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Raising Good Humans
Everything You Need to Know to Help Kids Manage their Anxiety with Renowned Yale Psychologist Dr. Eli Lebowitz
00:56:23
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The following podcast is a Dear Media production.
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Welcome to Raising good humans. I'm Dr. Eliza Pressman and I just, I want to take a collective breath with everyone. I know it's been such a week and here we are. And one of the things that I want to talk about is anxiety. But actually I've enlisted Dr. Ellie Leibowitz from the Yale University Child Studies center. And the reason I did is because his focus is both as a researcher and a clinician is on childhood anxiety disorders and the effects that they have on the family systems. And the most incredible thing about his work and why this is a two part episode is it is absolutely asking nothing of our kids. So it helps us distinguish between the kinds of anxiety that we think can actually cause harm that are really prohibitive. And he gets into that and how to distinguish between typical and sometimes quite beneficial anxiety and the kind that is prohibitive and needs help. And then he's also incredibly concrete in the program that he created to help support parents so that they can support their kids and that the family can therefore thrive more. So we're getting into this in two episodes and the first part is going to really help the parent and caregiver understand and think about the challenges that we're constantly facing when we have kids who are tending to avoid anxiety provoking situations, the rage that can sometimes come along with that, the deep empathy and fear that can come along with that, all on the part of the parents. So the great news is he developed a highly researched, efficacious program that does not include any anything that kids have to do. They don't have to go to a therapist, they don't have to do exercises. This is all on us, which I think is incredibly helpful. So the first part of this episode we're going to distinguish between the kinds of anxiety where we would want to intervene and the kinds of anxiety where we really can just keep on going. I think that's a really helpful way that he talks about it. And also he's going to teach us how to help alleviate a lot of the growing anxiety and response to anxiety and the seeming, the feeling that we can't manage this anxiety by changing the response that we have and replacing them with different responses so that instead of the anxiety flourishing, our kids can flourish. This is so helpful. And if you want to learn more, you can go into the show notes. He has a book called Breaking Free of Child Anxiety and ocd, a scientifically proven program for parents. And I really highly recommend both of these episodes, not only if you're experiencing kids with anxiety. But if you're experiencing that question, that looming question that I hear so much from parents of, wondering whether or not the anxiety that they're seeing in their kids is the kind that needs to be addressed, if it's harmful or if it's actually quite adaptive and important, not for nothing, listening to this episode will help with your own anxiety, which I know is quite pervasive right now. So I hope you enjoy this episode. If you do, please go into Apple Podcasts and give it a review and let me know what kinds of episodes you like the most and what have you found to be the most helpful so that I can give you more of what you're looking for. And of course, you can always find me on Instagram at raising good humanspodcast and my substack drlisapressman substack.com thinking of everyone. So just to frame this conversation, can you help us just sort of identify anxiety, both subclinical and clinical? And how. I mean, this is probably too big of a question, but the distinction between kind of the good anxiety and the anxiety that makes us worry.
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A
Sure. Yeah. I think that's actually a pretty good way to approach anxiety, is kind of thinking of it that way. Because, of course, anxiety is not a disease, right? Like, anxiety is a normal part of being a human being. In fact, it's kind of a normal part of being most organisms, if you really want to go wide with that, right? Like, we have this capacity built into us to detect things that might pose a problem for us in life, whether that's a physical problem, like a danger, or even more of a psychological problem, something that might make us uncomfortable. And one of the really important things about our anxiety system is that we don't need to be facing a clear present danger in the moment in order to realize that something might be a problem and to take precautionary steps, to take preemptive steps. And that's really important because, you know, if you only thought about the dangers of crossing a street when a truck is about to smush you, well, that would be a little bit late in the game and you might end up being pancaked. And so one really important thing about our anxiety system is that we can imagine scenarios that might end up being problematic, and we can take steps in advance, like looking both ways before you cross that street so that you don't end up being smushed. Sorry, I keep talking about people getting.
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B
Smushed, but it really does highlight what you're trying to say. So it's actually a really good example.
