Supporting children through anxiety and the unknown

By Dr Krystal-Jane Verasammy

In typical and atypical child development, September is usually a time of heightened anxiety among children. This may be due to the change in routine and structure from the July-August break, hence adjustment issues.

In addition, the Covid-19 pandemic has not been helpful. The uncertainty, fears and worries related to the pandemic and school—whether face-to-face or online—has led to increasing reports of children struggling with the unknown, high levels of anxiety and dysregulation.

‘Dysregulation’ refers to the poor ability to manage emotional responses.

As adults in the child’s world, we ought to understand what’s going on for them, so that we can learn how to help them. To do this, we first need to understand the behaviours associated with anxiety, based on their developmental stage.

A child’s anxious behaviour

For little ones, there may be increased tearfulness, clinginess or excessive question asking. There may also be emotional and behavioural regression in milestones, e.g., bedwetting or baby talk. In school-aged children there may be resistance, oppositional behaviour, or somatic complaints such as headaches or stomach aches.

Other behaviours that we don’t necessarily label as anxious, but has an underlying component of anxiety include school refusal, irritability, aggression, withdrawal, difficulties separating from primary caregivers, being on edge and difficulties concentrating.

Reframing anxious behaviours

To fully understand and support your child, it’s important to note that these behaviours are normal and functional to the child. To further explain, your child’s brain is designed to track challenges and threats to their nervous system, (whether real or perceived); therefore, their body responds to threats in their environment.

When children are highly anxious or are struggling with the unknown, the anxious behaviours are their attempts to self-regulate. To reiterate, the behaviours or symptoms that your child are displaying are really their attempts to regulate their own nervous system.

Try to reframe how you view your child’s behaviour, not as good or bad, but as purposeful. For instance, if your child is displaying clingy behaviour, ask yourself, ‘What is the function or purpose of the clinginess?’; ‘What is the clingy behaviour doing or how is it helping my child’s own regulatory capacity?’; ‘How is it providing a sense of safety or comfort, as my child is clinging to regulate his/her own nervous system?’.

A child’s developing brain

To hold space for your child’s anxiety, you must also understand their brain development. A child’s brain is very much in process. This means the child is trying to figure out how to regulate themselves in what feels like a chaotic internal experience.

A child’s brain hasn’t developed enough to hold their own regulatory capacity. It’s not the strongest part of their nervous system. In fact, the dysregulated nervous system is the strongest part.

As adults, we may expect the child to have a specific regulatory capacity, but their brains have not yet developed.

When a child becomes highly dysregulated, anxious or fearful, they will orient outside of themselves to keep safe. They will look in their environment to assess where safety is. Therefore, as adults, we need to become their points of safety, by becoming external regulators.

External regulators and co-regulation

We need to help the child regulate, orient inward, self-soothe, take a deep breath, and have mindful awareness about what the child needs to calm their nervous system.

We must first learn how to self-regulate by connecting with ourselves and responding to our own anxious thoughts and feelings so that we can then co-regulate.

Co-regulation is defined as warm and responsive interactions that provide the support, coaching and modelling that children need to understand, express, and modulate their thoughts, feelings, and behaviours.

Co-regulation involves:

• Label: teach emotion words, to identify the feeling, to then work with it
• Empathy: model empathy for others, reflecting and considering the feeling of others
• Practice: try to practise different coping strategies together
• Support: provide a warm, supportive, nurturing relationship
• Positive: validate and acknowledge all feelings
• Presence: provide a calm steady presence throughout big emotions.

Working with the anxious child

A child who is anxious or struggling with the unknown is not necessarily fearful or worried about situations or events. Moreover, they are fearful of how their mind interprets these events, e.g., what will happen if I return to school physically.

The different scenarios, the content of their mind as they relate to the unknown is the scary part. In essence, the unknown itself is not scary, but how they are relating to the unknown alerts their nervous system.

For parents: First, ask yourself what is the type or level of dysregulation the child is displaying, and be mindful of what the behaviour is attempting to communicate. Next, recognise that the child needs an external regulator in their environment, and you are that external regulator.

For teachers: In a school-setting— whether physical or online—you are the external regulator for the child. Be mindful that you have had children returning to school who are nervous, anxious, or struggling with the unknown.

Help the child orient back to safety by focusing on the things that are known.  For example, a teacher can say, “Some things are different, yet some things are the same, let’s name these.”

Dr Krystal-Jane Verasammy is the Founder and Lead Counselling Psychologist of Therapeutic Spaces Counselling and Psychotherapy Ltd.

She is also a Board Member of the Down Syndrome Family Network (DSFN).

She holds a professional Doctorate in Counselling Psychology from the University of Roehampton, London, UK, and a Master’s degree in Developmental Psychopathology from Durham University, UK.

Email her at: therapeuticspaces2019@gmail.com

Key points to take away

• Anxious behaviour is manifested in varying ways.
• These behaviours are all attempts to self-regulate and serve a purpose.
• Be mindful of the child’s brain, its regulatory capacity, and what it is capable of doing or not doing.
• As adults we must learn how to self-regulate and co-regulate to become external regulators for children.
• When working with an anxious child, remember it’s not the situation that is scary, but how the child makes sense of it is scary.