有八分之一儿童受到儿童焦虑障碍影响,这成为困扰许多家庭的难题。然而,尽管儿童焦虑障碍较为普遍,却鲜有人讨论这个问题,因此面对焦虑的孩子,许多家长会措手不及,甚至感到无助。
美国全国儿童医院(Nationwide Children’s Hospital)儿科心理学家塔纳·斯奈德心理学博士表示:“患有焦虑障碍的儿童通常依赖性强,很难独立完成任务,而且可能脾气暴躁。这可能影响整个家庭。”斯奈德表示,家长既要给孩子设定限制,又要认可孩子的情绪,这很有挑战性。
但心理学家们表示,他们经常帮助有焦虑障碍的儿童,其中部分治疗方法是教会家庭如何应对相关症状。虽然没有心理学家会认为养育有焦虑障碍的孩子是小菜一碟,但他们发现有一些工具可以帮助他们的生活变得更加顺利。他们建议焦虑障碍儿童的家长要牢记以下几点。
焦虑表面看起来像是行为问题
发脾气在所有一定年龄段的孩子中都很常见,但它也可能是儿童焦虑障碍的外在表现。纽约大学兰贡健康(NYU Langone Health)临床助理教授、心理学家和《Mind in View》播客的主持人之一西娅·加拉格尔表示:“焦虑可能表现为因为某件事大喊大叫,或者与你争吵。有时候可能很难分清这是正常的儿童行为,还是因为某些更严重或更深层次的问题导致的行为。”
斯奈德表示,对于这些发脾气的情况,“焦虑症儿童可能很难控制,但设定限制和边界依旧很重要。”也就是说,你不能把孩子发脾气归咎于焦虑,并假定自己对此无能为力。斯奈德建议,在孩子平静下来之后,提醒他们你的规则和预期,并告诉他们如果不遵守规则可能要面临的后果。她说到:“你依旧需要基于事实规定纪律和强调后果。”
承认孩子的感受很重要
费城儿童医院(Children’s Hospital of Philadelphia)儿童与青少年精神疾病和行为科学科焦虑行为诊所的许可心理学家伊莎贝拉·米兰尼亚克博士表示,当孩子生气时,认可孩子的情绪很重要。她建议家长要有“成长同理性”,即家长不会忽视在孩子的年龄很严重的烦恼。她表示:“成年人可能觉得孩子的烦恼很幼稚,但它可能与孩子的世界是成正比的。不要说‘没什么大不了的’或者‘不需要担心’这种话。”相反,米兰尼亚克表示,重要的是让孩子知道你理解他们的烦恼。
她建议家长这样说:“我知道上学前的早晨,对你来说很难。我能看得出来你有些害怕,宁愿呆在家里。我能理解:有时候我也会因为紧张宁愿呆在家里,也不愿意去工作。”
加拉格尔强调“感受始终是真实的”,即使你不能理解为什么孩子会在某个时刻产生这些感受。她说到:“我们总是可以承认焦虑的感觉是多么糟糕。”加拉格尔建议跟孩子聊一聊“反击焦虑”,强调他们可以掌控自己的情绪,不让焦虑控制自己。
保持平静是关键
安蒙表示,对孩子保持冷静很重要。她承认:“有时候,当孩子悲伤、尖叫或大哭的时候,家长很难保持冷静。”加拉格尔也表示认同,但她强调了保持冷静的重要性。她说道:“尽量保持冷静。”
她指出,情绪可能具有传染性。她表示:“如果你处于危机状况,而其他人开始惊慌失措,你的应激反应可能也会受到影响。”如果你发现当孩子情绪激动时你很难保持冷静,她建议咨询治疗师,获取可以使用的工具或者自己接受治疗。她说道:“当孩子情绪激动时,家长最好的做法是尽量保持冷静,重申他们的选项,并谈论他们可以做出的选择。”
对于孩子的焦虑有时候要顺势而行
斯奈德表示,孩子的焦虑情绪可能很难阻止,尤其是当孩子情绪激动时。她表示:“如果孩子的焦虑情绪达到了最高点,有时候我们需要顺势而为。如果孩子已经极度焦虑,你可能无法带来任何有效的改变。”
加拉格尔表示,这意味着你只需要陪着孩子,给他们一个拥抱,给他们独处的空间,直到他们自己平静下来。斯奈德说道:“如果孩子发脾气或者感到焦虑,我们应该为他们提供一个安全的空间,让他们表达这些感受。”这时候可以帮助他们实践在治疗过程中学会的技能,例如一起深呼吸五次,倒数三个数,或者医疗保健提供者可能分享的其他技巧。斯奈德表示:“这样可以转移他们的注意力,让他们身体放松,让大脑平静下来。”
不要彻底避免可能让孩子产生焦虑的事情
如果有些事情会让孩子感到紧张,家长可能想要帮助他们避开这些事情,这是可以理解的。但专家们认为,这可能让事情变得更糟糕。米兰尼亚克表示:“随着时间的推移,导致焦虑症张加剧的主要机制是逃避,即孩子逃避焦虑、尴尬、不确定性、痛苦或其他负面感觉。随着焦虑障碍的发展,儿童会反复出现逃避行为,例如上课不举手、不上学和不发言等。”
但焦虑与女性情绪健康中心(Center For Anxiety & Women’s Emotional Wellness)的临床心理学家希拉里·安蒙博士认为,反复逃避某种状况会让焦虑症变得更严重。她说到:“你可能本能地想要保护孩子,允许他们逃避让他们感到恐惧或焦虑的情况。很可惜,这个决定有时候会加剧孩子的恐惧情绪。”
