From Sleeping in Their Own Beds to Ordering at Restaurants: How to Stop Rescuing Our Kids from Anxiety So They Can Learn to Rescue Themselves-- Part 2 w/ Dr. Eli Lebowitz

Summary

Raising Good Humans: From Sleeping in Their Own Beds to Ordering at Restaurants - How to Stop Rescuing Our Kids from Anxiety So They Can Learn to Rescue Themselves (Part 2)
Host: Dr. Aliza Pressman
Guest: Dr. Ellie Lebowitz, Yale Child Study Center
Release Date: November 15, 2024

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In the second part of the enlightening two-part series, Raising Good Humans, host Dr. Aliza Pressman engages in a profound conversation with Dr. Ellie Lebowitz from the Yale Child Study Center. This episode delves deep into practical strategies for parents to support their anxious children without overtly rescuing them, fostering independence and resilience.

Key Topics and Discussions

1. Understanding the Impact of Parental Accommodation on Family Dynamics

Dr. Lebowitz begins by addressing the common scenarios where parents may unintentionally rescue their children from anxiety, such as insisting a child stay in bed or accompany them to social settings like restaurants. She emphasizes the importance of allowing children to navigate these situations to build their coping mechanisms.

Dr. Ellie Lebowitz [02:35]: "We can't just say we're not going to have it at all. Teenagers are going to be using social media."

This sentiment reflects the broader theme of balancing protection with empowerment, ensuring that while children are safeguarded from genuine threats, they are also given space to handle manageable stressors independently.

2. Navigating Sibling Dynamics and the Family System

A significant portion of the discussion centers on the ripple effects of one child's anxiety on the entire family. Dr. Pressman and Dr. Lebowitz explore the challenges parents face when accommodating an anxious child and how it can inadvertently strain relationships with other siblings.

Dr. Aliza Pressman [09:40]: "When you're dealing with multiple children, accommodating one can sometimes come at the expense of another."

They highlight that families operate as interconnected systems, where changes in one member's behavior or needs influence the entire household. Dr. Lebowitz suggests strategies such as separate outings or designated times to ensure that the needs of all children are met without overwhelming the family unit.

3. Strategies to Reduce Over-Rescuing and Foster Independence

Dr. Lebowitz introduces actionable methods for parents to gradually reduce their tendency to rescue, thereby encouraging their children to develop self-reliance. One effective technique discussed is the “Simulated Independence” approach, where parents engage in role-playing to help children practice managing anxiety-inducing situations.

Dr. Ellie Lebowitz [17:31]: "Competence builds confidence. The way to build competence is by learning new skills."

This method involves setting small, manageable goals, such as briefly leaving the child’s bedroom, and incrementally increasing the duration to build trust and independence.

4. Addressing Parental Emotions: Anger and Frustration

The conversation does not shy away from the emotional toll that parenting an anxious child can take. Dr. Pressman provides guidance on how parents can navigate feelings of anger and frustration without projecting these emotions onto their children.

Dr. Aliza Pressman [33:06]: "You are not a bad parent because you feel fed up with the fact that your child's anxiety is having such an impact on the whole family's life."

Acknowledging these emotions is crucial, as it allows parents to process their feelings constructively while maintaining supportive relationships with their children. Dr. Lebowitz advises parents to express their struggles separately from their interactions with their anxious child, ensuring that the child does not internalize the parents' stress.

5. The Debate on Labeling and Over-Diagnosing Anxiety

An important segment of the episode addresses concerns about the potential over-diagnosis of anxiety in children, especially in the age of social media where trends and labels can spread rapidly. Dr. Pressman counters by highlighting the more pressing issue of under-diagnosis and emphasizes the importance of differentiating between normal anxiety and disorders that require intervention.

Dr. Aliza Pressman [37:54]: "Anxiety has long been the most common mental health problem, and under-addressing it remains a significant issue."

She advocates for a balanced perspective, recognizing that while over-identification can be a concern, the greater risk lies in many anxious children not receiving the help they desperately need.

6. Introducing SPACE: Supportive Parenting for Anxious Childhood Emotions

Dr. Lebowitz introduces the SPACE (Supportive Parenting for Anxious Childhood Emotions) treatment program, designed to equip parents with the tools to support their anxious children effectively. This program focuses on:

• Reducing parental accommodation
• Enhancing parental confidence in managing anxiety
• Promoting gradual independence in children

Dr. Aliza Pressman [48:56]: "SPACE does not ask of the child; it's asking of the parent, which is incredibly empowering."

The program emphasizes that change begins with parents altering their responses, which in turn positively impacts the child's anxiety levels and overall family harmony.

Notable Quotes with Attribution and Timestamps

• Dr. Ellie Lebowitz [02:35]: "We can't just say we're not going to have it at all. Teenagers are going to be using social media."

• Dr. Aliza Pressman [09:40]: "When you're dealing with multiple children, accommodating one can sometimes come at the expense of another."

