Helping a child with Separation Anxiety

In early childhood it is completely normal for a child to react to parental separation with tears, clinginess and even tantrums, all of which are normal developmental responses. However intervention may be necessary when it is prolonged and still apparent in older children (5yrs+) and if it frequently affects them day to day and their enjoyment of life, and yours too as parents.

With understanding and tailored coping strategies separation anxiety can be minimised significantly. It is important to note that the emphasis is on reducing and tolerating the anxiety rather than total elimination. It is key to teach children that we all experience anxiety and it is a perfectly normal response to a stressful/fearful circumstance. 
Issues arise when the symptoms of anxiety outweigh the situation.

With reference to all anxiety disorders, not just separation, there is a cycle which accompanies each situation. It begins with the thoughts of an individual, which then controls their feelings which then affects their behaviour. This cycle continues with each stage causing and leading to the next. 

To elaborate on what a child may be processing through each stage here are some examples:

Their Thoughts;
    What if something happens to mum/dad while they’re away?
    What if they forget to pick me up?
    What if they’re late and I get into trouble?
    What if I get lost?
    What if I am ill and mum/dad can’t come to help me?

Their Feelings;
    Tummy ache
    Dizziness/sickness
    Racing heart
    Headache
    Accelerating breathing (panic attack)

Their Behaviour;
    Refusing to attend school/club etc
    Avoidance of any new situation
    Nightmares
    Will not be left alone
    Sleep issues
    Enuresis
    Continuous checking parent is near
 

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So, as parents what can we do to help?

Firstly, communication is key.
At a time when you are not under pressure, talk to your child about their feelings. Be fully engaged with their worries and completely respectful of their feelings. As adults, what we may dismiss as trivial may be of great significance to a child. 
Engaging in mature conversation should give the child's confidence a great boost and help them to understand that Mum and Dad identify their worries and fears. 
It is important not to provide too much verbal input at this stage, just simply listen…. 
Let them know you hear them and that you understand. Try to let the child lead the conversation as much as possible, with you just prompting with subtle remarks or questions when necessary. 
Go on to ask them what they think may make them feel better or help them to cope when they are upset. As parents, we want to provide our children with the answers and guidance, but in this case if the child can come up with suggestions for themselves they have more chance of proving successful. Once they have discussed their ideas with you, you could then suggest some additional ideas or make adaptations of their suggestions. 

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Here are some coping strategies that should prove helpful: 

• A special goodbye routine that it just between the parent doing drop off and the child suffering the anxiety. (Not for any siblings, and if a different parents drops off one day they too should have their own goodbye routine) The child could come up with whats involved; sequence of goodbye kisses, cuddles/hand shakes, whispered words. 

 

• A small token or keep sake that the child can keep on them in a pocket or perhaps left in their coat. This item could be given a daily kiss/squeeze from Mum or Dad to renew the loving energy so its lasts the whole day while the child is away. Remind them of this token that belongs to only them and that they can access this safety feeling by thinking of the item or giving it a squeeze in their hand or simply looking at it. Exaggerate how special this item is!

 

• Rewarding days that are positive or that even seem uneventful from an anxiety point of view. Displaying no anxiety may look like a normal everyday response from the outside but its a huge achievement for a child with separation anxiety so this is well worth a reward. Rewards can be kept small, in the form of a sticker on a chart working towards a larger treat item. Or perhaps they get to choose their favourite item for supper or a special pudding, or a movie/cartoon after school with mum/dad on the sofa. What is important is not to get disheartened or have a big reaction if there is a relapse of anxiety when there has been a spell of ‘good’ days. Let those times pass with no recognition and start again. Rome wasn't built in a day!​

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• Teach your child the anchor technique. An anchor is a way to lock into a positive/secure feeling when you’re experiencing the exact opposite in reality.​ First of all you have to install an anchor.  To do so get yourselves into a one to one situation when you're unlikely to be disturbed.  Once they're engaged with you and relaxed ask them to think of a time when they felt really confident/special/important/strong etc.  It can be a similar sort of feeling to the ones suggested but one that would out weight the negativity of feeling anxious.  You can help with suggestions or prompting ideas of a time when they displayed the desired behaviours.  When they have a memory in mind get them to really focus onto it and everything they can remember about it.  Ask questions about what they felt like at the time, what else they can remember, even describe how it made you feel watching them.  Whilst this is taking place get them to do a small physical activity (anchor) at the same time.  This could be touching their finger tips together a few times, gently squeezing their wrist with the opposite hand, or something a little bigger perhaps squeezing their arms together in a subtle self hug.  Whatever the chosen anchor it needs to be repeated a few times alongside the in-depth discussion about their positive thoughts/feelings/behaviours.  This repetition will help to fully engage the anchor and install the physical sensation linked with the positive feelings. 
  

Be sure to fully explain what you're doing and the process involved and why it is going to help.  Use positive suggestive language when doing so.  Describe how they can use the anchor at any time when they are feeling sensitive to their surrounding, or feel their anxiety is peaking. 

• Practise relaxation techniques. If a child can establish a feeling of calm and relaxation when needed it will help to settle feelings of anxiety when they arise. In a home setting practise simple relaxation techniques together making sure to let the child know they have the ability to draw upon this same relaxed feeling whenever they need to. Below is a set of instructions for a simple relaxing meditation focusing on gentle breathing. 

Sit or lie comfortably and close your eyes.
Make no effort to control your breathe; simply breath naturally.
Focus your attention on the breath and how your body moves with each inhalation and exhalation. Notice the movement of your body as you breathe. Observe your chest, shoulders, rib cage, and stomach. Simply focus your attention on your breath without controlling its pace or intensity. If your mind wanders, return your focus back to your breath.
Maintain this meditation practice for two to three minutes to start, and then try it for longer periods.

The language you use should be adapted so it is relevant to the age of the child. It is important to express how this meditation practise will establish a sense of peace and calm that they can access whenever they feel they need to. They have the ability to do it in one setting (at home) so it can be transferred to any other (school/away from parent).

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​One of the most important tools to help a child with separation anxiety is for the parents to be calm and relaxed themselves. So it is vital to give yourself some TLC. The more calm and at ease you are this will have a huge positive impact on the children around you. It enables you to deal with things with a focused level head and makes cognitive processing easier. Make time each and every day without fail to commit to yourself and your wellbeing. Attach no guilt to this time as it is doing you the world of good and it is also doing the people around you good too. We all feed off of each others emotions so this TLC will benefit everyone. 

It is with much affection that I write this article and hope it can help others.

Samantha Friend D. HYP 
Clinical Practitioner for Kent Therapy