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Podcast 56: Separation Anxiety - Why and What To Do

3/14/2023

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These are notes from Jessica O’Connor, LMFT, who was interviewed for Parenting Decoded’s Podcast 56- Separation Anxiety.  There are so many great thoughts from her that I wanted to include them in my blog.  Enjoy!

Separation Anxiety – definition and description:
Separation anxiety is defined as recurring and excessive fear or worry about being separated from one’s attachment figure, like a parent. Features of separation anxiety include distress, worry their attachment figure will come to some harm when separated, worry about being kidnapped or lost, refusal to leave the home, reluctance to be left alone, difficulty sleeping without the parent, nightmares about separation, physical symptoms such as headaches, stomachaches, nausea or vomiting with separation or anticipated separation.  This fear, anxiety or avoidance lasts more than 4 weeks in children and adolescents or 6 months or more for adults.

Separation anxiety can increase during times of transition or following a break from school. It can happen after a stressful life event, such as moving, changing schools, a death in the family.  One recent event that all children experienced in some form has been the COVID-19 pandemic.

Have you ever played the game Chutes and Ladders? Chutes and Ladders game as a metaphor for development. Rungs on the ladders represent growth and development. It’s common that a child might miss a rung and that’s ok because children are resilient and can reach for the next rung to keep climbing.  What happens when a child misses more than one rung of development? When the gap between rungs is too great time can help. With time a child continues to grow and have lived experiences and can build a bridge to cover the gap.  A parent can also help by going back in time and re-building those rungs with their child.  Gas station and grocery store example.

Some signs that your child may be experiencing separation anxiety are school refusal, crying at drop-off, physically clinging to parents, avoiding going to birthday parties, camp or participating in extracurricular activities.

Separation anxiety like the other types of anxiety is not always abnormal, sometimes it’s actually advantageous. Since we all feel anxious from time to time, it’s not about eliminating separation anxiety it’s about moving through it and not having it get too big. We often talk about “controlling” our emotions, but what happens when we try to control our emotions is that they demand to be felt, and they get bigger. Instead of trying to control our emotions, we can focus on living with and moving through them. We all have everyday ups and downs; we’ll look in a bit about what to do in those moments of separation anxiety.

Individual differences
We need to keep in mind that every child has individual differences; these are the things that make us unique and special. The things that make you, you. Children navigate their world through their own lenses.  When we talk about a topic like separation anxiety it’s important to think about your own child’s individual differences. How do they see the world? How do they make sense of the information coming in from their environments and what do they give back to the environment in return?  When thinking about how to help support your child through separation anxiety it’s necessary to think through how they move through the world in their everyday lives.  No one knows a child better than the parent; By the way, I use the term parent to mean any adult that acts as a primary caregiver in a child’s life. With separation anxiety, it can be any attachment figure, it can be a parent, grandparent, coach, teacher, sibling, etc.

Questions About Separation Anxiety

-Is there a difference between anxiety and separation anxiety?
You can think of anxiety like a house and separation anxiety is a room in that house. Separation anxiety is a specific type of anxiety that we feel. Everyone experiences anxiety, it is a normal human emotion.  Separation anxiety occurs situationally in separation scenarios.

- Can you talk about separation anxiety by age from toddler through preschool:
Separation anxiety in younger years is common, in fact, separation anxiety early in the lifespan is functional.  It’s normal for children ages 9 months to around 18 months of age to experience separation anxiety. Humans are not born into this world able to care for and provide for themselves. Babies are born dependent on their primary caregiver for survival. Separating from the person who kept you alive from birth up until that point is an anxiety-provoking event, especially if the environment is new and the child does not know what to expect. Young children will be clingy and follow their parent around.

Being prepared for the first day back to school is more than just having your lunch box and backpack ready, it’s about being emotionally prepared too.  One of the best ways to help your child be emotionally prepared is by talking to them about what to expect. Validating your child’s fears, worries, and concerns is important. It’s okay for your child to feel their feelings.  It’s ok to feel separation anxiety, we just don’t want it to get too big to the point where it is impacting their day and the days of those around them.  As children get older, autonomy, or independence, increases. For a child with separation anxiety, this independence can be scary and unwelcome. 

- How does separation anxiety differ as children get older?
Children ages 5 years to around 8 years old most commonly report fear or worry about their attachment figure being harmed if separated.
Children ages 9-12 years experience withdrawal, sadness and/or poor concentration when separated.
Adolescents ages 13-16 years will have more physical somatic complaints and school refusal.

- What can a parent do to help manage/overcome separation anxiety -- known tips and tricks, role playing, whatever:
First, identify in what situations the separation anxiety is occurring. Is it only at school, or does it happen all the time? When we think about a child’s individual differences and the information coming in through their senses, it can be helpful to make sure that what is happening actually is separation anxiety and not something else like sensory processing disorder, some things to try:

-Talk about school at home. Helping a child know what to expect and setting up the stage for a familiar experience can help.
-Always say goodbye with confidence
-Use a clock to show them when you will be back
-Read children’s books on the subject with them
-Have playdates with friends and parents to practice separating in the least stressful situation as possible
-Practice at home: Exposure to separating in a safe and controlled way can give your child the experience of separating when they know it is going to be ok. Start with the least anxiety-provoking experiences possible. Can your child talk about separating? Or look at pictures of their primary caretaker at work? Then gradually increase to more separation moments. Can you walk into another room and back?

