Children Anxiety Strategies (Part II)

In the last issue of Psychealth we were introduced to ten year old David who was experiencing anxiety in anticipation of returning to school. Three basic strategies to help David better cope with his anxiety were introduced: the expression of feelings, controlling self-talk and practicing courage by facing one’s fears. In this issue I will introduce three additional strategies which are useful in helping children manage their feelings of anxiety:

RECOGNIZE AND PREPARE FOR TRIGGERS – Triggers are the starting point of the cycle of anxiety. For David, his trigger is any situation or event which causes him to start thinking about his return to school (i.e. Shopping for school supplies, making school transportation arrangements, arranging for before and/or after school care, etc.). Helping David to recognize his triggers, and the beginning of his fearful thinking, will be essential in helping him better control his anxiety.

Hint: anxietybc.com provides a “Realistic Thinking Form” as part of their self-help toolkit. This form helps to show the connection between one’s situation, one’s fearful thoughts related to the situation, and the feelings which result from those thoughts.

USE RELAXATION & BREATHING EXERCISES-Learning to recognize one’s growing level of anxiety and consciously catching oneself so as to self-calm, is a very effective skill to have. This “self-calming” can be achieved by controlling one’s breath as well as rehearsing short phrases or affirmations. For David, he could control his breathing by inhaling slowly through his nose and exhaling slowly through his mouth. This style of breathing could also be accompanied by a short phrase he repeats to himself while inhaling and exhaling slowly. Such phrases could include statements like “I’m” (while inhaling), “okay” (while exhaling). It is best to do this five or six times in a row making your breaths deep and slow while pausing for a second or two between inhaling and exhaling.

Hint: A good way to demonstrate to young children how they should control their breathing is to tell them to inhale through their nose as though they were “smelling a flower” and exhale through their mouth as though they were “blowing a candle”.

RECOGNIZE ROLE OF IMAGINATION & BELIEFS-The imagination plays a large part in anxiety. Often we create catastrophic pictures in our minds. These pictures in turn create sensations in our body indicating where we store our stress. This sensation in the body is our early warning system that we are feeling anxious. Paying attention to this signal immediately allows us to take action sooner than later and thus better head our anxiety off at the pass before it becomes overwhelming. In David’s case, it would be helpful to have him describe the pictures he creates and help him recognize their connection to the sensations of anxiety he experiences in his body – i.e. butterflies, headaches, neck pain, etc.

Hint: One effective use of imagination is to use “a worry box strategy”. To use this strategy you picture a big red stop sign when anxious thoughts occur and say to yourself “STOP”, then imagine putting your anxious thoughts into a “worry box” to be reviewed at a scheduled time later. This use of a worry box, and a scheduled time to briefly review one’s concerns, helps us to let go of our worries and more effectively focus on what needs doing in the present.

This strategy is described at length in Taming Worry Dragons by E. Jane Garland, M.D. and Sandra L. Clark, Ph.D. a copy of which can be ordered from BC Children’s Hospital. Additional articles on the topic of anxiety are also available on our website at www.denisboyd.com.

A number of strategies have been described to help children who are anxious about returning to school. Practice these strategies with your children and check with them occasionally to see if they are effectively dealing with their anxieties.