Phobias happen when tame, harmless things turn into bullies. They take on a power they don’t deserve, in ways that often don’t make sense. The fear is real and persuasive, and for kids, it can be particularly debilitating. The good news is that phobias and fears in children are very manageable, and with the right guidance and strategies, kids can be empowered to move straight through the middle of the intense fears that get in their way.
What causes intense fears or phobias?
Often (but not always) when there are specific phobias or fears in children, there will be a starting point – something that happened that first made the fear come to life. It might be something that happened to the person, to someone else, or something that was heard about in a story, a movie, or in the news. A fear of dogs, for example, could have its beginnings in an actual scary encounter with a dog, hearing about someone being traumatized by a dog, or seeing a news story or a movie about a dog attack. That event is then generalized from something that happened because of one gnarly dog, to something that could happen with any dog. All dogs are then avoided in order to avoid the frightening feelings that are associated with them.
With a phobia, being in the presence of the feared thing will bring on a fight or flight reaction that is so strong as to send parts of the brain ‘offline’. This is because the brain believes so strongly in the threat, that it makes way for the person to act automatically, on raw instinct, without the intrusion of the part of the brain that would prefer to take time to analyze the situation and come up with a different plan.
The avoidance that comes with phobias isn’t so much about avoiding the feared thing, but about avoiding the intense feelings that come with it. These feelings are connected to the fight or flight response, a physiological response that involves the release of neurochemicals to get the body ready to fight for its life or run for it. When the body doesn’t fight or flee, there is nothing to burn the neurochemicals. They build up and bring intense emotion and physical sensations (such as a racy heart, sick tummy, clammy hands) that feel awful.
The once-harmless thing (the trigger) becomes the warning alarm that ‘bad feelings are found here, and it drives avoidance, or ‘fear of the fear’. The trigger and the feelings become wrapped up in one scary bundle.
Avoidance is an adaptive, obvious solution, but it also comes with its own problems.
The problem with avoidance.
When children show overwhelming fear or anxiety, it is completely understandable that a loving parent would want to protect them from those bad feelings. Sometimes, whether through exhaustion or a lack of options, it can feel as though the only way to soothe their distress is to support the avoidance. This can lead to short-term relief for everyone (which sometimes is desperately needed!) but avoidance has a sneaky way of making things worse in the long run and keeping the anxiety well-fed.
Avoidance takes away the opportunity for kids to learn that whatever is worrying them most likely won’t happen at all and that if it does, they are resilient, strong, and resourceful enough to cope. There is no opportunity to learn that fear is a warning, not a prediction. What kids learn instead is that the best way to deal with an unusual or confronting situation is to avoid it. The more something is avoided, the more that avoidance is confirmed as the only way to stay safe. Sometimes avoidance will be a sensible option, and sometimes it will interrupt their reach into the world.
Our brains are always changing to be the best possible brain for us. It does this through experience. When an experience is repeated, the brain strengthens the corresponding connections. It will change itself according to what it thinks we need, and it will base this around the behaviors we repeat. If avoidance is a repeated response, the brain will shape itself to support this. The good news is that as much as the brain changes itself passively, without any deliberate effort from us, by actively exposing the brain to certain experiences, we can also change it in ways that are more in line with what we need. It’s called experience-dependent neuroplasticity and it happens in all of us – kids too. Here’s how to help them with that.
Phobias and Fears in Children – What to do.
In the midst of high anxiety, the part of the brain that can rationalize and use logic and facts to feel safe is offline. For this reason, the best time to work with a fear or phobia is during times of calm. This is when all of the parts of the brain will be relaxed and receptive to any information you present, and more open to trying something different. Here’s how to do that:
Fill in the missing pieces with plenty of information.
Younger kids are still establishing how the world works. They’re finding their way around cause and effect – that the effect follows the cause isn’t as obvious to newbies. It might be obvious to you that playing near a vacuum clear doesn’t mean you’ll disappear into the end of it when it gets too close, but for a little person, it’s not so obvious. Show them how it works. A button will fit into the end of a vacuum, but a shoe won’t, nor will a foot, a chair, a car, or a person. Even for older kids – for anyone – the more they know (stats, facts), the less they’ll worry. If they are scared of storms, talk to them about where thunder and lightning come from. Give them as much information as they need to feel safe.
