We get anxious and worried frequently in the normal course of life. Most of the time we don’t even remember it. It comes, it goes, it is just part of life. But when anxiety gets stuck or escalates to the point it interferes with life what has happened?
Think of the function of fear. It is a warning system. There is a problem so it commands, “Do something! Solve it!” If you can solve the problem or it goes away then the anxiety ends. So what is happening when the anxiety stubbornly persists? To put it simply, if you are still anxious then you have not solved the problem.
Your child may be very committed to solving this problem. It might look like they aren’t trying but trust me, they are trying. They just might be going about it the wrong way. You may also to go extraordinary lengths to help. It can be incredibly frustrating that nothing seems to work. You may have tried counseling, medication, natural treatments but still it isn’t getting better. If he remains stuck, then all the attempted solutions are malfunctioning in some way. If I may, I would like to suggest some possible reasons why real and earnest attempts might be unsuccessful.
Desire for Certainty
First of all, if your child is extremely worried or anxious about something she will want to know with 100% certainty that the “problem” is resolved and things are safe. This urge for certainty is specific. She might obsess over whether her hands are clean but never give a thought to whether a tree might fall on the house. It is specific to the fear. The big problem with trying to solve an anxiety issue is the desired certainty is just NOT possible. For example, if you daughter is worried she will get sick, she wants to know with certainty that she is not ill. She may ask you for reassurance. You might do what I did and say, “You are not sick, you won’t get sick and you will be fine,” as if I could promise that! That might work with younger kids for a while but the fact is that there is no way to know for sure. I have a book in my library aptly named, “The Myth of Certainty.” How can you know the future with certainty?
In the rest of life we all settle for uncertainty. We live with risk every day. I am sure my diet Mountain Dew is pickling me as I write. Don’t get me started on nitrates, unrefined sugar, aspartame, and everything else not in a cooler at the grocery store. Eating something out of a box, now that is risk! I am being a bit ridiculous but you get my point. On a more serious note, I found an article called, Analyzing the Daily Risks of Life by Richard Wilson. In the first couple paragraphs he lists as daily risks: electrocution, carcinogenic chemicals in our clothing, peanut mold called aflatoxin, too much meat increasing colon cancer, pollution, and being in an accident. He is just warming up.
No matter how hard you try you can’t know with 100% certainty that something bad won’t happen. If you are worried you might pick up a virus and if you want certainty you will go through daily life captivated by what you have to avoid and how to decontaminate just in case you came in contact. The fact is, you still are not sure you are safe no matter how hard you try. The unwillingness to experience uncertainty contributes to the anxiety. The belief that certainty can be obtained has to be abandoned.
If your child wants to overcome her anxiety the first step is agree to live with uncertainty. She does anyway. Think of some ways to help convey this point. You are not asking her to be in danger, just live with acceptable risk. As Dr. David Tolin said in a lecture I heard, “It is safe enough.” We all live with this. She will just have to accept the risk in the area of her fear. Not accepting uncertainty will keep her stuck.
Being afraid of Being Afraid
A second reason your child could be stuck is due to focusing on the wrong target. Everyone, and I mean everyone who has severe anxiety really hates how it feels. The natural impulse is to FEEL better. Because the feelings are so strong they become the headline, the big bold letters. As a result, reducing the anxiety becomes the primary target for treatment. This is true for an anxious child, the child’s parent(s), medical doctors and probably the counselor (if there is one). That is the wrong primary target. That is a desired outcome but NOT the target for solving the problem. The correct target is to disprove the threat, in other words, believing the problem is NOT as dangerous or threatening as it feels. Knowing and experiencing that is the key to overcoming anxiety. If you just reduce the anxiety you can still think the cause is threatening.
The desire to remove the feeling of anxiety leads to all kind of mistaken attempts to solve the problem. People get anxious about getting anxious. This leads to avoidance and coming up with “coping skills” which are often ways to play it safe. A family system can significantly change in order to keep a child from getting anxious. Parent’s miss work, they don’t go on vacation, they let kids sleep in their room. I’m not judging, I did this sort of stuff as well. I just wish I knew then what I know now.
The wrong but natural focus becomes finding ways to cope, manage or avoid the fear. Every parent knows how to distract. It might work somewhat but it is the wrong target. The way to change is to be able to not care about the anxiety. I like to say to my clients that they look at the fear and go, “Whatever,” (said with attitude). Of course, this isn’t easy.
This is very important for you as a parent as well. Our child’s anxiety makes us anxious. We try to avoid what makes them anxious. I mean, really, it wears us out, right? Please remember this, it is just anxiety. It is not crazy, a ruined future or evidence we are terrible parents. It is hard to watch your child be anxious (plus it usually shows up at the worst possible time – am I right??) but you have to help them face their fear, which means making peace with not removing the trigger and letting them experience the distress.
