Transcript for
Understanding your child’s experience of anxiety
Narrator (00:02):
Welcome to the Emerging Minds Families podcast.
Alicia Ranford (Host) (00:05):
Hi, I’m Alicia Ranford and you’re listening to an Emerging Minds Families podcast. When children are young, their life are full of big moments and new experiences. From riding a bike for the first time to heading off to school. Feeling nervous or a bit anxious is very normal as children grow and learn about the world around them, but for some children it can be difficult to manage these feelings, and as a parent it can also be hard to know what to do. In today’s podcast, we are going to talk to psychologist, Dr Angie Willcocks, about how to support children when these big feelings turn to experiencing anxiety. Welcome, Angie. Thank you for taking the time to speak with us today.
Angie Willcocks (Guest) (00:48):
Thank you, Alicia.
Alicia Ranford (Host) (00:49):
As a starting point, could you explain to our listeners what is anxiety?
Angie Willcocks (Guest) (00:54):
Sure. So anxiety is a normal part of life for everyone. It’s the feeling that we all get when something is new and a little bit scary, feels uncomfortable in our body, and usually people can push through this and go to the other side because it’s something that they want to do. For example, anxiety about meeting new people at a party or going to a job interview. And usually people then feel better when the event’s over or it shifts with some reassurance and support.
(01:24)
Sometimes people develop problematic anxiety, which is when their unpleasant feeling is overwhelming and gets in the way of living your normal full life. There’s different types of anxiety, but some of the main ones that are probably important to know would be generalised anxiety disorder, which is being quite worried about lots and lots of different things. Social anxiety, which is really excessive fear about being in social situations, really a strong fear of being judged by others and what will others think of me.
(01:58):
We have separation anxiety, which is a strong fear about being away from a loved one. This is usually driven from the fear that something bad will happen to that loved one when we are not with them or that something bad will happen to us. So it’s often related to safety of the other person or ourselves. And there’s also specific phobia, which is extreme, sort of debilitating fear of something really specific like dogs or insects or something like that. And sometimes people experience more than one type of anxiety.
Alicia Ranford (Host) (02:31):
You’ve spoken to me before that there are three components of anxiety. Can you tell our listeners a bit about these?
Angie Willcocks (Guest) (02:38):
Sure. So problematic anxiety is made up of three components, and they’re the thoughts, the feelings, and the actions or the behaviours. So I’ll talk a little bit about those. Anxiety is driven by worries, so this is the thinking component. There’s often what ifs in this or imagining worst case scenarios, so what if everybody laughs at me, with social anxiety. And then there’s the feeling or bodily sensations that always go along with problematic anxiety. This is heart racing, maybe feeling hot, dizzy, a choking feeling, some tummy symptoms, things like that, headaches. In children, it’s often the feelings or the physical sensations that are most obvious and more recognisable than the thoughts or the worries. And then finally we have the actions or the behaviours. These are things that we do when we’re anxious. So anxiety really drives avoidance and this is avoidance of whatever seems to be causing the anxiety.
Alicia Ranford (Host) (03:36):
What would parents be looking out for in their child to know that perhaps they should go and seek further support at their GP or go and see a psychologist regarding their child’s behaviour?
Angie Willcocks (Guest) (03:49):
That’s a good question, and I think it is also really important to note that sometimes it isn’t anxiety and there is a physical cause and I would often recommend that where there are ongoing physical symptoms that of course, go and see a GP and make sure that anything physical is ruled out. And I understand that that can be a tricky thing to do with something vague in a child like a tummy ache or a headache. But it is important to talk with a GP about ruling out anything physical before we jump to assuming that it’s anxiety.
Alicia Ranford (Host) (04:22):
And is it then a GP that might recommend that a parent take their child to go and see a psychologist for further support?
Angie Willcocks (Guest) (04:29):
A GP might recommend that, or parents can access some online information or online support as well.
Alicia Ranford (Host) (04:36):
What are some of the common concerns parents who come to you have about their child and anxiety?