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Well, yeah, I mean, it's just a really important part. But with that capacity to envision and imagine negative scenarios, which is really so important to us, with that also comes a liability because it means that we can come up with a lot of different scenarios and feel really anxious about them, even if maybe they're actually not that likely to occur, or maybe they wouldn't be such a real danger to us if they did occur. And so once we kind of open the door to potential dangers, as opposed to clear present dangers, we also open the door to tormenting ourselves with a lot of hypotheticals and living a life that is sometimes very dangerous, dictated by all of those possible hypothetical, sometimes low probability, sometimes not actually all that awful if they were to occur, but living a life that's really dictated by all of those situations, and that fear and worry and stress and anxiety, you know, all of that can become a really central part of what dictates our lived experience. There are a few metaphors that I sometimes like to use to try to just have some empathy for what it's like to live with a lot of anxiety. So, you know, if you'll. If you'll permit me, maybe I'll share one or two of those metaphors.
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For us as the. As the parents and caregivers, it's really hard sometimes if you're not. If that's not your lived experience, if it. Or if it is your lived experience, but you haven't thought about it from that perspective, and you're trying to support your kids. So I love your metaphors. Please.
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A
You know, one metaphor, it actually derives from a very, very different part of my life, like in another lifetime. Many, many years ago. I was actually in the military. And there's this training that you'll sometimes do, and it's supposed to prepare you for how you should behave if you find yourself in a minefield, right? Like you're in a minefield, you want to get out of there safely. And, you know, every step could be really, really, really catastrophically dangerous to you. Now, the truth of the matter is you don't really need this training. All you need is, like, an ounce of common sense, and you're going to do this stuff anyway. Because if you think about it, there are some really big changes to how you're going to behave. If you find yourself in a minefield, for example, you are probably not going to take extra steps, right? You want to take as few steps as possible because every step could be your last. And you really don't want that. And so you're going to try to take as few steps as possible, right? Like, if you see a pretty flower somewhere, you're not going to wander over there to look at it because it's just not worth the risk. And when you think about how children, and also adults with anxiety who live their life feeling as though you're in a minefield, feeling as though everything is so fraught with danger, it's easy to understand how you may choose to forego a lot of potentially positive experiences. Why? Because of the risk of it being catastrophically negative. And that risk just outweighs the possible benefit, right? Like, could I have fun on my school field trip? Maybe? Sure. Possible. Will I go? Definitely not. Why? Because of all the negatives, right? What if I throw up on the bus in front of everybody and I'm humiliated forever? What if my bus goes off a cliff? What if I come home and find my house burnt down? What if I like all of these? What if they just crowd out any place that might be left for all the fun stuff that might actually happen? And that's one big change, is the way that you'll just avoid anything that has even the potential for something negative to occur. The other thing that I think you're going to do if you're in a minefield is you're probably going to show a really strong preference, I would say a somewhat fanatical preference, if at all possible, to step where you have already stepped before, because that is always going to be infinitely safer than anywhere else, right? Like if you have to backpedal, you have to go back in the other direction. You want to put your feet in the exact same places because that's always safer. And you see this in anxious children as well. Sometimes it is very bewildering how they may be so averse to change, to novelty, to difference, even on things that seem like they don't matter. But the point is, I don't know if it matters, right? Like this. I know this is familiar. And so even something that seems trivial, we're driving a different route because there's a detour on the road. You changed the furniture, you painted the house. Like, things that seem like they shouldn't matter at all, but they do matter, because I don't know, right? Whereas everything else is familiar to me, and I do know it. And this can lead to a child being, like, really resistant to change and really focused on the pattern and the familiar in a way that can be a little irritating sometimes and a little confusing. When you're not in that same mindset.
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You know, I think that aspect of how it can sometimes seem very exasperating and very irritating is actually well captured by the other metaphor that I was going to, that I was going to share, which comes from a much more recent part of my life when. Well, I'll put it this way. My, my wife is a big fan of escape rooms. And so we do a lot of escape rooms. And when I say we do a lot of escape rooms, what I really mean is we go to a lot of escape rooms and my wife solves the escape room while she condescendingly lets the rest of us feel like we are also contributing by, like we get to turn the key at the end or input the code. Because she's really, really good at these, at these puzzles. I really, I, I, I, I'm very, I have a lot of admiration because she seems really good at this. But it made me think about, you know, if you've never, if you've never been to an escape room, like, what is it, right? It's this puzzle. You go, there's always a story, like, we're going to lock you in this room and you have one hour to solve all these puzzles and get out, right? Or else, you know, the world is going to end and world's gonna break out. Whatever, something horrible is gonna happen. But what it made me think about is imagine if you went to an escape room, but one person in your group didn't realize that it's a game. Like, they're just really concrete and they don't get that it's make believe. And so they heard we have an hour to solve these puzzles and if not, catastrophe. And just think about what would that experience be like. Well, they are going to be incredibly annoying because they're not having fun, right? Like, they're not there for fun. They are so focused and they want to solve it and why are you not working hard enough? And they're going to be very controlling and very bossy and you're going to find Their behavior exasperating and annoying because they're ruining it for everybody. But from their perspective, your behavior is bewildering because why are you goofing around? Right? Like, why are you so.
