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Pressure and the Anxious Child: A General Guide for Emotional Support

Enter the mind of an anxious child, and you step into a storm.

Thoughts are a constant swirl that instantaneously run through a thousand catastrophic scenarios as they rapidly assess situations and determine their safety level, at the same time gauging an internal barometer for available energy and the motivation to deal with those selfsame situations. And mind you, we could be talking about pleasant, fun things like a birthday party or a play date, but for the anxious child, everything raises heightened emotional alertness to an unmanageable degree that turns thoughts into a churning mass that seemingly can’t be sorted. Choices evoke anxiety, as one thought spawns what feels like hundreds of other thoughts about everything that could go wrong, consequences, potential judgment, who will stop talking to them as a result….On and on until the single question that sparked the thought cascade has splintered their sense of will and wanting into a thousand fragments. And then it becomes much scarier to leave the house, leave their bedroom, leave bed.

Of course, anxiety looks different for everybody. Some children experience mild anxiety in situations that would typically trigger it, such as having to present a project in front of all their peers or being around someone that they particularly want to impress. That type of anxiety can cause some physiological and emotional discomfort, but children are generally able to navigate their way through those situations and emerge on the other side. There are more severe forms of anxiety, however, that can cause extreme physiological reactions such as stomachaches, headaches, muscle tightness, difficulty breathing, numbness or tingling in the extremities, sweating, and feelings of not being connected to reality or of not being within their bodies. For those children, anxiety can upend daily life. It can cause loss of sleep, as anxious thoughts are typically worse at night, when things are quiet and there is little to distract from worries and fears. It can spark thought spirals that are difficult to stop.   It can create withdrawal, self-doubt, an aversion to any risk taking, and lead to a sense of paralysis with respect to decision-making, actions, or responsiveness.   It can live in the same space as sadness, in response to having to experience such feelings at all, and to have everything that should be easy or “normal” feel so complicated and suddenly unattainable.

When children experience any anxiety whatsoever, it tugs at the heart, but nothing strikes at a parent’s core worse than the debilitating anxiety of their child. For those who are acutely anxious, the indecisiveness and fear are tremendous interferences, and that is gut-wrenching to watch. Moreover, the helplessness experienced by family members can be devastating. At such times, parental anxiety can express itself in any number of reactions, the most common being over-rationalizing behaviors, anger, rescue-parenting, and compensation:

  • Over-rationalizing is quite common. When triggered by fear, parents will often explain things down to the minutiae, compelled by the hope that logic will make things more comfortable, sensible, or easier to bear. However, it is important to remember that children already know EXACTLY what they are supposed to do, and it is the inability to follow through or to complete a task perfectly that triggers tremendous anxiety. Often, the anxiety is attached to the sense of overwhelming expectation that they will somehow be found wanting, and children put themselves under tremendous pressure to avoid that unwanted self-imposed responsibility.
  • Anger is something that parents often don’t want to respond with, but it happens. Unwittingly, usually motivated by fear for what their child will experience, and incongruous with the love that is actually behind a parent’s worries, anger sometimes becomes the response. This is purely reactionary, an impulsive expression of heightened anxiety (often because the child’s anxiety triggers the parent’s own). It is fear of the unknown, manifesting itself in a type of “coaching” that uses the vehicle of anger to elicit preferential behavior, except that it does not work, and creates an additional layer of pain and guilt that has the opposite effect of entrenching anxiety.
  • Rescue-parenting is an offshoot of the last response mentioned, being a form of compensation. It is a self-soothing type of actionary response, because the helplessness involved in being an observer of the anxiety is often overwhelming. Parents feel better if they can step in, speak to someone (ANYONE!), negotiate the situation on behalf of their child, pilot the crashing plane and try to offset the potential consequences that they see and somehow believe that their children do not see.
  • Compensation is a fallback that parents often resort to. There may be a retreat from typical rules or routines, a reversal of household fundamentals, and a pullback of expectations. It is proffered in the hope that not giving the child anything to come up against will somehow ease worries and reduce the strain. What parents don’t realize is that to their children, this feels like further confirmation that they are not “normal,” and runs the risk of tipping the delicate balance of power between parent and child.

When problems rise to the level of acute, parents often feel disheartened and relegated to the sidelines as their children experience something that they cannot directly fix. They are forced to sit back and watch their children battle with their own brains, the source of the problem being ironically the source of the “cure.” Helplessness is a terrible place to live.

It is generally useful to manage anxiety in a collaborative format, with the shared efforts of those in helping positions who have been clued in as to how to step into their roles effectively. Parents can provide crucial support to work that is spearheaded by a psychotherapist, as acute anxiety often requires therapeutic attention for appropriate management. Working with a therapist can help to identify triggers and strategies to cope in both the home and school setting, bridging the gap where the child is without direct therapeutic assistance. Informing teachers of successful strategies is also an important step, so that everyone with an important role in the child’s life is verbalizing the same reinforcing things, and practicing the strategies that are known to be beneficial to a child.

Taking a deep breath, being aware of your emotions, and keeping your “emotional brain” in check is helpful before approaching your child. Remind yourself that they are very attuned to your reaction, and are probably picking up your tension or already fearful from what they see in reading your non-verbal responses (your facial expressions, vocal tones). Rather than talking about the specific consequences or outcomes of what their paralysis/anxiety/withdrawal will result in, back off from painting scary scenarios and find out what their thoughts are about the situation. Get a sense of what their intended outcomes are, or if they don’t know, provide a patient sounding board that consistently reflects back what you hear them say. Sometimes, hearing their thoughts aloud can provide clarity, or at the very least, validation that they have been heard. Refrain from problem-solving for them, because that can create a sense of implicit pressure (as in, your solutions could be a reflection of what YOU are comfortable with, not what they feel they can do). Allow them space to process ALL the thoughts that they are having, but once they begin escalating through repetitious thoughts or cycling in a panic, impose a break and help them breathe, distract themselves, do something with their hands that is sensory, or do something that they traditionally find soothing. Remind them that you are not interrupting them, you are interrupting the panic. Above all, tune in to what you see and hear. More often than not, children will signal you as to what that may be. It may not be what you hope to hear, but if you are being trusted with the source of their anxiety, LISTEN to the clues they are giving you.

The most important thing to remember is that resolving anxiety is a complex and slow process. It does not always respond to single interventions alone, and instead require time, practice, and tolerance. In persistently compromising cases, medication can be a useful component of treatment. Indeed, the highest clinical rates of success for managing anxiety in children and adults derives from a combination of medication and psychotherapy working in concert. This is greatly assisted by keeping to regular routines (sleep, mealtimes), not “ambushing” children (i.e. forcing them to respond immediately and to your standards with respect to situational changes or disappointed expectations), and providing a space for them to talk through their worries aloud. Permit them their feelings without losing grasp of yours, although it is fine to express genuine concern in non-“laundry-list” terms (avoid recounting all your worries and detailing your expectations at once). Communicate with your child and the extended “helpers” in their lives, and be sure that everyone is on the same page in how they respond.

Above all, remember that your child is not choosing this. If they had a magic wand and could make it all go away with one stroke, make everything easy for them and for you, they would. They would do anything for daily life to not be excruciating, for everyone involved. They know what they SHOULD be doing, they just can’t quite do it in the moment. If you can stand where they stand, and let compassion be the lens through which you see their predicament, it will be much more tolerable to do the painstaking task of walking side-by-side with them as they figure out what THEY are capable of. Having you as a partner can make the journey so much less frightening for them, even if it means that you are not completely guiding the ship.

Help them get to other waters, be patient with that process, and someday, they’ll be ready to take the helm again.

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