• Dr. Ellie Lebowitz [17:31]: "Competence builds confidence. The way to build competence is by learning new skills."

• Dr. Aliza Pressman [33:06]: "You are not a bad parent because you feel fed up with the fact that your child's anxiety is having such an impact on the whole family's life."

• Dr. Aliza Pressman [37:54]: "Anxiety has long been the most common mental health problem, and under-addressing it remains a significant issue."

• Dr. Elliza Pressman [48:56]: "SPACE does not ask of the child; it's asking of the parent, which is incredibly empowering."

Conclusions and Takeaways

The episode underscores the delicate balance parents must strike between protecting their children from anxiety and allowing them the space to develop resilience. Key takeaways include:

• Gradual Reduction of Accommodation: Implementing small, consistent changes in how parents respond to anxiety triggers helps children build coping skills.

• Family-Centric Strategies: Recognizing and addressing the broader family dynamics ensures that all children feel supported without one needing to be a focus of anxiety management.

• Parental Self-Care: Acknowledging and managing parental emotions prevent the inadvertent transfer of stress to children, fostering a healthier family environment.

• Access to Resources: Programs like SPACE provide structured support for parents, offering evidence-based strategies to effectively manage their child's anxiety.

Overall, Dr. Pressman and Dr. Lebowitz provide a compassionate and practical roadmap for parents navigating the challenges of raising anxious children, advocating for a supportive yet empowering approach that benefits both the child and the entire family.

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Additional Resources:

• SPACE Treatment Information: spacetreatment.net
• Facebook Page for SPACE: Join here
• Books and Further Reading: Available on the SPACE website.

Note: This episode may contain paid endorsements and advertisements for products and services mentioned by the speakers.

Transcript

[Dr. Eliza Pressman]

The following podcast is a Dear Media Production.

[Dr. Ellie Lebowitz]

We talk a lot about different ways to parent on this podcast, of course. And you know that one of the topics that comes up is teens and their relationship to social media. And I want to introduce Instagram teen accounts to you because it's game changing. Listen, I know that it's exhausting to try to monitor all this, but I think Instagram's taken a really great step in automating a set of protections for teens that they've built in to address parents top concerns. What I love about the Instagram teen accounts is that they were built to give parents peace of mind to make sure that teens are safer with the right protections in place. Like making their profiles automatically private by default, having automatic contact limits so they can be messaged only by people that are already following them and they're following and they're connected to and the content restrictions that place them into the most restrictive settings and automatic filters for offensive comments or DMs. Look, this is a huge issue and I actually really am trying to get to the heart of it. But what I know is that we can't just say we're not going to have it at all. Teenagers are going to be using social media. So I really love that Instagram is taking a step to to make it automatic and no extra work on parents who are already exhausted. So I really want to encourage you to take notice of what is going on in your teenagers social media accounts and what protections they have. And note that Instagram is automatically doing it. So if they're on Instagram this is the requirement, time limit, reminders and sleep mode included. That means like they just now mute notifications overnight between 10 and 7am and in terms of safety, Instagram teen accounts limit who can contact teens and the content that they see. Most importantly to help ensure teens time on the app is better spent and that I can definitely get behind. Welcome to Raising good humans. I'm Dr. Eliza Pressman and today is part two of a two part episode I did with Dr. Ellie Lebowitz from the Yale Child Study center who has this incredible intervention, clinical work and evidence based program on helping kids with anxiety.

[Unknown Speaker]

And OCD really flourish instead of helping.

[Dr. Ellie Lebowitz]

The anxiety and the OCD flourish. And specifically today we're getting more in the weeds of how to respond to scenarios that are pretty common and that hopefully you can translate to other scenarios. We talk about a child who doesn't want to sleep alone. We talk about even down to ordering at a restaurant and we're also talking about not rescuing our kids so that they can learn that they're capable of rescuing themselves, not in the case when they aren't, but in the case when we really know that they can, and working on how to distinguish between those times when they do need help and when they don't.

[Unknown Speaker]

And finally, we're talking about the family.

[Dr. Ellie Lebowitz]

Systems, because these are kids who are oftentimes needing to live in a world.

[Unknown Speaker]

With other kids in the household, in.

[Dr. Ellie Lebowitz]

The family, in their classrooms. And that can be really hard on parents. Thank you for listening and if you enjoyed this episode, please make sure to give a little review on Apple Podcasts. I cannot tell you how much it helps me both to create content that is helpful for you and also to.

[Unknown Speaker]

Put it out there in the algorithm.

[Dr. Ellie Lebowitz]

Of whatever happens on Apple Podcasts to get it out there.

[Unknown Speaker]

So thank you.

[Dr. Ellie Lebowitz]

And you know, a five star rating wouldn't be the worst. I hope you're all doing well. I am wishing everybody a happy holidays. And please send in any questions and comments to at Reason Good Humans podcast. You can just DM me or put it right on the posts.

