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by Jessica Darling Wilkerson, LMFT
Anxiety in children can often take on the characteristics of other disorders and can be “misdiagnosed” by the people in the child’s life: parents, family members, teachers, etc. This is because children don’t have the ability to conceptualize and articulate what’s going on intrapsychically for themselves. A child identifies, “I don’t feel good.” They don’t identify the sense of foreboding, or feeling of “waiting for the other shoe to drop.” They can’t figure out why they feel this way, but they want the feeling to stop and they’ll do anything to make that happen. To stop the anxiety they might refuse to participate in an activity. They could seem keyed-up or restless. They might isolate themselves and fight their parent tooth and nail to keep from engaging in whatever the parent wants them to do (go to school, do homework, get dressed, leave the house, etc). They might create little rituals that seem like OCD. |
All these behaviors can be mistaken for ADHD, ODD, and OCD. The child seems out of control.
But what’s really going on under the surface?
Has this child heard about or witnessed an event that may have put themselves or someone they love in jeopardy? This can happen and then the child begins to worry excessively about it happening again. If a classmate is injured or a family friend goes to the hospital the child may have processed this event in such a way that he/she is worried that the event could occur again, and this time it will happen tragically in their own life. This child might become clingy to a parent, have nightmares, be aggressive to peers or adults, create rituals, and/or have meltdowns. The common denominator here is that the child is trying to find a way to exert control in his/her life in order to keep themselves safe or keep a loved one safe. They are feeling scared and powerless over safety issues and so they do the only things they know how to do… Shut Down.
The adults keep asking them what’s wrong and expect a young person who’s shut down to have the capacity to articulate of their fears – because that’s the only way we adults know how to get the information on how to help them. It makes sense and also doesn’t at the same time.
Some more questions to ask:
Does this child have a concept in his/her mind that is hurtful and they are trying to cope and avoid that fictitious situation?
Let’s say this child has decided they have two left feet, and that they’re terrible at sports. Let’s say they’re actually average, neither good nor bad. But every time it’s nearly P.E. they start getting a headache or a stomachache. Every time it’s recess they suddenly become engrossed in their drawing and they ask the teacher if they can stay in the classroom. If the teacher has things to do and tells the child they must go outside then the child has a meltdown because they think they’ll have to be athletic on recess.
It might look like they are trying to get their way. It might look manipulative. But these avoidance behaviors are an effort not to get to do a different thing or to have control over someone else, but they’re usually in response to something negative they’re telling themselves about engaging in situations. Then, self-fulfilling prophecy kicks in – they go to the school nurse for their stomach ache during PE, they don’t keep practicing the sport during their P.E. class, the classmates improve their skill and camaraderie, and the child’s self-image of not being good at sports is reinforced. So the following day, as it gets closer to P.E. his/her headache comes on sooner or stronger and they need to skip again.
So what are you supposed do?
Do you just let kids skip class subjects because of their anxiety?
It depends.
Sometimes sitting with a tutor until the child’s sense of competence has elevated can be really helpful. Sometimes discovering the maladaptive script the child is repeating in their mind and then providing believable contradictory statements to build confidence is what’s needed. Sometimes having the child talk with a therapist can do wonders. All three together can create synergy!
Personally, I’d start wherever the child is the most comfortable – they might be too embarrassed for a tutor, but they’ll talk to you or talk to a therapist. They might be more closed and unwilling to talk, but they’d sit with a tutor and learn while the tutor also points out how smart they are or how far they’ve come so they can start to look at themselves differently.
When engaging with a child who might have anxiety (or any of the other disorders) it’s important to maintain your sense of compassion. This child didn’t ask for this. They didn’t look at a menu of behaviors or mental health issues and request it, even though it often FEELS like they’re being willfully defiant.
They just know that they “don’t feel good.” and they are guessing at why – and usually they’re wrong, but they’re trying.
Find your own inner peace, try your hardest to be present and to ask, and listen to what they need in that moment. Find a way to compromise so they get their needs met, but still follow an amended request. Ex: Your child doesn’t want to go to school, you ask why, they don’t know or won’t tell you, then you ask what they need. They say they need to stay home. That won’t work, you have a job to go to and it’s the law they go to school. You are calm and relaxed and you say, “I hear you that it’s hard to be at school all day and you want to stay home. Unfortunately, I have to go to work and I can’t stay home with you – and you’re too little to stay home alone all day. So is there something else you need to help you feel better about going to school?”
This is where the child might make a request: different shoes, new pencils, cold lunch, to be picked up early, etc. Then keep it in your mind that they aren’t asking for these things because they “just want them” but because somehow this request is intended to keep them safe from a perceived danger. Work with your child on how to meet their need, and while doing so continue to assess and build them up in their self-efficacy.
Patience. Breathing. Being present. Compassion.
Anxiety is hard for grownups. Can you imagine being little and experiencing that big feeling?
For more information and a bulleted list of symptoms on Anxiety in children click here.
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Jessica Wilkerson is a Licensed Marriage & Family Therapist #104464 and is registered with the California Board of Behavioral Sciences. She is also the owner of Inspired Life Counseling and provides mentorship to the pre-licensed therapists in the office.
Jessica spent the beginning years of her career working with children and families. This has directed her overall therapy to have compassion for all members in a family when there is strife or stress that’s interrupting the dynamic. She has over fifteen years in the field of psychotherapy and focuses on adults and teens in her own daily clinical work. She also provides EMDR Intensives for clients who want to hunker down for a five+ hour EMDR session to get it all out on the table and out of the way. To learn more about Jessica Wilkerson or to schedule an appointment, please go to her bio by clicking the button below.
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