Psychology: Solutions for separation anxiety • Lifestyle (www.HometownAnnapolis.com - The ... |
| Psychology: Solutions for separation anxiety • Lifestyle (www.HometownAnnapolis.com - The ... Posted: 09 Sep 2010 10:11 AM PDT When Kylie arrived at school for her first day of third grade, she made it clear she did not want to get out of the car. Her mother tried everything to convince her that she needed to join her classmates, but Kylie refused. Though her mother didn't know it, Kylie was suffering from separation anxiety, a disorder that makes it difficult for a child to attend school independently. For some children the symptoms are brief and part of a normal adjustment process. For other children, though, the problem becomes more deeply ingrained and eventually threatens normal development and functioning. Psychological symptoms of separation anxiety include a child's intense fear of harm coming to a parent or attachment figure while separated from them. The disorder features clinically significant levels of anxiety characterized by severe emotional distress, unrealistic worries about the safety of loved ones, reluctance to fall asleep without being near the primary attachment figure and tantrums when separation is imminent. There also may be nightmares with separation-related themes and homesickness. Physical symptoms of separation anxiety may include dizziness, lightheadedness, nausea, stomachache, cramps, vomiting, muscle aches and palpitations. These symptoms may cause the child to go to the doctor frequently for medical treatment, and can unintentionally form the rationale or justification to stay home and remain in proximity to the parent. Even experienced parents and savvy medical practitioners can sometimes miss the root cause of separation anxiety and end up treating physical symptoms, which only serves to deepen the problem. Separation anxiety is not caused by one thing, but appears to be based on a host of interacting biological and environmental factors. Children with separation anxiety and school refusal often have a family history of anxiety disorders. These sensitive children are prone to a strong fear response in new or potentially threatening situations. They then often face family patterns in their home that unintentionally reinforce or contribute to their anxiety regarding separation. It is also believed that some families may unknowingly reinforce separation anxiety in young children. For example, when the family faces a source of stress and the child expresses mild reluctance to leave the primary caregiver (who may also be anxious, distressed or unhappy), the child may not be encouraged to appropriately separate from the grown-up. Then, because the child's presence is comforting to the adult in some way, he may actually be given extra attention or other rewards when he stays close to the parent. In much the same way, children who stay home from school are sometimes given powerful rewards of attention and pleasurable activities to help them "feel better." Unfortunately, once parents become aware of the pattern that is developing, it may be too late because the anxious and avoidant behavior may already be well-established. Children who show clinical levels of separation anxiety or school refusal usually benefit from cognitive behavioral therapy. This counseling approach helps the child and his family recognize what is happening and learn strategies to cope with being separated and facing new or feared situations. Parents also can act by gently but firmly helping their child separate from them. One approach is to plan events ahead of time and spend considerable energy building a positive expectation of both the separation and the activity. By experiencing a happy and successful event of separation and reunion, the anxiety should begin to dissipate. It is helpful for children to have a clear sense of structure and how their parents' varying presence and absence fits into that structure in a positive way. Reducing the drama at both goodbyes and reunions is another good idea. For example, when saying goodbye, it might be appropriate to give your child a hug and say, "I love you and I will see you at the end of the day," and then turn and leave. Even if the child is in distress, it is important to keep going and not try to soothe him, because part of a child's independence is based in his ability to learn coping and self-soothing skills when he is unhappy. It is also very important to reward the child for his successful time away from the parent and to point out how the time was well spent for everyone involved. A good counselor can help identify, understand and treat separation anxiety. Developing a graduated plan of exposure to the feared situation that is humane and loving but also clear and firm can be highly effective. In Kylie's case, she began to attend school regularly and thrive once she received positive reinforcement for engaging in activities with her peers while acknowledging that her mom was safe even when they weren't together. It may be one of a parent's most important jobs to clearly give their children the task of developing their own thoughts, feelings and behavior, and to learn how to separate from parents and function independently. Children do not need to suffer from separation anxiety and school refusal, because effective treatment is available. And as with most difficulties, the sooner it is treated, the sooner it will get better. --- Dr. Scott E. Smith is a licensed clinical psychologist with Spectrum Behavioral Health in Annapolis and Arnold. For services or ideas regarding this column, call 410-757-2077 or write to 1509 Ritchie Highway, Suite F, Arnold, MD 21012. This entry passed through the Full-Text RSS service — if this is your content and you're reading it on someone else's site, please read our FAQ page at fivefilters.org/content-only/faq.php |
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