What Seattle’s children are anxious about today might surprise you. While many are afraid of the dark or getting bad grades, some local mental health professionals say others worry about Mt. Rainier erupting and Donald Trump becoming president.
Regardless of the source, anxiety is a natural part of being alive. When we perceive danger, our thoughts race, our heart rate increases, stress hormones pump, and our breath becomes shallow. This physiological response compels us into action when a real threat is present, or it’s time to perform a challenging task. But when the anxiety is prolonged and irrational, it can become a barrier to fully engaging in life.
A longitudinal study by Harvard developmental psychologist Jerome Kagan found that some children are born with a more anxious temperament than others. The nervousness can often be attributed to over-reactivity in the amygdala, a small site in the middle of the brain that, among its many other jobs, responds to novelty and threat. Despite this potential genetic predisposition, Jocelyn Skillman, an Issaquah-based youth and family therapist and child mental health specialist, says that caregivers can help children who worry to excess by keeping their own anxiety in check.
“Parents might notice that when they experience their child’s anxiety, it can spike their own anxiety,” says Skillman. “The more effective the caregivers are at regulating their own distress and modeling healthy coping skills, the more likely it is that the child won’t become a victim of their own temperament and contributing biological factors.”
One of her favorite activities to do with anxious kids is an exercise called “smell the soup, blow the soup,” where kids pretend to inhale and cool down an imaginary bowl of soup. She says it’s a fun and effective way to teach kids to take deep breaths so they can regulate their bodies when they feel anxiety ramping up.
Skillman says her personal experience of childhood anxiety greatly informs her treatment approach. She was diagnosed with Generalized Anxiety Disorder at age 9 and prescribed a heavy-duty antidepressant that she stayed on for 10 years with limited professional oversight. She says she’s troubled by the medical community’s continued over-reliance on medication as a first-line treatment before trying other therapies.
“Deep listening, embodied compassion, and family healing goes a long way to mitigate the impact of fear on our systems,” says Skillman.
Depending on the developmental stage of the child, kids will sometimes act out what they are feeling during play. Rosie Newman, a licensed counselor at Seattle Play Therapy in the Maple Leaf neighborhood, says play therapy acknowledges that many children do not developmentally have the cognitive ability to express themselves in words. Newman’s role as a play therapist is to help the child feel accepted and understood, and to gain a sense of control or understanding about difficult feelings or situations.
During play therapy, the child can choose from a range of therapeutic toys that they can use to explore worries from real life in a safe space. “The child might choose a lot of scary animals, and the whole goal of their play might be about caging the animals, or creating some kind of mastery over those scary situations,” Newman says.
Validating a child’s real feelings of fear even when we know they are unfounded isn’t always easy, but it is the most helpful first response, says Sarina Behar Natkin, a licensed clinical social worker and co-founder of GROW Parenting, a Seattle-based parent-education practice.
“It’s hard when our kids are upset about something that may seem irrational, and it can be frustrating when it holds up our day. But when we try to quickly reassure them by saying things like ‘There’s nothing to worry about’ or ‘That will never happen,’ we actually dismiss it, and most kids’ minds will go to ‘But what if it will?’” says Natkin. “Anxiety doesn’t respond to logic; it’s not logical. So being empathetic is very important.”
Supporting children to challenge their specific fears incrementally can be a great way to build confidence. For a child who is afraid of swimming or going to school, for example, Dr. Molly Reid, a partner at Seattle Psychology and at Eastside Psychological Associates, likes to do an activity called “acts of courage” using the instructive metaphor of a ladder.
“You work with the child to identify things outside of their comfort zone, and we call those; An act of courage. We put the easy acts of courage on the bottom of the ladder, and then they build up to the harder ones higher up on the ladder,” she says. Over time, this gentle and compassionate process can help the child become desensitized to the experience they fear.
Natkin says that when children are scared to do something, but they get through it, that’s a great time for encouragement and reflection. She suggests prompting them with questions like, “Wow! You were really feeling scared about that and you did it anyway. How did you do that? What did you tell yourself?” She says kids might not know exactly how they got through it, but just by asking the question, parents are helping them connect the dots between “This felt scary” and “I survived.”
Before seeking out the help of a professional, Reid suggests that parents try some of the great resources available. She recommends a series of children’s books written by psychologist and author Dawn Huebner. The books address anxiety issues, with titles like What to Do When You Dread Your Bed and Sometimes I Worry Too Much But Now I Know How to Stop.
“I love working with anxious people. They care about everything,” says Reid. “I don’t think anxiety is an all-bad quality; I think it’s actually kind of a good thing, but it can sometimes get out of balance. Anxious kids are, by and large, very caring people. They just need to learn skills so that they can be in charge of their anxiety, instead of anxiety being in charge of them.”