Be careful not to overreact.
Validate what your child is feeling, but be careful not to overreact to the fear. If you scoop your child up every time he or she becomes scared, you might inadvertently communicate that there is something to be scared of. It might also communicate that the only way to feel safe is in your arms. In your arms will always be their favorite place to be, but let the cuddle be a reward for brave behavior, not an inadvertent one for avoidant behavior. Rather than over-comforting, gently talk to them about what you see, ‘That balloon scared you when it popped didn’t it.’
‘You can only work what’s happening now, but your ability to do that is powerful.’
Phobias are a curly combination of the past (‘I know dogs are scary because one has scared me before) and the future (‘what if the dog bites/the balloon pops/a monster comes out when you turn off the light.’) Bring your child back to now. This is particularly important to deal with the generalization from one frightening event, to all similar ones. Talk about the differences between this event and the one that scared them.
Rework the association.
The problem with intense fears is that they become associated with intense feelings and memories – bad ones. Rework this association by pairing something fun or relaxing with whatever it is that’s causing the trouble. An example of where this might come in handy is for children who have an intense fear of thunderstorms. During a thunderstorm, if your little person is scared, acknowledge this and let them know that it’s normal. Catch the feeling first (they need to know you’re taking them seriously), then redirect – encourage him or her to watch a funny movie with you, or to color in while listening to relaxing music, even if it’s through headphones. Eventually, when they’re ready, you can try working up to a game – every time there’s lightning, someone has to tell a funny joke (have plenty ready) and everyone eats M&M’s until the thunder cracks – or something. Anything that takes their focus away from their scary thoughts or memories or feelings and replaces it with something positive will help to dilute the negative associations.
Even though fears and phobias seem irrational, there will often be a very rational story that gave them life in the first place. The generalization to other similar triggers (‘all dogs are scary’/ ‘all thunder means danger’) often happens automatically and without awareness. Telling the story of that initial event can interrupt this.
We humans have been telling our stories for thousands of years. It’s how we heal and it’s how we connect. With our knowledge of the brain ever-expanding, we now have insight into why storytelling is such a fundamental part of being human. It brings meaning to our experience and soothes our strong emotional and physical reactions.
This happens on a brain level. Memories and emotions live in the right brain, but the logical rational factual detail of the world lives in the left. We need both sides of the brain to work together, and when a response seems ‘out of fit’ to a situation, it’s a fairly clear sign that the right brain may have taken over and disconnected from the left. Storytelling reconnects the left and the right side of the brain, helping to make sense of overwhelming emotions and memories. The dominance of the right brain during times of intense fear is automatic. The reintroduction of the left brain will have to be done deliberately. Encouraging a child to tell their own story of the first time they remember feeling the specific fear can be a powerful strategy. Without left-brain logic, the automatic response becomes, ‘All dogs can hurt people because they can all bite. I know because I’ve seen it/heard about it/had it happen to me.’ Eventually, with left-brain logic and facts involved, the response will shape towards, ‘this dog is okay because my parents have said that it’s a friendly dog. It’s sitting calmly and I can see other people patting it. It’s different to the dog that scared me because it is a different color and it’s smaller and its ears are bigger.’
Gently start them off, but if they don’t want to talk respect that. Try, ‘Can you tell me about the first time a dog scared you?’ If they are old enough, encourage them to write about it. Let the words and ideas flow. Encourage them to name the feelings they experienced or the feelings that come up for them when they tell their story or when they are in a similar situation now (such as when they see a dog). Name what you see as they speak. ‘You look scared when you talk about that.’ Research from the Yale Centre of Emotional Intelligence has found that when an emotion is named, the intense emotional circuitry in the right brain is soothed and tamed. This happens regardless of age.
