Managing children’s anxiety and worries

1. Managing children’s anxiety and worries

2. Question: what are your children anxious about? • Our role as Parents • Just what is anxiety? • Why some and not others? • When is it a problem and types of anxiety disorders • Why and how parents can help • Helpful hints • Where to go for further help • Resources Overview

3. Permission for Parents to care for themselves Parenting is quite simply one of the hardest things adults do. It is extremely difficult to watch our children struggle. It is very normal for us to feel worried when our children are stressed and anxious. Today’s discussion may be the first time that you have approached the issue of how to support your children. In amongst this information there may be things that are more relevant to you than others. That is ok. We want to listen and acknowledge your challenges, help to develop further understanding and provide some options to help manage.

4. Generally most parents would want our children to: • feel success • to achieve • be happy • feel safe • be curious • be well liked and accepted by others • feel loved We want it all and lots more… Through a Parents eyes: our wishes for our Children

5. It can be very difficult as a parent to watch your child struggle. • The reality is that, all children at some point, will come across a range of challenges in their day-to-day life. • Consider this if we protect our child / children from every disappointment, the more devastating future disappointments will be. • As parents, need to do our best in preparing our children the for uncertainty and to sit with the emotions that lies ahead. The Reality

6. It is said that the human brain will process over 10,000 thoughts is one day. The anxious mind can get quite creative indeed, anxious children spend a lot of time in their heads!! afraid agitatedalarmedapprehensive concern edgy fearful freaking out fretful frightened frozen hesitant nervous overwhelmedpanicked petrified restless scaredstressed terrified thoughts racing troubled uneasy worried Anxiety aliases

8. Anxiety is a perceived threat even if its not real which then evokes an intense emotional response this then impacts on our thoughts, feelings and behaviours. Anxiety is most commonly thought of as: • Fight • Flight • Freeze response • Intense anxiety often means a child is living in the “what if” space. • They worry about anxious situations occurring. • Most people can’t understand unless, they too, have • lived and experienced it. • It affects people differently. What is Anxiety

9. Stressors and/or threats often beyond their control such as: • Seeing a traumatic event * Seeing /experiencing violence • Divorce of parents * Theft or threat to personal safety • Becoming sick /vomiting * A serious injury • Illness in the family * Being bullied • Natural disaster * Abuse • High parental expectation *Separation • Performance pressures/ fear of failure What is common to most anxiety is an intense emotional response to an experience and then, continuing to worry about it reoccurring. So what do Children worry about?

10. Physical- breathing, agitated, tummy upset, sweating. • Cognitive- fuzzy head, can’t concentrate, black and white thinking, catastrophizing. • Emotional- sad, frightened, overwhelmed. • Behaviourally- Acting out, restless, shy, reserved. Anxiety impacts on our mind and body

11. Feelings Physical symptoms Behaviours sadness head aches withdrawal emptiness tiredness dreaming shock heart palpitations changes in eating habits yearning stomach upset crying phobias tingling/shaking sleep disturbance disbelief sweating/dry mouth crying frustration difficult breathing chemical and alcohol abuse depression blurred vision avoidance fear/loneliness weight loss/gain acting out Common- feelings physical symptoms and behaviours

12. Black and white thinking-all or nothing approach deciding that things are all good or all bad • Discounting the positive-only looking at the negative • Catastrophizing- everything is a disaster based on minimal evidence • Emotional reasoning- in the heat of the moment can’t think clearly and rationally. • Perfectionism-feel as though anything they can’t do perfectly is not worth doing Cognitive …common thinking traps

13. When anxiety becomes a problem • If the constant worrying lasts for a period longer than six months • When it significantly interferes with the child’s enjoyment of life i.e. Attend school Participate in activities Enjoy relationships When anxiety becomes a problem . . .

14. Separation Anxiety – Most common in young children and centred around excessive anxiety when separating from parents and carer’s • Generalised Anxiety – Anxious about a number of events, they also struggle to switch off. • Social Anxiety- Children struggling in the company of others, worried about being judged or humiliating themselves, believe others will think bad of them. • Obsessive compulsive disorder (OCD) – Obsessions are defined as; distressing, recurrent, persistent thoughts or images that are inappropriate and intrusive. Compulsions are repetitive behaviours that the child believes helps sooth the obsessive thoughts. • Panic Disorder- Extreme anxiety in the absence of real danger. Anxiety Disorders

15. Genetic Factors Parental Anxiety Parents supporting avoidance Personality Emotional, Anxious, Vulnerability Development of an Anxiety Disorder Buckley Consulting Parent Modelling Stressors and Life Events ANXIETY DISORDER

16. Social and emotional learning is designed to: Build and enhance emotional intelligence. Help your child to understand their emotions and the emotions of people around them. Make better decisions, and resolve conflicts in a positive way. These children become emotionally intelligent and lead happier and more successful lives. Why is it important to address anxiety with our children?

