Dr. Sarah (00:02):
Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.
(00:41):
Hello everyone. Hi Emily. Thanks so much for joining me.
Dr. Emily (00:49):
Hey.
Dr. Sarah (00:50):
So we are back at Beyond the Sessions on the Securely Attached podcast and we are going to address a challenge that one mom asked us for support around related to her child’s fears and anxieties. So this Emily, here’s what she said. She said, Hey Sarah, I’m kind of desperate with my 6-year-old right now and was wondering if you have any input. She very suddenly has a fear of monsters and dying. It’s causing her some major distress. She’s been sleeping in my bed, having trouble getting to sleep, wanting both me and my partner and our dogs to sleep with her and some days will literally not let me out of her sight. She started telling me that she’s afraid of dying. She’s afraid I’m going to die, and she’s afraid a monster will get her. I have no idea what to do. We have talked about how monsters aren’t real. We have my dog checked for monsters at bedtime. This seems to help, but she’s stuck on the whole death thing. Do you have any advice or resources I could look into or is this worth trying to find a child therapist for? It’s seriously just breaking my heart and I don’t know what to do for her. I feel this mom.
Dr. Emily (01:46):
Yeah.
Dr. Sarah (01:47):
Yeah. So let’s start, I think by addressing the last part of her question first, when is it perhaps time to get some outside help from a psychologist or a mental health professional? Given this what she’s describing, Emily, what would your advice to this mom and other parents when they want to? What’s the threshold for wanting to get some extra help?
Dr. Emily (02:08):
I mean, it’s interesting. I mean, I think this parent has described some really appropriate things. They’ve tried for what they understand and what they know, and it’s a really upsetting thing to see your child this upset. So it’s like you’re doing all these things and you’re checking bedtime, you’re looking under the bed, you’re making, you’re doing all these things to sort of assuage the child’s anxiety. I think if you feel like you’ve done your whole bag of tricks and you’re still really distressed or your child’s still really distressed and you sort of don’t know where to go, you’re backed into a corner, absolutely the time to reach out to somebody and now that doesn’t mean you’re signing up for lifelong therapy. That could be like, I just want to bounce this off of a psychologist. Maybe a couple of times, a few sessions or a time limited assessment. It could be that you want to pursue something more or different, but I also think, I love to dispel that therapy has to be this ongoing thing. I think consulting a professional on next steps or if this is a point of concern is completely appropriate and might just save you some just unnecessary heartache really for both you and your kiddo and your family system.
Dr. Sarah (03:28):
I think that’s such a good point, and I think it’s also speaking specifically to this mom’s question in the context of what are we looking at here? We’re looking at the observable symptoms, which is increased anxiety around monsters and dying. We’re looking at increased requests from the child for the parents to accommodate the family rhythm in order to ease the feeling of anxiety, right? Mom has to sleep in her bed or everybody and the dogs are going to be sleeping with her or she’s coming into their room or things need to be sort of checked or this idea that it’s repeating, repeating, repeating, repeating. A lot of times I’ll a bit of a sort of determining question I’m asking myself or people I’m working with when I’m trying to figure out is this thing we’re seeing the constant requests for reassurance or constant requests for information, is that a sign of anxiety or is that information gathering?
(04:46):
And typically my sort of framework for answering that question is if you answer the question like let’s say it’s are you going to die or when are you going to die? Or what’s going to happen to me after you die? Because kids do. There’s a developmental appropriateness around being curious and even preoccupied by death because once kids recognize what that is, it’s something they need to revisit a lot to make sense of. That’s pretty typical and not necessarily the sign of an anxiety disorder, but I also feel like if a child is constantly asking the same or very similar questions and you’re giving them the same information every time, it starts to stop being about information gathering and it starts to be more about soothing and anxiety. In the moment, I have this feeling, it makes me want to ask you this question. You give me the answer, same answer you always give me, and that kind of releases some of that anxious tension.
(05:53):
I get relief, I relax. Guess what? Some other thought, some other intrusive worry thought comes in, my anxiety pops back up. I seek out your reassurance. You answer my question again. I get that relief until the next thought comes up. And then what you can find is this sort of accommodation loop where the child keeps using the parent’s reassurance as an external regulator for their anxiety. That’s not information gathering, that’s not just trying to make sense of something that’s starting to move into a space of anxiety. And it’s worth kind thinking about is my answering the questions, is my constantly checking under the bed? Is me always having the dog spend the night in her room If that’s not where the dog really is best to be sleeping, whatever, I don’t care if the dog sleeps in the kid’s room, but how much is it disrupting family life for these things to be happening? But also is the child getting some inadvertent messaging from us that yeah, we do need to check under the bed for monsters because that could be something we need to protect you from, or I am going to reassure you constantly about me never leaving you or me all the fears you have about my death.
