By: Kristen Berthiaume PhD
Every Time You Go Away…
Helping Your Kid Deal with Separation Anxiety
My thanks to Hall & Oates for the title (you’re singing it in your head now, aren’t you? Sorry about that…). Separation anxiety is a normal part of development that typically occurs in infants between 9 and 18 months of age. It’s a process that protects the baby from being taken from her primary caregivers by a stranger (although, grandma may get screamed at, too). When separation anxiety occurs in older children, it can be heartbreaking for parents who just want our kids to feel happy and secure. If you’ve noticed your child becoming increasingly clingy, terrified that something awful will happen to her, you, or someone else, and avoidant of regular activities she used to go to willing, you may be dealing with separation anxiety.
Start by arming your child with some tools to help relieve anxiety and build self-reliance. Together, come up with a list of positive reminders that you can both agree are true. For example: “I am safe;” “My mom is a careful driver;” “My teachers will take care of me;” or “I know how to get help if I need it.” Post these reminders places your child will see them – by his bedside, on his wall, in his backpack, in his pocket, on the fridge. Consider putting together a book of reminders and having your child illustrate it. Practice them together frequently. The goal is for these to become second nature so they’re accessible when the worried thoughts get going. Practice deep breathing and talk your child through tensing and releasing each of his major muscle groups, one at a time. Right before bed is a particularly good time for relaxation. Teach him to rate his anxiety on a scale from 1 (feeling great!) to 10 (full blown panic) so that he can tell you specifically how nervous he’s feeling in a given situation. If he rates everything at a 10, try to help him calibrate that by saying, “You look fairly calm to me – just a little shaky. I would guess you’re lower than a 10 right now – maybe a 5.” Most kids can tolerate a 3 or 4 on a 10-point scale on their own but it’s time to start using some relaxation skills if the anxiety gets higher than that. You can help your child learn to monitor his level of concern by talking about what physical symptoms he’s noticing as anxiety increases. Beating heart? Sweaty palms? Butterflies in his tummy? Those are all signs he has some work to do to calm down.
Now that your child has some tools to use, it’s time to get serious. It’s very important that you don’t cancel important plans or activities, or allow your child to stay home from school because of her anxiety. Doing so will strongly send the message that being apart is DANGEROUS and should be avoided at all costs. As much as you want to take away your child’s hurt and worry, giving in to irrational fears is not the answer. Although this may seem helpful temporarily, it will make things much worse long-term. You may decide to be apart a bit less during this period to avoid unnecessary battles but you can’t glue your child to your side so she doesn’t have to feel bad.
Preparation for being apart is KEY to managing separation anxiety. Keep a family calendar with everyone’s appointments. Color-code the schedule so the kids know at a glance which is a whole family activity and which will require separation. Pick a time on Saturday or Sunday to review the upcoming weekly schedule in advance. Talk about the events for which you’ll be apart. When do they start and end? Who will take your child to his activities and who will pick him up? Who will your child stay with on date night? Explain which activities are optional (i.e., a play date) and which are not (i.e., going to school). Give her some control to skip the optional activities if she’s not up for them but talk about the pros and cons of missing out. You might even consider providing extra incentive if your kid goes ahead and tries the optional activities despite her hesitation, even if she has to come home early. Be sure to go over changes as they come up. For longer periods of separation (e.g., work trips), have the person staying with your child mark off the days as they happen so she can see the return date getting closer and closer.
Before an activity, talk again about the specifics. Explain if you’ll be hanging around or dropping off, and where and when you’ll pick your child up. Answer questions and provide some reassurance but don’t dwell on the anxiety. Once you’ve made details clear, try to move on to a new topic. It’s important to validate your child’s feelings but if you spend too much time on them, you’ll send the message that there is real reason to worry. When picking up your child, do your best to get there when you said you would to help increase her trust that things usually go as planned. But, make very clear to her that something could come up and to use her reminders to help with the waiting. “If I’m a little late, it’s just because I didn’t leave on time or got stuck in traffic. Remind yourself that I always come back to get you and that I’m a very careful driver if you start to get worried.” Give her a goal to focus on such as: “If I am five minutes late, you can call my cell phone to see when I’ll get there” or, “I will call you if I’ll be more than ten minutes late.” Whatever plan you make, stick to it.
Talk with your child about what she could do in the unusual event that you’re not where you said you’d be for pick up. Older, responsible children can manage having a cell phone with them. Program in back-up numbers (e.g., a friend’s mom, granddad) in case you’re not answering your phone for some reason. Talk about who your younger child can go to for help in various situations – teachers, camp counselors, coaches, friends’ moms, etc. – and be sure some of these sources have your contact information and that of the child’s other parent or a relative.
Some kids need more help than you as a parent can give them. When the separation anxiety is causing stress and disruption for the whole family, it might be time to call in an expert. Ask your pediatrician for a referral for therapy. Ideally, you’re looking for a therapist who works with children and uses cognitive-behavioral techniques to treat anxiety. Plan to attend weekly sessions, at least for a while. Your therapist will talk to you if he or she feels that medication might need to be considered. Therapists don’t prescribe medication for anxiety but they can help you find a treating physician.
Know going in that the process of working through separation anxiety will be a bit of a roller coaster. Some days you’ll feel enormous empathy for your sweet son who just wants constant hugs. Other days you’ll want him to stop touching you and get on the bus already. Do the best you can to limit displays of frustration in front of him. Showing annoyance with his attachment may actually make the problem worse because he’ll double his efforts to stay close. Be caring but always firm when it comes to maintaining limits. He still has to attend school. He still has to go to bed. You still have to have privacy when you go to the bathroom. If you have a spouse or partner (or sister, brother, parent, neighbor), tag team with each other so no one gets burned out. There will be tears (His. Yours.) but you will all survive. Promise. The skills you’re teaching your kids now for dealing with the anxiety will serve them well throughout life.
About this column: Send your parenting- and kid-related questions my way and I’ll tell you what I can: parentingwithaphd@gmail.com Please be aware that email is not a secure method of transmitting personal information so it’s best to keep your questions general. If your question is featured, your name and email will not be published. Submitting a question does not constitute a professional relationship in any way and this column is not meant to substitute for face-to-face therapy. If you feel you’re doing the best you can and still need help, it may be time to bring in a professional. Start by talking with your child’s pediatrician to get a referral.
Kristen Berthiaume, Ph.D. is a clinical psychologist with Grayson and Associates (www.graysonmentalhealth.com). She obtained her doctorate in clinical psychology from the University of Kentucky. She completed a predoctoral internship in clinical psychology at the University of North Carolina at Chapel Hill and a post- doctoral fellowship in the Attention Deficit Hyperactivity Disorders (ADHD) Program at Duke University Medical Center. She specializes in providing assessment and treatment of children, adolescents, and families dealing with the following issues: ADHD, learning disorders, social skill deficits, organizational problems, behavioral difficulties, anxiety, and depression. She generally focuses on behavioral and cognitive- behavioral techniques, but maintains a flexible approach to therapy. Her other day job is as mom to her six-year-old daughter and two-year-old son, and as incubator to a third kiddo.