17. The best gift we can give our children is to allow them to struggle. • If you always solve your child’s problems and make their life easy, they will never learn how to struggle to achieve something. • As parents we can support and encourage, but do not do it for them. • The more they take responsibility to work out their problems the better they will understand life. • Never do for your child what they can do for themselves. Anxiety often means learning to life with uncertainty…

18. Understand you can’t make it go away • Don’t be afraid to experiment • Part of the stress of anxiety can be not knowing what to do. • Anxiety is often hardest to manage when it comes on unexpectedly, so communicating with your children and helping them to understand becomes very important. • Its about offering warmth, safety and comfort the best way you can. • Open, caring and honest communication about the following can empower children and help them begin their journey of managing their worries. So how can parents help:

19. Discuss anxiety in an age appropriate way. Use the “barking dog” and the “wise old owl” analogy if appropriate. Questions such as: Can you describe how are you feeling right now? Can you tell me / show me where on your body is that feeling? Can you remember what you were thinking about before you felt this way? Have you had these feelings and thoughts before? Can you tell me what is making you feel scared right now? What are you worried will happen? How did you get through this before? Can you tell me what would help you right now? How to help children verbalise their anxiety

20. What to do… • Provide a strong and stable presence • Trust they can cope and learn to manage • Also trust their capacity and efforts to approach their anxiety and come out the other side • Note what works What to say…so things like… • Do whatever you need to do. Even if its nothing. The less we feel the need to fight the feeling , the more likely the feeling can come and go. • Suggest a walk / physical activity to find those strong breaths we need right now until you brain knows its safe • Talk and practice about what can be done when the anxiety is not there. • Brains have an extraordinary capacity to change and the more children can understand this and accept this the more they will want to try to work through it. How can we respond…when anxiety takes over

21. Encourage your child to work through it : • Write down the situation that makes you anxious… What makes you think that? • Sam’s birthday party.. Won’t know anyone? Haven’ t seen the list? • Ask yourself can I do anything right now to change this situation? • No • What do you have the power to change right now that might help? • Could ask Sam who is going. • What could help you let go of worrying about it so much? • If I knew someone! • In moving forward, encourage the child to break down the situation into “chunks” or “steps” which is less overwhelming. Thinking is powerful – challenge it!

22. Feelings can be felt emotionally and physically as a result of a situation and or experience. Talking about feelings …provides relief and allows children to process what’s going on. How do we as parents explain this to our children? • Feelings come and go, like the waves in a ocean • Feelings come and go like clouds in a windy sky. • Children may not understand that their faces and inside feelings are clues to their emotions. Example “I feel really sad and upset because Sarah can’t come over to play today” • Firstly encourage children to state how they feel and why (event / situation) • Secondly emphaise and validate your child’s feelings so they feel heard. Parent’s Response … I understand you are feeling sad and upset because Sarah cant’ play with you today but she is unwell. When she is feeling better maybe we could organise another time soon. This that ok. Communicate their feelings

23. “Children are like wet cement. Whatever falls on them makes an impression” Haim Ginott Good role modelling techniques include: • Create a dialogue aiming to normalise the situation...”Sometimes when.. it feels like..” • Share personal coping strategies / stories you’ve learned over the years. • Walk the talk ...practice these strategies with your child. • Problem solve together • Encourage outgoing behaviour. Acknowledge your child when they handle or deal with an unfamiliar situation well. “I really liked it how you...” • Try goal-setting with your child. Aim for small, incremental steps and praise them for their progress. • Deliberately take your child and yourself into new situations to challenge and grow • Be accepting and supportive. • Make sure you acknowledge the successes with your child and talk about them. Try modelling helpful behaviour

24. Children will learn and thrive in a well ordered and predictable environments • Routines can provide opportunities for children to learn more about themselves • Can give them a sense of consistency • Sense of safety and security • Learn and respect expectations • Create family routine charts • Brainstorm what needs to be done • Everyone has a role Create rules, routines and rituals..

