What does child separation anxiety look like?
A child with separation anxiety may be flooded with worries about parental injury, death or simply being left. We know that children, particularly 7-11 year olds, are intelligent and imaginative. They are just starting to become aware of the risks in our world but don’t quite know how to protect themselves yet. If a child feels unable to cope with these worries, they may become oppositional. Perhaps the morning school run has become a song and dance or the word ‘bedtime’ causes tantrums. These behaviours tell us that a child may have become clingy and developed the need to consistently check that their parents are around. Playdates, after school activities and parties may all be a no-go. These activities not only cause physical homesickness for a child, such as nausea and headaches, but they can cause distress for the family too. Events may not even reach the calendar if they align with the child’s worries and separation behaviours. It’s difficult to encourage your child to do anything that causes them distress and so we often find that parents over-accommodate and become protective of their child’s worries too.
A case study
Kent is a ten year old boy. Though, he finds it hard to engage with activities that boys his age would enjoy. He doesn’t like to spend time outside on his bike nor does he go to play with his friends. Leaving the house in general is hard for him because he feels the need to stay close to his mum so he can check on her. This need is so strong and always on his mind, so much so that when he is in lessons at school, he can’t concentrate.
Kent’s parents are divorced and shortly after this happened, they moved away from their hometown. The divorce was tough for his mum especially. There were days where she felt so overwhelmed and struggled to get off the sofa. She felt as if she’d failed in her marriage. Some weeks, Kent went to stay with his dad too.
Kent wanted help at age 10 because he started to become noticeably more anxious after playing with his friend one day. His friend lay on the football pitch in front of Kent and pretended to die.*
How could we help Kent and his family?
Cognitive behavioural therapy (CBT)
To help Kent using CBT, we aim to find the niggling thought which is causing him to show separation anxiety behaviours. At first, he may tell us that he’s worried that Mum was upset because she couldn’t get off the sofa. Often, the crooks of worry are not the first thing mentioned so we always ask ‘well, what happens then?’ to really understand the matter. So, the ‘what thens’ might be ‘I worry Mummy can’t look after us’, ‘I worry that we move back to Dad’s’, ‘I worry Mummy is gone forever’. We can now see how this worry fuels Kent’s clinginess and consistent checking. So, then we challenge these thoughts. Perhaps we ask Kent to think about all of the times that Mummy has been able to look after him by herself. We might help Mum with some parenting skills, so she knows how to reinforce the truth that she’s strong and capable at home. Then we’ll encourage Kent to face his fears too. We might challenge him to ride his bike outside with his friend for 30 mins, reassuring him that Mum will be okay.
Eye movement desensitization reprocessing (EMDR) and family therapy.
EMDR may help Kent to process any distressing memories. We will encourage him to take note of any negative thoughts and body sensations that come up when he thinks back to the time.Through bilateral stimulation (engaging both halves of the brain at the same time) we will move this memory to the long-term memory store, where it can’t keep cropping up to bother him. Kent might have a distressing memory about his Mum’s divorce which leads him to think that ‘people just get sick of me and then move away’. Through EMDR, we help Kent to work through this memory and replace his thought to ‘I belong and I’m wanted’. Or take Kent’s experience of his friend pretending to die. We’d process this small T (small trauma which is non life threatening, but has a significant impact on the individual) by tackling the thought that he’s helpless. We may help him to realise that he is capable and build resilience generally.
Our brain’s lead in EMDR, telling us what bothers us and therefore, what we should focus on. Kent’s brain came to terms with Mum’s divorce but worried that if he did go out to play, she’d retreat to the sofa and they’d miss out on quality time together.
So, we might offer Mum some EMDR- it’s important that she processes her memories too! We don’t want Kent to feel as if he’s responsible for managing his Mum’s emotions and we want Mum to feel happy and capable. As for quality time together, family therapy may help here. Both Kent and his Mum will have a safe space to discuss their thoughts and feelings about the family dynamic. We want all voices to be heard, for the family to work as a unit again and most importantly, for them to have fun!
What is the best approach to help Kent’s family?
That’s a tricky question. All of these approaches have been researched and found to be effective to help separation anxiety behaviours. So, we believe that an integrative approach is best- be open to try a bit of everything! Clients respond differently to different approaches and so it’s important that we always suit their situation and needs.
Spoiler alert!! If you’d like to know more about the different types of therapy, we have a new course coming out in the next week. It’s free to access and Dr Andrea Shortland talks you through a step-by-step process to find the right help for your child.
In the meantime, head to our Instagram page for regular parenting tips and tricks.
*The case of Kent and surrounding information has been taken from Michelle Morrisey’s paper, written in 2013. For the full version click here https://connect.springerpub.com/content/sgremdr/7/4/200.abstract
Pocket Family Psychologist
Written by Ellie Harper