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Right, Right.
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Like, this is. You're crazy. How are you not taking this more seriously? And so they are going to be very frustrated with you while you are also going to be very frustrated and irritated with them, which I think actually is what ends up happening in a lot of families when there is a child with a lot of anxiety. And they just are having a really different experience from. From the experience that the rest of the family is having. And, you know, you try to go on vacation and everybody wants to relax and just have fun, but they're not relaxed. They're like, wait, what if we get lost? What if we're not back in time? What if we don't find the way? What if this or that happens and everybody is saying, like, just relax. Just have fun. But they can't because they're really anxious about it. And that, like, miscommunication, that kind of different outlook can really lead to a lot of stress in families where one person, maybe one child, just has a lot of anxiety. Now, you asked about, like, differentiating the, like, subclinical and real kind of like impairing anxiety. And there isn't, you know, there isn't really, like, one rule for this because, like, a lot of things in our field in mental health, you don't do a blood test to tell you you're in the range or you're out of the range when it comes to anxiety. So what do we look at? We look at how much this is messing up your child's life. How much is it impacting their ability to just lead a normal life in the various domains in which you expect a child to be functioning. Are they able to go to school and also to feel okay in school and to learn there and pay attention, et cetera? How much is it affecting their social interactions and relationships and behavior? Are they able to be with other people, communicate with them, enjoy that interaction, relax, et cetera? How are things going at home with the family? How much is family life starting to revolve around this child's anxiety, which is something I think will give get into even a little bit more? And. And of course, how much is it affecting them just personally? Like, are they able to sleep at night, to eat, to, like, feel relaxed, to enjoy the things that they would like, normally want to enjoy and have interest in? And so you look at all of this, all of these different domains of function, and you just ask yourself, is this significantly impacting their functioning across these domains? And has it been that way for a while? Because sometimes everybody's going to have like a bad week or a bad day or times when they're anxious. You know, you go into a classroom in the first week of middle school and lots of kids are going to look like they have social anxiety because it's a new environment and new kids, a new teacher and they're all really anxious. But a few weeks later, most of them have settled in and they're separating fine, and they're interacting with the other kids and they're okay. But one or two of those kids still look really, really socially anxious or really struggling to separate from the parent or something else. And those are the ones that probably have a more significant anxiety problem. So you're looking at the impairment and you're looking at the duration, and that's kind of how you're going to make a judgment on does it seem like this is a real significant problem? Bottom line, if you are concerned that maybe your child has some significant anxiety, I think it's worth having a conversation. Talk to your pediatrician, talk to a teacher, talk to a psychologist or another mental health professional and maybe they'll tell you, oh, you're just too stressed as a parent, give them some time and they're fine. But maybe not. Maybe they'll say, you know what, actually your kid really is struggling a little bit and could get some help. Because the reality is that even though insurance companies think only people who have fully diagnosed disorders should get any kind of help, actually your child doesn't need to have a clinical diagnosed anxiety disorder to potentially benefit from getting a little bit of help. So maybe they don't need to develop that problem at such a high level.
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Well, and actually that brings me to what, what want to talk about, which is what are the behaviors that are actually in our control as parents that can support kids whether or not they have clinical anxiety disorders, or they're just experiencing like the normal wear and tear of being a person, but they're experiencing it. And then we have these opportunities to give kind of support and guidance so that they can move through those inevitably anxiety provoking experiences that we're always going to have. And before we get into that, just like a side thing that I noticed, first of all, those were two metaphors. I have not heard of yours. So there you go. I was wrong. They were amazing. I just think metaphors are so helpful because when something is unfamiliar to your lived experience, it just is. It's like, why, why can't you just, you know, fill in the blank?
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Exactly.
