How can you help an anxious child?

It can be really tricky to know when to step in and help your kid when they’re having anxiety. Unfortunately, this is a really common situation: 10 percent of kids have diagnosable levels of anxiety. 

So on this episode of Parenting Behavior with Dr. Andy Kahn, we’re going to learn three key things:

• What is anxiety?

• How can you help them manage it?

• When should you step in as a parent?

Related resources

• The difference between typical anxiety and an anxiety problem

• Classroom accommodations for anxiety

• The connection between anxiety and stress   

Timestamps

• (0:54)   What is anxiety?

• (3:28) How can I respond to my child's anxiety? 

• (9:37)  How should we talk about anxiety with kids?

• (14:03 ) How parents can project on kids

Episode transcript

Andy:  It can be really tricky to know when to step in and help your kid when they're having anxiety. Anxiety and worry can affect people of all ages, but keep in mind, 10% of kids have diagnosable levels of anxiety. So, today we're gonna learn three things: what is anxiety, how to help your child manage that anxiety, and how to make the decision about when to stop in versus let your child move through and learn about their anxiety by experiencing it. 

This is "Parenting Behavior," and I'm your host, Dr. Andy Kahn. I'm a licensed psychologist and parent with over 20 years experience working with kids and families on behavioral challenges, anxiety, and other concerns. Today, we're going to talk about managing your child's anxiety and helping them learn and understand how best to live with and cope with anxiety. 

Now we're gonna talk about what anxiety is and what purpose it serves. For the most part, anxiety is something that's here to help us survive and to be safe in the face of danger. Thousands of years ago, humans needed their anxiety and their senses to really scan the environment and to figure out, is there something here that's dangerous for me? Because those environments were really dangerous. In the modern day, there are a lot less perils. There are not things here that are gonna jump out at us typically. So, having anxiety that is really strong and being reactive to stimuli can really lead us off track. 

So, at the same time, anxiety is something that can be learned with relation to certain situations and certain experiences. So, if you're in a scenario where you feel ashamed or embarrassed by something you've done, or you start to feel embarrassed about not having a certain skill, as you approach those situations again in the future, you anticipate and start to worry in advance of those scenarios. 

Also, if you have situations where you're unable to navigate your environmental stimuli, so let me say that in English: I have ADHD. One of the things that can be hard for me is I don't filter sensations in my environment well. So, I might be overwhelmed by a sound coming from this environment or be distracted by something off in the distance. And all of those things pulling at my attention can make me feel worried, make me overstimulated and uncomfortable, which makes me and other people with ADHD more susceptible to feeling anxious. 

Finally, we think about feelings getting attached to scenarios. When tasks are challenging and kids are having difficulty processing information, obviously, they're going to be more nervous about how to do it again in the future. They might anticipate, "Oh, going to class is really stressful," or "Going to social events makes me really uncomfortable," and it may make them harder for them to go and do those things in the future, which is where anxiety impairs us. 

For kids with learning and thinking differences, those challenges also makes it less likely they're gonna wanna try new things. They're gonna feel less confident about activities that seem a little bit hard on the surface. And this can affect them in academics, in doing activities like playing sports. Or other things that can make them generally feel good about themselves. 

The other part that we have to keep in mind is that kids with learning and thinking differences also may struggle with social awareness and understanding the give and take of interactions and in turn making and keeping friends. So, then entering social situations can be a source of increased anxiety. "I'm not good at this. I'm not sure I'm gonna do it well." I really want friends and I feel pressure. These things make it extremely difficult, and kids might start to isolate themselves and pull out of those scenarios. 

All right, let's talk about how to respond to your child's anxiety in a helpful way and an appropriate way. As a parent, we often respond to our kid's worry and anxiety in very automatic way. And the way we respond can affect how comfortable our children are talking about what they're going through and breaking down how to improve or cope with that experience. So much of this is automatic, and we have to be aware if my child is showing me anxiety or they're talking about it, what I do next can help them or derail them. 

In a lot of situations, what I want you to think about is approaching your child with some really simple steps. First, validating what your child is experiencing. What they're experiencing is real to them, it is uncomfortable, and acknowledging this gives them permission to talk to you about it a bit more. Next, it's really important to respond in an empathic way, which is showing your child in as genuine a way as you can that you sort of get what they're going through. Making a statement like, "Wow, that seems really scary for you, and that must be really uncomfortable." 