[Unknown Speaker]

Now I want to go into a few other examples, but I just would love to get back to two other things that we talked about. One, I just want to expand this idea of sort of if you came into the world in a particular way, you might have more of a predisposition. If you came into the world what, you know, Thomas Boise calls a dandelion, you're probably doesn't really matter. You just might annoy your kid, but you're not watering an anxiety plant. So I want to talk about that and I also want to piggyback off of that. When you think about, let's say you have multiple children and you have the one child who in some ways, you know, I'm thinking about the orchid and the dandelion metaphor. And if you are an orchid, maybe you do have this more sensitive response to, to the world. And so maybe you are going to, you know, be feeling like you're walking through a landmine. But let's say you have a sibling who's exhausted from all of this because they are dandelions. And this is just so hard to understand. So not only are we dealing with the parents, but we're also in a community with other people in our households. And, and you know, thinking about the, the escape room that everybody's trying to play a game here. So now how does that work if, let's say multiple kids are going to the library and they're, you know, there's time that you want to give to being sensitive to your child who you're trying to teach this sort of, nobody's bleeding out here, but that sounded very insensitive, but you know what I mean. But then you also are trying to make sure that you can have fun at the library with all of your children. Can you help us sort of understand that?

[Dr. Eliza Pressman]

Yeah. You know, I think the question of, like, the other siblings in the house, the other children in the house, it is a really important one. One of the, like, unfortunate, I guess, aspects of having almost any problem, whether that's a chronic physical, medical condition, whether it's a mental health problem, like anxiety, is that it is going to impact not only the child with the. With the problem. And that's because families are systems. And in a system, what happens to one also affects others. I think that is an unfortunate. And that is sometimes compounded by the fact that accommodating one child a lot sometimes does also come at the expense of another child. Right. Like when I'm doing something with you, I might not be as free to do something with someone else when I have to lie with you in bed at night because you're scared to be alone. I'm not helping your sibling with their homework, for example, or going on a walk with them like we planned, or to the gym like we said we would. And so there is burden, if you will, or impact on the family system. And on the one hand, yes, that is unfortunate. I also think it's not entirely a negative message for all the children in the house to live and to learn that, yes, sometimes what happens to one does also affect us, and that is part of being a family. Right. That sometimes one need has to supersede another need. And these things are part of life. And so as much as we might prefer that it not be the case, there is something not entirely negative in the. In the. In living the message that that is how systems work. Right. Like when your child has an appendectomy, and we're all focused on that right now, the other child who had a birthday party planned will sometimes have to pay a price, if you will. But that, I guess what I'm saying is don't feel like that's entirely negative because there's something positive about learning that as well. But reducing those accommodations actually has the added benefit of sometimes freeing up a little bit of oxygen in the family system for those siblings as well. And that can be a really positive thing for them to be seeing that you're working on that. That you're working on reducing some of that accommodation that maybe is impacting. That maybe is impacting them as well. It's also a good message to them because siblings also engage in a lot of accommodation. Parents might be the primary ones doing the accommodation, if you will, but actually a lot of siblings will find themselves accommodating their anxious sibling as well. And so there's a positive message for them also in learning that that might not be the most helpful way for them to be helping their sibling either. Now, when you're actually planning the specific step that you're going to take, like going to the library, et cetera, I think it's. It's good to be wise about it. Meaning maybe you want to do a separate trip to the library for this anxious child and, you know, just let it be about that for. For now. Maybe you don't want to do it in the exact same time that you're also taking two other kids and trying to manage a whole family system.

[Unknown Speaker]

You know, as. I think you already used this example, kind of won't allow. That's the language that the parent uses. He won't let me leave his bedroom, so I can't deal with my other older kids. And they kind of have given up. And so they kind of do their own thing and are like, that's our crazy brother. And. And I said, well, what. What happens when you leave the bedroom? And what's interesting is, first she said, I. I can't. Like, he'd be clawing at me. And I know these are examples you hear all the time. He'd be cl. And so if I even could physically remove him from my body just to go to the bathroom, he would force his way into the bathroom. And, you know, if I said, well, what if you said, the bathroom is just my space? I'm gonna. I'm gonna be locking this bathroom door just to go to the bathroom and you're safe and whatever. And she was like, I would never do that to my child. Like, that sounds like a vicious way to treat my child. And so she can't go to the bathroom by herself. She can't leave the bedroom when the other kids are in the house. And I actually don't think this example is as unusual. It's just sort of maybe a louder, clawing, screaming kind of thing might be a little harder. But I think using that example because it does impact other kids in the house, some of them have given up. Some of them might just resent the younger child. Some of them, who knows or maybe they're sweet and sensitive and they're just like, coming together to support the. The sibling. Who knows? But I think there was something to what she said about how she would never do that to her child, go to the bathroom by herself and lock the door so that she didn't have to experience his distress. And I wonder if. If you can speak to that example. I think it is. Because I think the smaller examples we can live with, but that one felt to her like bleeding out. And, And I guess the larger question is, what is it that we are so what is our real fear? What. What is a parent's real underlying fear if they don't accommodate?