相反,米兰尼亚克建议家长对于焦虑的孩子,要“富有同情心地培养勇敢的技能”。这意味着重复对他们的期望,告诉他们:“我知道这对你来说很难,但上学是你的责任,就像上班是我的责任一样。我们怎么做才能让今天上学变得更容易?” 米兰尼亚克表示,重要的是立场坚定,即使孩子开始变得更加激动。她说道:“保持冷静,并以稳定的语气重复你的话,让孩子知道你没有被孩子的情绪吓到。”你可以告诉孩子“你因为害怕产生了一种激烈的情绪反应。我并不害怕这种反应。我们可以一起解决它。情绪不会永远持续存在,你现在的这种情绪很快就会结束。”
米兰尼亚克表示,如果孩子出现扔东西、打人或者冲下车等行为,一定要让他们承担自己的行为造成的后果。她强调:“情绪始终是有效的,但我们必须对自己的行为负责。”
表扬孩子好的表现
对于容易焦虑的孩子,家长需要应付很多事情,但医生认为,当孩子表现良好时,表扬很重要。加拉格尔说道:“当孩子表现良好时给予表扬,不要只专注于孩子表现不佳的事情。”
斯奈德也认同这种观点。她说道:“你依旧应该像一般父母一样,让孩子知道你为他们感到骄傲。”开放式的问题也很有帮助,例如在吃晚饭或在车上的时候,让孩子分享自己当天最开心和最糟糕的部分。她说道:“如果孩子有不好的遭遇,这样做可以创造机会,让孩子与你沟通,分享情绪。”
总之,斯奈德建议时刻提醒自己你正在竭尽全力。她说道:“如果孩子容易焦虑,家长可能会感到压力、沮丧和不知所措。但重要的是提醒自己,尽管目前事情可能并不顺利,但你依旧是一个好的家长和监护人。”(财富中文网)
翻译:刘进龙
审校:汪皓
有八分之一儿童受到儿童焦虑障碍影响,这成为困扰许多家庭的难题。然而,尽管儿童焦虑障碍较为普遍,却鲜有人讨论这个问题,因此面对焦虑的孩子,许多家长会措手不及,甚至感到无助。
美国全国儿童医院(Nationwide Children’s Hospital)儿科心理学家塔纳·斯奈德心理学博士表示:“患有焦虑障碍的儿童通常依赖性强,很难独立完成任务,而且可能脾气暴躁。这可能影响整个家庭。”斯奈德表示,家长既要给孩子设定限制,又要认可孩子的情绪,这很有挑战性。
但心理学家们表示,他们经常帮助有焦虑障碍的儿童,其中部分治疗方法是教会家庭如何应对相关症状。虽然没有心理学家会认为养育有焦虑障碍的孩子是小菜一碟,但他们发现有一些工具可以帮助他们的生活变得更加顺利。他们建议焦虑障碍儿童的家长要牢记以下几点。
焦虑表面看起来像是行为问题
发脾气在所有一定年龄段的孩子中都很常见,但它也可能是儿童焦虑障碍的外在表现。纽约大学兰贡健康(NYU Langone Health)临床助理教授、心理学家和《Mind in View》播客的主持人之一西娅·加拉格尔表示:“焦虑可能表现为因为某件事大喊大叫,或者与你争吵。有时候可能很难分清这是正常的儿童行为,还是因为某些更严重或更深层次的问题导致的行为。”
斯奈德表示,对于这些发脾气的情况,“焦虑症儿童可能很难控制,但设定限制和边界依旧很重要。”也就是说,你不能把孩子发脾气归咎于焦虑,并假定自己对此无能为力。斯奈德建议,在孩子平静下来之后,提醒他们你的规则和预期,并告诉他们如果不遵守规则可能要面临的后果。她说到:“你依旧需要基于事实规定纪律和强调后果。”
承认孩子的感受很重要
费城儿童医院(Children’s Hospital of Philadelphia)儿童与青少年精神疾病和行为科学科焦虑行为诊所的许可心理学家伊莎贝拉·米兰尼亚克博士表示,当孩子生气时,认可孩子的情绪很重要。她建议家长要有“成长同理性”,即家长不会忽视在孩子的年龄很严重的烦恼。她表示:“成年人可能觉得孩子的烦恼很幼稚,但它可能与孩子的世界是成正比的。不要说‘没什么大不了的’或者‘不需要担心’这种话。”相反,米兰尼亚克表示,重要的是让孩子知道你理解他们的烦恼。
她建议家长这样说:“我知道上学前的早晨,对你来说很难。我能看得出来你有些害怕,宁愿呆在家里。我能理解:有时候我也会因为紧张宁愿呆在家里,也不愿意去工作。”
加拉格尔强调“感受始终是真实的”,即使你不能理解为什么孩子会在某个时刻产生这些感受。她说到:“我们总是可以承认焦虑的感觉是多么糟糕。”加拉格尔建议跟孩子聊一聊“反击焦虑”,强调他们可以掌控自己的情绪,不让焦虑控制自己。
保持平静是关键
安蒙表示,对孩子保持冷静很重要。她承认:“有时候,当孩子悲伤、尖叫或大哭的时候,家长很难保持冷静。”加拉格尔也表示认同,但她强调了保持冷静的重要性。她说道:“尽量保持冷静。”
她指出,情绪可能具有传染性。她表示:“如果你处于危机状况,而其他人开始惊慌失措,你的应激反应可能也会受到影响。”如果你发现当孩子情绪激动时你很难保持冷静,她建议咨询治疗师,获取可以使用的工具或者自己接受治疗。她说道:“当孩子情绪激动时,家长最好的做法是尽量保持冷静,重申他们的选项,并谈论他们可以做出的选择。”