25. Try gradual small steps to face the fear building to, over time, full exposure. • The ladder approach helps build self confidence / self awareness and helps develops skills gradually . • Acknowledge growth and achievements • Be careful not to give power to the anxious activity by avoiding Try the step ladderapproach

26. Breathing is directly related to both our level of arousal and our capacity for regulation. Our bodies need a mix of oxygen and carbon dioxide. Hyperventilation (breathing to hard and fast) can lead to symptoms such as dizziness, confusion, numbness and tingling, blurred vision, increased heart rate etc.. Hyper arousal (shallow breathing) can lead to triggering the fight/flight and freeze response • Mindfulness of Breath Technique • Breathing waltz • Nostril breathing • Belly breathing • Drawing circles on the back of your child’s hand / fingertips Breathing

27. Children can experience muscle tension Teach children the difference between tense and relaxed. With practice they will learn how to relieve physical tension by relaxing the part of their body that feels uncomfortable Use words that make sense to them Try new things Work on developing a sense of calm (the mind is quiet) • Clench fist / body muscle groups tightly count for 5 or 10 and then release • The jelly tree • Ripple in a pond • Make up their own Relaxation

28. Grounding enables you to self –soothe by re-connecting to the earth and solid objects through supportive breathing techniques. Grounding techniques requires you to focus on the here and now. Gives you a greater sense of physical and psychological safety and stability in the present moment. Useful for people who feel a sense of numbness, disconnected, detached emotionally and physically, depersonalisation • Walking barefoot on the grass • Using the 5 senses • Mug of hot chocolate • Wash your Hands/ face running warm water • Making a Worry Doll / worry beads Grounding

29. Mindfulness is a way of paying attention and self-observation. It teaches you to switch from your normal mode of functioning and enables present moment awareness. Paying attention in a particular way; on purpose, in the present moment and non-judgementally. No right or wrong way • Mindfulness of Breath Technique • Body Scan • Mindful garden • Mindful gratitude list Mindfulness

30. The practice of guided imagery based on the idea that your body and mind are connected. By providing positive pictures, creative imagery and self-suggestion, visualization can assist in managing and changing emotions. Visualization can be done on your own or in a group with scripts, a guide, tapes or CDs that subsequently have a physical effect on the body, Visualisation relies on nothing more than one's imagination and concentration abilities which people always have at their disposal. • Bubble technique • Aladdin’s Magic Carpet • A safe place • Role plays Visualisation

31. STOP what you are doing • Take a breath • Observe what is happening externally and internally • Plan and proceed what actions can you take to improve the situation (proactive rather than reactive behaviour) STOP technique

32. Hungry • Angry • Lonely • Tired If you answer yes to any of those, think of a healthy way you can respond to those needs? HALT technique … self care tips

33. Work on connecting with our child not correcting (see our child for who they are and not “define them” by what they have done) • Be realistic talk at their level physically and verbally • Improve our listening skills.. Listen with intent of understanding your child’s situation better. Allow your child to express his or her emotions or they'll drive his or her behaviour. This helps them know you're listening, gives their feelings value and helps them understand and control emotions • Establish Boundaries.. Be a parent not their friend • Create new opportunities and possibilities this might include others • Be present with your child “savour the moment” encourage them to be in the moment How to improve our relationship with our child?

34. Other things to try 1. Keep note of the strategies that help in a diary. Routines vs Spontaneity Help and allow your child to express your thoughts in a healthy way 5. Exercise – do something to use that spent energy 6. Draw on your belief system and practices. Allow and teach your child to ask for help Include things that are relaxing and soothing Communicate with the school and keep them in the loop. As a parent seek help if you need it.

35. Helpful hints for parents Listen well Acceptance of all feelings(same/ same but different) Don’t judge Accept a wide variety of emotions Offer practical support if requested Use their words Acknowledge the feelings Don’t say “I understand” Understand you can’t fix it or make it go away Don’t assume anything Be a parent not a friend Be realistic about your expectations. Be patient with your child As a parent be kind to yourself

36. Children's BooksApps • A handful of Quiet Author Thich Nhat Hanh Smiling mind • Mindful Movements Author Thich Nhat Hanh Colourfy • When my worries get too big Author Kari Dunn Buron Calm • Frog’s Breathtaking Speech Author Michael Chissick / Sarah Relax melodies Peacock • Take the time Author Maud Roegiers Parents Resources Helping your Anxious Child Ronald .M Rapee PhD, Susan H Spence Fear- free children Janet Hall The Optimistic Child: Proven Program to Safeguard Children against Depression and Build Lifelong Resilience (1995) Martin. E Seligman You and your Anxious Child DeAnne Marie Albano, Ph.D. Resources

37. Life isn’t about waiting for the storm to pass…It’s about learning to dance in the rain. It’s about learning to live with, and even enjoy the inevitable storms of life. Sing or dance, enjoy your life, no matter what the weather might be. Thank you for coming