Christopher McCurry - Parenting Your Anxious Child with Mindfulness and Acceptance: A Powerful New Approach to Overcoming Fear, Panic, and Worry Using Acceptance and Commitment Therapy

If you are reading this book, perhaps you are anticipating, or have been through, a diagnostic assessment with a school counselor, psychologist, family physician, or psychiatrist. In this chapter, I address the world of child mental health diagnosis in order to help you to understand the standard diagnostic process and to appreciate its usefulness as well as its limitations. Ill spend some time talking about what anxiety is and describe its common features. I will also describe some of the more common subtypes of anxiety that children can experience. Finally, the impact of anxiety on the life a child and his family will be considered.

Anxiety is a complex reaction to a perceived threat. Many authors make a distinction between anxiety and fear. Fear is the intense reaction we experience in the face of immediate danger. It is natural, automatic, and necessary for our survival.

Consider this scenario: While walking with your child down the sidewalk near your home, a large dog in a neighbors yard suddenly hits the fence beside you and starts barking fiercely. Both you and your child startle and withdraw quickly. Your arm may instinctively reach out to enclose your child and pull him away from the danger. You feel the blood pounding in your ears. Your child starts to cry. That is fear. The anxiety comes later.

Fear in the Moment: Fight, Flight, or Freeze

You may recall the fight-or-flight response from high school biology. This is a cascade of lightening-fast, automatic physiological events preparing us to fight or to flee whatever is threatening us. I add freeze in describing this response, since often fear results in a paralysis of mind and body. However, in the coming pages I will simply refer to this phenomenon using the standard term fight-or-flight response.

Deep within our brains are collections of neural circuits responsible for monitoring the body and the environment for signs of trouble. When danger is perceived, the alarm is sounded, and what happens next is automatic and almost impossible to stop once it gets going. First, adrenaline is dumped into the bloodstream from the adrenal glands sitting on top of the kidneys. Adrenaline is a multipurpose hormone that causes over twenty immediate biological responses. Ill list just a few examples:

• Pupils dilate to let in more light and enhance vision.
• Heart rate increases to move oxygen-carrying blood cells quickly through the body.
• Breathing quickens to provide oxygen and expel carbon dioxide.
• Capillaries near the surface of the skin close off to minimize bleeding in case of injury (which is why we become pale when were frightened).
• Palms become a bit sweaty, which improves grip.

Unfortunately, these bodily reactions show up suddenly (an alarming event in itself) and tend to be pretty unpleasant. There are, of course, adrenaline junkies: people who seem to thrive on arousing their sense of danger through activities such as bungee jumping or auto theft. To a large extent, its all in how you think about it, as I will describe later.

By and large, at least for young children, this fight-or-flight physiological roller-coaster ride is quite disturbing. But it would be a poor defense mechanism if it didnt get our attention and make us leery of going through that again. Imagine a pleasant and softly chiming home smoke detector. It would not be helpful in an emergency. As an adult, you can appreciate the need for a robust and even alarming mechanism for calling your attention to danger. But your child just knows he is in acute distress and wants it stoppednow.

False Alarms and Persistent Alarms

If the fight-or-flight response simply got us activated to escape real dangers in life, the way a smoke detector might rouse you from your sleep when your house in on fire, there would be no problem. Unfortunately, as I will describe below, the minds alarm system can naturally be set at extremely sensitive levels or be programmed through experience to respond when there is in fact no danger present: a false alarm.

Similarly there are times when the fight-or-flight system keeps putting out adrenaline and other signals long after the danger has passed. A friend recently told me about a malfunctioning smoke detector in his house. It kept beeping over and over, as if the batteries needed to be replaced. He replaced the batteries and the beeping continued, disturbing his infant sons nap. Finally, in frustration, my friend pulled the detector from the ceiling, opened a window, and tossed it outside, where it shattered into a dozen pieces on the driveway. Satisfied, he started to close the window but stopped when he heard a faint but clear beep-beep-beep coming from the pile of debris in his driveway. It was as if the poor smoke detector were saying, You can throw me out the window, but Im still going to do my job! In the same way your childs mind may be saying, I dont care about rational arguments, Im going to keep this child safe at any cost. Unfortunately, as we will see, the cost of overreacting to or getting stuck in false alarms can be quite high.

The Stomach: Innocent Victim of an Overzealous Mind

One especially important fight-or-flight reaction is the shifting of blood from the digestive system to the large muscle groups. The muscles enriched blood supply is supposed to help in the fighting or fleeing that our mind thinks is necessary. Unfortunately, the stomachs sudden loss of blood supply can create nauseasometimes low-grade, sometimes acute. Stomachaches of various kinds are a very common complaint in anxious children and can be quite debilitating.