Phobia in your child can be overcome just like other anxieties

Phobia and phobic anxieties have been in the press recently on account of the 2020-21 pandemic.

Some adults are needle phobic – this would show up as a fear injections (tryanophobia) in these circumstances.

Children are scared of all sorts of things. They can become phobic if a fear is intense. This will result in panic attacks and a refusal to even countenance going near the feared object.

Normal fears come and go as they grow up and get more experience of the real world. But phobic anxiety will last longer and take longer to deal with if it’s left until it’s an ingrained reaction. 

There’s a couple of good ways of dealing with phobia, and one method in particular that will probably work fast to remove a child’s phobia. And I’ll deal with these methods in a moment.

Spiders, snakes, dogs, dentists and thunder rank high for phobias in children, but I’ve known children be phobic about buttons, dark places, dogs and anything connected with something traumatic that once happened to them.

Questions typed into search engines show that parents realise phobias are not good for mental wellbeing:

• What triggers a phobia?
• Can phobias go away?
• How are phobias treated in a child?
• Is phobia the same as anxiety?
• Is phobia hereditary?

My brief answers, in order, are: 

• If it’s not a trauma-based phobia, or parents can't work out what caused it, sometimes you never do find out. 
• Yes, they can, with help. 
• CBT, with or without medication, is used to treat a child’s phobic anxiety, as is a therapy called EMDR – but parents can do a lot, first, to ease it. 
• Phobia is an extreme form of anxiety. 
• It’s been thought to be sometimes inherited or genetic. That said, if a child watches a parent scream about seeing a spider, they may well pick up the belief that spiders are dangerous (I wonder how I know that?!).

What can you do when your child starts developing a phobia?

You’ve noticed something’s turning into a phobic-like reaction for your child. 

Perhaps the scary response is becoming constant and worsening? 

Or perhaps they’ve started freezing when they see or hear something?

If you can catch the fear early, you can have a chat with your child, listen to the "what and why" of it, and try to explain a little about why being scared of things spoils their life for them.

The reason is (you tell them) that if you’re scared, you avoid things, you have to watch all the time in case the scary thing appears or happens, and that means you’re running away from having adventures instead of towards them.

Keep to your child’s language and understanding. Picture it for them. Try not to get too serious at first. "Imagine running away from a super adventurous life just because of X!" (whatever is bugging them).

So in these early stages, my first suggestion is a star chart, if your child’s not too old for one – and with the right rewards, I reckon no child is too old for one!

If you use a star chart, it’s probably best to keep to two well-established rules:

• Don’t change the reward you agreed they would get after five or 10 stars – your child’s trust and willingness to try to overcome fear is at stake.
• Never leave a gap when an opportunity to get a star is missed. Guess what? Like everyone, your child will only “see" failure! Just add a star each time they face their fear and at least try to overcome it.

What else can you do at this early stage?

If your child is old enough to enjoy an imagination moment, my second suggestion is a “What If…?” game.

I’ve had fun with this game in a couple of different contexts. I used to be a visiting author in junior schools. Before telling the class the particular “What If” that was the basis for the Lothian Dragon stories (no, I’m not going to tell you!), I would ask them to suggest “What Ifs” of their own. 

I could have taken suggestions all morning. They were full of brilliant ones.

So, if you can hook into this wonderful sense of fun your child has, then try some “What Ifs” about the thing they’re frightened of. 

Let’s take 3 possible phobic fears as an example: spiders, thunder and dentists.

What might your child and you come up with if you can make it fun? (You’ll think of better ones than these – I don’t have a child sitting beside me right now! Stay open!)

• What if a spider was in a tray with only a leaf for company?
• What if three spiders started arguing over one web?
• What if no one was ever frightened by a roar of thunder?
• What if thunder met a huge dinosaur?
• What if the dentist’s drill was made of chocolate?
• What if the dentist cried every time they had to check a child’s teeth were OK?

The idea is to start making the topic less sensitive, less frightening, by becoming engaged with it.

You could continue by making a picture together of the image you’ve conjured up. Or tell the story, inventing alternate sentences until the story ends.

I guess with something like the practical first idea of the spider in the tray, you could humanely gather a spider and put a leaf in the tray and both watch what happens. Your child needn’t touch the spider but just observe and comment. Being in the same room as one is a good start to solving the phobia!

If it's thunder, something equally practical would be to measure on a phone timer how long various rolls of thunder last?

Jot down a variety of timings and discuss them. It’s just another way of engaging with the topic in a conversational way. More scientific, more left-brain.

When a phobia has started spoiling your child’s daily life

This is when you need to use some techniques from cognitive behaviour therapy. That sounds alarming, but there are many books out there which tell you all sorts of ways of helping. Parents can easily do it.

