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Control, Anxiety, and Outbursts

By Kathleen M Sisti, MSW, LMSW

It can be challenging to parent an anxious child.

Parents may feel exhausted when their child has issues with anxiety, outbursts, and meltdowns with no end in sight. As a therapist, I commonly see parents who are imploring me to change their child’s behavior. Usually, it leaves both child and parents frustrated because the focus is on the behavior and not the underlying cause, which may be anxiety.

It is important to recognize that kids with anxiety often have issues with control and that lack of control leads them to feel powerless, which in turn compounds their anxiety. Parents are a child’s first educator, and the good news is there are steps you can take to help your child learn how to manage anxious feelings and have a greater sense of control.

One activity that you can do with your child at home is the ‘circles of control.’ Take two paper plates, one big, and one small. Center the small one on top of the larger one and staple them together. On the larger outer plate, you and/or your child will write a few of the biggest things not in your child’s control. For example, if there are issues related to school, these might be starting school, what class they are in, and the rules set by the school. When talking with your child to discover what to write, make sure to be empathetic to their responses by using reflective statements like, “I hear you. Tell me more about that.” Try not to bring your own experiences into the conversation or let them influence your response. On the smaller plate, write 5 things you and your child identify as being within their control. For example, what they bring for lunch, what they wear, what color notebook they get, what book to read before bed, how they respond to the teacher and students. Here, it is important to empower your child by emphasizing how much control they do in fact have. Let your child color and decorate the plates, then place them in areas of the home that are clearly visible as a visual cue if they start to become agitated or anxious.

At the same time, children with anxiety can become overwhelmed by having to pick from too many choices. That is why, despite what your child may say, for the items over which they have control, it is important to offer a limited number of choices (often no more than two) and to make them concrete.  For instance, if they have control over what they bring for lunch, you could limit their choices that day to a cheese sandwich or yogurt with fruit. After giving the limited choices, allow for reflection and ask for feedback from your child. Ask questions such as, “How did it feel to make that choice?” “Do things feel easier now that you have made your choice?”

If your child gets stuck on a thought, a common behavior in children (and adults) with anxiety, it may be appropriate to ask them to sit with you and draw the thought OR take three deep breaths with you. But what if they don’t want to use these skills? What if they are too elevated to calmly choose? Fret not. It might be time for some ICE. Yes, Ice. Filling a bowl with ice and placing their hands gently in the bowl can help regulate their parasympathetic nervous system controlled by their vagus nerve. This causes a shift and will calm them down quickly. It’s a neat trick because it really does work. In fact, I would recommend trying this when they are not elevated so they are familiar with the skill. The key is to not engage in a power struggle, and instead empower your child.

Working with a child therapist can be a great strategy. We commonly see multiple presentations of anxiety. Together, you can create a treatment plan that will work well for your child including art and play therapy. One of the best supports for an anxious child is a parent who does not feel overwhelmed or anxious; please remember you do not have to do this alone.

Photo of Kathleen Sisti

Kathleen M Sisti, MSW, LMSW is a Clinical Therapist at JCS.

Jewish Community Services (JCS) provides programs and services for people of all ages and backgrounds, helping them achieve their goals, enhance their wellbeing, and maximize their independence.  To learn more, visit jcsbalt.org or 410-466-9200.

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