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Anxiety and Selective Mutism: Why Your Child May Be Anxious and Not Simply Shy

Did you know that anxiety is the number one diagnosed psychological disorder in children? As a psychologist who specializes in childhood anxiety, I am all too familiar with how anxiety plagues children. Despite the increased awareness and diagnoses of ADHD and Autism, anxiety remains one of the major reasons parents seek therapy for their children. It is not uncommon for children to face separation anxiety, social anxiety or fears as they grow and develop. While these difficulties are simply phases for many children, other children struggle in a deep, painful and prolonged manner with anxiety. And while it may seem as though children are just being shy, they are often truly anxious.

I have had the privilege of meeting some talented, funny and amazing kids who struggled greatly with anxiety. In the context of the therapy session or with their parents, these children smile brightly, laugh loudly, love fiercely, and have beautiful imaginations. Then these same children go to school and appear sad, lonely and withdrawn. Parents often wonder how their child who was just running around the house laughing is the same child who cannot seem to utter a word at school.

For all the children who become shy and withdrawn, there are actually just as many children who become irritable, disruptive, or even defiant when anxious. For these children, their anxiety is so pronounced that they are acting out of discomfort.

Throughout development, children are faced with many challenges

Following along Erikson’s psychosocial stages of development, children are tasked with creating a sense of self, a sense of belonging, figuring out what they are good at, who to trust in their worlds, and where they belong. These tasks are hard enough for adults, let alone children. Developing a sense of identity and purpose is critical to creating a self-concept and self-esteem. While navigating all of these tasks, children are also trying to figure out how much they still need their parents. I am sure every parent has at one time observed their child’s internal struggle with wanting their parents to remain close, but also wanting to figure out challenges independently.

A mediating factor with figuring out all of these big things is temperament. We all know the child who is fiercely brave or independent. Contrast that image with the child who is more of a quiet observer and sensitive to others. It is important to remember that temperamental dimensions such as openness, agreeableness, intro/extroversion, and flexibility do not have “rights and wrongs,” but rather have a unique expression in each child. Temperament makes us who we are. At the same time, children who may have an anxious or less flexible temperament may have more difficulty with developmental changes and life tasks.

It is important to remember that being shy is a dimension of temperament, while anxiety is more of an acute struggle with worries or fears. Children may be shy without being anxious. And children may be anxious even if they are not shy.

Children may face anxiety for many reasons

Life events and changes may trigger anxiety. Your child may have a temperament that predisposes him or her to anxiety. Life also offers many fairly daunting tasks for children, such as going to school, making friends, balancing homework and activities, following rules vs. fitting in. Anxiety is often characterized by worry and fears. When worry significantly interferes with daily life, your child may benefit from support.

Sometimes anxiety is shown through physical complaints. Some children will report stomach aches, headaches, trouble eating or sleeping, or general discomfort. Physical complaints usually occur because children are still developing a vocabulary for emotions.

A particular diagnosis of concern is selective mutism. Children with selective mutism may be talkative in comfortable environments such as their home, but may not be able to utter even a word anywhere else. This diagnosis feels confusing for parents because no problems seem evident at home. However, these children experience great fear when faced with interacting outside their comfort zones.

Most children with selective mutism also have social anxiety or social phobias. Parents often report that they initially thought their children were being overly shy or even rude to strangers, as the contrast between home and social behavior can be so drastic.

Given the importance of supporting your child through anxiety, keep in mind the following:

  • Anxiety is both common and normal for children. Life brings many challenges and the world is a big place for children. Encourage kids to talk about fears and worries. Create an environment in which talking about emotions is encouraged and reinforced.

  • Being shy is totally okay. If your child is shy, help him or her learn to find a niche in the social environment. Set up structured and unstructured play dates to help your child learn how to engage with others. Start with small interactions (one child) and build into group play dates.

  • Help is available. If your child demonstrates anxiety by withdrawing or acting out, therapy is a great way to build self- awareness and emotional insight. For younger children, play therapy is a safe and comfortable way to explore social interactions.

  • As a parent, you are in the best position to help your child. You know your child best. Even if you need help from a psychologist, you hold the key to role modeling prosocial behaviors and ways to handle scary situations. You have gift of being real about your own fears and anxieties so your child knows he or she can face fears, too. Parents are the secure “home base” for their kids.

  • Changes and new things are hard for some kids. Many children with anxiety struggle even with positive events and changes. So many children I work with have difficulties anticipating family vacations, school ending, parties, and Christmas. Even though these events are positive, the overwhelming emotions associated with them, including changes in normal routine, may be a lot for kids to handle. Talk about changes and how you and your child will handle them. Prepare them for changes in routine.

  • Therapy creates lifelong coping in a positive way. When you take your child to therapy when they are young, you are exposing them to an amazing way of healing and coping. Since anxiety may recur at different stages of life, you are reinforcing the idea that therapy is always available for support. Children who participate in therapy develop positive associations with sharing emotions in healthy ways and are far more likely to seek such a healthy outlet in later years. Therapy now sets up kids for success both immediately and into the future.

Note: Opinions expressed in this blog are based on my years of education and experience. These are general statements and should not be used in place of individualized assessment and treatment.

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