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MumsnetGuestPosts (MNHQ) Thu 18-Aug-16 14:04:31

Guest post: "It's important to recognise when childhood anxiety is becoming a problem"

Peter Fonagy says parents can play a valuable role in helping children overcome anxiety

Peter Fonagy

CEO, Anna Freud National Centre for Children and Families

Posted on: Thu 18-Aug-16 14:04:31

(24 comments )

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"The best approach is sympathy combined with robust and calm confidence."

Feeling anxious and worried is a normal experience for children. Their still-developing sense of how their minds fit into the world means that thoughts and fears can be overwhelmingly powerful and very real: there really is a hungry tiger hiding under the bed, or eating those Brussel sprouts really could kill me. Most parents will recognise how intensely children can hold some of their beliefs about the world.

There is also an element of temperament in this. Even as babies, some infants startle more easily and are less easy to settle; we all know toddlers who howl at the sound of a hairdryer, while others blithely plough through whatever chaos may surround them. One of the hardest tasks of parenting can be learning to accommodate the particular sensitivities and needs of our children, whether this is because they differ so much from our own, or because we painfully recognise them.

While a degree of anxiety is natural, it is important to recognise when it is becoming a real problem – which is when it interferes with the child’s everyday life, perhaps through school attendance, their ability to interact with peers or adults, or to participate in and enjoy normal childhood activities. Early intervention makes a real difference.

If you are concerned that your child may be developing an anxiety disorder, the first step is to discuss it with your GP. The initial line of treatment is cognitive behavioural therapy (CBT), which has been found to have high success rates. Children are supported in developing strategies to regulate their feelings and skills to help them cope with their fears. Parents of younger children will also normally be involved and support their child in any ‘homework’ suggested by the therapist.

While a degree of anxiety is natural, it is important to recognise when it is becoming a real problem – which is when it interferes with the child's everyday life, perhaps through school attendance or their ability to interact with their peers.


Parents may also be asked to attend a CBT course where they will learn skills to help their child cope with and overcome anxiety. The fact that such courses normally focus on parenting approaches tells us how much parents can do to support their children with their fears. Parents should not feel blamed by this approach, but strengthened in their role – they can make a real difference in helping their children manage what can often seem an overwhelming and scary world. For some children, this additional parental support will be all they need, while some children may need further professional help - and there is no shame in this. As childhood anxiety expert Professor Cathy Creswell says, if a child has eczema, we consider the parent who consults a doctor and gives medicine as responsible and caring, we don’t blame them for the eczema.

Luke’s story is a typical example of childhood anxiety, and shows the positive impact CBT can have. When Luke was 10, his sleeping pattern became very disrupted and he developed severe anxiety about separation from his mother. It started in the run-up to a school trip away from home. He couldn’t sleep with the window open, and was frequently anxious and scared, upset even when his mother was on another floor in the house. The situation caused a great deal of tension within the family, as Luke’s father saw his behaviour as babyish and attention-seeking. In fact Luke had developed an anxiety disorder, and, fortunately, the family were able to access help.

Using CBT open questioning techniques, Beckie, Luke’s mother, asked him why he didn’t sleep with the window open. He told her that was afraid that men would come up a ladder at night and take him out the window. By asking questions and engaging Luke on his fears, Beckie was able to understand and reassure him. As part of the therapy Luke took charge of the window being opened and opened it a little more each night. His parents helped him monitor his feelings using a fear thermometer and learnt exercises to do when it went too high. After they completed the CBT course and used the tools learnt to help Luke, he is no longer anxious and sleeps well.

When supporting an anxious child, one of the most difficult - and important - things for parents is to remain calm themselves. Anxiety can be highly contagious; for very good evolutionary reasons, if we detect anxiety in someone else, it raises our own anxiety levels. If we respond to a child’s anxiety by seeming anxious, angry or upset, it is likely to set off a vicious cycle of increasingly negative emotions. This is not an argument for a ‘stiff upper lip’ denial of the child’s anxiety: instead the best approach is sympathy combined with robust and calm confidence that shows the parent themselves is not fearful. Try to talk in a calm and curious manner, ask open questions and listen to their fears without dismissing them as silly or attention-seeking

For more information on anxiety in childhood, download the latest podcasts from the Anna Freud National Centre.