Angie Willcocks (Guest) (04:42):
Often the main concern would be is it anxiety? Because of the physicality of anxiety for children, parents’ concern would be trying to distinguish is there actually a physical problem or is this anxiety? And it’s important to note that this is also true for adults. Sometimes even for adults with anxiety, it’s difficult for them to know if the physical sensations that they’re experiencing are from anxiety or is there an underlying physical cause and that’s a difficult thing.
Alicia Ranford (Host) (05:13):
That’s a great point, Angie, because it can be hard for parents to know. And so what is a parent’s role when thinking about the behaviour in their child and whether it’s due to anxiety?
Angie Willcocks (Guest) (05:25):
Again, just reiterating that that’s a hard thing to know, and parents won’t always get it right. They sometimes might think that something physical is wrong with their child when it’s anxiety or vice versa. It’s also hard for children to know that, so they can’t easily report, “I’m anxious and so I have a headache.” They might just say, “I have a headache.” But some things to look out for would be the avoidance behaviour, and so really resisting doing something like going to school or sleeping over at a grandparents or something like that along with distress. So crying, clinging, becoming quite overwhelmed with distress. We would also think about looking for things like frequent tummy aches, frequent headaches, lots of physical complaints, especially when they’re happening in relation to something or at certain times of the day. For example, bedtime before school, dinnertime, things like this and especially if at other times the child seems to be okay.
(06:28):
Sometimes kids will actually tell you what they’re afraid of and they’ll look for excessive reassurance. So they’ll ask over and over again, is it okay to do this or can you please say this to me? Or want you to say things sort of repeatedly. And on that sometimes there are repeated behaviours from the child wanting you and them to get into patterns of reassurance and repeating things and then importantly, getting quite distressed and upset if things don’t go their way.
Alicia Ranford (Host) (06:57):
Angie, is it important to help children to verbalise what they’re feeling?
Angie Willcocks (Guest) (07:05):
It is important, but it’s also important to understand that children, like some adults don’t always know what the worry is, and that’s probably why they experience it more as physical sensations in their body. So sometimes parents will get into a dynamic with their child when they’re wondering if it’s anxiety and saying, what’s wrong and what are you worried about? And the child actually won’t know. So it is important to try and get them to verbalise what’s happening but not pushing too hard on it. It can be useful to ask them, is anything different for you or are you worried about anything? Or what do you feel in your body? But not with too much focus on trying to get at what they’re thinking because children can’t always articulate or understand what it is that they’re thinking to be able to verbalise it to their parents. And that can be frustrating for both child and parent.
Alicia Ranford (Host) (07:58):
Understandably. And you mentioned earlier that a common concern for parents is around school related anxiety and perhaps a subsequent refusal to go to school. What would you suggest parents can do to support their child with this?
Angie Willcocks (Guest) (08:14):
This is a really stressful and triggering time, often for parents, for a couple of different reasons. One, because they’re really obviously unsure of what to do, but often it can trigger a lot of worry for parents because they start to think, what’s going to happen if the child doesn’t go to school? They’re then not going to go well at school and what’s this going to mean for their whole life? So parents can become really quite overwhelmed themself about it as well as of course, the practical concerns that parents need often to get along with their own lives during the day, like get to work themselves. So there’s a lot of pressure around getting children to school, and if children are refusing that or anxious about that, it’s a very stressful time. But what I’d say about that is first of all, try and be curious with your child, like a detective, trying to figure out when did this start.
(09:08):
Was there anything obvious going on at the time? We often think of school related anxiety and school refusal as being only linked to separation anxiety, but it’s not always the case. It can be related to perfectionism, friendship changes, changes with schoolwork, different teachers, all sorts of different things. So I’d encourage parents to be really curious and detective like about that and see if they can get some more information about what’s going on, including problem solving with the child if possible. And really importantly, working with teachers in the school to try and get some information on what might be happening for that child is quite individual. And also as a rule, we would talk about gradually encouraging that child in a supported way to get back to school. And remembering that this is the process and it’s not just about making the child go to school if you even could do that or keeping them home. There’s a middle ground in there and recognising that that sort of supported process is actually going to build resilience in your child. Resilience is a process that you can help your child learn the skills.