对于孩子的焦虑有时候要顺势而行
斯奈德表示,孩子的焦虑情绪可能很难阻止,尤其是当孩子情绪激动时。她表示:“如果孩子的焦虑情绪达到了最高点,有时候我们需要顺势而为。如果孩子已经极度焦虑,你可能无法带来任何有效的改变。”
加拉格尔表示,这意味着你只需要陪着孩子,给他们一个拥抱,给他们独处的空间,直到他们自己平静下来。斯奈德说道:“如果孩子发脾气或者感到焦虑,我们应该为他们提供一个安全的空间,让他们表达这些感受。”这时候可以帮助他们实践在治疗过程中学会的技能,例如一起深呼吸五次,倒数三个数,或者医疗保健提供者可能分享的其他技巧。斯奈德表示:“这样可以转移他们的注意力,让他们身体放松,让大脑平静下来。”
不要彻底避免可能让孩子产生焦虑的事情
如果有些事情会让孩子感到紧张,家长可能想要帮助他们避开这些事情,这是可以理解的。但专家们认为,这可能让事情变得更糟糕。米兰尼亚克表示:“随着时间的推移,导致焦虑症张加剧的主要机制是逃避,即孩子逃避焦虑、尴尬、不确定性、痛苦或其他负面感觉。随着焦虑障碍的发展,儿童会反复出现逃避行为,例如上课不举手、不上学和不发言等。”
但焦虑与女性情绪健康中心(Center For Anxiety & Women’s Emotional Wellness)的临床心理学家希拉里·安蒙博士认为,反复逃避某种状况会让焦虑症变得更严重。她说到:“你可能本能地想要保护孩子,允许他们逃避让他们感到恐惧或焦虑的情况。很可惜,这个决定有时候会加剧孩子的恐惧情绪。”
相反,米兰尼亚克建议家长对于焦虑的孩子,要“富有同情心地培养勇敢的技能”。这意味着重复对他们的期望,告诉他们:“我知道这对你来说很难,但上学是你的责任,就像上班是我的责任一样。我们怎么做才能让今天上学变得更容易?” 米兰尼亚克表示,重要的是立场坚定,即使孩子开始变得更加激动。她说道:“保持冷静,并以稳定的语气重复你的话,让孩子知道你没有被孩子的情绪吓到。”你可以告诉孩子“你因为害怕产生了一种激烈的情绪反应。我并不害怕这种反应。我们可以一起解决它。情绪不会永远持续存在,你现在的这种情绪很快就会结束。”
米兰尼亚克表示,如果孩子出现扔东西、打人或者冲下车等行为,一定要让他们承担自己的行为造成的后果。她强调:“情绪始终是有效的,但我们必须对自己的行为负责。”
表扬孩子好的表现
对于容易焦虑的孩子,家长需要应付很多事情,但医生认为,当孩子表现良好时,表扬很重要。加拉格尔说道:“当孩子表现良好时给予表扬,不要只专注于孩子表现不佳的事情。”
斯奈德也认同这种观点。她说道:“你依旧应该像一般父母一样,让孩子知道你为他们感到骄傲。”开放式的问题也很有帮助,例如在吃晚饭或在车上的时候,让孩子分享自己当天最开心和最糟糕的部分。她说道:“如果孩子有不好的遭遇,这样做可以创造机会,让孩子与你沟通,分享情绪。”
总之,斯奈德建议时刻提醒自己你正在竭尽全力。她说道:“如果孩子容易焦虑,家长可能会感到压力、沮丧和不知所措。但重要的是提醒自己,尽管目前事情可能并不顺利,但你依旧是一个好的家长和监护人。”(财富中文网)
翻译:刘进龙
审校:汪皓
Childhood anxiety disorders impact one in eight kids, making this a condition many families grapple with. But despite how common they are, anxiety disorders in kids aren’t discussed a lot, leaving plenty of parents feeling unprepared and even helpless when it comes to raising an anxious child.
“Kids with anxiety disorders can often be clingy, may have difficulty doing things independently, and can have angry outbursts,” says Tyanna Snider, PsyD, a pediatric psychologist with Nationwide Children’s Hospital. “It can impact the entire family.” Parents face the tough challenge of trying to set limits for a child while also validating their emotions, Snider says.