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But what I was thinking about is if you're in that escape room and you're annoyed with your kid because they can't understand that it's not real, then it makes sense that you would just try to convince them. But now if you put yourself in the shoes of the person's brain who's like, are you guys crazy? This is we're going to die. Like, then of course they'll double down on trying to convince you because they're living in a different real. And the only thing that I can think of is my listeners know this because I think I've mentioned this before, but I, I loathe flying. I loathe. That's where I experience tremendous anxiety. And I really, really have so much compassion for people who move through the world like they're in a minefield all the time. Because I experience, I experience it with just flying. It's not rational. But at the, in the, in the heat of the moment, it's like if somebody's like trying to say like calm down, it only makes me double down on my belief system. Now I have to travel all the time and suck it up. And I do, but I don't like it. And the only thing that I can say is like, I never have grown out of it. I just like do it out out of necessity. And that is a solution that has worked for me. But I like there have to be better tools that you can get growing up over time with the adults in your life to, to support you. But the only thing that I was thinking is I know that feeling of like everyone else that is giving me more and more reasons why I'm wrong is just making me double down on my belief that I'm right. And so when you try to convince somebody out of those, those feelings, it's not very effective. And now my sponsor Bobby is something I really want to tell you about. Bobby is the only mom founded and led infant formula company in the United States. Bobby's infant formula recipes are USDA organic, they are Clean Label project certified. They only use ingredients that your baby needs and none of the garbage that they do not need. No palm oil, no alternate sugars, no fillers. They do have DHA for brain support, which is super important. And vitamin D for bone health. They're organic lactose for energy and all American grass fed milk. So you know the TO formula or breastfeed is so controversial and it's so bothersome to me because you know exactly what your child needs for you and what you need. So forget that. But what I want is for parents to have a beautiful option, whatever their choice is. And Bobby is a beautiful option. You can feel good about it, you can feel confident about what you're feeding your baby and then you can do what's best for your family. Whether it is exclusive breastfeeding, whether it's combo feeding, whether it is exclusive formula feeding, it doesn't matter. What matters is that you feel good as a parent so that you can parent your child and none of this baloney about anybody caring about how you're feeding your kids, but absolutely offering something with this high quality that Bobbi has. Because Bobbi's just like a gorgeous brand. So shop any of Bobby's starter bundles to see why half a million families choose Bobby right now. And you can get 10% off your first subscription order of Bobby's Organic Infant Formula, plus free shipping and all subscription orders for the duration of your feeding journey by using code raisinggoodhumans10@hibobi.com that's H I B O B-B-I-E.com code raising good humans10 for 10% off your first subscription order. The offer is valid for first time customers only through 1231 24. This episode is sponsored in part by BetterHelp. Give online therapy a try at betterhelp.com humans and get on your way to being your best self. There's no question that mental health is really challenged right now. And there's also no question that the mental health of the caregiver is inextricably linked to the mental health of our children. And so I urge you to take care of your mental health not just for you, but for the humans you're raising. And if you are thinking about starting therapy, give BetterHelp a try. It's entirely online. It's designed to be convenient, flexible and suited to your incredibly busy schedule. All you have to do is fill out a brief questionnaire to get matched with a licensed therapist. You can switch therapists if it's not the right fit at any time for no additional charge. So let the gratitude flow with BetterHelp. Visit betterhelp.com humans today to get 10 off your first month. That's BetterHelp H-E-L-P.com humans BetterHelp H E L P.com humans I like the that.
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A
You brought up playing because it is that it it does also get to the role of the adult in the setting and the, the parent in the setting. Because if you are on a plane and let's say it is bumping around and it is turbulence.
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This is my best friend. Her face.
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Yeah. You know, exactly. Like the thing you don't want to see is a freaked out flight attendant.
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Yes.
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Yeah. Nobody wants to be nervous on a plane and look at a flight attendant and see them looking freaked out. Right. Like that is not helpful at all.
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Yeah, you're speaking my language.
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Right. Like you want to look at them and see, oh, I guess, I guess we're okay. I guess we're, you know, they look calm, so I guess we're fine. They're giving out, you know, they're pushing their trolley, so I guess it's all right. And that helps you to know that you are in a safe situation as well. Which really gets to what you were saying about what, you know, we as parents or what, what parents can be doing in those moments. And there's a word that you used that I really liked. You said opportunities. Right. Like these moments where your child is anxious, like, you call them opportunities. And I think that is such a good way to think of those moments because it's a little counterintuitive. Right. Like, I think naturally you don't really think of moments when your child is anxious as an opportunity. You see it as a problem.
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Right?
