Research indicates that kids are sometimes born with a temperament that predisposes them to develop an anxiety disorder. This temperament, called “behavioral inhibition,” can be identified in toddlers. Such toddlers tend to have nervous responses to novelty or unexpected changes; they also tend to be more clingy and fussy than their peers when faced with separation from a primary caregiver. Toddlers with this temperament are then at higher risk for developing an anxiety disorder. What follows are six tips for trying to help such a child to not develop an anxiety disorder.
1. Avoid avoidance. This is one of the most important guidelines. This means not avoiding those developmentally appropriate situations that make your child feel nervous. When our kids hurt we parents hurt worse. So, it’s a natural reaction to just let our child avoid any developmentally appropriate situations that make her feel nervous (e.g., being left with a babysitter, getting on a school bus, joining a rec soccer team). Avoiding such situations reinforces the notion that they are dangerous and also tends to promote them becoming even more threatening over time. Moreover, this sort of a coping strategy tends to spread: your child may end up wanting to use it for more and more situations. Barring other complicating factors (e.g., the presence of Post Traumatic Stress Disorder), avoiding avoidance usually comes with initial distress but is followed by calm and a sense of accomplishment. (“Eventual” often ends up being just a few minutes.)
2. Promote your child’s comfort as you avoid avoidance. This can be done in any number of ways. One of my favorites is to gradually expose your child to aspects of the feared situation in doses before the due date. For example, you might play soccer with him on the field where the first practice will be held or arrange for her to sit on the empty school bus before the first day of school. You would usually stay within these situations until your child seems calm, using some of the other tips in this article. This can also be done in smaller chunks prior to the due date.
3. Teach belly breathing and pasta muscles. Have your child pretend that his lungs are in his lower belly, instead of his chest cavity, while breathing deeply but comfortably, both in and out. Relatedly, ask your child to make her muscles as soft as a piece of cooked pasta. Click here for a free 15-minute audio training module I created that can promote this sort of muscle memory. These behaviors short-circuit the fight-flight response, which is the brain system that becomes activated whenever someone feels anxious. (When in the anxious situation your child should not tense then relax his muscles, as is done in the training module. That is only done for practice. When in the anxiety provoking situation, only relaxation and belly breathing should be used.)
4. Avoid reassurances, especially those that are excessive. Few things will trigger your child’s anxiety more quickly than your reassurance that a safe situation is safe, especially when those reassurances that are issued with emotion or conviction. I tell the parents in my practice, “imagine I told you not to worry about the ceiling over us collapsing on top of our heads. You’d probably instantly start wondering what sort of a dangerous situation you might be in.” Kids often hear many parental reassurances as, “time to start freaking out!” Moreover, when you are separating from your kid (e.g., leaving the practice, leaving the school), leave as quickly as you can. Your presence, and especially if you are issuing reassurances, will often tend to promote the very anxiety you’re trying to mitigate.
5. Get control over your own anxiety if that’s a problem. This temperamental vulnerability, by definition, usually runs in families. If anxiety is interfering with the quality of your life, you would do your kid an awesome solid by seeking out cognitive behavioral therapy for yourself.
6. Get help if these efforts don’t work! Anxiety disorders in anyone, including kids, is usually very treatable and in a short period of time. The aforementioned cognitive-behavioral therapy can be delivered to kids and teens and has a ton of research supporting its efficacy. For a referral, click here.