(07:21):
And in some way I’m also conveying to you this is something that you should be scared about. Obviously it’s tricky. Yes, one day everyone is going to have to deal with that and it’s a possibility, but the probability of it happening anytime soon is relatively low. Emily, you talk about possibility and probability all the time when it comes to anxiety.
Dr. Emily (07:43):
Yeah, and I mean the other thing that while you were saying that occurred to me is the other piece is again, super technical. It’s when you’ve tried all of your rationalization to your child and at some point you start to get frustrated as the parent. The fifth time they ask you about the monsters under the bed and they’re worried about you, they’re worried that the monster’s going to get them is maybe okay, but the 25th as a parent, the radar to me of when do I need help with this is if you’re starting to hit, you lose your empathy almost because the repeat how you so nicely explained that that’s our cue, that it’s an anxiety loop. And one of those signals to us as parents is like, oh, eye roll. Oh my gosh, I can’t say this again. Or frustration or something along those lines.
(08:42):
And I think the other piece that I did want to touch upon is this is really hard because this is death and danger. There are big scary concepts even to adults. So if your child was really, really worried that the bandaid would not leave, would not stay on their skin forever, you could almost blow it off a little. You might be able to elevate your parenting self to say, I’m not going to accommodate this. This is crazy. I have to change your bandaid every day. This, it might not, but when I think one of your child is afraid of a topic that’s hard for you too or hard universally, that it puts you on a little bit more edge to sort of address the accommodate to not accommodate as much, and it doesn’t jump on your radar as, oh, maybe I shouldn’t be doing this because the topic is sensitive and you want to make sure you’re addressing it.
(09:38):
So I just want to empathize with this parent because obviously in this question there’s two, there’s the monsters, but there’s also the death piece. So it’s a confusing thing. As a parent, how do I appropriately respond? Because I want to be, I both want to respond, I want to respond. I want to be able to say something reassuring, but when does that go too far? Is I think the thing that we’re talking about and some of those tips that we said I think are the ways to know how do I check this out? And as we talk about a lot on this podcast, there’s a lot of treatment for that, so we can really, really help with some of the reduction of the parental accommodations. The thing that you were saying, Sarah, is the thing that sort of propels that anxiety forward, and so there’s a lot of different treatment options to reduce that, which ultimately will increase the resilience of your child and reduce their anxiety.
Dr. Sarah (10:33):
And so I think going back to that point initially of okay, at what point do I actually need to get help for this one? I think whenever you’re feeling like I am overwhelmed by this and it’s impacting the flow of our family life or it’s impacting my ability to really be patient and hold empathy for my kid, I’m getting burnt out, I’m getting frustrated. It’s irritating me. What’s my motivation for shifting this dynamic? Or if you’re seeing it really escalate, if you’re seeing a real shift in your child’s worry to the point where it’s maybe it’s not getting in the way of family life, but it’s getting in the way of their play, they’re not playing as much or they’re not able to be as interested in things or their mood or their…
Dr. Emily (11:24):
Sleep.
Dr. Sarah (11:25):
Their sleep or other activities of daily living is getting, we can’t get our teeth brushed because there’s worries about things or it’s impact. They’re not eating as much because there’s worries about how the food is being prepared or whatever. I’m expanding on what I don’t think this mom is dealing with those particular worries, but I think those are things that can be sort of common for kids, but if they hit a certain threshold of frequency and intensity, they start to get in the kid’s way of living their life. Those are all kind of the sort of questions in the back of my mind when someone’s coming in for therapy around anxiety to be like, when we’re trying to diagnose an anxiety disorder, I’m like, what is the function? How much is this impairing function? How much is this impacting the relationships in the family? And then how much of this is better explained by just a development evolution? This is pretty typical to be afraid of monsters or to be afraid of death, but does it match up with their developmental timeline? If we have a 12 year, a 12-year-old who’s so afraid of monsters, they can’t sleep in their room, that’s really different than a 6-year-old who’s afraid of monsters and can’t sleep in their room. The other thing that I think is really important that this question, the letter that this woman wrote in doesn’t say, but is also something that Emily, you probably agree with me, is in the back of my mind when someone comes to see me and the question is, is this an anxiety disorder or something? Is I want to know the onset of it.
(13:12):
Is this sudden what it might have been going on that might be activating this particular fear? Did someone in the family just die? Have they been confronted with information about death that they weren’t ready for yet or that was new, right? Or was there a scary dog that kind of lunged at them when we were walking and now all of a sudden we have this kind of question about monsters under the bed or try to think of was there something that could have activated this particular fear or maybe directly or maybe kind of indirectly? Because I do think the context and the antecedents of a new fear or preoccupation can also be something that helps put it into context and also can help us try to help the child make sense of whatever that fear might be or the root cause of why it got introduced now. Why now?