Alicia Ranford (Host) (10:29):
And perhaps that it’s going to take some time as well. It’s not going to happen overnight.
Angie Willcocks (Guest) (10:34):
Yes, it’s definitely going to take some time. And I understand that that’s really frustrating for parents when they, as I said, have their own things that they need to do. And they may need to, if appropriate, speak to their own work or something like that to get some flexibility just while the child is getting support to get back to school.
Alicia Ranford (Host) (10:57):
That’s a great point, and as a parent myself, I know it’s sometimes difficult to find the balance between forcing a child to do something that you know won’t hurt them and giving in and letting them avoid the situation altogether. So what would your advice be to parents about this?
Angie Willcocks (Guest) (11:14):
I think this is a source of a lot of frustration for parents because they wonder how much should I be forcing my child to do this? How much should I be listening to my child? It’s very distressing to see your child as being distressed. And sometimes parents can, I suppose, feel like they should give into that, “And it wouldn’t be good for my child to go to school if they’re very, very distressed.” And so they might err on the side of, I guess letting them get away with it and staying home. On the other hand, if parents are thinking of forcing their child to go to school, even if parents are feeling frustrated about that, many of us as parents know, you can’t actually force your child to go to school. You can’t actually bundle a 10-year old in a car and carry them.
Alicia Ranford (Host) (11:59):
It’s very difficult.
Angie Willcocks (Guest) (12:01):
You can’t carry them. So there’s a frustration around it. But also if we come to understanding we can’t force our child to do something, I think that’s very difficult for parents and where their own anxiety and fear can come in, like what am I actually going to do in this situation? So that’s where we go to a graduated program, a gradual plan on helping the child face the fear after we’ve problem solved what we can. Considering how are we going to get the child to go to school without avoiding it because avoidance breeds more anxiety. And if you, I guess, let your child stay home in an ongoing way, then that is never going to address anxiety. That’s only going to make the anxiety get bigger and bigger and bigger. So an example of this that I’ll give you is not related to school, but about hair washing. You need to wash your child’s hair.
(12:59):
And so let’s say we are thinking of a four-year old with this, and your child is very anxious about getting water tipped over their head, and they’re very fearful of that. They’re forcing them to do it would be holding them down and tipping water over their head and maybe that’s an old school way of parenting that we now know is ineffective and does not build resilience. That just builds more fear and maybe causes problems in the relationship between the child and parent. So that’s not recommended. On the other hand, we don’t want to just say, “Never mind, you never need to wash your hair.” I know it takes patience, but a middle ground of that would be tipping water over their shoulders, trying to make some fun of it, trying to get your child to be in a relaxed place, asking them if they want to tip the water over their head and gradually doing that.
(13:49):
And it might take a month of persistence and patience to be able to get to a point that the water can be tipped over the child’s head. It takes a lot of patience and parents really important to recognise, and I’ll probably say this a few times, but parents need to make sure that they get support in that as well because it’s quite tiring. It is frustrating sometimes as parents, depending on how we were parented, we can be tempted just to dunk the head under the water and tip the water over the head even though the child’s screaming because we’re under pressure to get things done and get the hair washed and cooked dinner. So it’s really important to get your own support in this and understand that it will be stressful and frustrating and that you’ll need to find some patience.
Alicia Ranford (Host) (14:35):
And when I hear you talk about the hair washing, it reminds me of where my own children were small. And I often found that I needed to get my husband to step in or if he wasn’t home, sometimes I know that even my mom would come and help me because it was fairly relentless and I know I was really lucky to have that support. What would you say for people who don’t have that network around them?
Angie Willcocks (Guest) (14:59):
Then I would say lower your expectations on yourself and get personal emotional support, maybe outside of the home, talk to friends, get professional help if you can. But also maybe wash hair, have a bath every second day, for instance, or lower your expectations around what you’re going to have for dinner that night or other things that you are doing with your day and your evening. For example, if you are thinking that you’ve got a long list of things to get to yourself, and I understand that particularly single parents do have a long list of things, but if you can take a couple of things off of that list for one evening, the evening that you’re doing the hair wash, then that’s going to give you a little bit more capacity to deal with a child’s resistance to having the hair wash and the patience that’s needed to do that in a gradual way. And ease that pressure slightly.
