The fact is, a little bit of worry is a good thing for children and adults — it motivates and helps children with performance. Also, in the case of a true emergency, some concern is biologically advantageous. However, when worry turns to anxiety, there is no longer an advantage. To the contrary, performance is adversely affected and no one, not you or your child, feels very good.
How can children who worry excessively turn their worry into an appropriate level of concern and feel better? A three pronged approach that combines (1) an understanding of what causes anxiety, (2) changing one’s thoughts, and (3) changing one’s behavior, is needed.
Understanding Why People Worry
It can be helpful to share with children what we know about worrying. We know that some people have a predisposition to get worried more easily. As a result, they startle more easily and feel physical sensations and negative thoughts more readily. Over time, a habit develops where both physical symptoms and negative thoughts occur automatically and too often. The goal is to help children change the way they think and act so that they develop new habits towards approaching challenging situations. Explaining that worrying is a habit that can be broken is reassuring to children.
Changing One’s Thoughts
Children can be taught to think differently about the situations that make them worried. Often, children who are anxious expect the worst to happen. The situation can be a neutral one, but the child expects the worst. For example, when approaching a test, a child may expect that he/she will fail. The goal would be for the child to identify his/her negative thoughts and come up with more realistic ones. In particular, children can ask themselves: Where is the evidence that what I am expecting will happen? Am I exaggerating? Am I jumping to conclusions? Am I focusing just on the bad things? Is it helpful how I am thinking? They then can come up with alternative, more realistic thoughts that will make them feel better. For example, in terms of taking an exam, they can ask themselves, what is the evidence that I will fail? Have I failed previous tests? Even if I fail, am I exaggerating how bad the results will be? Also, how is worrying about failing helpful? Is it helpful, or is it really the worst thing I can do since when I worry, I am not fully paying attention to the test. The goal is to get faster at catching these anxious thoughts and answering them back, almost instantly. With enough practice the new thoughts will take over the old ones.
Changing Behavior: Controlling Physical Sensations
Children who worry excessively are taught to detect the internal and external stimuli that trigger it. Instead of giving into these triggers, the children learn to apply newly developed coping skills. They can actually use the first physical sensations they experience as clues that they need to change their negative thoughts and behavior. Specifically, children are taught that the physical sensations they are experiencing (e.g., heart pounding, shortness of breath, dizziness, shaking, etc.) are harmless and only scare them because they tell themselves that they are dangerous (e.g., no one has ever died from anxiety). In addition, because the physical symptoms they are experiencing happen as a result of breathing too quickly, they are taught to slow down their breath. They are instructed to breathe from their stomach instead of their chest. This will bring down their physical symptoms.
Changing Behavior: Discourage Avoidance
In addition, children are taught not to AVOID situations that make them worried. There is a tendency for a person to avoid what they are worried about. However, this just increases the anxiety. Instead, they are instructed to face their fears. Exposing children to what they fear in a manageable and hierarchical way, allows them to learn that what they feared was not as bad as they expected. It also shows them that they can manage stressful situations successfully. This experience leads to true change and new positive habits.
Dr. Caren Baruch-Feldman works part-time in the Harrison schools and maintains a private practice in Scarsdale. She can be reached at (914) 646-9030.