Wednesday, February 9, 2011

Helping Children Cope With Anxiety

For those of you who know me, you will probably agree that a good majority of the work I do is based on positive, empowering movement art & imagery. I'm going to do something a little different today in the interest of education, so bear with me.

In today's imagery you are going to imagine for a moment that today, your workday is full of confusion, frustration & failure. Imagine that no matter how hard you try, you fail at almost every task you attempt; that your co-workers misunderstand, tease or ignore you and don't help or support you; your superiors are impatient, irate and mistreat you. Imagine that you feel like you don't fit in and the deep sadness, humiliation, and isolation you would feel. No doubt, it would be nearly impossible to maintain a happy outlook, positive self image or a cooperative attitude in this type of environment.

Let's further imagine that you have a similar experience in the cafeteria, in the train or carpool commute, and then all over again at home interacting with your family. Surely you would eventually respond by becoming moody, withdrawn, depressed, uncommunicative or even combative.

This is how it feels to live a typical day in the life of a child with cognitive, sensory or social challenges.

You can choose to stop the imagery now, but for a child with these challenges the imagery continues. A child goes to school for a living for 6 hours a day or sometimes more if you add in before and after school care. Its his or her  'job'. This job is a very difficult one. He is often unable to leave the day behind him when he gets home because the same behavior patterns & reactions repeat there too.

Children with these challenges are highly susceptible & reactive to stress & experience serious emotional effects to this cycle of school & social failure. They become fearful of & react abnormally to  typical everyday situations. They respond with fear & worry, more accurately called anxiety and it can complicate the lives and compromise the well being of so many children with learning challenges.

There is sometimes a misunderstanding between the definitions of anxiety & depression: depression is worrying about the past; anxiety is worrying about the future.These "what if..." obsessions with future events may be real, perceived or imagined, but the effect on the child is just as paralyzing especially during times of upheaval or transition. It causes extreme difficulty with the child's ability to concentrate and interact appropriately. It affects the child's ability to cope & in some cases, it results in chronic irritability.

Authority conflicts are common with children suffering from anxiety. This makes complete sense when you consider that the child is fearful of any changes in his environment and doubts his or her own ability to handle the transitions effectively. We call the resulting behaviors defiant, avoidant, argumentative, stubborn, rebellious, etc. however, it is important to remember that the child is not behaving out of rebelliousness or oppositional behavior, but out of genuine fear. The behavior is his best strategy for coping with the anxiety he is feeling at that moment.

The effects of anxiety in children can be grossly underestimated. We casually refer to these children as "high strung" or as "old souls". We often minimize anxiety by telling them to "stop worrying", as if they really had the power to stop instantly just because we say so. Be careful to not belittle or ridicule the anxiety. The fears are very real to the child and should always be taken seriously. Science tells us that anxiety has both a physical and a psychological cause. It is of no use to punish anxious behaviors just as it is no use to punish a child who has a fever. It is vitally important to remember this when working with children experiencing anxiety. They do not know why they are anxious or where it is coming from They cannot help themselves. Parents, teachers, therapists need to compassionately & actively teach usable coping strategies & guide them through how and when to use them!

There are many different types of anxiety disorders and many ways to treat them. Some involve medications and some do not. (Parent's should consult with the child's psychologist & pediatrician regarding use of medication.)

It is a widely accepted practice to have the child engage in pillow punching or some other unstructured physical activity to relieve stress and anxiety, however many experts will discourage this. These practices have no point and do little to release anxiety and can actually increase the tension level. Rather, have the child engage in an activity that has a specific beginning, ending with definable & measurable goals. (Example: take 10 deep breaths; shoot 12 baskets; run 5 times around the back yard, etc)

Below are some simple (non-medical) yoga based techniques that will help a child cope with anxiety. While these techniques do not replace  professional diagnosis and treatment, they will offer some tools for parents & teachers as well as reassurance & relief for the anxious child.

1-Design a positive, reassuring  & affirming word or phrase, (in yoga we call this a "mantra" ) to use during periods of anxiety that will comfort & reduce fear. (Example: "Things are getting better all the time", "Breathe" or "My body is calm/safe". )

2- Practice Deep Breathing. Deep breathing brings oxygen rich blood to the brain and improves focus. It also has a grounding, calming effect on the central nervous system if done correctly. I often use a "Breathing Ball" (pictured at left) to illustrate this and to give a point of focus. This ball expands to show is how our body is taking in air and collapses back again to send out air. To learn the technique, click here.

3- Movement & exercise can be a physical, fun & enjoyable way to release tension. A game of tag, soccer, a hike or riding a bicycle will relax the muscles and release endorphins (a neurochemical that has a tranquilizing effect) into the body. If it is not possible to go outdoors, then try the "Sun Stretch" which can be done anywhere indoors or out.

4- Squeezing Lemons is a fun exercise/imagery that I use that is also a progressive muscle relaxation technique. Start by holding an imaginary lemon in your open hand-(sometimes I have the children hold a pink lemon in one hand and a yellow lemon in the other-to make both kids of lemonade.) Now squeeze the lemons (into an imaginary glass) with your hands and get all the juice out. Next squeeze those lemons with your elbows (by placing it in your elbow and bending your arm.) Next squeeze with your armpits. (by now the children will probably be saying "Ewwwww" or giggling, which is also a way to release anxiety/tension.) Continue squeezing lemons with knees, toes, chin, chest, shoulders, back & face.

5- Practice Enhanced Focus. It is a common understanding that focus can be enhanced by allowing your mind to "go blank". However, the purpose of our mind is to think-so its very confusing and hard even for the most disciplined person to "go blank" and think of nothing. A better approach is to focus intensely on one simple object or image. (This is referred to in Yoga as "meditation" ) Children can do this with a little bit of guidance and maybe a photo or picture of a flower, and animal or a relaxing scene from a magazine to focus on. Focus can also be enhanced by a repetitive activity such as zipping and unzipping a pencil case, doing a maze puzzle, or drawing circles, numbers or "Sleepy 8s" on a piece of paper.

Try this activity for decreased anxiety right before a stress producing event such as a test or a doctor's appointment: Find 2 items or surfaces of different textures such as the car seat and a notebook cover. Place on hand on one surface, and the other hand on the other. With your fingertips make circular motions on both surfaces at the same time. You can switch hands and do the exercise again for a few minutes.

Anxious children respond well to reinforcement & praise. Be sure to tell them how proud you are when they are brave in the face of anxiety. (Example: "I know how that you were nervous about going to the doctor, and I am so proud of the way you handled it! )  Reinforced behavior will be repeated and the child will gradually gain confidence in themselves as they are learning to handle new situations.

Above all, remember to communicate the child's needs and strategies with the rest of the child's support system: family members, babysitters & caretakers, teachers, instructional assistants, bus drivers, therapists, etc. The more that we are all involved, compassionate and consistent with our interventions, the better it will support and empower the child coping with anxiety.






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2 comments:

  1. Thank you so much for posting this! I often feel we really "neglect" these children often in education and that makes me sad. My own son (age 17) has struggled with anxiety/ depression. People tend to want to deal with these things behavioraly (just go to school) when there is so much more going on. I also have a child in my class currently who is extremely shy and fearful and worried of many things (I love the great simple ideas you suggest! They could easily work for any age group! Thanks so much!)

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  2. Pam, thanks so much for your comment! I agree. We do tend to overlook the seriousness of anxiety in kids. I am very glad to know there are compassionate educators and parents that are looking out for them! If you'd like some more tips and tools,send me an e-mail at: barbara@bodylogique.com and I can provide you with some other options for your son as well as your student!

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