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Picturing Success: See It, Do It

Wednesday, March 31st, 2010

‘What if’ is the rallying cry of anxious children everywhere.  What if you aren’t there after school?  What if that noise was a bad guy?  What if I miss you?  What if I strike out?  Feel scared?  Get sick?  Terrible outcomes cascade through the minds of anxious children, some so awful, so utterly catastrophic that the mere suggestion of going to school, going upstairs, going to a friend’s house causes panic.

Parents spend a great deal of time reassuing their anxious children (which, as you’ve probably noticed, doesn’t help – more on that another time), while anxious children spend a great deal of time avoiding whatever has the slightest chance of causing harm.  It’s a viscious cycle.  One that will not end on its own.  If you child isn’t reassured the first or second time you tell him that going near the blanket his sister threw up on last week (which of course you’ve thoroughly sanitized) isn’t going to make him sick, he isn’t going to be reassured the 20th time you tell him, either.  And if your child is afraid of bees, continuing to avoid them isn’t going to make it any easier to go outside.

There are lots of things kids (and parents) can do to break free from anxiety.  Previous and future posts cover an array of strategies.  Here’s another: picturing success.

Picturing success is a visualization technique combining exposure (known to reduce anxiety) and relaxation (ditto).  Your child will need some help with it, especially at the start.  Let’s say your child is going to the orthodontist, where a mold of her mouth will be made.  She has sensitive gag reflex and is terrified of the procedure, sure that she will gag and throw up ~ her worst nightmare.  Every time you mention the appointment, your child tears up.  So you stop mentioning it, hoping for the best while bracing yourself for the major scene you know will unfold at the doctor’s office (assuming you are able to manhandle her into the car to get there).  Your child is only too happy to wipe the appointment out of her mind, too – except it keeps popping back up, reducing her to tears.

Rather than trying to avoid thinking about the appointment, help your child imagine it in as much detail as possible.  That’s right: picture it.  Imagine the beginning, the middle, the end.  In detail.  Even the scary parts.  AND the parts that show your child coping.  Create a story to review with your child every day (children ages 6 and over can participate in creating and telling the story).  Your story might sound something like this:

“It’s the day of your appointment and you wake up feeling a little sick but then you remember you are getting your braces off, and that part’s really great.  You have some breakfast, only a little, but it’s raisin toast with cream cheese and it tastes good going down.  I tell you it’s time to go and you really don’t want to because you keep thinking about that mold and it seems so scary.  But then you remember what the orthodontist said, that it only takes a few seconds to get the mold in place, and you know you can put up with a few seconds, even if you do gag.  You remember that you’ve gagged lots of times and it was unpleasant but it ended pretty quickly and you were okay.  So we get in the car and crank up the music, singing along to keep ourselves busy.  We pull up at the office and they call you in right away and your stomach starts to feel sick but you tell yourself, I can do this, and you follow the nurse in…(more details)…and then it’s time to open your mouth, and even though you feel scared, you do it.   And you remind yourself to keep breathing, nice and slow, just in and out through your nose, and you take yourself on a mental vacation to Grammy’s cottage.  You are sitting in the orthodontist’s chair, tilted back, and your mouth is wide open and you are breathing, breathing, and you are picturing yourself at Grammy’s the way it looks first thing in the morning when you and Grammy go out looking for blueberries.  And you feel like you might gag but you relax your throat and you’re okay.  You just need to breathe and think about Grammy’s house and then, all of a sudden, the mold is in place and you’re doing it!  You’re mouth is open and that mold is back there and it feels weird but you are okay.  And you breathe and see Grammy’s house and you can smell the lake, that earthy, watery smell, a little like fish only better.  You’re still in the chair and the nurse tells you to open just a little wider and you don’t see how you can, but you do, and she takes out the mold and you’re done.  You did it!”

Clearly, your child’s story will reflect her own experience.  Make it detailed enough for her to picture.  Include the hard parts, and the parts that show how she copes.  Underline that coping, again and again.  Tell the story (some version of it) every day in the days leading up to The Event.  Coach your child to imagine the scene in her mind, breathing slowly and deeply while she listens to (or tells) the story.  Repeating this exercise over and over provides a model for coping while easing your child’s anticipatory anxiety.  When it comes time for the actual experience, she’s practiced it (in her mind) and desensitized herself to the scarier parts.  Picturing success enables success.

