Q. My daughter will be seven in the summer, and has always been an anxious child. In recent months, she has started to get distressed at the thought of being on her own anywhere. She gets distraught, for example, going into another room to fetch something; going to the bathroom; going to change out of her school uniform. While we’re trying to support her, it’s become so bad that she’s holding the rest of the family hostage because she won’t do anything on her own and she gets distressed to the point of making herself sick. Nothing untoward has happened to prompt this, and she finds it difficult to name whatever it is that makes her scared to be alone.
A. Specific separation anxiety can be triggered by a distressing event, but frequently there is no trigger and it can become a habitual response. You are right to respond to her supportively, as she is likely to be feeling genuine anxiety, though you do need to help her move to more independence especially if her anxiety is impairing her – and the rest of the family.
Agree a goal
The first step is to agree a goal with your daughter about overcoming the anxiety. As with the question above, it is important to be supportive and not to blame her for the anxiety. A useful strategy is to talk of the anxiety as separate and bothersome to her. You could say, “That anxiety [or whatever name she might pick] must be really annoying, stopping you doing things you like,” before making a plan with her: “Let’s see if we can overcome the anxiety together.”
Break the task into small steps
The next step is to break down the task into small steps. For example, you might set a long-term goal of her going to her room by herself and getting dressed and then you break this down into many steps: 1) Going up to the room with Mum and getting dressed with Mum there. 2) Getting dressed with Mum there, while remaining calm and not looking for reassurance. 3) Getting dressed with Mum outside the door. 4) Getting dressed with Mum at the bottom of the stairs. 5) Mum taking me to the bottom of the stairs and then going up by myself.
Pick an easy first step
The key is to pick a first step that is easy for your daughter, to have many interim gentle steps (up to 10) and to move to the next step only when she is ready. Equally, it is important to be very encouraging and supportive so that she can get lots of praise for her bravery as she makes progress. You can also reinforce her progress with a star chart or other reward system.
Dr John Sharry, Irish Times Newspaper, March 2015. John writes in The Irish Times Health+ every Tuesday.