[Dr. Eliza Pressman]

Yeah, I think that's such a. It's a really good example. And I, I don't think it's all that rare. I really don't. I think we hear these examples a lot. And it is, it is really hard as a parent to, you know, seeing your child in that kind of distress, feeling like you're abandoning them, feeling like you're not there for them sometimes, also goes back to how you might have felt yourself as a child. People are very, you know, a lot of us carry a lot of our own baggage and, and are very committed to, like, how I want to be or how I don't want to be. And that can also.

[Unknown Speaker]

Didn't listen to you when you were feeling that way.

[Dr. Eliza Pressman]

Yeah, exactly. And so there's. There. It can be a really emotional process. But there are a few things that I would. That I'd probably want to touch on in a conversation with this. With this parent. The first thing is I do think it's important that we don't just surprise a child with a change. In other words, I would never recommend, like, waiting until it's bedtime and suddenly like, okay, I'm not doing this. Right. I'm not going to be there. Because you're asking for the strongest possible reaction in the worst possible moment. Right. Like, they need to get sleep and you need to get sleep and the other kids need to get sleep and we're all stressed and like, now is when we're going to have this, then, like, that's going to be really hard to deal with. And they haven't had a chance to really process that this is happening. And so we never do that. We would always want to first take a little bit of time when you're not even reducing accommodation, you're just communicating those supportive messages. Maybe you should spend a week still going and lying next to your child, but, you know, what, while you're there, maybe you say to them, I get it. It's really hard to be in bed yourself. I want you to know I actually think you can handle that. And you're not getting up and leaving. You're just saying it. But they're hearing that one night, another night, another night. And then after you've done that for a while, maybe you have a conversation in a calm moment, not at night, not when you're going to sleep, and you say, like, I want us to try something different or I'm going to be trying something different starting tomorrow night or, or something like that. So you're giving them an opportunity to process a little bit of that resistance and a little bit of that reluctance outside of the bedtime. Now, does that guarantee that this is going to go easy and smooth? Definitely not. But it actually does set up a better process than suddenly at night saying, okay, I'm out. No plan. Exactly.

[Dr. Ellie Lebowitz]

This episode is brought to you in part by Saks.com all right, it is that time. It's holiday seasonal shopping time. And I love Saks.com because it makes things easy. Plus, special events coming up in my life means that I'm doing a lot of shopping right now for clothing and outfits and presents. So if you want to have a fun and inspired way to shop, go to saks.com because they even have a holiday inspiration for topic. So, for example, if I want a hostess gift for this holiday season, I'm going in for not just a candle, but some other fun ideas to make sure that when I'm, you know, to make sure that I'm a nice guest. And also you can make a personal wish list to forward to family because, you know, everybody asks what your kids want, what you want, or maybe everybody doesn't. But in my experience, people want to get you presents that you want. And this just makes it easier, especially when you're talking about presents for a big family and lots of people who want to feel included. So if you're looking for anything to wear this holiday season and anything to buy as a present, go to saks.com you can find gifts guaranteed to bring joy to every hard to shop for person. This season at saks. Com, you know how we talk about social media and delay, delay, delay, but what happens when you are at that point when you want your kids to have a phone and you want to be able to reach them and they're kind of ready to practice, but you don't want them to have access to the Internet and social media Apps because they are not the right age for it. They're not in high school. So that's where Gab phones come in. GAB is the leader in safe phones and watches for kids, teens and tweens because there is no social media, there's no Internet browser, there's GPS tracking, so you can track your kids if that's something that you tell them you're doing and you want to be doing. Gab devices were built from the ground up specifically for young people. So, so this way you can stay safely connected. You can feel a little bit better about putting off getting a smartphone and your kids can feel a little bit better. They can have music and they can reach you if you're dealing with, you know, team sports and travel and after school and walking home alone. What I like about Gab's phones and watches are that it's built in with this smart filtration that proactively blocks harmful content so it doesn't even reach your kid for you to find out about it. That's why I really think GAB is a must have this year. And I really can't recommend enough that you and your family give them a try and do it now because right now Gab is offering a huge discount on their phones and watches. And the best part, there's no contract required. So you just go to gab.comhumans to get started. That's gabgabb.com humans g a b.com humans terms and conditions apply.

