How I Help My Son Manage His Anxiety

When we minimize a child’s fear we make them feel lesser. When we validate their concerns and help them work through a difficult situation we empower them to survive the challenges of life.

For the first three decades of my life I experienced fairly normal levels of anxiety.  I had short-lived fight-or-flight responses around events like public speaking. I lost sleep over important deadlines at work or school. I managed around it all.

​However, when a more severe anxiety latched on to me in my early-30s, it debilitated me for months.  My body was overwhelmed with a constant adrenaline rush. I went days in a row with no sleep.

My therapist suggested Valium.

I was furious.

I am not universally anti-medication for mental health problems. I have taken anti-depressants nearly my whole adult life. The drugs I take correct chemical imbalances that spur depression. I view them like any supplement—iron for anemia, Synthroid for an under-active thyroid, or SSRIs for severe depression.

Anti-anxiety drugs, the benzodiazepines like Valium or Xanax, do not target a biological source of anxiety. They suppress symptoms. They can be addictive, ultimately causing more problems than they solve. So when my therapist suggested Valium I interpreted that as her recommending that I superficially numb my pain instead of seeking a more authentic treatment that looked at the source of my fear.

I did not take the medication and eventually I did work back to the root of my anxiety. I was reliving the trauma of a sexual assault. I have since had other prolonged bouts of anxiety, each time declining medication and instead dealing with the root cause.

However, to my discredit, when my now 8-year-old son Bobby began exhibiting severe anxiety at the age of 3, I forgot my own beliefs and instead targeted his symptoms, not the root cause of his fears. My reaction made his anxiety worse.

Thankfully, with the help of child behavioral specialists and a lot of soul searching about my own experiences, I have learned to be a much more effective support for him.

Validate

Bobby’s anxiety mostly manifests itself at doctor’s appointments. He begins retching the moment he recognizes that we are near a doctor’s office. The dry heaving is so violent that nurses rush to isolate him out of fear he has whooping cough or some other infectious disease. Patients and staff alike bring us trash cans in anticipation of a vomiting spell.

He sweats through his clothes and mine.

In the beginning, I was discombobulated by the chaos of the retching fit. I turned away medical masks and the vomit receptacles, instead pulling Bobby close to comfort him. Over and over again I told him, “Shhh. It’s OK. You’re fine. Just calm down.”

The problem with my approach is that it wasn’t OK and he wasn’t fine. Bobby had three open heart surgeries before his third birthday. He spent the first year of his life with a feeding tube running from his nose to his stomach. He’s had 20 hospital admissions.

From his perspective as a 3-year-old, sometimes a nurse took his vital signs and he only had to endure a cursory examination—the main purpose of the visit was for me to speak with the doctor about treatment plans. Other times, a nurse took his vital signs, he was given a sedative, and then woke up the next day with a breathing tube in his throat and chest tubes draining the blood from a surgical incision.

When people have severe anxiety, our tendency is to view their extreme behavior as irrational. Bobby’s fears are clearly based in real experience. My own anxieties are ignited when a current situation triggers memories of my abused childhood. It isn’t irrational to be afraid when the circumstances of a past traumatic experience are recreating themselves in the present. It’s self-protecting. Sometimes the anxiety leads to unpredictable or damaging behavior, but we must remember that the core fear is very real.

When we go to a doctor’s appointment now, I don’t tell Bobby that everything is fine. I say, “The doctors need to draw your blood. It will hurt. I know it’s scary. I will stay with you and on the way home we will get a balloon.”

He listens. He is still afraid, but I have at least put structure around the experience. Instead of showering him with useless platitudes he rightly ignores, I respect his past experience. I do not leave him to dread what might happen; I accurately explain exactly what will happen. I give him something to look forward to once the task is complete.

The retching fits that used to last the entire appointment now wane once the nurse begins the familiar routine of vital signs. When the procedure is done he exclaims “Great job! I did it!”

When we minimize a child’s fear we make them feel lesser. When we validate their concerns and help them work through a difficult situation we empower them to survive the challenges of life.

Don’t Make It Worse

While Bobby’s anxiety attacks are largely limited to doctor’s offices now, that was not always the case. When he was 4, he retched nearly every time we went somewhere new. I assumed these moments were rooted in his fear of medical procedures, that when faced with the uncertainty of a new environment he went to his darkest place.

My verbal responses to his physical reaction were assurances like “This isn’t a doctor’s appointment. We’re going to see a movie/walk through the museum/play basketball.”

The immediate advice I received from a behavioral therapist was to cut that out. As she explained, all my rationalization was doing was reinforcing that a doctor’s appointment was a bad and scary thing, the evil that all other experiences are measured against.

In my experience as a survivor of sexual abuse, I know that people expect me to be triggered by a reference to abuse in a book or movie. I almost never am. Other people’s stories help me gain perspective and elicit empathy in me, not anxiety.

My actual triggers seem random to outsiders. A picture of an open wound, garbage left by the sidewalk, and secondhand clothing all produce a stab of anxiety.

My healing is not aided by other people reminding me of my abuse every time I see a movie on the topic. My healing is not aided by people minimizing my aversion to outwardly harmless used clothing.

Bobby’s healing is not aided by my constant reference to the doctor’s office as a symbol of the worst case scenario in every situation.

Now, when we go some place new and fun I prepare him well in advance. We talk about it when he gets out of bed in the morning and on the way to our destination. I point out the happy children in the parking garage who are excited to see the movie we are going to watch. I don’t mention the doctor’s office. He almost never gets anxious.

When we do go to the doctor’s office, I only give a couple of hours notice. Additional time is not extra time to come to terms with what’s on tap—it’s time to stew in his own fear.

Don’t Stigmatize

Bobby’s retching attacks attract a lot of attention. In the beginning this was why I focused on ending the symptoms more than helping him manage his anxiety. I did not like the stares.

Now I accept the retching as his way to relieve his body of the extreme stress of the moment. My propensity is to store negative feelings inside until they overpower me. The approach attracts less attention in the moment but is ultimately catastrophic. Stoicism does not come with a medal of honor.

I realized that my embarrassment about his retching would eventually create shame in him. That is unfair. He has endured so many medical procedures that he ought to view himself as a survivor, not as a fearful child.

So when people stare, I look them in the eye and calmly say “He has had a lot of painful surgeries. Being here reminds him.” If that doesn’t satiate their curiosity, I follow with a look that encourages them to end their questioning anyway. I wish Bobby’s reaction was more socially appropriate, but until he develops more mature tools, I expect those around us to respectfully live with the retching. It costs them nothing. However, Bobby suppressing his pain can be disastrous in terms of future angst.

Similarly, when people turn their noses down at me because of my storied mental health history I calmly remind myself that I was raped when I was 8 years old. What right do others have to judge?

I will not allow Bobby or myself to be ostracized simply because we have not swallowed our traumatic histories. As Bobby gets older he is able to better differentiate between appointment types. We work on deep breathing and other meditation exercises that will allow him to let out his anxiety in a much more comfortable and socially acceptable way. I hope his fear and violent reaction lessen in a tangible way, but whether they do or not, my hope for him is that he will always own his feelings and be assured of his right to express emotions about his past.

For my part, I need to be vigilant about making sure that I support him rather than trying to move too quickly past painful or awkward moments simply because I am uncomfortable.

Anne Penniston Grunsted writes about parenting, disability, and family life from her perspective as a lesbian mama. She has been published in The Washington Post, Brain, Child Magazine, Mamamia, and won the 2014 Nonfiction prize from Beecher’s Magazine. She lives in Chicago with her partner and son.

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