But psychologists say they regularly help kids with anxiety disorders, and part of that treatment is teaching families how to respond to symptoms of the condition. While none of them say that parenting a child with an anxiety disorder is easy, there are tools they’ve discovered that can make life with an anxious child a little more seamless. Here’s what they recommend all parents of kids with anxiety disorders keep in mind.
Anxiety can look like behavioral issues
Tantrums are common in all kids of a certain age, but they can also surface in children with anxiety disorders. “Anxiety can manifest as yelling or fighting you on something,” says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast. “Sometimes it can be difficult to figure out if this is normal kid behavior or if it’s caused by something bigger or deeper.”
Those tantrums “might be really hard for the child with anxiety to control, but it’s still really important to set limits and have boundaries,” Snider says. Meaning, you don’t want to chalk a temper tantrum up to your child’s anxiety and assume you can’t do anything about it. When your child settles down, Snider recommends reminding them that you have rules and expectations, and that there are consequences when they’re not followed. “You still need to provide discipline and consequences in a matter of fact way,” she says.
It’s important to acknowledge your child’s feelings
Validating your child’s emotions is an important step when they’re upset, says Izabela Milaniak, PhD, licensed psychologist in the Anxiety Behaviors Clinic within the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia. She recommends practicing something called “developmental empathy,” which is when you don’t dismiss worries that may feel like a big deal for your child’s age. “A child’s worry may seem silly to an adult, but it is proportional to their world,” she says. “Avoid making comments like, ‘It’s not a big deal’ or ‘You have nothing to worry about.’” Instead, Milaniak says it’s important that your child knows that you understand they’re upset.
