Overcoming Anxiety For Dummies, 2nd Edtion
Page 37
Relaxing to reduce anxiety
Children benefit from learning to relax, much in the same way that adults do. We discussed relaxation methods for adults in Chapters 12 and 13, but kids need some slightly different strategies. That's because they don't have the same attention span as adults.
Usually, we suggest teaching kids relaxation on an individual basis rather than in groups. Kids in groups tend to get embarrassed. They deal with their embarrassment by acting silly and then fail to derive much benefit from the exercise. Individual training doesn't usually create as much embarrassment, and keeping kids' attention is easier.
Breathing relaxation
The following directives are intended to teach kids abdominal breathing that has been shown to effectively reduce anxiety. Feel free to use your own creativity to design similar instructions. Say the following to guide your child through each step:
1. Lie down on the floor and put your hands on your tummy.
2. Pretend that your stomach is a big balloon and that you want to fill it as full as you can.
3. Breathe in and see how big you can make your stomach.
4. Now make a whooshing sound, like a balloon losing air, as you slowly let the air out. Excellent.
5. Let's do it again.
Breathe in and fill the balloon. Hold it for a moment and then let the air out of your balloon ever so slowly as you make whooshing sounds.
Repeat these instructions for eight or ten breaths. Tell your kids to practice this exercise daily.
Relaxing muscles
An especially effective way of achieving relaxation is through muscle relaxation. The following series of directives may help a child relax. Again, feel free to use your creativity. Have your child work each muscle group for about ten seconds before relaxing. Then relax for about ten seconds. Talk your child through the exercises as follows:
1. Sit down in this chair, close your eyes, and relax.
2. Pretend the floor is trying to rise up and that you have to push it back down with your legs and feet.
Push, push, push.
3. Okay, now relax your legs and feet.
Notice how nice they feel.
4. Oh, oh. The floor is starting to rise again. Push it back down.
5. Good job, now relax.
6. Now tighten your stomach muscles.
Make your stomach into a shield of armor, strong like Superman. Hold the muscles in.
7. Good, now relax.
8. One more time; tighten those stomach muscles into steel. Hold it.
9. Great, now relax.
See how nice, warm, and relaxed your stomach feels.
10. Now, spread your fingers and put your hands together in front of your chest. Squeeze your hands together. Push hard and use your arm muscles, too.
Pretend you're squeezing Play-Doh between your hands and make it as squished as you can.
11. Okay, now relax. Take a deep breath. Hold it.
12. Now let the air out slowly.
13. Again, spread your fingers wide, and squish Play-Doh between your hands. Hold it.
14. Great. Now relax.
15. Pretend you're a turtle. You want to go into your shell. To do that, bring your shoulders way up high and try to touch your ears with your shoulders. Feel your head go down into your shell. Hold it.
16. Okay, now relax.
See how nice, warm, and relaxed your shoulders and neck feel.
17. One more time now. Be a turtle and go into your shell. Hold it.
18. Good. Now relax.
19. Finally, squish your face up like it does when you eat something that tastes really, really bad. Squish it up tight. Hold it.
20. Okay, now relax. Take a deep breath. Hold it.
21. Now let the air out slowly.
22. One more time. Squish your face up real tight. Hold it.
23. Relax. Good job! See how limp and relaxed your body feels.
When you feel upset or worried, you can do this all by yourself to feel better. You don't have to do all the muscles like we did. You can just do what you want to.
Imagining your way to relaxation
One way to help your child relax is through reading books. Before bed, kids find stories very relaxing. Reading rids their mind of worries and concerns from the day. You can also find various books and tapes specifically designed for helping kids relax. Unfortunately, some of the tapes use imagery of beautiful, relaxing scenes that kids may find rather boring.
Rather than beautiful scenes of beaches and lakes, kids can relax quite nicely to more fanciful scenes that appeal to their sense of fun and joy. The scenes don't need to be about relaxation per se; they just need to be entertaining and pleasant. Again, the point is to provide engaging alternatives to worries and fears. One great idea comes from one of our clients and that client's mother. You can design your own book with your child. This child, with a little help from her mom, wrote and illustrated each page of her own relaxation book as in the following excerpt, titled "Imagine Unicorns and Smiling Stars":
Close your eyes and relax.