There is often the concern that by talking about the experience, it will make things worse, but given what we know about the brain this just isn’t the way it is. We know this intuitively. When something happens, we are often driven to find somebody close to us to talk about it. If the experience isn’t talked about, the brain will be driven to find other ways to make sense of things. Phobias are one of the ways this can happen. It can also happen by way of dreams. During dreams, the brain ‘replays’ information connected to unresolved issues, to try to sort through and find meaning and closure.
This technique is commonly used in therapy as a way to gently expose kids to the feared situation or object so they can become less sensitive to it and learn a different response. With a phobia, the feared object feels overwhelming and completely unapproachable. Step by gentle step, gradual exposure helps to build familiarity and confidence, so your child can feel more empowered and less helpless in the face of their fear. It is critical that this is done gently, and that your child is not pushed to go further than they feel they are able to. Here’s how:
- Get them on board with the plan.
Getting your child on board with the plan is critical – they need to be the hero in this story. They also need to be assured that they will have full control, and that you won’t be asking them to do anything unsafe.
‘I know that you’re really scared of dogs and I understand why. Some dogs are scary, but most of them aren’t. At the moment your brain is telling you that every dog you see is probably going to hurt you. That must be really frightening for you. It’s not your brain’s fault, it’s just trying to keep you safe. It’s kind of taken over though, and what we need to do is to make you the boss of your brain again. We can do that and I want to talk to you about a plan that we’re going to do together – as a team.
We’re not going to do anything you don’t want to do, and we’re definitely not going to do anything that could hurt you, but for this to work, you will need to do some brave things – but the decision will always be yours. The plan will have different steps. You can say no to any of those steps if they feel too big, and we can find something else that feels better for you. At the end of this, the things that feel really scary won’t feel as scary any more.’
- Explain how a stepladder works.
When you have them curious about the plan, or at least open to listening to it, explain how a stepladder works. Start with an example using something that other kids might be scared of, but which your child is fine with. Keep letting them know there will be an out. As soon as your child feels that they might be forced to do something they feel frightening for them, and their fight or flight response will kick in, overwhelming and sending offline the part of their brain that can receive the information and put it to good.
‘So this is how it works, and remember, I’m just going to explain it – it doesn’t mean you have to do it. Let’s say there was someone who was scared of heights. This would make playing on slippery slides very tricky – all that fun that would be missed! What do you think they could do to make themselves more okay with climbing the slippery slide ladder? How could they get used to being higher on a ladder little bit by little bit?’
See what they come up with (and remember, kids with anxiety often have a beautifully quirky way of looking at things). This process of planning and analyzing will be strengthening the connections in their pre-frontal cortex – the part of the brain that is needed to bring calm during anxiety, but which usually steps back at just the wrong time.
Hopefully, they will say something like, ‘Well first ask them to climb onto a little step, then when they get used to that, ask them to go higher and higher until they get used to it.’ If they come up with something like this, they understand the stepladder approach. If they come up with something completely out of left, like, ‘Just tell them not to go where there are any slippery slides and then they won’t get sad about not being able to go on them’, then you might need to get involved with a little prompting.
• Make it personal.
When you feel as though they understand the idea of gradual exposure, talk about how they can do this with their own fear or phobia. Ask them what they would like to be more okay with. Remember, something is only a problem if it is getting in the way for them. Give them a little prompting if you need to:
‘Do you think it would be good for you not to be so worried about school? Perhaps we could look at that. I think it’s something you could become really brave within no time. What do you think?’
• Break it down.
Break the fear into smaller worries and steps that your child can deal with. It’s really important that you involve them in this process. They’ll be much more likely to stick to the plan if they’ve been heavily involved in coming up with it. Start with a mild version of whatever it is that is causing the fear. Make it super-easy to start with.
So, if they are afraid of being on their own in their own bed at night, work with your child to come up with the steps. The first step might be leaving a little light on all night with you staying beside them in their bed for 10 minutes and then checking on them every 3 minutes. Do this until they feel okay with this step then move to the next one, perhaps laying beside them than checking every 5 minutes. Then, when they’re ready, move to the next step, maybe a quick cuddle and checking every 10 minutes. Put the steps in order from easiest at the bottom of the ladder to hardest at the very top of the ladder.