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This is a problem. And how am I going to remove that? How am I going to stop them from being anxious? Because I'm their parent and I want them to feel good and not anxious. But actually those are opportunities. They are opportunities to build in your child the belief that actually, you know what, you can be anxious some of the time and it's not the end of the world. That being anxious is not something that has to be avoided at all costs. Right. Like there's something in that leaping to the rescue that does communicate to your child this is a major problem that needs to be, you know, avoided. Before I was talking about people getting smushed and you weren't mad at me. So I'm going to use another ugly, another ugly image. But imagine if you're a parent and your child is bleeding and they're bleeding heavily, profusely. You know, it's like that's a huge problem. And if your child is there and they're like really bleeding out there, you are going as a parent and just as a human being, you are going to do everything in your power to make sure that you are stopping that bleeding. And you're not going to walk away, you're not going to do anything else. And even if it's not right working, right, like, even if you're failing, you're still going to keep trying because the kid is bleeding, right? Like, you have no choice. And sometimes when you as a parent, when you respond to your child's anxiety in that kind of manner, right, when you are there frantically doing everything you can to try to calm them, there is a message that's being communicated, which is you kind of are bleeding out, right? Like, you, this is a crisis, this is an emergency, and we need to solve it at all costs. Which is very caring, but also does build in your child that feeling that it's not okay to be anxious. And that feeling, the idea that I should not be anxious, I can't handle being anxious. That is actually the biggest vulnerability for a child who has any predisposition to anxiety, any tendency to anxiety. Because I just think about the planes. Like, what did you say? You said, like, they make me uncomfortable. I don't like it, it scares me, but I do it, right? I'm not comfortable. I get off, I'm tired, I'm exhausted. I hated it, but I do it. Which means you're kind of saying, okay, I'm willing to put myself through that. But if you said to yourself, no, I'm not willing to feel that way, right? Like, I'm not willing to put myself through that experience. Well, you'd never get on a plane, right? You'd never go anywhere. You'd live a much more limited life, professionally, personally, et cetera. And your fear would be 10 times bigger than it is because every time you chose not to do it, that would be another time when you're teaching yourself, yep, I can't handle planes. I can't do it. I can't be anxious. And so those moments when your kid is anxious, they really are opportunities to try to show them that actually it is okay to sometimes feel this way. And that's very different from telling them, you know, don't worry about it. For being in that escape room and saying, oh, stop freaking out, right? Like, of course they're going to double down, right? They just think you're crazy in that moment. Or they think you don't get it. Or maybe they think, yeah, you don't get it. Or maybe they think, look, you're Superman, right? Like, you're not scared of anything. You're so strong. That's great for you. That's awesome. But you know what? If my parent is Superman. That doesn't mean I can fly. Right. It seems to have skipped a generation. I'm not able to be Superman. And so that doesn't help me at all. If you can respond to your child in a supportive way, by which I mean responding to your child by showing them two really important messages you're showing them. First of all, I do get it. This is real. You're not just being a baby or being silly or being a sissy or a wuss or like all these words that people sometimes throw around. No, like, this is real. It's not just attention seeking. You're actually anxious. And that is valid. That's a real thing. It's uncomfortable, it's scary. It's a real valid, genuine thing. And I get it. So you're showing them that acceptance, but then you're combining that acceptance with another message, which is a message of confidence, meaning I actually do get it. And I also think that you can actually handle that, that you can get through that. Now, I'm not demanding that you think it. Right. I'm not saying to you, you have to agree with me. I'm not. It's not really trying to persuade you. I'm just telling you what I believe. But that makes a huge difference. Because as a child, if you're growing up and your parents see in you somebody consistently who can actually handle being anxious, who can tolerate it, can cope, can get through it, that's going to affect how you feel about yourself as well. I like to say to parents, you know, parents, you're like a mirror that your child looks into and they see who they are. All of your reactions to them, that's the reflection that they're seeing, and that's who they know that they are. If what they see in that mirror is a helpless, weak, vulnerable child who can't handle stress, who falls apart, who can't deal with difficulty, well, that's what they start to believe about themselves. And they're going to be so much more anxious as a result and so much more avoidant than impaired as a result. But if they look in that mirror and what they see is the image reflected to them of a child who actually has strength, who has resilience, who can cope with things, yes, it's hard. Yes, it's uncomfortable. We're not denying that that's the acceptance, like it's real, but also it's something you can get through, well, that also will affect how they feel about themselves. And they start to be more open to the idea that, you know what maybe I can actually get through some of these things. You know, we are that mirror all the time. It's not only for anxiety, it's for everything, right? Like, I mean, just think about it. If, if, if every time your child tries to be amusing, funny, interesting, if what they see reflected to them is an amusing, interesting, funny, lovable child, well, that's what they believe. If what they see reflected is you're annoying, for example, you're boring, you're annoying, I don't have time for you. Well, then that's how they feel that they are. And I can almost guarantee they will be more annoying as a result. But they're always looking in that mirror and seeing more about who they are. And that has a huge impact on what they believe about themselves in anxiety too.