Alicia Ranford (Host) (15:55):
And if there are parents listening who experience anxiety themselves, what could they consider when thinking about their own children and anxiety?
Angie Willcocks (Guest) (16:04):
Yes, so parents who are and have experienced their own anxiety recently or over the course of their life can often be really quite overwhelmed and triggered at the real possibility or the confirmed reality that their own child is also experiencing anxiety. They can become really upset and worried, especially if they’ve struggled to manage their own anxiety through their life. But I think it’s important to recognise that if you do experience or have experienced anxiety in the past, you’re in a really great position to help understand your child.
(17:11):
You can help support them, you understand them. And while you can feel overwhelmed, it’s also a great place to be able to know I understand what that feels like. And ideally be able to share with your child, “These are some of the things that I’ve found helpful.” Might also be a very handy reminder on what you need to do for yourself and what you’ve found helpful in the past to manage your own anxiety. So it’s important to understand that you can be a great source of support for your child if you understand what anxiety is like. Also key to recognise and remember what has worked for you in the past. And again, and I know I’ve said it a few times, that really reach out for your own support, touch base with people who’ve helped you before. Go online and refresh your own knowledge about how to manage anxiety, touch base with friends and family. These are important things. Where possible, take a break, focus on your own self-care.
Alicia Ranford (Host) (17:43):
And I love that. You’re right, people who have had their own experience of anxiety can really have an insight into what their children might be experiencing that other parents don’t have.
Angie Willcocks (Guest) (17:53):
That’s right.
Alicia Ranford (Host) (17:53):
Angie, thank you. It’s been so interesting to look at anxiety and give parents those really practical things that they can do at home. And if you wanted people to just remember three things from what we’ve talked about today, what would you say they would be?
Angie Willcocks (Guest) (18:10):
I think number one would be curious. Try and be neutral, if possible, type of curious about what anxiety is like for your child. Maybe why it’s emerging now, and be open-minded. Be willing to learn maybe how to manage your own anxiety and willing to learn how to support your child, build resilience, I suppose, in the face of problematic anxiety.
(18:39):
Secondly, be patient with yourself and with your child. You are not going to get it right all the time, and neither is your child. You’re both learning and you are both hopefully working together and at times you will be frustrated and so will they. So be really patient with yourself and your child.
(18:58):
And thirdly, I know I’ve said this a number of times because it is really important as an adult, make sure you get your own support. Make sure you understand what’s happening for you, what this is bringing up for you as a parent, and see if you can manage your own worries about your child’s worries through, as I’ve said, getting your own support. maybe your GP, some online courses, family and friends. And if you are not sure how to manage your own anxiety, then it’s a fantastic time for you to learn some skills in that too, that will then support your child.
(19:35):
It’s also a really important point to know that actually overcoming anxiety and finding skills and strategies to manage what is a normal part of life as well builds resilience in children. So resilience is actually built through learning skills. We know this now, it’s not something that you’re just born with. Resilience is learned through actually practicing things when things are a little bit hard. We don’t want things to be completely too overwhelmingly difficult, as I said. But just the right amount of difficulty helps kids feel strong and resilient and know that they can in the future face other challenges as well.
Alicia Ranford (Host) (20:19):
Angie, thank you for taking the time to talk with us today.
Angie Willcocks (Guest) (20:22):
Thank you very much.
Alicia Ranford (Host) (20:24):
You have been listening to an Emerging Minds Families podcast. If anything spoken about today has been distressing for you or you find yourself struggling, please reach out for help. You can call Lifeline on 13 11 14 or more resources for support can be found in our show notes.
Narrator (20:44):
Visit our website at www.emergingminds.com.au/families for a wide range of free information and resources to help support child and family mental health. Emerging Minds leads the National Workforce Centre for Child Mental Health. The Centre is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.