She recommends saying something like, “I know mornings before school are rough for you. I can see that you’re scared and would rather stay home. I get that: Sometimes I want to stay home from work because I’m nervous too.”
Gallagher stresses that “feelings are always real,” even if you don’t understand why your child is having them in a particular moment. “We can always acknowledge how awful anxiety can feel,” she says. Gallagher recommends talking to your child about “bossing back the anxiety,” stressing that they can be in charge of their emotions and not let anxiety take control.
Staying calm is crucial
Ammon says it’s important to try to stay level-headed with your child. “Sometimes it can be difficult to keep your cool when your child is distressed, screaming, or crying,” she admits. Gallagher agrees, but stresses the importance of being calm. “If you can, stay as calm as possible,” she says.
Gallagher points out that moods can be contagious. “If you’re in a crisis situation and someone else starts freaking out, your fight or flight response is going to go to that, too,” she says. If you find that you’re struggling to stay calm when your child is elevated, she recommends talking to their therapist for tools you can use or considering therapy for yourself. “The best thing you can do with your child when they’re getting worked up is to be as calm as possible, reiterate their options, and talk about the choices they can make,” she says.
Sometimes you have to let them ride the wave of anxiety
Anxiety can be tough to stop, especially when a child is really worked up, Snider says. “If your child is at peak anxiety—a 10 out of 10—sometimes we need to ride that wave,” she says. “You’re probably not going to make an effective change if they’re already at that high of a level.”
That can mean just being there for your child, hugging them, or giving them space to be by themselves until they calm down, Gallagher says. “If a child is having a tantrum or anxiety attack, we want to get them to a safe space so they can express those feelings,” Snider says. This is a good time to help them practice the skills they’ve learned in therapy, like taking five deep breaths together, counting backwards by threes, or any other techniques their healthcare provider has shared. “That can distract them for a moment, relaxing their body and calming their brain,” Snider says.
Don’t completely avoid the things that cause your child’s anxiety
If something makes your child anxious, it’s understandable to want to do what you can to help them avoid it. But experts say this can actually make things worse. “The main mechanism that grows anxiety symptoms over time is avoidance, where a child escapes the experience of anxiety, embarrassment, uncertainty, distress, or other negative sensations,” Milaniak says. “By the time an anxiety disorder develops, a child has repeated patterns of avoidant behaviors, like not raising their hand in class, not attending school, and not speaking.”
But repeatedly avoiding a situation can make anxiety worse, says Hillary Ammon, PsyD, a clinical psychologist at the Center For Anxiety & Women’s Emotional Wellness. “You may have the instinct to protect them and allow them to avoid whatever is causing them to feel fear or anxiety,” she says. “Unfortunately, this decision to aid them in escaping sometimes exacerbates those fears for the child.”
Instead, Milaniak recommends that parents “compassionately foster bravery skills” with anxious kids. That means reiterating expectations by saying things like, “I know this is hard for you and going to school is one of your responsibilities, like going to work is mine. What can we do to make going into school easier today?” Milaniak says it’s important to stay firm, even if your child starts to escalate. “Remain calm and repeat a steady mantra to show that your child’s emotions don’t scare you,” she says. That can include saying something like “You’re having a big feeling response because you are scared. I am not afraid of your big feelings. We will get through it together. Emotions don’t last forever and this one will be over soon.”
If your child does things like throwing objects, hitting others, or running out of a car, it’s important to have consequences for their behavior, Milaniak says. “Emotions are always valid, but we must be accountable for what we do with them,” she stresses.
Highlight the good stuff, too
There’s a lot to manage when you have a child with anxiety, but doctors say it’s important to praise your child when they’re doing well. “Highlight it when things are going well—don’t just focus on the things that didn’t go well,” Gallagher says.
Snider agrees. “You still want to do typical parenting and let them know that you’re proud of them,” she says. Open-ended questions can be helpful, too, like asking your child to share the best and worst parts of their day when you’re eating dinner or riding in the car together. “It opens the door about communication and feelings if something is not going well,” she says.
Overall, Snider recommends reminding yourself that you’re doing your best. “Oftentimes, parents of children with anxiety are really stressed, frustrated, and unsure of what to do next,” she says. “But it’s important to remind yourself that you’re a good parent and caregiver, even if things don’t feel like they’re going well at that moment.”