Dr Justin, Please help!!
My gorgeous (almost 8 year old) boy is suffering and going backwards and I think its our fault and I’m not sure how to fix it and make him feel better.
One recent weekend we were at a friend’s house and our son fell asleep in their son’s bed. He knew this boy and the family so I agreed to not wake him and we left him there for the night. My girlfriend heard him at around 2:30am wandering around and she said “It’s ok mate. Mum and Dad just went home. They thought you’d like a sleep over so go back to bed and they’ll be here in the morning to pick you up.” Apparently he got back into bed and went back to sleep.
Now he thinks we are going to leave him. He won’t sleep in his own bed unless one of us sleeps with him. He won’t go to sleep anymore in our bed by himself, one of us has to go with him and during the day he won’t let me out of his sight. He’s ok going to school (a bit reluctant but ok) but if he’s at home with me it’s like having a toddler again. If I go and have a shower, he’ll wait for me in the bedroom until I’m done. If I walk out from the bedroom to go to the kitchen, he’s close behind. He won’t sleep over at any friends places anymore and he asks how long before Dad is home.
I feel terrible that one misjudgement has created so much anxiety for our boy. Please let me know what you think we should do.
Dr Justin responds:
Your son is clearly concerned about being separated from you. While I don’t diagnose over email or in the paper, it seems that he is experiencing a powerful separation anxiety. Fortunately the anxiety he is experiencing is not carrying across to school participation, but it is obvious that it is having an impact on his capacity to function normally. My first recommendation is that you take your son to see a psychologist who will be able to assess whether or not his anxiety is normal for his age. Based on your email, it’s not, but there may be other factors to consider.
Dealing with separation anxiety is simple in theory, but putting it into practice is challenging. Ultimately your son needs to understand that you can be away from him without anything bad happening to you or him!
Most psychologists would agree that a structured and consistent ‘exposure-based’ process will be best for your child. What this means is that a gentle, structured, consistent program of exposing your son to separation from you in supportive ways will help him through his anxieties. It is best with any exposure therapy that appropriate professional supervision be utilised. By going it alone there is a risk that you may go too far too fast, amplifying the anxiety rather than reducing it.
Perhaps the most crucial part of working through a challenge like this is helping your son feel understood. Celebrated relationships expert John Gottman claims that this part of the process is probably 80% of the overall picture. What does it feel like for your son? How does his anxiety feel and what is it doing inside him? See his fears as an opportunity for closeness and connection. Then help him label those fears. Teach him to say things like, “I feel nervous when you leave me because…” or “When I’m alone I get anxious and worried about…”.
When your son explains why he feels worried, invite him to find examples where his fear never materialised. You might say, “You get worried that I won’t come back and you’ll be left alone. Can you think of a time when that has happened? How often has it happened? Do you think I would do that?” You can (later on) even problem solve with him, asking, “If I didn’t come back and you were worried, what could you do? Who could you call?”
Ideally your son will recognise that he has never been left alone, and that you are reliable, consistent, and trustworthy. Your task now is to help him to focus on that whenever his worries arise.
Additionally, if he is thinking these negative thoughts, it can helpful to teach him to flip them around. When he says, “If you leave you might not come back”, ask him what the flip side of that is: “If you leave, I’ll see you when you come back.” By teaching this flipping process, he will begin to challenge his negative thinking and over time this may reduce some anxiety.
There comes a point where talking is not enough and doing is necessary. Chat with him about what you’re planning to do and invite him to be part of the process. Tell him that you can either go to the bathroom for a few minutes, or go to the laundry for a few minutes (or the backyard, or garage, or whatever). Which does he prefer? And what will he do while you’re there? Slowly build that up so he is facing slightly larger challenges from one day (or week, or month) to the next.
When your son gets anxious it is very likely that you ‘catch’ that emotion from him. When you sense that he may be about to get anxious there is every chance that you get nervous and he catches your nerves. Emotions are contagious. When you know a separation is pending, consciously calm yourself. Take deep breaths, relax, and remind yourself that you are calm, and that he can be calm. If he begins to get nervous or his anxiety is aroused, stay calm and be an anchor of calm for him too.
If you are cold and distant, or if you are dismissive, or if you are strongly disapproving of your son’s behaviour there are two outcomes that are equally likely: either he will become even clingier and more anxious, or he will just ‘get over it’ (meaning he will internalise the stress, and it will likely resurface later as anger, irritability, or depression). Your son needs you to be responsive to him, understanding of him, and patient with him. However, if you are overly protective and do not let him grow through this challenge you will stifle his development.
It is a fine line. With love and support and his perception of an unconditional acceptance from you, his anxieties will eventually decrease, he will grow through them, and you will finally be able to go to the bathroom in peace!