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And now for a quick break so I can tell you about my sponsors. Okay, you've obviously heard me talk about how much I'm loving clean and affordable skincare from Dime Beauty. Now through Sunday, they're giving you early access to their Black Friday sale with 30% off site wide. So now you can get this affordable, already affordable skin care from dime beauty for 30% off. Their work system is fantastic. And my favorite, their tinted glow wonder screen. Also the Serum duo. I could go on and on, but I'm super into the tinted glow wonder screen because I live in California and I do not leave the house without it. It's a perfect time to stock up on your favorites, grab some stocking stuffers or just try something new. Dime Beauty is clean. It's high end skincare that's affordable and it's actually now even more affordable for this weekend with 30% off. And it really, really works. So since Dime has made millions of happy customers and their product Reviews are all five stars, go to DimeBeauty Co.com now and get 30% off site wide during their early access to Black Friday. Stock up on all your favorites, grab some incredibly priced holiday sets for stocking stuffers and of course pick up a treat for yourself. That's like my running theme. But hurry. This early access sale ends on Sunday. Go to dime beautyco.coM-I-M-E beauty co.com for 30% off site wide until Sunday. I recommend understood.org and have for years because when I work with families who have the experience of getting a diagnosis or raising a child with neurodiversity, it is such an incredible resource. And since October is ADHD Awareness Month, I want to tell you about this nonprofit organization. You can check it out. It's so incredibly helpful. They are all about supporting kids who learn and think differently. Understood is a nonprofit organization working to shape the world for a difference in the 70 million people in the United States with learning and thinking differences. And so they can thrive. And maybe it's your child or a friend's child or a coworker, or maybe it's you. You can go right to the website and you will see so many resources, so many articles, so many tips to help you understand navigating these differences. Learning differences are such an important way to understand how our brains work. They are not all cookie cutter the same. And you can make life so much easier and help kids and yourself thrive by having a better understanding and better access. Understood provides accessible expert reviewed resources for parents of kids who learn and think differently and teachers and other educators because they too need more support. So give today to join a community dedicated to empowering people who learn and think differently. @understood.org give. You know how important it is to me that we understand learning differences, that we are there for the different kinds of beautiful brains in this world. And understood.org makes it easier. The difference between acceptance and sensitivity and accommodation, one that actually supports kids in one way that inadvertently exacerbates. I think maybe exacerbate is a lighter word than you would use, the anxiety. And I think that is incredibly challenging to distinguish between when am I being sensitive and when am I being accommodating? And so I really want to to unpack that with you and think about concrete examples of the language that we can use to ask ourselves, oh, wait, are we in, in this attempt to be sensitive? Are we being accommodating? And how do we be. How are we reflective enough about that that we can move forward?