[Dr. Eliza Pressman]

Now there's some other things I would also want to touch on. You raised one of them, which is I want to talk with this parent about what is it that they feel they are doing? If they do, if they did go in the bathroom like even for a few minutes and lock their door and their child is crying, what do they think is happening? Maybe they think this is causing long term damage to their child. Maybe it is scarring, it's breaking the relationship. It's a child who feels unloved. Things like that, that could make it feel so vicious. But we might be able to actually frame that a little bit differently. Like, you know what, maybe those five minutes that you are sacrificing because you're in there and you're, you're bleeding, right? Like you're hearing your child banging on the door and crying and saying you don't love me and come back and things like that, that's you're going through probably an even tougher moment than they are in those, in, in those minutes. But actually maybe that is when you are doing the most for them, maybe that is when you are actually giving them something they really do need. Because what you want for this child probably is not only to grow up knowing that there is always somebody who can rescue them. What you really would like is for them to live a life where they don't need to be rescued all the time, where they can feel like they're not that vulnerable. You know, having someone rescue you is awesome, but always needing to be rescued is a really vulnerable way to go through life. And wouldn't it be great if even if it meant going through a hard five minutes right now? But you know what if that could start to change that feeling? So I don't actually need somebody always rescuing me, that could be a really big gift for them. Now, it's possible that for some parents, we might say, does that need to be your first thing that you're working on? Maybe it feels like the most important one because of the siblings, because of you. But is there some lower hanging fruit that we might want to work on first? And maybe it's not quite as like the biggest thing in the world, but it might be an opportunity for them to practice building up the feeling that I can handle some anxiety. Like theater, there's no real audience, but let's imagine that there's an audience. And in this show we need to convince the audience that you are going to sleep in your own bed. But you're not. You're really not. I'm still going to be sleeping next to you, but we are going to make a show as if you are going to sleep in your own bed. So what does that mean? It means that you're going to get ready for bed, you're going to brush your teeth, you're going to put on your pajamas, you're going to get into bed, I'm going to come in, I'm going to kiss you good night, and then I'm going to leave as though here's a kid going to sleep in his own bed. But you're not, because I'm only going to leave for, let's say three minutes. And once those three minutes are over, I'm going to come right back in and I'm going to say, game over. And then I'm going to lie down next to you and you're going to go to sleep with me next to you, just like you do every other night. Now, a lot of kids are willing to do this because now they still get the parents sleeping next to them at night, but they're doing it and it's success. They're doing what the parent wants instead of being the frustrating kid who's not doing what the parent wants. A lot of kids are willing to do with it. And so you just leave for three minutes. And I'll always say to the parent, if you do that, I really want you to be, like, conscientious, like, look at your watch. Come back after three minutes. Because I don't want your kid checking the time. I want them to trust that you really will. So make sure you come back after three minutes. And you just do that every night. And the only thing that changes is that after a few nights, we're going to start inching up on the time that you leave. So we started three minutes. Maybe we go to five minutes and then six and then seven and then 10 and then 12. And what happens is when you get usually somewhere between 10 and 15 minutes, kid falls asleep. Now, when the child falls asleep, you don't wake them, right? We don't need to wake them up. So you just let them. You go to your bed, they stay in their bed. You just let them sleep. If they wake up later and come to you, that's fine. And in the morning, you don't throw a giant party and say, from now on, you sleep alone. You say, hey, that was really cool. You fell asleep on your own, and you just continue the game the exact same way. Now why does that child fall asleep? Well, for the simple reason that they're calm. And why are they calm? Because they know you're coming back. Right? Like, if you said, you have to be here by yourself and I'm not going to sleep next to you, they could lie there for hours not falling asleep because they're freaking out and they're anxious and they're yelling and they're crying and they're scared. But now they're really calm because this is just a few minutes and then mom's coming back. And so when you have it calm child, and they're a little bit tired in a comfortable bed, what typically will start happening is that they will fall asleep. And you just keep that going until they're falling asleep in bed has really become very routine. And usually at some point you can just start to forget about it. Like, you don't even have to announce, we're not doing it anymore. Typically they just kind of get used to it and you can start to phase it out naturally. We have done this with, like hundreds of kids at this point, and it really works. Well, there are alternate Strategies like, you know, put your chair next to the child's bed and move it a foot away every time. Put a mattress near your bed and move it away. I find that this works better and is a really engaging kind of nice way to, to approach it. But that's almost like parenthetical. And the other things I was saying about this parent, I think are, are even more kind of germane to the, to the, to the question like, you know, how you set it up, how you think through those moments where I'm not there and what does that really mean? And also choosing which target accommodation you really want to start with.

[Unknown Speaker]

I think that's a very helpful suggestion is you pick the low hanging fruit. Not the biggest challenge and not at the most exhausting, vulnerable, emotional time.

[Dr. Ellie Lebowitz]

I wonder, are there things that parents.

[Unknown Speaker]

Can say to themselves, particularly if they see bleeding. I'm using, I'm beating this one to a pulp. But if they see bleeding out because of their own wiring, because of their own, you know, potential anxiety. So now you have a child and a parent who are very worried and in a majorly heightened stress response.

[Dr. Ellie Lebowitz]

What can a parent do if they're.

[Unknown Speaker]

Hearing all of these things but they don't know how to distinguish between an emergency and just a moment? That's hard.

