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The Pediatrician Next Door - Simple Advice on Parenting and Family Health
Ep. 138: How to Help an Anxious Child: Parenting Strategies That Ease—Or Increase—Anxiety
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Shop online@marshalls.com when did making plans get this complicated? It's time to streamline with WhatsApp, the secure messaging app that brings the whole group together. Use polls to settle dinner plans, send event invites and pin messages so no one forgets mom's 60th and never miss a meme or milestone. All protected with end to end encryption. It's time for WhatsApp message privately with everyone. Learn more@WhatsApp.com do you ever feel like you have to be on your best behavior at home? Or even more extreme than that, do you feel like you have to tiptoe around your own kid? You know, you watch every word you say. You might change your plans or do anything just to avoid them having a meltdown. Because you know even the smallest change might set them off. It it's exhausting. And I know it can feel like you're walking on eggshells in your own home. If this sounds familiar, you are not alone and today's episode is for you. I'm Dr. Wendy Hunter and I'm your partner in parenting. I don't just hand out advice. I want to investigate the mysteries of childhood alongside you. So here's the challenge I have today. What do you do with a child who melts down when plans change? Or the kid who asks you the same question over and over and over even though you have already answered them? What about the kid who holds the entire family hostage at the front door just because they don't want to go to their brother's soccer game? I know we've all dealt with this to some extent. So the question is, when is this normal kid behavior and when is it too much? And if it's gotten to the point where you feel like you're walking on eggshells in your own home, held hostage by your child's emotions, maybe it's gone too far. So here's what I want us to figure out. Does walking on eggshells actually help your anxious child? Or does it make things worse for them and the whole family? Keep in mind this is not a one way conversation. As you listen to this story, I want you to think about your own kids. Has this happened in your house? What's worked for you? Or totally backfired I would love to hear your story. So message me after the episode and let me know your experience. I'm Dr. Wendy Hunter and I'm the pediatrician next door. I'm that doctor friend you call for practical advice about your kid's health. I mix the science of medicine with the reality of parenting. I hear parents say it all the time. They say, I feel like I'm walking on eggshells. Or they'll tell me, we are constantly tiptoeing around her moods. Or this one, one wrong move and the whole night is ruined. I hear this stuff all the time. And when I hear phrases like this, it makes me pause because it usually means things have reached a level of worry or anxiety that it's time for us to be concerned about. And when it gets to that point, you. Yes, it needs to be addressed. But I also know there's a fine balance here. Sometimes if you're tuned into your child's emotions, that's a really good thing. If you're a parent who can read your child's feelings and head off a meltdown, well, that's parenting at its best. The challenge is knowing where the line is. As a parent and honestly, even as a spouse, I don't always know when I should push and and when I should tread lightly. So where is this balance? When does understanding what another person needs cross the line into enabling them? Do you know what I mean? To figure this out, I picked up my new favorite book about kids behavior. It's called Managing Childhood Anxiety for Dummies. That's just what I need right now. I need simple answers and some easy fixes from a person whose opinion I trust.
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So.
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So I called up the author, Dr. Natasha Burgert. She's a pediatrician and she wrote this book, which is full of the most practical advice I have ever heard on this topic. Because she has lived it day in and day out at work and she wanted to help herself. This is basically a book which is a collection of what she has found works for kids who are making life at home kind of tough. Most parents have moments like this with their kids. So how can we tell what's normal and when? We should be concerned that our child's behavior is more than just a phase.
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I want parents to be sensitive to a child's emotional state. We want to be aware of their emotional state. But when I hear a parent come in and say, we're walking on eggshells around them, that means that something is likely off. Most kids that are having anxiety need some reassurance some support tools, some validation, some love, and they're gonna be okay. And that's what most kids, as the capital K, most kids need when they feel anxious. But when you're really starting to walk on eggshells around your kid, that is usually a clue to me that something else is going on or this behavior is a lot more significant to the family than it should be.
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When Dr. Burgert said that, it really struck me. If parents are tiptoeing around their child, that's a red flag, not just for the child's anxiety, but for the whole family. It means the worry has grown so big that it is changing daily life. And when that happens, yeah, it's time to do something. I see this all the time in my practice. Parents bend over backwards trying to avoid triggering their child. They stop going out to restaurants. They might cancel sleepovers. Or they answer their kids same question over and over and over and over and over again just to keep the peace. And I get it. It feels like it's the nice thing to do. And in the moment, yeah, it prevents a meltdown sometimes. But here's the problem. In my experience, it doesn't help in the long run. So I asked Dr. Burgert what actually happens when families avoid a child's anxiety instead of addressing it.