- [41:30]
A
Yeah, it is a really important distinction to be, to be making. And you know, we think about accommodation. I think it's important to kind of have in mind that accommodating your child. And I'll explain exactly what I mean by that. But accommodating your child's anxiety is the most natural thing in the world. Right. Like it is the normal response. Like children are by our very biology literally hardwired in our brain circuitry. They're like programmed to respond to fear and worry and anxiety by relying on parents. That is true across mammalian life. Right. Like young mammals are born with the programming that you're a small mammal, you don't handle threats well on your own. And so what do you do when you're anxious? Yeah, you signal somebody else and they will deal with the problem, right? Like you know, if, whether you're a human or a primate or a mouse or whatever, right? Like when you are small and immature and you haven't fully developed your own ability for self defense and protection. Well, the natural thing is when you feel threatened or worried, you signal your caregiver maybe by crying or talking or just going to them and things like that, and they will then step in and take care of the threat. And parents are also equipped with that wiring. Like we are also programmed to notice when our kids are anxious and to respond by trying to protect them. And also to soothe and reassure and regulate and calm them. And that's a positive system. It's not a bad system, right? It's just like we said about the anxiety. It's a normal, healthy part of life. This is also part of that, right? Like we're supposed to respond this way. But anxiety disorders, they take these healthy, normal systems and they hijack them, right? So that they start running wild and becoming less adaptive. Right? Like looking both ways before you cross the street. Adaptive, healthy. Standing for an hour and not being able to cross the street even when it's empty. Not adaptive. Now you have a problem and you're stuck. And that is true on the parent side also noticing your child is in danger and protecting them and calming them. Adaptive. But when your child has an anxiety disorder, that gets hijacked as well. And so parents fall into this trap, if you will, of continually accommodating their child. What do I mean by accommodation? What it really boils down to is anything that you as a parent, you are doing differently than you normally would because you're trying to help your child avoid the distress of their anxiety. Maybe they have separation anxiety and they get really worried when you're not there. Well, you as a parent, you might be accommodating. Maybe you sleep next to them at night because they're scared to be alone in bed. Or you don't go out like for a date night or something because they're scared if you leave the house, even with a baby, babysitter. Or maybe they have social anxiety and they're uncomfortable when people try to talk to them or they have to say something. And so you step in, you see the anxiety, you see the discomfort. Also it gets awkward because like people are waiting for them to answer. And so you step in, right? And so you're like, oh, this is the answer. And you talk for them and they come to rely on that. Or maybe they just have like generalized anxiety, which really just means chronic worry. And they just continually come to you with all the things that they're worried about, and you start reassuring them and spending endless time going again and again and again over all the ways why they don't need to worry and it's all fine. And that works for like five minutes until they come back again with a new worry. And now you're accommodating again. Maybe they have obsessive compulsive disorder. You start doing rituals with them or you're buying them all the extra soap for their hand washing rituals, et cetera. There's accommodation is to say it's the rule and not the exception is an understatement. You know, there's research all around the world across cultures and races, ethnicities and geographies and everything. And something like 97, 98% of parents who have an anxious child report that they regularly accommodate that child's anxiety. Why? Because they're all doing it wrong? No, because that's the normal way to respond to a child who is anxious. But what research also shows, very consistently, in fact, completely consistently, as far as I'm aware, is that as you accommodate more and more, although you are bending over backward and really sometimes stretching yourself very thin to try to accommodate this child's anxiety so they won't be anxious. Actually what happens is they tend to get more and more anxious over time. So it's not like you've caused the anxiety disorder in the first place, but your response to it can actually maintain the problem rather than improving it. I don't want parents hearing this to hear blame for the parent in what I am saying. I don't blame parents. Parents. I mean, you putting aside really horrible behaviors like maltreatment and abuse, I do blame parents who do that. They're not listening to this podcast. Right, you're doing that. Exactly. Nobody's listening to raising good humans to learn how to be a better abuser of their, of their child. Right. Like that's not why you're here.
- [47:28]
B
But the assumption is everybody who's listening is, is in fact very interested in doing what they can to support and grow their humans. And while, while you're talking about this, can you, I think it will help to explain sort of the part, the part of this that's genetic, the part of this is, that is environmental that we know of, and, and maybe then sort of explaining the part that we can do to better support versus accidentally grow the, the existing anxiety disorder or things.
- [48:00]
A
And I wish that I could give you a really good, empirically founded Clear answer on how much of this is genetic and how much of this is environmental. The truth of the matter is that like in most areas of mental health, we don't really have a good answer to that question. We know there is a genetic component to the predisposition or vulnerability to anxiety. We also know there is some non genetic heritability, meaning a certain amount of modeling and learning and like observing behaviors, et cetera, can also be somewhat like cross generationally transmitted. But the truth of the matter is I would say it is primarily an innate predisposition. Whether genetically inherited or not. The vulnerability to anxiety problems is primarily an innate predisposition that your child was born with. If your child was not born with a strong tendency to anxiety problems, I don't think you are likely to give them an anxiety disorder. I know that we like to talk about all these styles of parenting. Helicopter lawnmower, snow blower, I don't know, whatever, right?
- [49:19]
B
No. But if you've got a dandelion, who cares?