When you’re dealing with a child’s phobia, you have to bear in mind that:

• there’s been an event that was scary and which involved strong feelings,
• this engenders thoughts, usually bad ones about what might happen next time, and
• this leads to your child refusing to face that kind of event again, plus
• a likely freeze-up or panic attack if they’re forced to.

If you look at it this way, it’s pretty obvious that you have to 

• talk with your child when they’re calm and 
• hear about the feelings they have, 
• hear about the bad thoughts, and 
• start to sort things out so it doesn’t need to have this emotional effect on them any more – but
• only after you’ve assured them you’ve heard and understood properly.

But if a phobic reaction has just happened, remember that your child’s thinking brain is offline. No point in discussing anything!

1 Try one of these ways of calming them down:

• slow, deep breathing
• sorting and arranging things (pencils, cutlery, a button box, books on the shelf, whatever)
• calm, quiet colouring of a pattern
• the butterfly tap.

2 Then you can start to hear them out: “So – what’s going on in your head when you think of spiders/dentist/thunder/whatever? Help me to understand. I really want to.”

The best way of listening to their answer is to say nothing much (ah-ha, um… etc) while they tell you. 

And the best way of answering is to show with your words you’ve heard them and understand. It’s not the best time to suggest something different because they first need to know you’re on their side and truly believe how bad it is for them.

3 Then you can suggest to your child you write a few things down together – hopefully using some of the words they’ve just used.

Try using a windmill sort of diagram, like this. Sketch it out in front of your child – much better than printing mine. You can draw it as you discuss each point (see under the diagram for suggestions).

It’s pretty obvious how it works. Jot down their stated thought at the top: “It will run up my leg” / “I won’t be able to breathe” / “It’s going to knock our house down” – that sort of thing.

This thought will make them feel something – usually scared, petrified, suffocated etc.

“How does this affect your body?” “What happens in your body when you think and feel that?”

Legs may turn to jelly; their whole body may freeze up; they may have sweaty palms and a rapid heart beat etc (a panic attack).

And what do they then do? Well, you know this! You’ve witnessed it. But get your child to verbalise it. Putting things into words really helps them get it away from themselves and open to discussion. Write what they say near the behaviour windmill sail.

And because they’ve refused to go, they've run away or hidden under the bed (for example), they have nothing to disprove their thought. So they think the same thought next time too.

Do you see how it’s self-perpetuating?

That’s what needs dealing with. If you don’t change anything, nothing changes. Help your child to see this.

What can you do next when your child has understood all this?

When your child has understood that their thoughts about the feared object or event are fuelling their feelings and behaviour, they need to practise changing their thoughts.

Sometimes this is simply easier if you help them to become desensitised – tiny step by tiny step – and look at their thoughts after each step. They will hopefully: 

• be pleased they managed that step, which increases their feelings of being able to sort the phobia out, plus
• have a slightly different thought about that feared event/object.

They could, of course, try out a new, more positive thought you've agreed on.

But with phobias, I've found it's often easier to agree your thought has changed after trying something new. Try doing it both ways and see?

I’ve given n example step-by-step activity concerning cats here, but for simplicity’s sake I’ll give you another example now. The more the merrier, really, as it’s you who has the job of inventing small steps that might help your child with their own phobia.

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Let’s revisit the dentist phobia – an example of small steps towards phobia-free life

The dentist scenario is a challenging one, and I admit it's challenging for me, too, to invent the mini steps. (No one said a therapist has it easier all the time, just because they’re trained!)

We don’t have access to a drill, a needle, proper surgical cotton wool, or a reclining dentist chair.

But there are some steps we can invent that will help reduce anxiety, bring about relaxation and allow a dental inspection to go ahead without a panic attack.

Write these mini steps on slips of paper

When you've written the following steps and any others you think of, nice and large on pieces of paper, put them on the table and let your child arrange them in the order they feel they could try them. Number them in order.

(The comments in brackets are for you – don't write those down!)

Talk about what caused this fear. (There might have been a specific event – listen well and accept the explanation. If your child can’t tell you, ask them: “If you could guess, what do you think might have caused the fear?” This at least reveals a fear, even if a bad experience never happened.)

Learn how to relax properly. (Many people do this by tightening and loosening each set of muscles in turn. Or you can teach them deep breathing. You can have fun testing relaxation by checking that an arm, leg, foot or hand is totally floppy. Make sure your child can do this “on demand”.)

Read a book together about what a dentist does. (I recommend either Going to the Dentist or People Who Help Us: Dentist for children up to 7 (see below) – and then have a chat about the story in detail. What is the main character thinking? Feeling? How does this affect what they do? If they don’t visit, what might happen to their teeth? What will the result be?)