Imagine unicorns dancing.
Imagine outer space. Look at the planets spinning and floating.
Imagine smiling stars. See how happy they are.
Imagine blue moons. See the moons smiling.
Imagine nice aliens. They like you.
Imagine spaceships soaring.
Imagine unicorns dancing in outer space with smiling stars, blue moons, and friendly aliens in their spaceship soaring.
Now, relax. Dream wonderful dreams.
Exorcizing anxiety through exercise
Exercise burns off excess adrenaline, which fuels anxiety. All kids obviously need regular exercise, and studies show that most don't exercise enough. Anxious kids may be reluctant to engage in organized sports. They may feel inadequate or even afraid of negative evaluation by others.
Yet it may be more important for anxious kids to participate in sports for two reasons. First, sports can provide them with important mastery experiences. Although they may feel frustrated and upset at first, they usually experience considerable pride and a sense of accomplishment as their skills improve. Second, aerobic activity directly decreases anxiety.
The challenge is to find a sport that provides your child with the greatest possible chance of at least modest success. Consider the following activities:
Swimming: An individual sport that doesn't involve balls thrown at your head or collisions with other players. Swimmers compete against themselves, and many swim teams reward most participants with ribbons, whether they come in first or sixth.
Track and field: An individual sport that has a wide variety of different skill possibilities. Some kids are fast and can run short dashes. Others discover that they can develop the endurance to run long distances. Still others can throw a shot put.
Tennis: A low-contact and relatively safe sport. Good instruction can make most kids adequate tennis players.
Martial arts: Good for enhancing a sense of competence and confidence. Many martial arts instructors have great skill for working with uncoordinated, fearful kids. Almost all kids can experience improvements and success with martial arts.
Dance: A sport that includes many variations, from ballet to square dancing. Musically inclined kids often do quite well with dance classes.
In other words, find something for your kids to do that involves physical activity. They can benefit in terms of decreased anxiety, increased confidence, and greater connections with others. Don't forget to include family bike rides, hikes, or walks. Model the benefits of lifelong activity and exercise.
Getting Help from Others
The goals of childhood include learning how to get along with others, learning self-control, and preparing for adult responsibilities. Children make progress toward these goals by interacting with friends and family as well as by attending school. If anxiety interferes with these activities, then consultation and professional treatment may be needed. In ot
her words, if a child can't play, learn, or participate in activities because of worries, it's time to get help.
Who to get help from
We recommend that parents first turn to their child's medical doctor to make sure there are no physical reasons for a child's anxiety. Certain medications prescribed for other conditions can cause a child to feel anxious. The physician may decide to switch medications first. If the culprit is anxiety, rather than a drug or physical problem, the medical provider may have recommendations for mental-health providers. The following tips may help you search more effectively.
Call your health insurance plan to see what type of coverage you have for your child's mental-health care. Your company may have a list of providers in your area.
Call providers and ask whether they have experience and training in treating childhood anxiety. The therapy can seem like play to your child, but therapy should be based on an approach that has been shown to help children overcome anxiety. We generally recommend practitioners trained in cognitive or behavioral strategies because their effectiveness has been supported most consistently by research.
Make sure the provider you choose has office hours that can accommodate several appointments. Although the treatment may be relatively brief, don't expect it to happen in one or two sessions.
Ask what state license your provider holds. Don't seek help from someone without a license to practice mental-health counseling. Professionals who usually treat children may be clinical psychologists, social workers, counselors, or school psychologists.
Psychiatrists can also be involved in treating childhood anxiety disorders; however, they usually prescribe medication. We recommend that treatment for anxiety, especially for children, begin with psychotherapy rather than medication. We take this approach because of unknown side effects of long-term use of medication and the great potential of relapse when medication is stopped. In contrast, the new ways of thinking or behaving learned through psychotherapy can last a lifetime.
If your insurance doesn't pay for psychotherapy, consider this: A study reported in the Journal of Abnormal Psychology (2008) found that the medical costs of anxious children were almost 21 times higher than those without anxiety. Covering effective treatment for anxious children is cost-effective for health insurance companies. Your medical provider may be able to advocate with your insurance company using this argument. Treating anxiety early can save considerable money and suffering in the long run.