I have seen an increase in separation anxiety in my practice. Some of this may be due to the COVID-19 pandemic.  If you think about normal childhood development without a pandemic, there are many opportunities for separation exposure. For example, when your baby is in the shopping cart at the grocery store and you step a few feet away to grab a bag of apples, your child experiences the foundational building blocks of healthy separation.  With enough practice, your child feels comfortable with you leaving and returning and does not feel upset or dysregulated when this happens.

- When does the scale tip to being too much for a parent to handle without professional help?
When the separation anxiety is disruptive to daily functioning, that’s when its time to seek professional help.  And, you don’t have to wait that long.  Children come to my office for a variety of reasons, and its not always because there is a problem or something is wrong.  Therapy with children is positive and strength based.  We focus on promoting self-esteem, self-value, self-worth, and self-confidence.  And these are things that every child can come to our office to work on.

- If my child has separation anxiety, are they more likely to have anxiety as they age?
Not necessarily, and with proactive parenting and supporting your child through their anxious moments, you can increase their emotional regulation toolbox and help them to navigate and mediate future anxious moments

- Tips for working with teachers and caregivers
-Communication is the greatest tool in your parenting tool box. Teachers and caregivers got into their lines of work for the love of working with children.  Collaborating on a plan is important.  Is it possible to meet the teacher one-on-one? Can the parent stay or volunteer in the classroom? Daycares, preschools, and grade schools should be safe environments for children, knowing your child’s individual differences ask yourself what you think your child needs.

-Ask the child what they need - If they are old enough to talk then even better, ask your child what they need in that space to feel safe and comfortable. I think sometimes well-meaning adults get together to talk about what a child needs and sometimes forget to simply ask the child themselves what they think. Their answers may surprise you.

- How can we deal with the stress on ourselves as parents during bouts of separation anxiety?
This is a really good question. Recent research on mirror neurons shows that we are biologically hardwired to mirror the emotional response of our children. What that means, is that when a child gets emotionally activated or dysregulated, the parent will automatically become elevated as well.  This is connected to the idea of a parent protecting their child, if your child perceives a threat and their flight, flight or freeze system is activated as is the case of separation anxiety, then your system becomes activated too so you are better able to protect your child from the perceived threat. Put another way, it is normal to become dysregulated when your child is dysregulated and there is a very good reason for that but it can be really hard to go through at the same time.

One thing that can be helpful to the parent living through this experience is to remind yourself that children can only learn to self-regulate when they can see the people around them being calm or self-regulated.  If your child is having a bout of anxiety, at an early age this is an opportunity for emotional regulation development. Remember, it’s ok to feel our feelings. Parents can model effective calming strategies by talking out loud about their own calm-down strategies.  It’s ok for a parent to say, “I’m feeling nervous about this new interview, and I’m going to take a deep breath, tell myself I can do this, and think about getting the job.”

Anyone with a teenager knows that if you tell your child to do something they are very likely to do something else entirely. Instead, one of the best ways to teach your child how to navigate the world is by showing them how you do it.  If you have been their primary caregiver for quite some time, chances are your child will be helped by the same things that help you. Ask yourself, how do I calm my anxiety? Your healthy regulation strategies are likely to be helpful to your child as well. I also try to remind parents that if you or your child is getting it right, that’s great, and if you or your child is getting it wrong, that’s even better because those are moments in which we grow.  If everything goes right all the time there is nothing to learn.  In our mistakes, we learn and grow and develop alongside our children.  The journey of development is not exclusive to youth.  We are all developing across the lifespan and if we do so with curiosity, compassion, and suspended judgment, then we can move through life’s everyday ups and downs and we will be alright.
 
Bio:
Jessica O’Connor is a licensed marriage and family therapist and supervisor with over ten years of education and experience working with children, parents, and families. She has a Master of Arts in Psychology and a Master of Arts in Infant and Early Childhood Development with an emphasis in Mental Health and Developmental Disabilities and a concentration in Reflective Practice. She is currently working in private practice in Campbell, California, and is a 3rd year doctoral student doing a dissertation on bullying perpetration. She is a contributor to the children’s book Wildfire! Kameika & Joey Prepare, and she enjoys giving presentations to parents and educators across the Bay Area. She lives in the Los Gatos mountains with her husband, two sons, two dogs, a fish, and nine chickens.
To reach Jessica go to her website at: www.jessicaoconnor.org.

Disclosure: This information is not intended to be medical or mental health treatment advice. It’s important to talk to your child’s doctor or therapist about concerns you are having about their mental health.

If you or your child are experiencing significant amounts of stress here is the phone number for 24/7 National Helpline for Substance Abuse and Mental Health Services Administration:
1-800-662-HELP (4357)

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