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We see this a lot with school. We see this a lot with vaccines. We see this a lot with even kids that fearful of going to certain soccer practices, certain auditoriums that are allowed. When we avoid those situations over the time, that's going to amplify and secure that anxiety pathway as a true fear. So, for example, if your kiddo is fearful of dogs and you're going on a walk, and every time you go on a walk and you see a dog coming down the sidewalk, you avoid that sidewalk. You cross the street so your kiddo can continue on his way without having to face that dog. You are teaching that kid's brain to say, yep, I'm right. Dogs are definitely something that I need to be fearful of. And I definitely need to cross the street every time I see a dog. So it's reinforcing that fear every time they're getting into that situation, rather than, I know that you're scared of dogs. So what we're gonna do is I'm gonna walk closest to the dog, and you are gonna walk on the other side of me, and we're just gonna calmly walk by them, and he's not going to bother you. And then the next time is, hey, maybe we could ask the owner if the dog would sit and we could pet it. You know what I mean? Like these small little steps towards approaching the dog without being fearful. Again with the parent taking the lead of, I see that you're scared and I see that you're worried. Let me help you through that. And that is what's going to make new pathways instead of reinforcing the fear. So school's a great one. If I say that I have a stomachache and I don't go to school, that reinforces that staying home from school is what's lessening my symptoms. I feel better when I stay home from school, and that's reinforcing that avoidant behavior. So. And it's. It's a slippery slope. It's tricky. But again, you're not going to break your kid or do something terrible if, like, in one moment you do make an avoidant pathway because you need to move on with your day, or you're not sure if they're really sick in the morning, maybe I don't know if they really have a stomachache, right? Like, I can't. I don't wanna send them to school if they're sick. So we're, again, we're watching for patterns. Is this happening every Tuesday? Is this happening every Monday, Sunday night? Are we always having Sunday scaries? Is this always, like, happening? And once we start to see those patterns, then we can kind of notice that avoidant behavior and that anxiety pattern. I think it's easier to address.
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I hear what she's saying. Being careful around your child doesn't make their difficult behaviors go away. The anxiety doesn't shrink. If anything, I think it grows because the child learns that the only way to feel safe is if the world rearranges itself around their worry. Parents think they're protecting their child, but what they're really protecting is the anxiety. As a parent, though, this is hard. I can't help but feel the emotions that I see on my own child's face. When my kid's anxious. I feel anxious too. And I think most parents know that feeling. We just want to take our child's discomfort away. That's fair. But deep down, I know my job is not to protect my kids from every fear. Right? It's to help them be brave and to face it. And I'll be honest, I need a little more convincing on this point. It's just so hard to watch them have anxiety. So I asked Dr. Berger directly, what really happens when you enable your child?
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I think the list gets longer. So it started out as dogs and now it's gonna be all four legged fluffy things. And now it's gonna be all different animals. Like, the list is just gonna get longer and longer and longer because the brain, again, doesn't know. The brain doesn't know that the dog's really not a threat. But what you're teaching the brain is in order to decrease the sensation that I have in my body when I feel a. By avoiding having that dog in my path. And so as that pathway, that avoidance pathway continues to get reinforced, it will often escalate or lengthen the list of things that kids want to avoid. And that's, quite honestly, I think, one of the most challenging things as a parent, because we don't want to put our kid in a situation where they feel uncomfortable, that makes us feel uncomfortable. We don't want to do that. So it does take discernment and effort and a choice not only on the kid to face their fear with good support, but it takes the choice of the parent to say, yep, I'm going to take a couple extra minutes on my walk today because I know we're going to see a dog and we're going to have to go through this routine. Right? But that is. That is support. That is helping their child through it. That is the solution. There is no shortcut to helping it with these kids. But you know what? That's why we have a long time with them and we have a long time to practice with them, and we have a long time to change our own behaviors and how we support these kids so that we can be better together.