By Peter Fonagy

Twitter: @AFNCCF

Monkeysmum03 Thu 18-Aug-16 22:34:16

My 3 year old son suffers with anxiety, Ive taken him to the gp who referred him to the hospital for assessment but they just sent us a letter saying he didn't meet the criteria to be seen. Ive had the health visitor out but at home most of the time he's fine. Sometimes it's hard work doing anything because I have to spend so long preparing him for everything, just feel like i'm banging my head against the wall.

BrainSurgeon Fri 19-Aug-16 00:21:12

Thanks, I wish there was way more awareness and understanding of this issue. My husband, just like the husband in the example, is very dismissive of our son's anxiety and blames it on me "pandering" to him. Apparently the best "cure" is to let your child cry and scream his brains out until he "gets over it" angry

HobnailsandTaffeta Fri 19-Aug-16 15:08:43

Why did he have to sleep with the window open, that's a fairly fact based fear in some areas confused

TheEmojiFormerlyKnownAsPrince Fri 19-Aug-16 15:27:35

We're just going through this now. Dd has dreadful anxiety, and we are waiting on CAHMs at the moment.

It's hard on the whole family☹️

HeyMacWey Fri 19-Aug-16 16:34:27

A well timed post - just going through this with dd11.

On waiting list for cbt. I'm really hopeful that is going to help her manage it. It's exhausting.

Or local Mind recommended the app Mindshift which is really good for helping understand anxiety and how it affects you and ways to manage it.

Looking forward to listening to the podcasts.

Dozer Fri 19-Aug-16 18:08:26

Child mental health services aren't good enough and need more resources.

I have had longstanding anxiety problems and really worry about passing this to my DC through nature and/or nurture!

one of my DC seems prone to it and it became an issue after moving to junior school, luckily improved with some help from us and some good pastoral care from teachers.

A friend's DC needed more help after a sibling was ill and family problems and the NHS didn't help - they could afford private talking therapy, but not everyone can.

Dozer Fri 19-Aug-16 18:09:46

Thank you very much for the posts and information/podcasts!

Waitingfordolly Fri 19-Aug-16 19:04:59

Yeah my DD couldn't get help through the NHS either because apparently her anxiety and panic attacks weren't bad enough even though they were causing her to miss school. We had to pay too. It's terrible.

OrangeNoodle Fri 19-Aug-16 20:05:38

My 7yr old DD has horrendous anxiety. Triggered by having to help me resuscitate her younger brother during a seizure over a year ago. She never wants to leave my side and has angry outbursts, can't go to sleep alone and has to be peeled off me in the mornings. She is worried that one of us will die sad.

I have read so many books with self-help tips. None of it is working. We have seen the GP and a paediatrician who said she has 'significant anxiety' but we have been told there is no help available and it's down to the school. School are great with her but they are not mental health professionals.

I can't believe it really. I can see it spiralling and am desperate to get her some help. Just don't know where to turn.

MumsFlouncingOnASummerHoliday Fri 19-Aug-16 20:18:47

My 5yo DD has severe anxiety. Its the only diagnosis we have in writing but with an Autistic eldest brother we are on the assessment pathway for ASD now too.

We've received an interesting mix of support. HV agreed reason for concern at 18months, moved areas new HV concured. Speech therapy at 3 agreed reason for concern and monitoring, school have been really good at supporting and nurturing DD to approach things at her pace.

I've been offered no therapies for DD or I. I get lots of sympathy off the professionals (who are generally lovely and overstretched).

OneOfTheGrundys Fri 19-Aug-16 20:40:16

DS suffers anxiety as a result of his learning difficulties.

Theres just nothing out there for him. He has a severe language difficulty. We've found some practical measures to help but they're not addressing the roots of his fear.

HeyMacWey Fri 19-Aug-16 22:11:58

orange can you not push for a camhs referral?

PearTree1 Fri 19-Aug-16 22:33:47

Glad I've found this post & going to check out the Mindshift app. My AD was placed with us a year ago & it took a while for me to realise the angry outbursts were anxiety. No one tells you a childs worry & fears will manifest as anger.
It's also helpful to read it's contagious. I found it really hard to manage my own anxiety when she was tantruming. Now I can ask if she's worried and try to diffuse things. Doesn't always work though!