Giving a reflection and permission for them to feel what they feel. That can, in many times, even reduce the child's anxiety and say, wait, I'm not nuts, I'm like completely out of my mind that I'm feeling this. When kids have permission to experience their own feelings, they're much more likely to continue the conversation, and they feel accepted. As a parent, when you have that interaction, you've got a chance to make an impact on your child's anxieties, or at the very least make them feel safe, which is hugely important when you can't always solve the problem. 

Finally, if we don't show that we get it, they're much less likely to come with us and work with us on stuff. In fact, they're gonna think we're being disrespectful and disregarding their feelings. It's really common for parents to unintentionally sort of disregard their kids' feelings. As a parent, I've unfortunately done this a lot of times and I wasn't really aware of it. The idea that if your child is anxious and you say, "Oh, don't worry about it" or "It's no big deal. Let's just move on," those are things that make your child feel like what they're going through isn't real and that you don't believe them. And in those situations, they're less likely to talk to you. 

If you acknowledge your child's fear and you're empathic to them, they're gonna work through this with you more naturally. And you may see that they're going to feel like, "Hey, I've got a partner in getting through this." Again, keep in mind, fear is a typical thing. And sharing with your child that we all experience fear and anxiety can be really helpful in getting them on the path to feeling better and navigating or challenging what's happening with them. 

This can be real hard when you have a young child who can't always articulate in their own words what's going on with them, and in these situations as a parent, you've got to be willing to do some investigation, become a detective and ask some questions or investigate what are the details of what's happening so you can figure out in sort of an educated way what is going on and then make a guess about how to help. 

At this phase with your young child, you have to start with your W questions. You got to start figuring out, "OK, where are they when this anxiety is coming on? Who's around when the anxiety is being felt? What are they doing or what are they showing during these moments?" And in many cases, it's really important to look at what happens right afterwards. Sometimes what happens afterwards can actually increase the chance of the anxiety happening in other situations. This information can give us a framework for what's going on and really how to navigate through it as we move forward. 

OK, let me share one of my case scenarios with you. In my work with kids in schools and in the clinical setting, it was really common for me to get called on kids who were having difficulty refusing to go to school or having difficulty with school-related phobias. Now, I was working with a fifth-grade boy, and two to three times a week, he was refusing to go to school, and his parents were starting to get really concerned. They were missing work, they weren't able to do the things they needed in the day-to-day. 

And what happens when you're trying to get your child off to school and it's not working? How do you feel as a parent? You start to raise your voice, you start to express pressure and negative feelings because you've got stuff to do and your kid isn't coming with. In those situations, anxiety and tension don't live well together. But let me get back to the details. 

So, in this situation, what was typically happening was two to three times a week in the morning, this child was starting to express lots and lots of feelings of physical discomfort, feeling nauseated, feeling really sick in their stomach, starting to cry, and get upset. So, as we looked at the scenario, we found that it was two to 3 times a day, Dad was almost always the one home in the morning and had to bring this child to the bus stop and was really struggling. And then what we saw was that each time that child was getting ready to go to school, they were unable to navigate through the steps of getting dressed. 

Now, when we started to pick apart some of those W questions, one of the things that was really important was trying to figure out, was there something that dad was doing that might have made this more challenging? Well, Dad admitted to us, he was getting really tense. He was not having a lot of interaction with his child, other than saying, "Move faster, get your stuff together. You'll be fine. Don't worry about it. As soon as you get on the bus, you're gonna feel better." All the things we talked about before, and yes, things that I've done, things that we've probably all done. 

The thing that we decided to talk about when we sat down in the room together was asking the child, "Hey, what's going on on those school days?" And the child got really sheepish, didn't really share a lot with us at the moment. So, we grabbed the child's schedule and we found one really interesting thing. On the days the child was most likely to stay home, he had PE. Now, at that point in time, what could be the problem? We could guess a lot about this. PE could be, "I'm insecure about playing sports." Or "I don't like the kids. Somebody's bullying me." 

