“Mommy I can’t breathe!”
No, my four year old was not choking or dying - although to her it felt that way. She has anxiety with a sprinkle of sensory processing difficulties thrown in. Her nervous system was reacting like she really was choking. Her fight-or-flight response was making her unable to think clearly or be reassured by me. Cue loud wailing, shaking her body, holding her breath. Being a pediatric occupational therapist, I know now that the best response to these episodes is to first give her a hug. Not a whimpy one-hand-pat-on-the-back hug. A big, pick her up into my lap and rock her back and forth kind of hug.
I can’t remember what the cause of this so-called-panic attack was. To her, the problem was real and it was big. I do not get to decide what is a big deal or a real fear to her. If I were upset about something, how would I feel if my husband simply said “knock it off, Melissa, just calm down.” Spoiler Alert: I would not calm down. As adults, we tend to dismiss children’s fears because we know the logical explanation for things. Anxiety is not logical. As parents, often our first response when our children are scared is to reassure with words. Were you ever afraid of the dark? Did you feel better after a parent said to you “it’s okay, there is nothing to be afraid of”. I sure didn’t. I have vivid memories from my childhood, feeling paralyzed in my bed, eyes fixated on some obscure spot in the darkness that I was certain I saw movement.
When Anxiety is in charge, that monster under the bed is real and it feels as if it will attack unexpectedly. Help your child calm down with some quick, sensory solutions and foster a healthy relationship through positive communication.
Remember to connect with your child first. Try these sensory approaches to anxiety:
1. Hug your child. This idea is grounded in the human need for proprioceptive input. Proprioceptive input can be calming to the nervous system when your child is in fight-or-flight mode. Proprioception is how our bodies feel and move in space. We have sensory receptors in our skin, muscles, and joints that contribute to proprioceptive input. Big body movements; crashing, pushing, jumping, pulling, and hugging for example, provide deep pressure to the body and can reduce the nervous system’s arousal and decrease anxiety. Ask your child for a hug, or tell them “I need a hug”. Give your child a big squeeze. Hold them in your lap. Firmly rub their back and their arms. Avoid light, ticklish touch.
2. Breathing: Help your child focus on calming their breath. Model the slow, steady breathing for them. I help my child calm her breathing by modeling long, deep breaths and saying “smell the flowers, blow out the candles”. The fight-or-flight response speeds up our heart rate and our breathing becomes rapid. Help your child slow it back down with steady breathing.
3. Validate your child’s fear and emotions. “I see you feel scared” or “I know that this is hard” or “I see this upsets you”. These statements are validating statements. On the other hand, invalidating statements such as “calm down” or “it’s/you’ll be okay” or “don’t worry” make a person feel like their emotions are not important. Yes, your tiny child’s emotions are real and important. Logical? No, not usually. By fostering healthy communication, you will lay the groundwork for a strong relationship with your child.
4. Visualization. In the middle of a fight-or-flight response, our eyesight literally narrows so that we can better focus on what is directly in front of us to lead us to safety. Help your child calm their nervous system with pre-practiced visualizations or guided imagery. This is an exercise that you will have to practice with your child when they are already in a calm state. This is something that you will be adding to your “toolbox” of strategies. The one I use with my daughter is simple. “Feel your feet on the ground, feel my arms around you” You can find much more elaborate guided imagery scripts by searching “visualization techniques for children”.
5. The 54321 exercise: This strategy is best for older children (and adults!) in the middle of an anxiety attack. “5 things you can see, 4 things you hear, 3 things you can feel, 2 things you can smell, and 1 thing you can taste.” This exercise is grounding and reassuring. With a smaller child you can try the exercise in a 1-1-1-1-1 format: (1 thing you can see, 1 thing you can hear etc.)
When facing an anxiety driven meltdown it can be frustrating, exhausting, and tempting to say “calm down!” When in doubt, give your child a deep hug, breath with them, help them feel grounded with visualization, and express empathy to them. If your child demonstrates anxiety, talk with them about what can be added to their “toolbox” when they are in a calm, regulated state. Consult with a pediatric OT on ways to incorporate proprioceptive input into your child’s day to help them decrease anxiety.