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How hard should I push my 9-year-old son to overcome his anxiety?

Learning to tolerate fear is the key to conquering it  

Jerry Bubrick, PhD

Senior Director, Anxiety & Mood Disorders Center; Director, Intensive Pediatric Obsessive-Compulsive Spectrum Disorders Program
Child Mind Institute

Q:  My son, now in the 3rd grade, has suffered from anxiety most of his life. This is not a situational anxiety; it affects him in every area of his life. He reacts strongly to transitions, new experiences, and unfamiliar social settings (sports teams, play dates at others' homes, etc.). As a result he shies away from anything he perceives as stressful. The question is how hard do I push him against his anxiety? Is there benefit to forcing him to play a sport, for instance in order to build tolerance (and in the end build up positive endorphins) or does this place him in a stress-inducing situation that is beyond his capacity to handle? Where's the operating manual?!

A:  As a parent, I completely understand the pain that comes with knowing that your child is suffering with anxiety, and wanting to do everything in your power to prevent it.  But as a psychologist, I know the value and power of his facing and overcoming those anxieties, and I always want children to grow and mature from their experiences.  So the dilemma of how much to push and cause (temporary) pain is a tough one. "Understanding Anxiety" and "Coping Skills" are definitely key chapters of that owner's manual you'd like to have. 

Anxiety is a normal human emotion and, at reasonable levels, is actually a protective and positive force in our lives.  However, when anxiety is excessive and/or beyond our control, it tends to cause disruption and pain in our lives.  Anxiety disorders are the result of having high levels of anxiety without adequate coping skills.

People with anxiety disorders tend to make two fundamental mistakes: overestimating how badly a situation will go, and underestimating their ability to effectively cope with that situation. Avoiding the situation relieves the anxiety, but the only coping skill he has learned is to avoid things he's afraid of.  What he doesn't realize is that by avoiding or escaping, he is actually making their anxiety worse for the next event.

This is why we should encourage them to face their fears head on, but support them to strengthen their coping skills.  We need to give our kids better tools to face and overcome anxiety and set them up for success, rather than allowing them to quit and/or never get started.

We want children to be positive self-coaches and talk their way through anxiety-provoking situations, by saying things like "I can do this," "I have ways of fighting my anxiety if it comes" and "I can handle tough situations."  We want them going into those situations with a sense of pride and confidence, and exiting those situations with a sense of mastery.  This will encourage them to try it over and over again.

Encouraging other activities like sports for endorphins is wonderful and physically healthy, but may not give him the skills he needs to face situations that are anxiety provoking for him.  I'd encourage your son to slowly face those situations and praise him with hugs, kisses and high-fives for making the efforts to try.  You can increase the length of those tasks over time, allowing him to make progressive strides forward. Set him up for success and let him learn that anxiety can be overcome.

For more, read What to Do (and Not Do) When Children Are Anxious.

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ocdtalk.wordpress.com · Apr 03 2014 Report

Great advice, and it is so true that avoidance is never the answer to dealing with anxiety. It only makes our world smaller and smaller. So much of what you advise is in line with Exposure and Response Prevention therapy, the frontline treatment for OCD, and the therapy that saved my son's life. I talk about anything and everything to do with OCD on my blog at: www.ocdtalk.wordpress.com.

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