But we asked him and he was able to share with us. For a PE, we have to change up our clothes. You go into a locker room, you gotta get out of your school clothes into your PE clothes, and then change back out. And this kid hated the idea of changing out of his clothes. So, we were able to strategize. He felt that he was being heard. So, on PE days now, he was wearing sweats and a comfy t-shirt and a hoodie, and his school gave him permission to wear those throughout the PE days. 

He started going back to school with regularity, Dad was learning how to be more empathic on those anxiety days, and we navigated the situation. But we had to ask a lot of questions and get out of our own way, which is a really common scenario to try to navigate in our families. 

I'm often asked, "What can I tell my child to help?" One of the things I do in therapy with a lot of my kids who are anxious is help them learn to challenge the things that they're afraid of. Now remember, don't forget our first steps. We need to validate those kids' feelings first and be empathic towards what they're going through. But back to the point here. When we talk about helping your child navigate and challenge anxiety, the lot of things that we do are talk about comparing facts and thoughts. 

So, for example, a fact might be "Have you ever been in a situation where the bus has been unsafe for you?" And then asking some yes and no questions. "Have you had success taking the bus back and forth regularly from home to school?" And then, asking the kids about what's going on, "Have you actually seen things that are dangerous?" Now, if the answer to these questions are no, that the facts don't support the fear, some kids are able to say, "OK, you know, that makes sense, I shouldn't be afraid of that." And they can actually think their way out of being anxious. 

In reality, there are other kids who just can't do this. Their thoughts are far more powerful than whatever facts that may be out there. Maybe they saw a movie that was scary, or someone has talked about something that happened on a bus ride somewhere across the world. And in those situations, there's a different strategy. Helping your child work through a step-by-step process of being in the environment they're afraid of and navigating their feelings and emotions so that they can get through it and not miss out on going to school via the bus or some other route. 

One of the strategies that I'll often talk about is how we can go from the challenging of the behavior or challenging of emotion to creating a plan to navigating what your child is struggling with. Let's say your child's having difficulty and fear about taking a test in school. Now for kids with learning and thinking differences like ADHD and dyslexia, this makes sense for a lot of them. Taking tests can be really anxiety-provoking; they struggle to organize and plan how they study, and they experience a lot of failure. So, those things sort of make them anticipate that this is not going to be good for them. 

Giving your child the empathy to say, "Hey, I get it. Like those tests are really hard for you and I can see how much you struggle in organizing your work." Then, creating a plan. "OK, let's break down the topics and things that you need to study for that test into chunks and use specific time windows to study each of those individual chunks. If you're feeling confused by this or it's something you're not really sure how to do, have a call with your child's teacher, and they can give you some structure to help break down those activities." 

Once you give your child that information and say, "Hey, we're gonna do a good strategy here to help you through this. It gives them permission to use that energy and to really focus on specific tasks. And you're gonna see the anxiety start to reduce. The other thing you wanna share with the child is the fact that, "You know what? Anxiety and being afraid of failure is a really typical thing." 

One of the great things to use, particularly when your child is anxious about something, is reframing that anxiety. So, if your child's afraid of taking a test, you can say, "You know, I understand that being afraid or worried about getting a bad grade is something that really feels quite bad to you. But what I also see is you care so much that you wanna do well, that this makes you uncomfortable. And I'm proud of the fact that you're so interested in doing well. So, let me help you do that. Let's break this down together."

Giving the child permission to say that you can have a feeling that in one way, is negative can actually be transformed in taking that energy into doing something to help you be successful. For so many kids, they can't focus their attention because everything is swirling around, and that information swirls because they can't pull pieces together as they're nervous. Breaking activities down helps kids shrink focus and feel more able to do activities and they feel much more manageable, which in turn lowers anxiety. 

In addition, brainstorming with your child about how to do this task, give them a role in figuring out what's the most important thing we're gonna study first? What's the thing you like the most? And maybe let's put some attention to that first. That's a little tricky part because you can trigger some dopamine, which is feel-good chemicals that helps the body. Build motivation and attention. 

When your child is engaged in these activities of brainstorming and planning, you're giving them something really important. There's a school psychobabble term that we call agency, which means they feel engaged and responsible for parts of their own process in education, and that builds motivation for kids and is really shown to be helpful in these situations. In addition, by controlling and harnessing some of the energy of fears, you have another strategy you can use as a parent. 