[Dr. Eliza Pressman]

Yeah, I think we see that all the time. You know, they're like a lot of anxious kids are going to have really anxious parents. And you know, I think there's a few different ways that you could kind of talk about this or think about this. You know, sometimes it's just worth reflecting on the fact that yeah, maybe you do have a lot of anxiety in your own life, but wouldn't you want to, for your child to have a life that is less blighted by anxiety than maybe your own has been? Right. Like sometimes when you have a lot of anxiety, your natural thought is, oh, I have to make sure they're not anxious. But sometimes you can give them a better gift and a better life by saying, yeah, look at what anxiety has done to my life. Like the opportunities that I've missed, the choices that I've been. Not really choices because I've been so anxious. Right. Like the way that it's affected me. I don't want that to be my child's life. And the way that I get that is not by convincing them that we have to do everything to remove anxiety. That's the way I've lived my life. The way that we do that is by showing them that actually it is okay to be Anxious, even if that means that I am going to bite my lip and like get through some really horrible moments. And I think it also relates to just like reminding myself continuously that there's a difference between accommodation and like protecting from danger. Of course you want to protect your child from danger and of course you should. Right? Like that is up there in the top things that a parent should do to their child. Right? Like of course, you know, I have three children and I will do literally anything that I can to protect them from danger. But there is a difference between protecting from danger and protecting from discomfort. Protecting from distress. When I make it my mission to protect from distress, I'm conflating those two things. I'm conflating danger that can harm them with distress that makes them uncomfortable and that becomes a trap. Your child being anxious is actually not a danger to them. It's not a danger physically. Even a full blown panic attack. You know, some parents say, well, what if they have a real panic attack? Well, you know, what if your child is healthy enough to run a quick sprint and you don't think that's going to be a physical danger to them, even though they will be out of breath and their heart will be pounding and they will be sweating. If you think that's safe, it's also safe for them to have a panic attack. Believe it or not, there is not much difference physically between those two experiences. The difference is that one is caused by running and the other is caused by anxiety. But physically it's actually no more dangerous and psychologically it's not a danger either. Being anxious some of the time is actually part of what we are like built for. And so you're not putting them in danger when you allow that anxiety to play out a little bit longer. And yes, it's a more uncomfortable process, but what they gain is being less anxious the next time and having a life that is less impact by anxiety. When you as a parent, when you practice, even if the words feel a little artificial and synthetic to you, maybe they don't roll off your tongue so naturally. But when you practice saying to your child, I see that you're anxious and I do believe that you can handle it, that is going to affect how you feel as well. You will see that you come to believe it more too and it will change how you feel too. You know, everything we've been talking about, the supportive responses, the reducing the accommodation, these are the cornerstones of a parent based treatment that is called space or supportive parenting for anxious childhood emotions. And clinical trials of space. What they show is not only does child anxiety improve and you can treat a child's anxiety disorder by doing this, but actually parent anxiety improves as well. We see less anxiety in the parent as they are doing this, even though that's not like the stated goal of the treatment. The stated goal is we want to treat this child's problem, but actually when we look after treatment, parents are reporting less anxiety for themselves because this has a really big impact on you as a parent too.

[Dr. Ellie Lebowitz]

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[Unknown Speaker]

Not feel the anxiety but actually feels the anger or frustration. Because I think that that is something we have to address and also because I wonder what language we can use with kids to help them understand what's going on with them and somehow, you know, appreciating the way their brain works versus feeling like they are just a nuisance or just a real frustration.

[Dr. Eliza Pressman]

Yeah. Well, you know, the first thing I would say to a parent who is mad or fed up or frustrated or exasperated and irritated, etc. Yeah, the first thing I would say is, of course you are. Yeah, I get it. I would be too. Like, it is a burden for you. That's real, right? Like, you're not a bad parent because you feel fed up with the fact that your child's anxiety is having such an impact on the whole family's life. Of course you feel that way, but I would also say, hey, this is not a choice, right? Like, your child is not waking up in the morning and rubbing their hands in glee and saying, like, how am I going to drive my parent crazy? The first victim of this anxiety really is the child. Sometimes parents do start to doubt that. You know, it does feel like, well, maybe this is all some diabolical manipulation, speculative scheme to just like, take over. Honestly, I don't think so. I really don't. I think children who are anxious are uncomfortable and wish that they could be less anxious, even if they are insisting on everybody accommodating Their anxiety. It's not really a, a choice. But of course you're going to feel exasperated. But part of the reason that you feel so exasperated by it is that you are putting so much of your energy and time and resource and sometimes money into accommodating the child's anxiety, right? Like, reducing that is actually going to make your life easier, not harder. It might, you might go through some hard days along the way because change can be difficult, but actually that is going to ease the burden on you while you are improving your child's anxiety. So that's like a bit of a win win, right? Like, you are also easing your own burden. And you know, sometimes parents really do fall into this stance that we think of as a very demanding stance, right? It's like, enough is enough. You have to stop it, right? Like, just get with the program, get a grip, suck it up. Like all of these, all of these things. But the reality is, if that was going to work, right? Like, if saying that to your child was going to work and they could just like, you know, stop it, it would have worked already. Like, you tried that, right? Like you tried that before you picked up this book or came to this therapist or like, are listening to this podcast and it doesn't work because it's really not a choice, right? Like, they don't have that choice. What it leads to is just the child feeling misunderstood. They're just as anxious, maybe more anxious, but certainly just as anxious as they were anyway. But now they also feel kind of misunderstood or they're a disappointment, or they're. They feel guilty and ashamed of. And that's not going to improve anything. It's just adding some negatives, but it's not really going to improve anything. And so I think taking this stance that says, like, first of all, yeah, this is like making life harder, that's fine, that's legitimate. But I get that it's coming from my child really being anxious. I can express that. I can, you know, I can communicate that to them. And at the same time, I can also say, but I'm going to make these changes, I think is going to ease, like, vent some of that pressure from the system. So you can, you know, as a therapist, I'd say that you can come into me and vent yourself about how much, how fed up you are. But when you go home to your child, I just want you to stick to that supportive message because that's how we're going to actually lead to some change, right? Like, that's how we're actually going to make this better.

