Q: Over the past year, our 4-year-old has developed several fears that have become quite disruptive. It started with a fear of dogs, which is inconvenient given that there are lots of dogs in our neighborhood. Since then she’s become afraid of noises at night, wind (she thinks a hurricane is coming), and dying in her sleep. Needless to say, she is anxious a lot of the time. We’ve talked to her, reassured her, and so on, but nothing has worked. She’s becoming a wreck, and so am I. Should I take her to a counselor? If not, then do you have any advice?
A: With very selective exceptions, I generally recommend against having children — especially young children – talk to mental health professionals. First, there is no research-based body of evidence that would verify the general efficacy of any form of child therapy. Second, over the course of my now 40-plus year career, I’ve collected a significant body of anecdotal evidence to the effect that exposing a child to psychological counseling often (perhaps more often than not) makes matters worse. Having said that, I must add that my point of view on child therapy is not widely approved of by my colleagues, so if you’d feel better having your daughter see a therapist, then do so.
The problem is that almost invariably, therapists talk to children about fears, anxieties, and persistent thoughts as if they represent something meaningful — as in, deep-seated issues that the child is incapable of expressing otherwise. Example: A child’s inability to tell her parents that they haven’t been giving her enough attention since a baby brother arrived in the family is expressed in frequent tantrums (an actual account recently related to me by the parent of a 5-year-old). This is what therapists were educated and trained to do; so was I.
The fact is that a child’s thinking and emotions need as much if not more discipline than her behavior. The more adults talk to a child about irrational fears and persistent thoughts, the worse they are likely to become. One such conversation is enough, and it needs to contain the message that the fears/thoughts in question do not represent reality and are not going to alter, much less dictate, parental decisions or parental behavior. In situations of this sort, I encourage parents not to “explore” the child’s fears/thoughts, not to ask lots of questions about them, but to simply tell the child, authoritatively but lovingly, that fears are common during childhood, they do not represent things that are likely, and that life will go on as usual in the family.
Your daughter doesn’t want to take a walk through the neighborhood because she’s afraid of dogs? You’re taking her on a walk anyway. She doesn’t want to go outside because of wind? She’s going anyway. She is afraid to go to bed because she thinks she’s going to die in her sleep (one of my daughter’s fears, around age 10)? She’s going to bed anyway. And by the way, sometimes crying is a necessary purgative and needs to be allowed (if contained in the child’s room) until it’s run its course.
A child who has become caught up in and carried away by the sort of randomness that often characterizes a child’s thinking and feelings needs parents who will act quickly to keep her grounded, who will continue to steer a straight course in the face of the emotional tempest.