One topic I talk about in therapy is how parents can actually project their anxiety onto their kids. So, let me explain the psychobabble here a little bit. As parents, how we react and how we respond to situations in our environments can tell our children whether or not we think it's dangerous. And if our children consistently see that we respond to things that are dangerous all the time, they're likely to think of the world as a scary and dangerous place. 

Now, let me give you an example here. So, back in the 60s, there was a really interesting study called the visual cliff experiment. Now, the purpose of the study was actually something not really having to do anything with anxiety. They were trying to study at what age infants were able to see if there was drop off or something that they were afraid they were gonna fall off of by what we call depth perception. If you see a step and there's a step down, we as adults can say, "Oh, watch out, I don't wanna go tumbling." 

But for little babies, they weren't exactly sure when this was happening. How would they do it? Well, they put a child on a table, and at one point in the table, there was a piece of plexiglass where there was a drop-off, at least it looked like a drop-off. The child would crawl across the table and they watched to see when and if the child would stop. Now, a variable that they put in play was they had the parent on the opposite side of the table. The child actually would tend to go across the table regardless of whether or not the cliff was visible. 

If their parent was smiling, they would keep going. If the parent looked fearful or scared of what was happening, the child would stop. So, what we learned here is even in infancy, how a parent responds to a child and in what they show them about how they see the environment, particularly in their facial expression, teaches a child about what is safe and what is unsafe. So, what does this mean as parents? We actually teach our children what to be afraid of and how scary the world is by how we react. And it's something we don't really intend, it just happens. 

So, this is gonna become part of our process as we talk about how we help our kids manage their anxiety and what role we have in making them anxious. When we share about anxiety with our children or about the things that we're afraid of, we wanna be mindful of a handful of factors. First and foremost, where is your child developmentally? You wanna be really careful about drawing the appropriate line about what anxiety information you share with your child, particularly around things that they can developmentally handle. 

So, having conversations around real-world dangers. We stay away from things like fire, a hot stove, being careful about crossing the street or communicating with strangers. These are things that are completely appropriate and smart to share with your young children because you want them to learn about how to keep themselves safe. More conceptual kinds of anxiety, financial fears, fears about things in politics or the larger world, or issues happening in other countries that can be really bothersome and really important to us as adults, are things your child probably can't process or manage. 

So, showing a lot of anxiety and talking about this a lot in front of them can lead to global anxiety, just fears of things that they don't really understand. So, drawing that line can be super important in protecting your child and keeping them in situations where they can navigate what the world is for them, not just the adult world that they can't understand. 

At the same time, anxiety feelings in adulthood can lead to things that kids really struggle to understand, like negative thought loops or engaging in unhealthy coping and behavioral patterns. Whether those things are things like shopping or using alcohol. 

Those kind of pattern behaviors or things as adults, we need to get some help for ourselves. Getting some professional support, joining a support group for parents who are struggling, are all things that can be really great for you, and can be a nice role model for your kids in terms of the things you're willing to do. 

Let's talk about two really important takeaway things here. Parent self-care and doing what you need to do to make yourself healthy will make you a better parent and help you take better care of your child. And remember, it's a lot harder to break your child than you think it is. Making mistakes, having your own anxiety, isn't gonna break your child. You just have to show them that you're willing to work on it. Take the steps you need to and move on. You don't have to be perfect to be a great parent. 

Thanks for listening to this episode of "Parenting Behavior with Dr. Andy Kahn." We'd love to hear from you if you have any thoughts on the show. You can email us at parentingbehavior@understood.org. I'll put the email in the show notes too, where you can also find more resources and links to anything we mentioned. 

"Parenting Behavior with Dr Andy Kahn" is brought to you by Understood.org. It's produced and edited by Cody Nelson, editorial guidance by Gail Belsky. Music and Mixing by Justin D. Wright. Our video producers are Calvin Knie and Christophe Manuel. Special thanks to Dr. Karen Wilson. Briana Berry is our production director, and Neil Drumming is our editorial director. Our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. 

Understood is a non-profit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, donate at Understood.org/give.