QUESTION:
Our eight-year-old son does not want to go to sleep without one of us staying upstairs – he seems afraid of being upstairs on his own. We have talked about this to him and while he understands there is nothing to be afraid of, he seems stuck in the same response and doesn’t want to be left alone.

If we do go downstairs, he remains very anxious in his bed and waits until we come back up or until we are going to bed before he will go asleep. We try to be reassuring all the time, but at times we get very frustrated with him because it has being going on for a long time.

He has always been a bit of an anxious child, often being nervous in conversations with adults, and has lots of nervous habits such as biting his nails or chewing his hair. The biggest problem is him going to sleep alone, how can we help him with this?

ANSWER:
Anxiety is probably the most common childhood problem and all children go through periods of anxiety from time to time. Some children, in particular, can be prone to anxiety and it can affect many different areas of their lives to varying degrees.

Dealing with an anxiety can be challenging as a parent. On the one hand, you can feel sad to see your child experiencing a worry and want to protect and rescue them from feeling it.

On the other hand, dealing with anxiety can be very frustrating. Your child’s worries can be hard to understand and they interfere with their life, so it is easy to reach the end of your patience, especially if the anxiety continues indefinitely.

As a parent, you can alternate between upset and worry at what your child is feeling to anger and frustration as you wonder why they can’t just snap out of it, especially when the anxiety is excessively disrupting family life.

The good news is that there is a lot you can do to help your son tackle this problem. Anxious children tend to have great imaginations (usually employed against themselves as they visualise all the bad things that can happen) and can be very self-aware and motivated to change the problem.

Both these qualities are assets you can use to help them to manage their worries. For example, in tackling the sleeping alone issue, the first step is to sit down with him and to use his self-awareness to explore his worries and anxiety.

Listen to your child
In a non-judgmental way, help him articulate what his fears are and, in particular, what he visually imagines might happen when he is alone.

It can be a great relief for a child to feel really understood and not judged for these irrational feelings. Only after actively listening to your son, should you explore with him strategies for managing these worries.

Explore Strategies
There are lots of well researched and practical ideas that can work. These include:

• Positive visualisation (going through a step-by-step process of imagining a happy place or things you are grateful for) practising relaxation through breathing
• Systematically relaxing different parts of the body.
• Learning to challenge worrying thoughts with alternatives such as “it will be fine, I am over reacting”.
• Specific sleep-time rituals can also help, such as: writing down worries, putting them in a box to be dealt with in the morning or using a special cuddly toy as a comforter or “protector” or reading a relaxing and entertaining book before sleeping.
• There are some good children’s books that describe a range of strategies in a child-centred way, such as ‘What to Do When you Worry too Much’ by Dawn Huebner, which you can read together to come up with helpful strategies and exercises.

Make a ‘Withdrawal Plan’
As your son learns his own strategies to manage anxiety, it is also important to agree with him a “withdrawal plan” and to gradually reduce the support you provide him to sleep.

Currently, he needs you beside him to sleep, but perhaps you could gradually withdraw this, for example, by waiting outside his room, or at the top of the stairs, or going back in to check on him after a period of time.

The key is to make sure to go at your son’s pace and to make the withdrawal steps as small as needed, as well as giving your son control of how the steps are carried out such as by deciding how quickly he goes through the steps.

If he does become anxious and calls you, it is important to encourage him to relax by himself before returning to reassure him – “when you are quiet and trying to relax for a couple of minutes I will be in to tuck you in”. The aim is to gently work towards his self-coping and independence.

Tackle Issues that arise one by one
A child who has a tendency to be anxious can display anxiety in many areas of their life. Yet it is generally best to tackle the issues that arise one by one, as you are doing in tackling sleeping.

As he conquers one issue, this will boost his confidence and give him a “toolkit” of coping strategies that he will be able to use in other areas.

Working as a Team
Also if you are “working as a team” and helping him to tackle his problems, this will be a real boost to your relationship and provide you with the confidence to support your son dealing with future issues.

Be Patient: When supporting children in dealing with anxiety, it is also important to be patient. They can make great progress only for something to set them back and for you to have to start again.

Be Self- Aware: Be self-aware about your own anxiety and feelings as a parent. Anxious children tend to have anxious parents and can feed off each other’s worries. The more you can demonstrate how to cope with worries, the better for your son.

Seek Support
If problems persist, consider seeking professional help perhaps via a local primary care team or child mental health service. You could also get professional help privately via www.psihq.ie or www.irish-counselling.ie, but do make sure to select a professional who has experience in working with children with anxiety.

Prof. John Sharry, Irish Times, March 2011. John writes in The Irish Times Health+ every Tuesday. John will be giving courses for parents on how to help children overcome anxiety in the Harbour Hotel, Galway on Saturday 24th November 2018 (9am-1pm) and in Dublin and Cork in January 2019. See www.solutiontalk.ie for details.