For parents of children with anxiety, it can be very difficult to know how to respond appropriately to your child’s distress. Your instincts are to help ease your child’s anxiety in any way you can. What seems helpful in the moment, however, may actually be reinforcing your child’s fears and anxiety. By helping them avoid the source of stress, you are teaching their brain that the situation is indeed something to be afraid of and that if they don’t seek help from you they will not be ok. We call this behavior a ritual or safety behavior.
Many parents unknowingly engage in rituals or safety behaviors with their anxious child on a daily basis. Some examples include allowing their child to avoid the mall because they are fearful of crowds, rushing to their child’s side to comfort him when he is upset because his hands feel dirty, allowing him to wear the same outfit ever day because other clothing feels uncomfortable, or allowing him to avoid sleepovers or play dates.
Even after you realize these behaviors reinforce your child’s fear, it may be difficult to stop engaging in them. For some parents, it just takes awareness and practice. For others, the struggle is much greater. This is often due to their own anxiety being triggered by their child’s distress. For these parents, a successful treatment outcome for their child means confronting their own anxiety as well as their child’s
Here is an example of how one parent’s struggle with anxiety interfered with successful treatment of her child (identities have been masked for confidentiality):
Stephen is a 14-year-old boy, whose perfectionism interferes with his self-esteem, his relationships with his parents, and his ability to maintain peer relationships. Perfectionism here is characterized by a fear of making a mistake. When Stephen gets lower than an A on an exam or homework assignment he breaks down and cries, yells, and is inconsolable for hours, even days. In order to avoid the anxiety caused from a making a mistake, Stephen engages in rituals. Stephen’s rituals include re-reading, over-studying, checking, erasing and starting over, and seeking constant reassurance from his parents and teachers that he has not made mistake.
As part of Stephen’s treatment he and his parents learned that in order to overcome his anxiety Stephen would have to gradually be exposed to the situations he feared without engaging in rituals. Stephen seemed to understand this concept and appeared excited to begin. One of Stephen’s exposures included not asking his parents to check his homework assignments. After a few sessions, it become apparent that although his father had stopped checking his homework assignments, his mother Sandra was still doing so.
Sandra expressed that it was very difficult for her to stop engaging in these rituals with her son as it sparked some of her own fears. Sandra feared that if she did not check her son’s assignments he might not get into a good college, and therefore would not get a good job, and would then be resigned to an unhappy life. It was clear that Sandra had her own unresolved issues with anxiety that led her to believe this chain of events was likely to occur. But her continued participation in rituals was undermining her son’s treatment. Stephen would not get to confront the feared situations and overcome his anxiety.
Although Sandra was able to see her role in her son’s continued anxiety, she was not able to tolerate her own distress and Stephen was unable to continue with treatment.
Had Sandra decided to move forward with the treatment, she would have been asked to gradually face her fears in order to help her son. Because not helping Stephen with all homework was too overwhelming, she would begin with just one subject at a time. After successfully stopping rituals with one subject, a new subject would be added until she was no longer helping Stephen with homework at all. Sandra would engage in weekly check-ins where she would get the support and structure needed to be successful. Not only would Sandra overcome some of her own anxiety, she would serve as an excellent example to Stephen of how to manage his own fear.
This case is an example of how one parent’s own anxiety interfered with her child’s treatment. Parents, although it may seem like you are helping your child by reassuring them or allowing them to avoid stressful situations, you may actually be engaging in rituals/safety behaviors that reinforce your child’s anxiety. Stopping these rituals/safety behaviors may trigger your own anxiety, but it is the best way to help your child conquer his or her fears.
– Andrea Starsiak, Ph.D.