Have you tried this with your child?  How did it work?

Posted in Managing Strong Feelings, Picturing Success, Relaxation | No Responses »

Why Breathing Doesn’t Work…and How to Tweak It So It Does

Tuesday, March 2nd, 2010

We all do it.  When faced with a panicky child, our most common piece of advice is, “Take a breath.”  And then one of two things happen: 

Compliant child: Opens mouth to sob in more air, only to find her chest is too constricted so not much goes in, which is so scary, escalating the panic as she wails – I CAN’T BREATHE!

Less compliant child: THAT DOESN’T HELP (and she’s right)

It doesn’t help to simply tell our kids to take a breath.  When they are already hyperventilating (or close to it), they can’t breathe effectively, which only serves to escalate their fear.  And when it’s the first thing we say, it feels (to a frantic 5-year old, 7-year old, 9-year old) hopelessly inadequate.

Think about the last time you were really worked up.  How would you have responded if someone met your sobbing (ranting, panicking, clenching) by telling you to breathe?  “I am breathing, damn it!”  It doesn’t really help.

And yet, it does.  Not telling someone to breathe, but the act of breathing.  When we are worked up (frightened, angry, tense) our breathing changes.  It becomes more shallow, less restorative.  We begin to starve ourselves of air, throwing off the balance of oxygen and CO2, making it harder to remain calm, to think, to figure out how to help ourselves.  We need to breathe to restore our inner stasis, and kids do, too.  Here’s how to help them do it:

  1. Start with an out-breath.  When chest muscles are tight (which happens as our feelings escalate), it is hard to breathe in.  Not being able to breathe in is scary, triggering a danger alarm deep within the brain, adding to that sense of panic already spiraling out of control.  Coach your child to breathe out, first.  Purse your lips a little and do it with her, blowing the air out like you would blow to extinguish a candle.
  2. Do it with your child.  Even before you start speaking, blow out some air.  That’s a cue for your child, a nonverbal reminder to exhale.  Keep your breathing nice and slow.  Focus initially on the out-breaths, making them long, with shorter intakes through your nose in between.  Gradually lengthen your own in-breaths, so you are breathing in deeply (through your nose) and breathing out long and steady (through your mouth).  People have a natural inclination to match the pace and emotional pitch of their companions.  You are consciously bringing yours down, to help your child begin to de-escalate, too.
  3. After your first out-breath, say something empathic.  Reflect what you are seeing, or put your child’s feelings into words in a calm, steady voice.  Something like, “Wow, that seemed scary” or “You are really mad right now.”  Keep all judgment out of your tone.  You are letting your child know that you get it.  You see what your child is feeling and whatever it is, it’s okay.
  4. After that first, supportive comment, say something along the lines of “blow it out” or “let’s work on making your body feel okay so we can figure out what to do.”  Breathe as directed above, setting the pace, modeling for your child, letting your calm presence soothe her.
  5. Resist the temptation to jump in with lots of words.  Questions, admonishments, threats – all of these are disorganizing to kids when they are already in a heightened state.  Practice what Dr. Teresa Bolick has described as “Low and Slow” (from Aspergers Disorder and Young Children), bringing the pace, tone, volume, and complexity of your speech down a few notches.
  6. All of this will work substantially better if you practice breathing with your child ahead of time.  Start with a simple explanation: You know, when we get worked up it’s hard to think clearly.  We need to calm down before we can figure out what to do.  Making sure we’re breathing nice and slow can help us calm down.  Let’s practice so the next time we’re super-mad or really scared (or whatever feeling your child tends to have trouble with), we know just what to do.  Then aim for two or three brief practice sessions a day (we’re talking minutes here – in the car, before bed, etc.).  Simply prompt with, “Let’s do a few of those breaths.”  And you do it, too.
  7. Some kids respond better when there is a visual component.  Have them imagine a smell to breathe in – brownies, sun tan lotion, horses.  They can picture the object and sniff in the scent, pulling it into their nostrils. 

Have you found a way to coach your child to breathe?  A visualization or relaxation exercise that works?  Feel free to share it here.

Posted in Breathing, Managing Sensory Challenges, Managing Strong Feelings, Relaxation | 1 Response »