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Okay? This reminded me of something that we didn't talk about directly, and that's using a therapist. In many ways, what she's describing is the parent stepping into that role, you know, being their child's coach or therapist in the moment. And that's exactly what kids need. Because what I have found is that kids under about age 8 or 9, and sometimes even as old as 12, they don't really get anything out of therapy, especially if they're very anxious. So don't waste your money or your time trying to convince your child to go to a therapist. For these kids, my recommendation is often for the parent to work with a parenting coach instead. Someone who can give them tools and strategies that they can use at home so they can be their child's guide. I mean, they're right there at the moment when the child needs help. So who better to be their therapist? Okay, so it's time for a break. And when we come back, we're going to find out which parenting styles are the most helpful. And we're also going to figure out a bunch of practical things that we can do at home to help anxious kids. Your teen adjective used to describe an individual whose spirit is unyielding, unconstrained, one who navigates life on their own terms, effortlessly. They do not always show up on time, but when they arrive, you notice an individual confident in their contradictions. They know the rules but behave as if they do not exist. The new fragrance by Miu Miu defined by you this episode is brought to you by State Farm. Listening to this podcast Smart Move Being financially savvy Smart Move Another smart move having State Farm help you create a competitive price when you choose to bundle home and auto bundling. Just another way to save with a personal price plan like a good neighbor, State Farm is there. Prices are based on rating plans that vary by state. Coverage options are selected by the customer. Availability, amount of discounts and savings and eligibility vary by state. Upgrade your laundry routine with a durable and reliable Maytag laundry pair at Lowe's, like the new Maytag washer and dryer with performance enhanced stain fighting power designed to cut through serious dirt and grime. And what's great is this laundry pair is in stock and ready for delivery when you need it the most. Don't miss out. Shop Maytag in store or online today at Lowe's. Before the break, we figured out why walking on eggshells makes a child's anxiety worse. It's not helpful. I mean, parents mean well. We're trying to keep the peace, but in the long run, it turns out it just feeds the fears we're trying to protect kids from. So now the question is, what should we be doing instead? This is where, I suspect parenting style comes into play, and that's what I want to find out. When I think about parenting styles, we all fall somewhere on the spectrum. Some parents are authoritarian and they have very firm rules. I'm sure you can think of some of those parents, and others are more permissive, sometimes too permissive. You've seen that too. They let their kids dictate everything that happens. And then, of course, there are the helicopter parents. They're always hovering close by and ready to swoop in at the first sign of their child's distress. These approaches all come from love, but they do affect anxiety in a child in all different ways. So is there a best parenting style? And what effect does parenting style have on kids? What do we need to be aware of?
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I think the classic helicopter Mom, I think is kind of the classic overprotective parent. Certainly comes from a piece of love. It looks like love on the outside, but it's a lot of doubt and insecurity on the inside. So if there's a lot of doubt and insecurity on the inside of not making sure that that kid's safe, you're not even gonna put them in places where they can challenge that resiliency muscle or challenge any. So those kids really don't even. They become anxious because they don't even get a chance to practice being uncomfortable and overcoming it. And that's important practice. Of course, there's the other side where you have people that are super, super strict or heavy, really strict disciplinarians. That's also kind of a fear based parenting that those kids will become more anxious because they want to want to avoid that discomfort. So of course the gold is always try to kind of meet in the middle to be able to help our k learn with respect and compassion and still have those boundaries. And that looks like different, that looks like a lot of different things for a lot of different families. But there's generally when we meet in the middle, that's the place where we can support a kid with anxiety very comfortably and eliminate a lot of things that might trigger that anxiety. In those type of environments, we have to show safety with our whole body and our whole demeanor. And part of that is sometimes being strong our ourselves to be able to kind of let them do it. And kids are amazing. It's amazing when you can give them just some calm reassurance what they can do on their own.
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It's true. If you don't try hard stuff, your threshold for handling hard things stays very low. You can't handle anything and everything feels uncomfortable. Even the everyday challenges that kids should be able to manage, like ordering their own food at a restaurant or walking into a new classroom on the first day of school. So if walking on eggshells for us doesn't work, and we know it doesn't, the real question is what works? What are the practical, doable strategies that we can start using right away to support a child with anxiety? Here's what Dr. Burger told me.
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Kids with anxiety need a lot of predictability in their lives. They like a lot of routine. They like to know what to expect because there's nothing that makes an anxious kid more anxious. That's something that surpr for all of my behavior management strategies, I really encourage families to work in collaboration with their kids. Behavior management is a partnership. There's still going to be some guide rails and some boundaries that you're not going to want your kiddos to cross. But they need to know what those are. Those need to be very clear and they need to be very consistent. I think with kids that are anxious, especially if they have some misbehavior or some behavior that's not desirable, having really inconsistent reactions to those type of behaviors really makes anxious kids worse. They don't because they never know what to expect. So having some predictable outcomes, having some predictable consequences, helping them understand what your family's expectations are through conversations and through compassion are exceptionally helpful in the approach that I always encourage with families. And that's what you'll find in the book.