Not Addressing the Core Fear
A third reason your child may be stuck in anxiety is that a core fear may not be addressed. For example, if your child is panicking at school that is a problem he has to solve. The most obvious solution that comes to his mind is not go to school. You wouldn’t be the first parent who just gives in and lets him stay home just for some peace! As you will know and your child may not understand fully that causes other big problems and is a solution of last resort. But let’s say you are at the last resort and you decide to homeschool. As a result, the immediate cause of the panic is removed. Well, unfortunately the core problem is still present – the only thing gone is the most prominent trigger. Having a panic attack at school is not the core fear. The core fear may be something like, “I will have a panic attack at the worst possible time and be completely embarrassed. I won’t be able to escape without causing a scene. That will be awful, terrible, humiliating and I can’t live with it.”
One aspect of this core fear is humiliation. If you try to solve it by avoiding school you won’t address this core fear. Your child has to disprove the fear that he will be humiliated and that he can’t take that. He will still fear humiliation even if he is not panicking because being at home is simply avoiding and not solving. You and you child may feel tremendous relief because there is less panic but it really is only because you removed the trigger. The fear is just sitting there waiting for a new trigger like church, sports, a party or when he has to go back to school. The core fear could be triggered by any of those settings.
Here are a few common core fears and how they might show up in your child:
- Fear of harm to self or others – might show up as checking things over and over to be safe
- Fear of losing control or going crazy – might show up by wanting to know exactly what is coming next, no surprises.
- Fear of being responsible for something terrible – might show up by frequent apologies, warning of any possible danger, scanning for problems.
- Fear of embarrassment – might show up by avoiding performance situations or social groups, meeting new people
- Fear of being judged – might show up as trying to be perfect
- Fear of being defective or bad – might show up as being super nice, always agreeable, hyper-moral
Failing to Test the Fear
Continuing on, the next reason your child’s anxiety may persist is that she is not putting the fear to the test. This is done by facing the fear and is called exposure. Say she wants to meet some other girls and make friends at the beginning of the school year. Imagine the fear being something like, “They won’t like me. I don’t know what to say. I will look stupid.” In her mind, she rehearses the danger and thinks of all the things that could go wrong. How does she disprove the fear?
Simple. But terrifying. She has to walk up to people and talk or respond to someone who talks to her. It may take several times and experiencing some conversations that fall flat or someone who doesn’t seem interested in talking. Facing it once probably won’t be enough. You have to face something for a long enough time that the fear begins to drop on its own. You have to repeat it over and over until the fear drops. You have to practice and repeat anything that you want to learn. You have to teach your nervous system the difference between uncomfortable and threatening. If you are shy this will be uncomfortable. Being ignored is very hurtful but it is not dangerous. Saying something dumb is awkward but not hazardous.
Is there some risk? Yes, but it is safe enough. Each time you test the fear it is increasingly disproven. You get used to it and eventually get better at it. We do this all the time. I remember the first time I drove some friends out of town. I was sporting a Ford Country Squire station wagon with fake wood paneling; a thing of beauty. Not. I just got my license. We took a two-lane country road. Every truck that passed in the other lane evoked serious anxiety in me. I totally faked being fine but I was about to wet my pants. If I would have stopped driving then the fear would have taken root and my life would be very different. Now I hardly give driving a second thought. It is still risky and I still have some level of vigilance but I am used to it. By testing the fear, you put it in the correct perspective and prevent it from growing and limiting life.
Playing it safe
Fourth, your child may only be partially putting the fear to the test. In other words, he is playing it safe. We call these “safety behaviors.” It is way of hedging your bet. For example, if your son is afraid something will happen to you he may want to know exactly where you are going, how long and have a way to contact you. Although he may put the fear to the test by not going with you, he is only doing it part way because of the other ways he is playing it safe like knowing the timeline or being able to call. If your son is afraid of bad weather like lightening or a tornado he may obsessively check the weather report. He may avoid windows during storms. He may not want to be alone during a storm. While there is no way to avoid the weather, he can create all kinds of ways of hedging his bet. In order to test and face the fear he has to stop all of the ways of playing it safe.
When I work with kids on this I have them watch videos of storms. Then when a storm comes I have them look out a window at the storm and eventually go stand out in the storm. There are other steps in this process but that gives you an idea. You both test or face the fear and gradually remove any safety behaviors. This all helps to disprove the core fear. As long as you play it safe you are still treating it like a threat and giving it power.
A very interesting and useful review. My 12 year old son started a new school and knew no one in the class. He experienced nausea, anxiety, crying, upset when leaving me. He settled down during term but after half-term the same anxiety returned. He is afraid of making a mistake and being humiliated or being left put. Very little confidence in himself. A clever kind boy too.