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When fears turn to phobias

psychologywhen fears turn to phobias When fears turn to phobiasBees, costumed characters, germs, thunderstorms: what do they have in common? They all have the potential to cause fear and anxiety in both children and adults. Childhood fears are commonplace, in fact, psychologists view it as not typical if a child experiences no fears or worries during the course of their development. Childhood fears help us learn to appreciate real dangers that exist in the world, and also give parents the opportunity to teach ways of coping that will come in handy in adult life. In many instances, fear may start to become a bigger problem for a child, causing avoidance behaviors like fleeing from the feared object or character, worrying too much of the day about encountering the situation, or avoiding any place that might lead to encountering the feared object or insect or character. At this point, the fear may have evolved into what psychologists call a phobia. No, this doesn’t mean tossing a child in the middle of a feared situation, but instead it calls for introducing the feared item back into the child’s life while helping the child resist fleeing with the relaxation and thinking technique he or she has learned. The two main points in guided exposure are to go slowly, in fact, the first situation can involve only having the child look at a picture of the feared thing in a book, and to replace fleeing with relaxation and staying in the situation. By staying in the situation until they are able to feel relaxed instead of a racing heartbeat, they learn that time will reduce fear if we give it a chance. If it is not a dangerous risk, like a child running outside into the street, a parent can stay in the situation rather than running after the child, and can role model being safe near the feared thing. Again, the point is to take some time and move slowly into closer encounters because the fear took some time to develop and needs some time to be unconditioned. Even if parents decide to seek professional counseling or advice from a health care provider to deal with the problem, understanding these steps will move things along more quickly. There are a number of books and guides for both parents and children in dealing with fears and phobias.

Phobias are are real problem for most parents and children who are dealing with them, and talking about the problem alone may not help them go away. Since the fear is not rational in the first place, using rational logic to convince a child there is no danger just leads to the child hiding the fear and not necessarily dealing with it. In other instances, parents act out disagreement in the situation with one parent consoling the child and the other parent passing judgement or frustration with a message of “just get over it.” The fact is that these approaches do not reduce fearful worry and behavior and may make them worse.

What does work when every time a child even thinks of the feared situation he or she runs back through the front door? There are some coping approaches that psychologists and counselors typically suggest when fear has gotten out of hand.

First, it is important to give yourselves a little time to work on the project. Although “getting back on the horse you fell off of,” might work for a single fearful event, we are talking about a pattern of fearful events that have turned into a phobia. Next, there are two invaluable tools a child can learn that can also be applied to other fearful situations: teaching “what are the real chances” thinking is an approach that helps children with the thinking style that goes along with fears and phobias. The point isn’t to try to talk the child out of the phobia, but instead to help the child accept the low risk of harm in the situation.

The next approach is to teach a child to counter his or her natural physical response to fear, that is, the muscles tightening, the increased shallow breathing and “tensing up.” Relaxing via teaching slow, deep breathing, loosening muscles and continuing to do this until fear passes is maybe the most important tool the child can take back into the feared situation. Remember to work on this skill a few times before the fearful situation is encountered. After these tools are learned and practiced, a parent can try guided exposure. This is a slow approach in which parents guide a child in re-encountering the feared situation, but this time armed with tools of relaxation and “what are the risks” thinking. The point in guided exposure is to move slowly, avoiding the “get back on the horse” approach which won’t work once the fear has turned into a phobia. Starting slowly can even involve just having the child look at a picture of the feared thing in a book. The two main points to remember in re-exposing a child to a feared object is that the point is for them to replace fleeing behaviors with coping tools, and that staying in the situation will allow time to reduce the rapid heartbeat and shallow breathing. If it is safe to do so, meaning the child is not going to run out into the street to escape, it may be better for a parent to stay with the situation rather than joining the child in avoidance. Finally, sitting with the child afterward and talking about what worked and what didn’t work can help prepare for the next encounter. Even if these suggestions don’t work, learning these tools and others in books written for children about coping with fears such as Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias by Tamar Ellsas Chansky, or  What to Do When You’re Scared and Worried: A Guide for Kids (Easy Reading) by James J. Crist Ph.D., can help parents and children get a head start before they seek the advice of a professional child-trained counselor.

For more information and help please go to  Anxiety Disorders in Children and Adolescents and Helping Your Child Deal with Fears & Phobias

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2 comments
D. Paltin
D. Paltin

Fears and phobias are common occurences in five year olds, but there are very common ones, and not so common ones. Fear of the dark, spiders, etc. are among the common, whereas worries about a particular direction, side of the body, are not common. Some things a counselor or child psychologist might ask would be "How intense is the child's avoidance or fear of this thing," "How distressed is the child when pushed to not avoid the fear," and "Is there any family history of serious anxiety or obsessive/compulsive concerns." The vast majority of childhood fears resolve by themselves or with positive coaching by a parent. In some cases, when the fear persists or starts showing up more frequently in behavior, such as walking a certain path at school to avoid any left hand turns, parents may consider a consultation with a child counselor or professional. Finally, although talking a child logically about the fear might clear up some misunderstanding, quite often it doesn't get rid of the anxiety or fear itself. After all, by definition the fear is unrealistic. There are a few books written for children as young as five about coping with fears and phobias, either available through Amazon such as "What to Do When You Worry Too Much," by Huebner, and for parents, "Freeing Your Child from Anxiety," by Chansky.

Bo
Bo

My son is almost five years old, and for several months now has been developing what I am concerned may be some kind of aversion to the left side. He tells us that he doesn't like the left side of his body and certain objects. He is very intelligent and has good dexterity of both sides of his body, so it may be nothing. Should we be concerned? I wasn't sure where the best place to post this information was. If anyone has any advice to share, please let me know.