[Unknown Speaker]

I think when you spend time thinking about how much anxiety is sort of in the water right now and how the worry about anxiety and I'm curious what is going on with the labeling and the identifying with and is there harm in that or is there a way to say this is, you know, because there's a lot of controversy over kids that are, you know, as they get older they're sort of sharing on social media or they're talking with each other and casually. I mean I'm in LA and New York so those are obviously it's a more acceptable state to be in. And I think kids connect over it. But I wonder like how what does that do to, to, to center it and how much of that is like so awesome because you're allowed to be exactly who you are and it's elite, it's relieving and how much of it is over identifying with something that now is your identity.

[Dr. Eliza Pressman]

Yeah, it's a really good question. It's a really good question for some parts of the population than it is more so than it is for others. You kind of touched on that in the way that you, that you framed the question because let's face it, like zooming out population wide, nationwide, worldwide, we are so much more in the, in the under detecting and diagnosing and addressing anxiety problem than we are in the over as worried, as worried as some people might be and maybe sometimes with reason, but as worried as you might be about over identifying and like labeling, et cetera, mental health problems, it is a drop in the bucket to the vast ocean of under addressed mental health problems. And that has not really changed. That is still very much the case for most children. It is going to be a very long time before anybody gives them any kind of mental health assessment or treatment that they may very urgently need. And so to be very frank, I agree that it's an interesting sociological and kind of cultural question. I really do. I'm not dismissing the question, but I am still so much more worried about the children who have anxiety and are not getting the attention that they need than I am about the ones who are over tiktoking their anxiety.

[Dr. Ellie Lebowitz]

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[Unknown Speaker]

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[Dr. Ellie Lebowitz]

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[Unknown Speaker]

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[Dr. Ellie Lebowitz]

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[Unknown Speaker]

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[Unknown Speaker]

So interesting because I, you know, Abigail Shrier is a journalist who wrote a book about, I can't even remember what it's called. It was a massive bestseller in this last spring about like basically bad therapy or like we're over therapizing our kids. We're over, we're, we're talking about feelings too much and all that. All that. And I'm like, I work at Mount Sinai. Like we, we get requests for referrals constantly and we never have capacity. Like there's like a nine month wait list. I was frustrated because I think it's like, it's like dangerous because we have a whole swath of the population, like you said, the majority that can't even get treatment, that doesn't even know that this is a thing. But we have, there's like where, obviously where we are, this is an open conversation and it's part of the culture and it's acceptable. And so I think it's a huge disservice because I was kind of angry about it because I was thinking, well that's very irresponsible. I get so worried when there are these sweeping statements about what's going on with our young people for that reason because, because ultimately I can't even find somebody to treat most of the kids that are even asking about it. And by the way, that's in New York and.

[Dr. Eliza Pressman]

Right. And that is east coast and west coast, which are probably the best places in the country, maybe in the world to find mental health providers. And if you're in between, then the situation is really dire. Access to care is, remains a massive barrier, a massive, you know, obstacle to many children getting care that they very urgently need, disqualify or invalidate. Discussing are there cultural trends that can be problematic? I don't think it invalidates that. Right. Like you know, are tics being spread like memes on TikTok? Sometimes. Maybe, I don't know, it's possible. Is there sometimes an over pathologization of the normal range of like human functioning? Yes, I think sometimes there is. But we need perspective, we need a frame of reference. And the perspective is that we as a country and as a world have a much bigger problem with under attention to mental health problems and with remaining stigmatization of mental health problems than we do with the, with the opposite. And so I just am more concerned. It doesn't invalidate the other, but I am more, I remain more concerned with that side of the equation. And lastly, I would say when your attitude about anxiety is one that promotes tolerance and coping and resilience to anxiety rather than avoidance of anxiety, well, that's another reason to be less concerned with the over identification if it does exist. Because my message still would be, well, okay, maybe there, maybe you are anxious. That is something that we should be getting better at dealing with, rather than an attitude that might be built more around over avoidance or accommodation, in which case over identification could potentially be a bigger problem.