Use two puppets or dolls and invent a discussion between them. (One must argue that it’s best to check up before things get bad and give reasons. The other must argue back about not going at all – and give reasons. Use puppet voices. Your child gets to choose which role they take on.)

Draw a three-part cartoon strip showing a child visiting the dentist. (Let your child choose if it’s to be a bad visit or a good one! It could be themselves? They should fill in the speech bubbles and give captions a suitable label. Discuss what they’ve drawn – admire the drawing skill anyway, but also discuss the portrayal of the visit they’ve depicted.)

Lie back on a settee and cushions (or similar) with mouth open. (Allow you to use a dry electric toothbrush to simulate the drilling vibration.)

Visit the dental surgery for a non-visit. (Liaise with your child-friendly dentist to have 5-10 minutes in the treatment room – maybe after hours – for your child to talk with the dentist when no inspection is planned. Check your child is calm and breathing slowly throughout the visit – get them to show the dentist how they do it. Maybe they could lie in the chair and show the dentist how they’ve learnt  to totally relax. Most dentists will be trained to deal with fearful children.)

List three things your child could do to help them face the dental trip. (We’re talking here about the dental visit that eventually has to take place. This could include taking a soft toy or their “lucky charm”; deciding what story they will mentally recite to themselves while the dentist checks their teeth; and perhaps a music list on a phone to be played while in the chair. 

Have a run-through before the scheduled visit. (This is going to be a visualisation. Relax with your child. Prove to each other that you’re both relaxed first! Shut your eyes and mentally run through the event with them. Pretend to gather up the things – talk out loud:

“OK, you’re picking up your soft toy and remembering the story of Red Riding Hood you’re going to tell yourself while the dentist checks your teeth… Now imagine going out the door… walking down the road… catching the bus with me… We’re arriving at the dentist now. You can see the grey door and the letter box. You’re starting to feel anxious so you immediately relax your tummy… Do that now… OK, now it’s our turn. I go into the room with you. Stroke your little soft cat and tell him it’s all right…”

Continue like this till you’ve covered the whole scenario. Slowly. Maybe hold your child’s hand, if they don’t mind, while you do this visualisation. Then both open your eyes. Ask them what their thoughts were; what they felt like.

What our minds have prepared for, they accept and repeat far better. Our mind doesn’t distinguish between past and present. That’s why actors and sports people rehearse. It primes the brain.)

The message to your child – however subtly explained – is that people who avoid dentists, because they have a phobia or phobic anxiety, end up having more treatment in the end, poorer oral health and a worse quality of life.*

Yes, sedation is available, but that doesn’t solve the long-term problem.

During the 2020-21 pandemic and for a while after, dentists will be limiting visits and wearing masks or visors. This isn't particularly helpful to a phobic child, but it has to be included in the talk and activities if the situation still applies when you read this.

*See here for some research on this in relation to youth. 

Two books for younger children

Remember, this example was to show you how to construct a staged improvement, a step-by-step ladder to solve the phobia. Dentist phobia is common. But you'll now be able to work out your own version for your own child's phobia.

And remember, the hugely worrying topic of school phobia is like any other phobia in essence. It needs the same way of dealing with it and might involve issues you can read about on my other pages: bullying, separation anxiety, social phobia and panic attacks. 

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In summary

To overcome a phobia, we all need to do five things:

• Understand the fear
• Self-calm
• Talk back to the anxiety – refuse to avoid it 
• Use self-exposure to the feared thing to help with progress
• Think of how to maintain gains – fears love to strike back when we’re weakened by something else.

There’s no reason why a parent shouldn’t be able to help with this, or at least get things started. It's all based on CBT techniques.

If you need help to move things further on, please visit my Help page where you can find out how to safely find a suitably qualified children’s counsellor.

The reason I say this is this:

I helped a child overcome a button phobia to the extent that they could manage it really well and their life got back on track. A few years later, though, they wanted to be completely rid of the underlying fear. At that point a visit to an EMDR therapist was arranged (sadly, I wasn’t free then). 

EMDR (Eye Movement Desensitising and Reprocessing) can completely remove phobias caused by trauma. This is where you can find a list of trained child EMDR practitioners in your area in the UK.

QUICK CHECK: PHOBIAS

• Talk to your child about what they’re afraid of
• Help them identify what's causing the fear – a dark room, or heights etc
• Ask questions and be interested to find out more
• Help them face their fear in small steps chosen by them
• Give them control each time over how long they face their fear for 
• Teach your child coping skills like breathing or relaxation techniques

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ALWAYS:

Trust your instincts,
use your judgement, protect the spirit
of your child