Here is an example for someone who is scared of dogs:
>> Start with a book about dogs. Spend some time looking at the pictures.
>> Move to a fluffy toy dog. Touch it and hold it with them.
>> Watch a movie about a friendly dog.
>> Hold a friendly little dog (a real one) and encourage them to look at it.
>> Hold a little dog and encourage them to touch it.
>> Let them hold the little dog.
>> Encourage them to pat the bigger friendly dog.
• Keep a very small distance between steps.
It’s really important to make sure that the steps aren’t too far apart. The smaller the distance between the steps, the easier it will be for your child to come on board with the plan, and the greater the likelihood of success. If the steps are too far apart, the risk is that they will lose confidence when they are unable to complete the step – and that won’t be good for anyone.
• There’s no hurry.
Take as many steps as your child needs to get to the top of the ladder comfortably, and spend as much time as you need to on each step. There’s no hurry. Going gently is critical. Repeat the steps as many times as it takes for your child to feel confident enough to move to the next step. Every time they accomplish the step, the experience is changing their brain and strengthens the parts that support resilience, confidence, and brave behavior. It will also be imprinted over the memory of the experience on that step as a scary one. Rather than it being scary, it becomes tolerable as new experiences feed into the right brain with new memories and new feelings, such as success and pride. Your child will learn that the more they do something, the less anxious they will feel. Repetition leads to familiarity which over time will decrease their anxiety.
• If they get stuck between steps.
If this happens, don’t worry. Check how your child is making sense of this. Are they telling themselves that they ‘just can’t do this stuff,’? ‘That there’s no point’? If this is happening, shift the focus away from them and onto the behavior. They are really capable of getting this, but perhaps there was too much of a gap between the steps. They can do it, but they just can’t do it YET. It might just take a little more time, and that’s always okay. It doesn’t matter how long it takes to get to the top of the ladder. What matters is that they’re moving closer and closer towards it.
Encourage them to see it from a different angle by putting them in the position of a bystander, rather than the star of the show. This will help to access a different part of their brain. What would they say to someone else who wasn’t able to complete that particular step just yet? What would that person need to hear to be okay to try again next time? Some steps will just take a little more time and effort than others, and that’s to be expected.
• Make it worth their effort.
Stepladders can be challenging for anyone – especially kids – though they will have it in them to be brave. Your child might not see any good reason to put themselves through it. For your child, it might seem like a perfectly reasonable option to avoid whatever it is they’re scared of for the rest of their lives. Completely understandable.
You might not be able to change the way they feel about taking their steps but you might be able to influence their behavior. This is where rewards might come in handy. We all need a reason to do the tough stuff. Kids are no different, and ‘you’ll feel better in the future might not wash as a good enough reason. They might need an added boost. When they aren’t able to see the long-term benefit (and it’s completely reasonable that they might not be able to) we need to give them enough to make it worth their effort in the short term. Remember, even the biggest reward won’t work if the fear or anxiety is too big. The steps have to be small.
Rewards don’t need to be excessive and they don’t need to be material. Things like time with you, doing something fun, or staying up later might be enough to get them over the line. The reward has to be given as close as possible to when the step is achieved, and it should only be handed out if the step is achieved. All attempts deserve to be acknowledged – they won’t always make it on the first go, but there are other rewards for that – praise, cuddles, etc.
And finally …
It’s important to keep in mind that the goal isn’t to completely get rid of the anxiety but to make it manageable. Your child might still feel a little anxious about the dark or being away from you, for example, but it will no longer get in the way for them or for you. Having a little bit of anxiety is normal, healthy, and realistic. Part of living well is understanding that sometimes we do feel anxious, scared, lonely, sad, or angry and that a manageable amount is okay. The problem is when it takes over that it gets in the way.
We don’t want to take away the normal avoidance behavior that will protect them and keep them safe. What we want to do is to help them to manage the fear and to not be squeezed out of life because their anxiety is so intrusive. We want to teach them that life isn’t as scary as it feels sometimes and that they are amazingly resilient little beings with incredible ability to cope, even when they don’t feel like it.