When Fear Turns to Phobia

Although we often think of childhood as a time to be carefree, fear and anxiety are common experiences for nearly every child at some point or another. Whether it is fear of the dark, separation anxiety in a toddler, or fear of a specific event or object such as going to the dentist or seeing a dog across the street, being afraid is simply a part of the human experience. For most children, these moments are fleeting and easily managed by the loving reassurance of a parent or caregiver, but for others common fears such as these can become debilitating experience that need more attention.

Fear and its accompanying physical responses are like a fire alarm system. Like a smoke detector, our bodies are designed to perceive danger, emotional and physical, and send out an alarm (the physical and emotional responses) to alert us that we may be in danger. As anyone who has been scared by a movie or startled by a slamming door knows, sometimes we get the warning even when the danger isn't real. For most of us, that happens occasionally but in general our fear response is manageable and important, keeping us from dangerous situations. For a child with a phobia the fire alarm system has become hypersensitive to a specific trigger- like a sprinkler system that goes off every time you light a candle. The response is excessive in relationship to the perceived danger. Whether it is a paralyzing fear of a real but minimally dangerous situation such as a larger dog or a fear of something that does not pose a real threat such as thunderstorms, the internal experience of fear is real and must be addressed. The key is to help your child understand first that fear, however difficult to manage, is a valuable emotion and not one that we want to dismiss.

As adults, when we see a child with what we believe is an irrational or excessive fear our first instinct is often to minimize their experience. The desire to relieve your child's panic often triggers a very logic response in parents but before you try to convince your child that their fears are unfounded or silly, start by talking about the role fear plays in keeping them safe. Teaching children to evaluate the danger of a situation is an important part of treating their phobia but it is also crucial that you do not send the unintentional message that their fear can not or should not be trusted. Although in this situation fear has become distorted, in general we want our children to listen to their fears. Fear is that uneasy feeling that they may get around a stranger or when watching a friend try something risky at the playground- it is their first line of safety when you are not around and it is important to remind them of that.

The next step is to help your child understand that they can be in control of their response to fear. It is not necessary for them to ignore their fear and the automatic physiological response that it creates in order to regain control. Instead children can learn to identify the physical cues that tell them they are beginning to feel fearful and then learn to calm their bodies and their minds. It can be helpful to get your child to keep a feelings journal for a week or two (maybe longer depending on how often they encounter their specific phobia). As parents we are often aware of our children's responses to fear and anxiety; whether its a stomachache or sweaty palms. It can be useful to point these out to children but also encourage them to identify these experiences on their own. As they identify the ways in which their body tells them that they are afraid, children can begin to stop the process of overactive fear and anxiety before it gets out of control. Using methods such as progressive relaxation, a technique where you tense and then relax each individual group of body parts one at a time, meditation or prayer, deep breathing, and even counting slowly can help to slow heart rate and begin to minimize the physical agitation of fear.

As your child masters identifying how their bodies respond to fear and how to relax, they can begin to incorporate skills to relax their minds as well. This where teaching children about how to evaluate potential danger comes in. When they are not being exposed to the situation that causes fear you should talk about whatever their phobia is. Begin by asking them to talk about why it is so scary to them. Often adults assume that they understand why children feel the way they do but it is important to hear from the child what it is that they find so threatening about a particular situation. Maybe it's a logical (although unlikely) reason such as fear of crashing in a plane or begin bitten by a dog but it can also be something more complex such as the dark reminding them of the time a sibling locked them in a closet or feeling unable to control their response to vaccination. Even if your child can't articulate the reasons for being scared, share with them some of the reasons that they don't have to be so afraid. The goal here is to give your child tools that they can use to talk themselves down when the fear begins to rise not minimize or disregard their fear. Regardless of it's logical merit, the phobia is very real to your child and it is important to remember that no amount of reasoning is likely to resolve the fear on its own.

In addition to talking about reasons that your child is not really in danger, you should spend a lot of time talking about your child's ability to, with practice, control their extreme response. This is often not an easy process but remind your child that together you can work to manage their response to these intense feelings. Often with phobias the fear of the anxiety and how that makes them feel can become just as difficult as the phobia itself. Find ways to slowly introduce the fear in small manageable doses so that your child can practice mastering their response. For a child that is afraid of thunderstorms that may be listening to a CD of storm weather then moving on to watching storms on TV while using relaxation and self-talk techniques. Be sure to remind your child that like any new skill, this will take time and practice. If they are struggling to face even the minor exposure to their phobia, don't force the issue. They may need more time to practice their relaxation skills and you may need to include some professional support to help them do that.

One of the most helpful steps for kids is having successful moments of facing their fears. Whenever you can point out how your child was able to identify and then respond to a fearful or anxious situation successfully. Remember the goal is not to dismiss the feeling but rather regulate their response in such a way that it is not overwhelming. It can also be helpful to point out when an extreme reaction is warranted, such as crying when you see a younger sibling get hurt or running inside when a stranger approaches them unsupervised. Praise your child for listening to their feelings and then choosing their response.

Working together with your child you may be able to help them recover from their phobia but it is important to also consult your pediatrician and or mental health professional. While many children's phobias can be resolved with time and parental support, many others need the intervention of a child therapist. A therapist can help you and your child implement a structured plan to address the phobia as well as rule out the possibility of a more generalized anxiety disorder. Many cognitive-behavioral therapists can help a child resolve a phobia in just a few sessions. This is also another great way to demonstrate an important skill in addressing fear- asking for help. Teaching children to ask for help when things are difficult is a great way to help reduce their shame and encourage them to seek support in the future when they are facing overwhelming challenges.

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