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Those strategies make so much sense and they're practical. But the real test is when you're in the middle of it with your own child and things are not going according to plan. Here's my classic scenario. Okay, what is a parent supposed to do when they have a child who completely loses their mind? Because every Friday night is pizza night, but this one week another family invites you over for tacos. Suddenly the routine is broken and your child loses their mind. How does a parent respond in that moment? Are we supposed to cancel taco night in those moments?
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This is a great opportunity to kind of first of all, calm approach, take that deep breath first, but help them problem solve. Help them understand what's going to be the great thing about Taco Friday instead of pizza Friday. I'm not going to apologize that the schedule has changed. I am going to say I know this is not what you expected, but now we are going to go do tacos. What do you want on your tacos? Who are we going to go see? What do you like about them and kind of reframe it? Everything that you like about pizza night. We are going to do a taco night too, but we are going to taco night. And that is not, that is not the option. Again, these are a million little moments. You are going to have the meltdowns, you are going to have the breakdowns that are going to be very uncomfortable during some of those transitions. But if your kiddo begins to expect that mom and dad's always just going to tell you what's going to happen and going to be there through those transitions and give you warning when you can. Kids will develop the ability to have resiliency and work through those transitions if they're met without apology, with calm demeanor and with good explanation and problem solving.
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Okay, so we're going to Taco night. And at the same time, we are supporting our kid through the discomfort. And we will be rewarded with guacamole and margaritas because we would have earned it. But what about the kid who you are able to get them to accept taco night? They're pretty calm about it, but then they can't stop checking. Do you know what I mean? That's the kid who asks the same question again and again. When are we going? Who's gonna be there? What food do they have that I'll like? And you answer them every time. And they keep asking the same question every two minutes. What do we do with the checkers, the checking kids?
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I mean, that consistent reassurance is classic for a young kid with anxiety behaviors. What time are we leaving? What time are we leaving? What time are we leaving? What time are we leaving? For those kids, I like to use a makeup word. So I like to tell those kids we're gonna be leaving at 8 o'. Clock. The next time you ask me what time we're leaving, I'm gonna say the word bananas. And that is going to remind you that you know what time we're leaving and that you could do something else until we leave. And I just kind of continue to do what I'm doing. And the next time, when are we leaving? When are we leaving? I just say bananas. And I keep working through what I'm doing so the kid knows he's being heard. I told you when we're leaving again, engage that cognitive problem solving and help them not get validation from you that, yes, I need to keep asking. Yes, I need to keep asking. Because the more you answer, the more you're priming that pathway. The reactive bed sharing is a big one. That's one of the most common accommodation things that we experience. Because in the moment it's very comforting, it's very soothing. But it only takes one time for that scared kid to come into your bed and they're going to expect to sleep with you every night. And unless that is part of your family's desire, like you, this was, this was planned bed sharing. If it's reactive, meaning that you're doing it as an accommodation behavior because you just want to get sleep. Those kids are also tough. But there's certainly some different techniques you can use and all of these different type of behaviors in order to reassure them and to validate what they're saying and support them through it. But it takes changes with us, it takes our behavior to change in order to get their behavior to change. And so that's a choice for us to make and to hold that boundary and hold that new change. And often when it's that severe, those are often the kids that I see that need a little bit of professional support, often to kind of make those transitions, especially if they've tried some things on their own and it's not working.
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I feel like we've made some good progress here. We have figured out that walking on eggshells does not help. That was easy. We've learned how to coach our kids through the tough stuff. But I also want to zoom out and think about the bigger picture, what happens day to day at home. As I flipped through Dr. Burgert's book, I noticed she has a whole chapter called optimizing your home environment. It's full of great ideas, everything from foods that support emotional health to how to set up playdates so they're more successful. And since I had the author sitting right in front of me, I could not resist asking. If I'm a parent and I want to start with just one thing to make my home a better environment for my kid, where should I begin?