Dr. Emily (14:15):
Yeah. I think that also helps you just to know is this just to loop it back, is this something that’s discreet or is this something persistent that I want to have looked at a little bit more closely?
Dr. Sarah (14:29):
That makes a lot of sense to me. You kind of brought this up, Emily, when you were saying there’s lots of treatments that deal with this, but just to give as parents some strategies, some very straightforward strategies. The treatment that’s coming to mind is SPACE, Supportive Parenting for Anxious Childhood Emotions. That’s a therapy that comes out of the Yale Child Study Center by Eli Liebowitz who is on this podcast. We actually have a SPACE podcast with Eli. I’ll link it in the show notes in the show description because it’s really, if you are dealing with a situation like this mom, I think space is one of the best ways a hundred percent to understand how to respond in a different way that is both very, very emotionally supportive and validating of the child’s fear and experience and not dismissing of it, but also not getting into that accommodation loop because that’s the parts we can be very, very validating, but if we aren’t also kind of saying, oh, it’s so scary to be thinking about monsters under your bed, I get that. That can make you feel a little worried. I know that there are no monsters under your bed, and I also know that it’s okay to feel scared versus constantly having this routine where I check all the crevices for monsters.
(15:52):
It really teaches about ways to support anxiety while not necessarily accommodating the worry. So that’s just a resource. I think go to that episode if you’re interested, but I think that that’s a really good collection of resources for responding to this kind of stuff because this mom is asking, do you have advice or resources? I could look into Eli’s book, Breaking Free of Childhood Anxiety and OCD is a fantastic resource for kids who have worries, whether they’re just a little bit worried about stuff or they’re legit dealing with an anxiety disorder or obsessive compulsive disorder. That book is a very, very good resource. And one other thing that I feel like is worth noting is a lot of times when our kids are worried about something that like Emily, like you said, makes us also uncomfortable, like our death, we can sometimes avoid wanting to talk about this stuff when our kids aren’t feeling anxious and they’re not asking us questions like we don’t want to poke the bear.
(17:00):
It’s hard to have these talks, and I don’t want to make them more anxious by bringing it up when they’re not already asking me about it, but actually having conversations that we’re initiating outside of their anxious moment when they’re saying, check out her the bed or tell me you’re going to be okay, is to sort of in those more sort of resilient moments that they’re having where they’re not worried about that, it’s not impacting them as much to then kind of say, we’ve been thinking about this a lot. It’s been coming up a lot. Like I’m initiating this conversation with you to kind of give you some information because I think that’s also a way for us to give our child reassurance and information to help them manage their anxiety that doesn’t serve that function of being in the accommodation loop, not immediately turning off their anxiety in the moment because they’re coming to us with that request.
(17:51):
We’re using a different time to give them that info so they can input it at a time when they’re not actually anxious and that can be more useful. But also in those calm, non-anxious moments is also a time to talk to them about anxiety and help them learn a little bit about how anxious feelings work and how they can make us want to go revisit and revisit and revisit, and when you want me to take your anxiety away, what I’m kind of showing you is you can’t feel anxious. It’s not safe, and so helping them, another really good resource actually is this series of workbooks from Dawn Huebner who is a therapist who wrote these. They’re really great books. We use ’em in our practice a lot, but she has one called What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety and What To Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD.
(18:54):
I love both of those for kids who have worries because it can really help give them some information about how, what is actually, what’s structurally happening for them, and again, you could do this in these calmer, more connected moments when they’re not actively seeking out reassurance or making you check under the bed, but that’s another time to give them info on the anxiety so they can understand what’s happening. And then when they are asking for the reassurance when they are being rescue me for my anxiety in this moment, then instead of answering the content of the worry request, like check under the bed and then being like, we’re not going to check under the bed or we’re going to check under the bed, there are no monsters to say, oh, I think you’re feeling worried right now, or I think you’re feeling scared. That’s a hard feeling and that is a safe feeling. Now we’re talking about the feeling and we have the shorthand that comes from talking about that stuff outside of the moment. I feel like those are good places to start.
Dr. Emily (19:55):
Totally agree. Great being here. As usual.
Dr. Sarah (20:00):
Talk to you soon.
Dr. Emily (20:01):
Bye.
Dr. Sarah (20:03):Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in this new series Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.
✨We want to hear from you! Go to https://drsarahbren.com/question to send us a question or a topic you want to hear us answer on Securely Attached – Beyond the Sessions! ✨