- [49:22]
A
Yeah, yeah, yeah. I, I think I'll put it this way. Maybe you're a very protective, very controlling, very anxious parent yourself. Honestly, if your child does not have a tendency to anxiety, I don't think any of that is going to give them an anxiety disorder. I do think it will irritate them because having an incredibly hovery parent when you're not anxious can be somewhat annoying. But I don't think it's going to give them an anxiety disorder. However, putting aside the question of blame for parents, which I think is really misguided, but it's important for me to note, just because our field over the years has done a lot of damage by blaming parents for psychopathology, our field, I mean, like writ large mental health, we've done a lot of parent blaming and I think it's almost always been wrong. Right. Like parents were blamed for schizophrenia. No, you don't give your child schizophrenia by being this style of. And so putting aside all of the parent blame, the reality is that if you have a child who does have anxiety, well, inevitably you are going to be responding, right? Like because you're the parent in the house, like you are going to be responding to that and some of those responses are going to be better optimized toward helping them to become less anxious and cope better. And others are not going to be optimized that way. And it turns out that accommodation, although very natural, is not optimized to less anxiety over time. It tends to lock in a pattern of ongoing anxiety and increasing accommodation. So that the whole thing just kind of blooms and grows. And so I think help, like as a parent, figuring out some of the ways in which you might find yourself accommodating and taking some gradual. Not all at once, not overnight, but taking some gradual steps toward reducing that accommodation while maintaining a very supportive stance. That is accepting, that does communicate confidence. That ends up being a good recipe for helping children to gradually become less anxious. And it really works like, you can actually help children to, you know, really overcome these problems through the combination of those two things of being consistently supportive and gradually systematically working at chipping away those accommodations. And I'm emphasizing you don't have to do it all overnight. Like, when you sit down and really think about it, you might come up with a list of 20 things that you're doing that are accommodation. And I would not recommend saying to your child, hey, here's this list of 20 things I've been doing, and now I won't. I'm done with that, so good luck to all of us. Right? That's probably not going to work out all that well. But what you could do is say, look, I know you get really, really anxious when people try to talk to you, and it's hard for you to answer, but I don't really think that I'm helping you when I'm always jumping in to talk for you. And so let's start with this particular setting when we go to the library and you want to get your, you know, the next book in your favorite series, and you always want me to ask the librarian for it. I'm not going to be doing that. I know it's really hard for you, but I'm totally sure that you can actually handle that anxiety and you stick with it. And you don't expect your child to immediately go and talk to the librarian on the first day. And you also don't expect them to give you a big hug and say thank you for your deep understanding of child anxiety. Right. Like, you accept they may not love this plan, but what we see is that even when they get really upset about it at first, very quickly, that anger or frustration, and sometimes they'll say really hard things like, why don't you care? Or things like that. That can be really hard to hear. But that anger or that frustration, they quickly become replaced with hope because this child is starting to see you really do believe that this can change, that they really can handle more than they have been, and they start to take a little baby step. And maybe it means that there's two weeks when they don't get their favorite book. But maybe on the third week, they manage to pass a note to the librarian saying, I'm looking for this book. That's a huge step. And maybe the next week they're able to mumble it, and then they're able to talk and suddenly they're feeling a lot better. And that has effects that will ripple outward to a lot of other situations that you didn't tackle so specifically well.
- [54:16]
B
And to go back to your bleeding analogy or your bleeding metaphor, if you're saying, I'm, you know, I'm. I'm not helping you, I don't think I'm helping you. So the next time we go to the library, I'm not going to ask for the book you're giving, you're giving the message. I obviously wouldn't think that. I wouldn't do that if you were bleeding out. I mean, I think that that is so powerful that every time we struggle to distinguish between accommodation and being sensitive and loving that we ask ourselves, do I think my child is bleeding out? If so, I'm going to stop the bleeding. But if they're not bleeding out, what a gift it is to find out this is not an emergency. And so is it a bummer if there's no book at the end of the day? If you walk into the library for a couple of weeks and you leave the library without a book, it's a bummer, but it's not bleeding out. And their feelings about it might be very big, but it's not bleeding out. We have to take a break until next week to have the rest of the episode, and we're going to talk more about concrete examples and how to respond to them. We're also going to talk about what to do when you have more than one kid, because sometimes it really does mess with the whole family system and it feels very confusing, like, well, what do I do if I'm going to be working on this with one child and now I've got another child or multiple kids who don't feel like they have a voice or who feel like their whole schedule is monopolized by the child who's experiencing extreme anxiety? So important. Thank you for listening and more next week with super helpful concrete tools.
- [56:12]
A
Please note that this episode may contain paid endorsements and advertisements for products and services.
- [56:17]
B
Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.