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If I had to pick one, hands down, it'd be sleep. I think sleep is like so underappreciated and so important, especially for any behavioral management, but especially kids with anxiety, especially for families with anxiety and like sleep. A bad kid with anxiety who doesn't sleep well affects the whole family. So working on sleep not only for the individual, brain development, growth, emotional regulation, brain clearance, like memory formation, learning everything that we do when we sleep. I will spend a lot of time with my patients trying to get their anxious kid as much consistent sleep as we can get. And sometimes I simply with great sleep, prioritizing sleep, prioritizing great nutrition, family meals, having that predictable family meal, having a predictable morning routine before school, sometimes a little supplement if we want to do something like that. Like those type of things are so formative that if we can get families to really take hold of them as like as an active support. Sometimes just getting your kid a great sleep routine is like the better than any medicine I could possibly give you. It's better than any therapy you're ever gonna go to. Is just working on these normal home environment, predictable factors so that your anxious kid not only knows what your routine is, they expect what the routine is and it's biologically helping them grow. That can be one of the some of the best investment that any of my parents can do.
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Getting good sleep makes so much sense. This reminded me of a 16 year old girl I worked with who had crushing anxiety. She had been staying up until at least two o' clock in the morning every night to study because she had to get all A's. But the less she slept, the more anxious she became. Until her anxiety was paralyzing, she couldn't do anything. She even stopped going to school, which was the whole point of staying up late. I convinced her to try an experiment. It was tough. I said, you need to go to bed at 11pm every night for one week. That's it. Just one week. And wake up at 7am Nothing else. Just do this. And she was scared to try it. But she did. And here's the amazing part. After one week, her anxiety improved dramatically. She was actually really excited to share it with me. She wasn't cured overnight, but she went from feeling like she was drowning to being able to breathe again. And she went back to school. Sometimes the most effective treatment is not complicated. It starts with the basics, like getting enough sleep. There was honestly so much more I wanted to cover with Dr. Burgert. Her book has chapters on calming techniques and why they work and sections on anxiety medications. We could have talked for hours. And we did get off on a few tangents because that's what happens when you're sitting with another pediatrician who's also a mom. One thing that stood out though about our conversation was when she brought up the importance of family meals. And if you're a regular listener to this show, you have heard me go on and on about family meals. Yes, I love them. And yes, the research list of benefits is very long. But I promise I'm not going to beat you over the head with that list again today. Instead, I want you to hear this little part of our conversation. Just two moms who also happen to pediatricians, reflecting on the role family meals play in our own kids lives. And especially now that they've left home.
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Well, my daughter just went off to college. I just, I just launched her. Me too. Me too. Oh my gosh. And not having her around that family dinner table has been the hardest thing because that is where our family became a family is around that dinner table. That's where we were.
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I didn't cry at drop off, but I was at Trader Joe's and I started crying.
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So I was like, have anybody to make dinner for? It's true. Like it's such a formative thing. It made me happy when she checked in the other day and she had made some food and so her volleyball teammates and they could all have dinner together. Like I'M like it's that's formative of being human.
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Thank you for indulging me and listening to that clip and not fast forwarding. Seriously, if you take nothing else from this episode, remember what Dr. Berger said. That is where our family became a family. And did you catch the best part? Her daughter is carrying the tradition forward and so is my son at college. That's the power of making family meals a regular tradition. Even a couple of nights a week will hook your kids for life. So what have we learned? Even though walking on eggshells feels like the right thing to do sometimes, in reality it keeps anxiety in charge. The real takeaway is that parents can stop enabling and help their child face the things that scare them. This is how they get stronger and ready to live a big life. A huge thank you to Dr. Natasha Burgert for joining me today. Her new book, Managing Childhood Anxiety for Dummies is full of more practical tools and insights that we just started to touch on here. I really recommend her book, whether you have an anxious child or any child, because we really do all have some amount of anxiety at some point. That's kind of what makes us human. And if this episode gave you some clarity or encouragement, please, please follow the show so you don't miss the next mystery we solve and share it with a friend who might be facing the same struggles. And also, please leave a review on Apple Podcasts. It really helps more parents find the support they need to thanks for listening and and I'll see you next time. For more from the pediatrician next door, find me on the web@ pediatriciannextdoorpodcast.com if you've got a question about the weird things kids do, send an email to hellopediatriciannextdoorpodcast.com for a chance to hear your voice on the show. I'm Dr. Wendy Hunter. And I'm the pediatrician next door. This show is produced by Rent Rock Music. Make sure to subscribe and leave a review wherever it is you're listening. I'll be back next time with more. Here we have the Limu Emu in its natural habitat, helping people customize their car insurance and save hundreds with Liberty Mutual. Fascinating. It's accompanied by his natural ally, Doug.
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