MrsMcMoo Fri 19-Aug-16 23:33:04

Hobsnail has a point. We live in South London, and would never sleep with the window open! I'd never, ever dream of letting the dc do it. Maybe it's not that irrational.

gadispoker Sat 20-Aug-16 00:34:31

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gandalf456 Sat 20-Aug-16 22:45:41

Timely thread. DD is going to go on Monday as it's getting out of hand

BirdintheWings Sun 21-Aug-16 07:24:48

Well, it's quite a nice friendly soothing post, but it does remind me a lot of Tanya Byron a year or so back, telling us all that we shouldn't be embarrassed to seek help for our children's mental health.

Most parents on that thread weren't embarrassed, they were desperate to find help. It often just isn't available for months or years.

Sorry if that lacks the calm, strong, confident tone recommended.

OneOfTheGrundys Sun 21-Aug-16 08:08:16

Quite, Bird .

I can only dream of a resource like the Anna Freud centre where we live. I would love for that to be available for my own child and those I work with.

As it is, at work, we call the crisis team for a suicidal child who has harmed themselves on, say, Monday, and they are able to visit on Thursday. They are brilliant at what they do but waaay overstretched.

TheEmojiFormerlyKnownAsPrince Sun 21-Aug-16 09:42:40

I don't find self help books work either, it's beyond that.

Fortunately we only had to wait about 4 weeks for a referral. She was initially referred to a level below CAHMS, but they have referred her on. But they are continuing to support and help until the CAHMS people arrive.

It's bloody disgusting reading what some people on here are saying about getting help.😡why is getting help for children so difficult?😰

lukeymom Mon 22-Aug-16 03:39:19

I've suffered anxiety ever since childhood. When I once saw my gp about it,he kind of laughed at me when I told him,sort of brushing it off as nothing.
My 7 year old son suffers anxiety. I know alot of kids go through a faze of worry ,worry about fitting in with peers.Or anxiety about their bodies. My son does ,but also at home which is a flat ,he is afraid of going into another room on his own,either calling me or his little brother to go with him.He hates going to the toilet alone.If he foes he rushes,sometimes not even flushing the chain and washing his hands. He won't sleep alone,not even with his brother in the room. I am a single parent and he always wants to sleep with me.Even his little brother does as well now. I can't get rid of them. smile At school he is quiet and had friends who since moved to different schools. He plays with just once other child.He has no friends at home because there is no one in the neighbourhood to play with. If I take him to parks during school holidays and other kids want to play or just talk to him he will often run away. Some boys wanted him to kick a ball around with them the other day but he just said no and ran. He thinks it's funny and laughs off. I tell him not to be so afraid. If a girl talks to him he finds her less threatening and he will sometimes stay and talk.I hate him being so timid around other kids.Often his frustration builds up and he starts bullying his 4 year old brother or he shouts and punches me in the arm. He has now started to think people are staring t I'm.He stares at them ,then he gets nervous if they stare back asking me why are they staring at him. I had times myself where I would feel self conscious thinking people were staring.But people stare at eachother I have come to the conclusion.You can't stop it.I'm working on building his confidence more.

Starduke Mon 22-Aug-16 08:16:54

I think my DS (nearly 5) suffers from anxiety - this post has pushed me to talk to our GP about it.

Our car broke down on the way home from holiday this weekend and his anxiety shot through the roof, from being afraid we'd be hit by cars (we were on a motorway), to thinking we wouldn't be able to take all our stuff. He was in tears most the time.

I won't even begin to go into how badly he sleeps at night. I'm on my knees with exhaustion.

MidnightMargaritas Mon 22-Aug-16 09:02:27

I took my DD(6) to the GP about her anxiety which she has had for years. Only now its stopping her from going out with her grandparents, shes not sleeping, not really eating and is constantly upset or scared something bad is going to happen sad The GP said oh this is normal for her age group. Just keep reasuring her and be supportive, it will pass. When I explained this has been on and off since she was 3 I was told the same thing. My DD starts school in less than 2 weeks again and its going to be hell, I just hope the school can be supportive. This breaks my heart. We seemed to be fobbed off quite a bit.

Waitingforsleep Thu 25-Aug-16 19:46:11

My Dd has been diagnosed with anxiety however I believe it's wrong I believe she has Aspergers. It's so hard to get anyone to listen! Yes she is anxious about things but I think it's the Aspergers causing the anxiety - things like dislike of change, rigid thinking, not understanding some things... But how do I get professionals to see this? We have been in the system for years and the effect it's has had on me is quite depressing sad

hannahgibbons01 Thu 01-Dec-16 16:39:37

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