Fear is a natural emotion that exists to protect and preserve life. But in certain minds, fear can go haywire and transform into conditions like chronic anxiety and obsessive-compulsive disorder (OCD).
These conditions can be thought of as maladaptive ways of dealing with the fears we all experience.
Here are some telltale signs that your child may be struggling with anxiety. Do they…
- Worry frequently and doubt their abilities?
- Engage in repetitive, ritualistic behaviors?
- Have trouble sleeping?
- Engage in perfectionistic behaviors?
- Tell you they have thoughts that don’t feel like “theirs”?
These are only a few examples of what anxiety in childhood can look like. Let’s break down the root causes of OCD and anxiety in children, and see how they can be helped.
The Heart of Anxiety and Obsessive-Compulsive Disorder
OCD is known as “the doubting disorder.” The obsession aspect of OCD is a specific fear about something, and the compulsion is the action performed in an attempt to prevent that fear from coming true.
Compulsions can look like extreme checking, organizing, cleaning, sharing, praying, or any other activity done in an attempt to quell the anxiety generated by doubt and fear.
Your child becomes worried about something, maybe having to do with losing a loved one, becoming embarrassed, or becoming something they’re not, and they feed their fears with compulsive behaviors.
Adults who struggle with OCD and anxiety are often fully aware that their fears are irrational (i.e., If I don’t check if my stove is off at least 50 times, then my house will burn down).
But even then, they still feel compelled to carry out their rituals because it makes them feel better before the fear drums up again (and it always does).
In short, OCD rituals are an attempt by your child to get rid of the uncomfortable feeling of doubt in a maladaptive way. And they are always rooted in plain old fear.
Another way to look at it is that anxious individuals are constantly striving for certainty. Meaning, they believe that if they perform enough compulsions they will arrive at a point emotionally where they will feel certain about everything and will no longer have to worry. They will know for sure that they and the people they love will be ok.
Of course, certainty never arrives, because uncertainty is a fundamental feature of life, and becoming less anxious means making peace with that fact. All compulsive behaviors serve to do is trap children and adults in their heads.
Luckily, effective treatments do exist for anxiety and OCD, and your child does not have to feel trapped.
How Anxiety In Childhood Is Treated
The most effective treatment for anxiety disorders in children and adults is called Exposure Response Therapy. If you’re looking to help your child through their anxiety, getting them involved in an ERP treatment plan is one of their best options.
Exposure therapy is a process of identifying the fears at the core of your child’s anxiety and guiding them toward facing them in a safe, controlled way, one at a time.
To quote the Mayo Clinic:
“Treating anxiety disorders with exposure therapy, an action-focused form of therapy, involves a child or teen facing their fears and learning through lived experience that what they are afraid of is unlikely to happen and that they can in fact handle feeling anxious.”
The primary objective of ERP is to get your child to realize that they can face their fears and still come out ok.
A child will work with a therapist to create a hierarchy of what they are afraid of (be it real or imaginary; any fear can be creatively addressed). After that, they may be taught relaxation techniques. Then, they will begin systematically climbing the rungs of their fear ladder.
Let’s look at an example:
Say a child has an obsession with symmetry and exactness. They spend hours aligning the furniture in their room, their pencils, their papers, and their clothes, putting everything in an exact place, in an exact order, before they start their day. This only makes life more difficult for them.
Here’s a potential fear hierarchy:
- Start by leaving one thing out of place, maybe angle a couple of pencils, or leave one piece of clothing on the floor, and leave it that way for a day. (Each rung will cause some discomfort. They may be asked to rate their anxiety levels during each step so they can see how they reduce over time).
- Leave your bed unmade for a week. (Each rung builds upon another, tackling each fear when the child feels ready).
- Mix up your notebooks. (The child will be encouraged to sit with their discomfort and learn to delay their compulsions).
- Make your room as messy as possible and leave it that way for a week. (When they reach their strongest fears, they will see how far they’ve come since they started. After multiple rounds of exposure and delayed compulsions, they will start to realize that they can handle life’s messiness and symptoms will begin to decline).
This process makes your child realize that certainty is not what they should be striving for. Instead, they discover that they are strong enough to handle uncertainty and be able to adapt to any outcome.
When they feel that they no longer need to prevent uncertainty, they can start moving away from fear and compulsions and toward freedom.
How to Best Help Anxiety In Childhood as a Parent
The best way to help your anxious child is to understand and encourage.
You understand that the fear your child is struggling with will not be alleviated through rituals or avoidance. You help by (safely) guiding them toward facing their fears without taking their discomfort away from them, knowing that their discomfort is necessary for them to feel more free.
Be with them as they slowly confront what scares them. If they become overwhelmed or fall back into old patterns, remind them that what they are doing is challenging and that they will get it next time. They can always readjust, reevaluate, and try again.
What’s best to remind them is that, now, they get to be brave. The answer to anxiety has been scientifically proven to be courage, and this is their opportunity to become courageous.
Their moments of bravery liberate them from their perceived limitations and make them feel less burdened and more carefree. And how awesome is that?
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