the name “Worry” or “The Anxiety” or, more colourfully, “The Tyrant”. Having a name allows you to poke fun at the anxiety and to develop strategies to contain and overcome it. For example, you can first explore with children the impact of the anxiety such as:
“ What is ‘The Worry’ making you do?”
“ What is The Worry saying to you?”
Then you can explore what they can do in response:
“ What do you want to say back to the Worry when it bothers you like that?”
“ How can you keep the Worry at bay?’ What normally works well for you?”
Externalising anxiety like this is a very useful strategy for parents, because instead of fighting your children over their anxiety and meltdowns you can join with them in fighting the common enemy of their Anxiety; you can become allies working together rather than opponents. In addition, the strategy can add a much needed lighter note to dealing with serious problems. The Externalising Strategy is also a well-respected therapeutic device for working with children and teens affected by clinical problems: see the interestingly-titled book How I Ran OCD off my Land by John March.
Identifying worrying thoughts
It is important to help children to identify their worrying thoughts and to pinpoint the beliefs that underpin them. For example, some children might have social anxiety because they have a belief “that everyone does not like me” or other children might be over-perfectionistic because they have a belief like“I can’t ever make a mistake or no one will respect me”. Help your children uncover and pinpoint and, ideally, these beliefs so you can encourage them to evaluate them. When working with children, I often get them to write out these “worrying” beliefs in thought bubbles or to draw pictures of them if they are more artistically inclined. Once they are identified then you can get the children to challenge them by asking questions such as
“ Is that really true? What is the likelihood of that happening?”
“ What is a more likely explanation?”
“ How does thinking this way affect you?”
“ Is it the most helpful way to think?”
Creating more realistic thinking
Once their negative anxious thoughts are identified and challenged the next step is to invite your child to think differently and in more helpful ways. Once again asking good questions is the best way to do this. For example, you can ask the child:
“What is a more realistic explanation?”
“What is the most helpful way to think about that situation?”
The goal is to help your child create more helpful thinking about situations. For example, when a child has fallen out with a friend, instead of assuming “everyone hates me” you invite the child to think in a more balanced way: “Okay, I had a row with J, but I can make up with him again” or “There are lots of other children I could be friends with, I just have not got to know them yet”. Or when your child has failed at something, instead of them concluding “I am useless at this”, you invite them to think: “Each time I try, I can learn something new” or “I’m going to do my best” or “It is not my best subject – there are things I do/enjoy better”.
It can be helpful to do up a set of coping cards with children, that contain positive affirmations that they can refer to when their anxious thoughts affect them (such as “I will always do my best” or “I always feel better once I get started”). As well as remembering these coping thoughts, they can take these cards out and read them any time they need to during the day.
Dr John Sharry is a social worker and psychotherapist and co-developer of the Parents Plus Programmes. He will delivering a talk on Promoting Positive Self-Esteem in children in Kilkenny on Monday 20th March and in Dublin on Wednesday 10th May and a workshop on Parenting Young Children in Cork on Saturday 1st April. See www.solutiontalk.ie for details
This is article 5 in a special six-part series by John Sharry on helping children overcome anxiety. The last article in the series will be on March 21st, and will look at how parents can help children put together step-by-step plans to overcome anxiety-based problems. see irishtimes.com for full set of articles.