Spotlight On: Anxiety

5 May 2023

BY MS ELIZABETH STONE

This article first appeared in Queenwood Weekly News on Friday 5 May 2023.

One morning at recess, I walked from my office down to the staff room to get a cup of tea. Along the way I was stopped in the corridor four times by four different teachers for the same reason. They were asking me to let ‘Olivia’ off after breaking a rule. She had been caught wearing headphones and, in that school (not Queenwood), this attracted a demerit. The demerit had been recorded by the teacher and under that system, four demerits would trigger a detention.

Olivia was horrified. In her four years, she had never had a demerit. She had been wearing the headphones in the library (permitted) and simply forgot to take them off. She had no intention of breaking the rules. She was flustered, apologetic and desperate. It was imperative that this stain on her record, deep in the bowels of a database somewhere, should be removed.

Never mind that there was no risk that Olivia would ever acquire another three demerits and a detention. Even if she did, this would have no effect on anything. Yet the torment caused by this demerit was intolerable, so she ran around finding every teacher she knew to petition me for relief.

In the space of ten minutes, four teachers found me and made her case. Every few steps I was bombarded with Olivia’s anxiety and distress, transmitted through her caring and trusted teachers, who were clearly feeling anxious on her behalf.

These four sensible, experienced colleagues had not, however, stopped to ask an important question: why are we acting as if this is a Major Threat? Olivia’s distress was infectious, and they had, entirely unconsciously, accepted her distorted perspective. What she really needed, however, was for the adults around her to challenge not the reality of her distress (which was genuine) but the reality of the threat to which she was so obviously overreacting.

While Olivia’s distress was not caused by her teachers, this is a good example of how adults can inadvertently exacerbate and entrench anxiety. This is borne out by an increasingly extensive body of research which shows that the behaviour of adults (including teachers but, for obvious reasons, particularly parents) is an important factor in the incidence and treatment of anxiety.

Most of us, for wonderful and compassionate reasons, have an inclination to ‘accommodate’ (to use a technical word) a child’s anxieties, i.e. to adjust the circumstances to minimise distress. This might mean avoiding the overnight sleepover, granting an extension on an assignment, accompanying them in a social situation, removing a public speaking obligation, letting them share a bed, bringing familiar food from home… or removing anything else that is causing them distress. What caring person would want to do otherwise? The problem is that, step by step, we can sleepwalk into a situation where we are heightening and reinforcing the child’s fears, even when they bear little or no relation to reality.

In recent years, it has become evident that one of the most effective ways to alleviate anxiety in children is to work with their parents. This can feel insulting, as if parents are being blamed, but researchers are quick to point out that while parents are not necessarily the cause of an anxiety disorder, adapting parents’ response to their children’s anxiety is one of the most effective treatments.

I strongly recommend that all parents read this illuminating (but long) piece from The Atlantic which sets out the issue:

[A]ccommodation has become a focus of anxiety research. We now know that about 95 percent of parents of anxious children engage in accommodation. We also know that higher degrees of accommodation are associated with more severe anxiety symptoms, more severe impairment, and worse treatment outcomes. These findings have potential implications even for children who are not (yet) clinically anxious.

The everyday efforts we make to prevent kids’ distress—minimizing things that worry them or scare them, assisting with difficult tasks rather than letting them struggle—may not help them manage it in the long term. When my daughter is in tears because she hasn’t finished a school project that’s due the next morning, I sometimes stop her crying by coaching her through the rest of it. But when I do, she doesn’t learn to handle deadline jitters. When she asks me whether anyone in our family will die of COVID-19, an unequivocal “No, don’t worry” may reassure her now, but a longer, harder conversation about life’s uncertainties might do more to help her in the future.

Despite more than a decade’s evidence that helicopter parenting is counterproductive, kids today are perhaps more overprotected, more leery of adulthood, more in need of therapy.

Parents know they aren’t helping their kids by accommodating their fears…but they also say they don’t know how to stop. They fear that day-to-day life will become unmanageable [if they confront rather than accommodate their child’s anxieties].

I hasten to add that, as my experience above illustrates, it is not only parents whose efforts to reduce distress may backfire. We are, as a society, more risk-averse than ever and everyone needs to take some responsibility for the effect on our children. Nevertheless, as with most things, parents have more influence over their children’s outcomes than most other people in their lives – and that’s a good thing.

Finding the right treatments and programs for children is important and there are some excellent options in our neighbourhood. It appears, however, that working with parents can be one of the most effective ways of tackling anxiety – for instance the Yale Child Study Center’s program for Supportive Parenting for Anxious Childhood Emotions program (SPACE). If your child or someone in your family shows signs of anxiety, you will find high quality and research-based information and resources here. The earlier we adapt our responses, the better our chances of avoiding an anxiety disorder or reducing its impact.

Finally, I have found the work of Oxford’s Lucy Foulkes thought-provoking. Her recent book, What Mental Illness Really Is… (and what it isn’t), walks through many of the social and cultural issues pertinent to the unprecedented rise in mental illness: the implications of recognising psychiatric diagnosis as a human construct; the expansion of categories and definitions through the DSM and looping effects (i.e. once you name and describe something, you see it more often); the effects of the environment, biology, hormones, adolescence; the asymmetric impact of social media on the vulnerable; the effects of mental health awareness campaigns; and the consequences of using medical language to describe everyday human experiences and emotions. These are not issues that can be adequately described, let alone analysed, in a school newsletter but they are certainly making me re-examine my responsibilities as both a parent and an educator.

By the way, Olivia left school with achievements to be proud of and has gone on to thrive at university and in the workplace. Somewhere, there is a computer system in that school that still has a ‘black mark’ against her name – a record of the most trivial of mishaps which, despite her conviction of looming catastrophe, she now understands bears no relation to her success in life.