[Unknown Speaker]

I wonder what resources and I'll, I'll put resources in the show. Notes to your book, to your website. Can parents access space if they want to?

[Dr. Eliza Pressman]

Yes, they can. So the website is spacetreatment.net you can put a link and there's a lot of resources on that website, including articles and videos and things like that to read and listen to, etc. But there is also a list of providers that I have trained in doing this treatment. And there are a few thousand people listed on the website. There is at least one in every single state in the U.S. and so, you know, if you want to consult with somebody, go on the website and you can put in your zip code or whatever your state and, or even country, because there's many people around the world and you can find somebody to work with. You can also find links to the book that can help you to do some of this on, on your own. As, as well. There's a Facebook page. I'll send you the link for that. We can include that as well. You won't find Ellie Leibowitz on Facebook or any other social media, but you can find a page dedicated to space that you could follow if you.

[Unknown Speaker]

And I think the distinguishing feature about space that's really important to emphasize is that it does not ask of the child, it's asking of the parent. And that feels, I think, like a warm blanket of comfort because we can, we could do that. We don't have to expect anything of somebody. I mean, just in that we cannot control anybody else. It feels incredibly empowering to have work that is heavily researched and so thoughtful and so efficacious in an area that feels incredibly out of our control.

[Dr. Eliza Pressman]

Yeah, no, exactly. That's. That's exactly. Children don't have to come to therapy sessions. And not only do they not have to come, but if you as a parent are doing space, there's no point where you have to make your child do anything at all. It just, it's just not how the treatment works. It really focuses on the things that you can directly control and that you can do. And so that makes it easier. I think in a lot of, in.

[Unknown Speaker]

A lot of situations do we acknowledge that people are feeling like this heavy weight of anxiety and then also being told that there's like all these different things that are contributing to making a whole generation of more anxious people or can we alleviate some of the pressure that we have like the worst generation of kids ahead of us because we have totally screwed them up.

[Dr. Eliza Pressman]

I think it's good to remember that every generation has always been the worst generation. Yeah, I don't think there's ever been a time when people said finally a decent generation came along to replace us and we nailed it this time. I'm not sure that has ever been uttered throughout history. And so, you know, it's good to have that perspective in mind. It is true that anxiety is very common, may actually be on the rise. There may be elements of our life today that contribute to that. The world is a rapidly changing landscape. Do we really understand the effects of a hyper connected social media like world in which we live? These things came about very quickly. Our lives are not mine personally because they're not on social media as I said, but most people's lives are very much like hooked into this, like these networks driven by algorithms that are designed around maximizing for engagement which is not the same as maximizing for mental health or well being. And so like there are a lot of reasons to think that anxiety may actually be on the rise. But it's also important to I think also remember that anxiety has always been a problem. It has long been the most common mental health problem. And yes, we may have a little bit more awareness today. It's certainly more common today for children to self realize or self diagnose which I see as a positive. It's good that children today can Google why do I feel this way and realize that they may have an anxiety disorder. That is easier to do than going to your local library and checking out a dsm. I don't know, a lot of kids who you know, might have done that X years ago and those are positives but maybe there is an increase. But anxiety has always been a significant, very common, very prevalent and under addressed as it remains mental health, mental health challenge. I think of myself less as a parenting guru if you will. I'm not really in that mode of like this is how we should raise children or that is how we should raise children. I am much more in the mode of this is a way to address anxiety when it is a problem. And I have a lot of respect for other people who do other things. But I also believe that there are a lot of ways to be a very good parent and not one way to be a very good parent. Right. Like I think our, our. Our species did not evolve from everybody that is attuning their parenting to an exact model of exactly how we should be. Children actually are quite resilient and actually are very much the product of what they bring to the table. And so I think sometimes we may overestimate the ability of parents to shape every child into a particular mode by a particular style of parenting. And I still say, I said honestly and genuinely that I have a lot of respect for parents who are. For people who are dealing with like the much bigger, broader socio cultural questions of parenting. My own focus is more on ways to help anxious children. And this is one of those ways.

[Unknown Speaker]

Well, I am a. I'm a generalist and I do talk a lot about parenting. And it is. I could not agree more. I think it's out of hand that we think there could be this one prescription. And I really feel for all of us as parents that it seems like if we could just get it this way with these scripts, we could nail this thing. But I do very much appreciate the work that you do because it gives tools for this incredibly painful experience of raising kids who are really suffering.

[Dr. Eliza Pressman]

Yeah. Please note that this episode may contain paid endorsements and advertisements for products and services.

[Dr. Ellie Lebowitz]

Individuals on the show may have a.

[Unknown Speaker]

Direct or indirect financial interest in products or services referred to in this episode.