What to expect at the first session
Generally, the first session is a time for your child's therapist to learn about the problems your child is having. You can expect lots of questions. Parents are almost always invited into the first session to provide information. You may want to prepare for the first appointment beforehand by keeping a journal of what you're concerned about. For example, consider taking notes on the following questions:
What happens? Does your child avoid certain situations? Is anxiety getting in the way of her schoolwork or her play with other children? Is she getting bullied at school?
When do your child's symptoms crop up? Is he fine at home with familiar people and afraid at school? Does he get worse when he's worried about a test or when meeting new people? Are there particular times when his anxiety seems better or worse?
How long have you noticed these symptoms? Have there been any changes in the family, such as the birth of a child, death, or divorce? Has your child experienced any trauma?
Do other members of the family have problems with anxiety? If so, what sorts of problems?
Has your child experienced any recent health problems or hospitalizations?
Generally, what a parent or child says to a therapist is held in strict confidence with only a few limitations. One important limit to confidentiality with professionals is that they're required to report suspicions of child abuse. Another limit is that they must report cases involving children who appear to represent an imminent threat to themselves or other people.
What happens in therapy?
For young children, much of the work is likely to focus on the parents. In other words, the therapist spends much of the time teaching the parents things they can do to facilitate their child's progress. This focus doesn't mean the parents caused the problem, but they often can do much to alleviate it.
Older children and teenagers spend more time in discussions with the therapist, and parents' involvement varies more widely. In either case, you can expect the therapist to give tasks to both parents and their kids to be carried out in between sessions. You should expect the therapist to discuss what the specific goals of the sessions are, as well as detailed plans for getting there. However, you shouldn't expect therapists to reveal details of what is discussed in sessions with your child. Kids need to feel safe in revealing whatever they want to their therapists. Parents are, however, entitled to progress updates.
More often than not, childhood anxiety can be expected to improve significantly (not necessarily resolve entirely) within six months or so of treatment. If that doesn't seem to be happening, discuss it with the therapist and consider getting a second opinion.
Part VI
The Part of Tens
In this part . . .
We offer ten quick ways to defeat anxious feelings on the spot. In case your anxiety comes back, we review ten ways of dealing with relapses. Also, be sure to take a look at the ten indications that you may need professional help. Finally, we include an appendix where we recommend books and Web sites that you can turn to for more help in dealing with your anxiety.
Chapter 21: Ten Ways to Stop Anxiety Quickly
In This Chapter
Talking away your anxiety
Jumping (jacks) into action
Making whoopee
Sometimes you need quick, temporary relief from anxiety. With that in mind, this chapter describes ten assorted therapies from our anxiety/stress reduction first-aid kit. Select one or more when worry and stress start to get out of hand.
Breathing Out Your Anxiety
Anxiety makes breathing shallow and rapid. And rapid, shallow breathing has a way of increasing anxiety — not a useful cycle. Try this quick, easy-to-learn breathing technique to restore a calming pattern of breathing. You can do this anytime, anywhere. It really works. Give it a try.
1. Inhale deeply through your nose.
2. Hold your breath for a few seconds.
3. Slowly let your breath out through your lips while making a slight sound — hissing, sighing, or whatever.
4. Repeat Steps 1 through 3 for a minimum of ten breaths.
Talking with a Friend
Anxiety is a lonely feeling, and loneliness increases anxiety. Research shows that social support helps people deal with almost any type of emotional distress. So don't hesitate to reach out to friends and family. Find a trusted person to confide in. You may think that no one would want to hear about your troubles, but we're not talking about whining and complaining. We're talking about sharing what's going on with you.
No doubt you would do the same for someone else. You likely know some folks who want you to call them in troubled times. If you find yourself without friends, call upon a minister, priest, or rabbi. If you have no religious connections, call a crisis line. You can also see Chapter 23 for signs that you may need professional help.
Exercising Aerobically
Anxiety floods the body with adrenaline. Adrenaline, a chemical produced by your body, causes your heart to beat faster, your muscles to tighten, and various other body sensations that feel distressing. Nothing burns off adrenaline faster than aerobic exercise. Good examples include jogging; a long, fast walk; dancing; rope jumping; and tennis.